1.The impact of modified capsule polishing technique on visual quality of pa-tients after femtosecond laser-assisted cataract surgery
Changle LI ; Cheng PEI ; Xin ZHOU ; Li'an WU ; Congyi WANG
Recent Advances in Ophthalmology 2025;45(10):816-819
Objective To explore the impact of modified capsular polishing technique on visual quality in patients af-ter femtosecond laser-assisted cataract surgery.Methods Eighty-four patients(84 eyes)who visited Xi'an People's Hospital(Xi'an Fourth Hospital)from January to June 2023 and were scheduled to undergo femtosecond laser-assisted phacoemulsification cataract extraction combined with intraocular lens implantation were selected as the research subjects.Before the surgery,the patients were randomly divided into an observation group and a control group.The observation group consisted of 44 patients(44 eyes)who received modified capsular polishing treatment.Viscoelastic material was in-jected behind the iris into the subcapsular space of the anterior capsule,causing compression of the peripheral posterior capsule and elevation of the central posterior capsule,so that parts of the anterior and posterior capsules adhered to each other.A Whitman Shepherd bimanual capsular polisher was then inserted through the main incision to perform a thorough 360-degree polishing of the anterior capsule and equatorial region,while simultaneously polishing the adhered areas of the posterior capsule.The control group consisted of 40 patients(40 eyes)who received traditional irrigation/aspiration(I/A)capsular polishing treatment.There were no statistically significant differences between the two groups in terms of gender composition,age,and preoperative best-corrected visual acuity(all P>0.05).Both groups of patients were followed up to observe their best-corrected visual acuity,spherical aberration,coma aberration,and trefoil aberration at 1 day,1 week,1 month,and 3 months postoperatively.Results At 1 day,1 week,1 month,and 3 months postoperatively,the best-cor-rected visual acuity of patients in the observation group was superior to that in the control group,with statistically signifi-cant differences between the two groups at each time point(all P<0.05).At 1 day,1 month,and 3 months postoperative-ly,the spherical aberration in the observation group was significantly lower than that in the control group(all P<0.05).Three months postoperatively,the median coma aberration in the observation group[0.060(0.034,0.108)]was signifi-cantly lower than that in the control group[0.100(0.070,0.146)],with a statistically significant difference(Z=-2.805,P=0.005).One day postoperatively,the median trefoil aberration in the observation group[0.272(0.159,0.418)]was significantly lower than that in the control group[0.360(0.248,0.449)],with a statistically significant difference(Z=-2.299,P=0.022).Conclusion The modified capsular polishing technique can improve the visual quality of patients in the mid-term period after femtosecond laser-assisted cataract surgery.
2.The impact of modified capsule polishing technique on visual quality of pa-tients after femtosecond laser-assisted cataract surgery
Changle LI ; Cheng PEI ; Xin ZHOU ; Li'an WU ; Congyi WANG
Recent Advances in Ophthalmology 2025;45(10):816-819
Objective To explore the impact of modified capsular polishing technique on visual quality in patients af-ter femtosecond laser-assisted cataract surgery.Methods Eighty-four patients(84 eyes)who visited Xi'an People's Hospital(Xi'an Fourth Hospital)from January to June 2023 and were scheduled to undergo femtosecond laser-assisted phacoemulsification cataract extraction combined with intraocular lens implantation were selected as the research subjects.Before the surgery,the patients were randomly divided into an observation group and a control group.The observation group consisted of 44 patients(44 eyes)who received modified capsular polishing treatment.Viscoelastic material was in-jected behind the iris into the subcapsular space of the anterior capsule,causing compression of the peripheral posterior capsule and elevation of the central posterior capsule,so that parts of the anterior and posterior capsules adhered to each other.A Whitman Shepherd bimanual capsular polisher was then inserted through the main incision to perform a thorough 360-degree polishing of the anterior capsule and equatorial region,while simultaneously polishing the adhered areas of the posterior capsule.The control group consisted of 40 patients(40 eyes)who received traditional irrigation/aspiration(I/A)capsular polishing treatment.There were no statistically significant differences between the two groups in terms of gender composition,age,and preoperative best-corrected visual acuity(all P>0.05).Both groups of patients were followed up to observe their best-corrected visual acuity,spherical aberration,coma aberration,and trefoil aberration at 1 day,1 week,1 month,and 3 months postoperatively.Results At 1 day,1 week,1 month,and 3 months postoperatively,the best-cor-rected visual acuity of patients in the observation group was superior to that in the control group,with statistically signifi-cant differences between the two groups at each time point(all P<0.05).At 1 day,1 month,and 3 months postoperative-ly,the spherical aberration in the observation group was significantly lower than that in the control group(all P<0.05).Three months postoperatively,the median coma aberration in the observation group[0.060(0.034,0.108)]was signifi-cantly lower than that in the control group[0.100(0.070,0.146)],with a statistically significant difference(Z=-2.805,P=0.005).One day postoperatively,the median trefoil aberration in the observation group[0.272(0.159,0.418)]was significantly lower than that in the control group[0.360(0.248,0.449)],with a statistically significant difference(Z=-2.299,P=0.022).Conclusion The modified capsular polishing technique can improve the visual quality of patients in the mid-term period after femtosecond laser-assisted cataract surgery.
3.Clinicopathological features and prognosis of early-onset gastric cancer: a large-scale retrospective real-world study
Jingdong LIU ; Changle YANG ; Peili JIN ; Bosen LI ; Junjie ZHAO ; Haojie LI ; Xuefei WANG ; Yihong SUN
Chinese Journal of Gastrointestinal Surgery 2024;27(5):452-456
Objective:To clarify the clinicopathological features, prognosis, and recurrence pattern of early-onset gastric cancer (EOGC).Methods:Using data from the gastric cancer database of Zhongshan Hospital, Fudan University, we performed a retrospective, large-scale, real-world study of 5046 patients with gastric cancer who had undergone redical or palliative gastrectomy from January 2013 to December 2018, including 425 patients with EOGC (age ≤45 years) and 4621 controls. All those patients were pathologically confirmed adenocarcinoma with complete follow-up of five years. Residue gastric cancer and patients without complete clinical or follow-up data were excluded. We used a combination of outpatient and telephone follow-up, ending in October 2022 (median duration of follow-up 60 months), and compared the clinicopathological features and prognosis of the two groups.Results:The clinicopathological features of EOGC included female predominance (61.1% [262/425 vs. 26.3% [1217/4621], χ 2=234.215, P<0.001), fewer comorbidities (31.3% [133/425] vs. 58.5% [2703/4621], χ 2=34.378, P<0.001), poorer differentiation (90.6% [385/425] vs. 78.2% [3614/4621], χ 2=30.642, P<0.001), higher proportion of diffuse type (53.9% [229/425] vs. 18.3% [846/4621], χ 2=274.474, P<0.001), higher proportion of T4 stage (44.7% [190/425] vs. 37.5% [1733/4621], χ 2=17.535, P=0.001), more lymph node metastases (60.5% [257/425] vs. 53.9% [2491/4621], χ 2=6.764, P=0.009), and higher proportion of pathological stage III/IV (47.5% [202/425] vs. 42.4% [1959/4621], χ 2=4.093, P=0.043). The 5-year overall survival rates of the EOGC and control groups were 55.1% and 49.1%, respectively. Overall survival was significantly better in the EOGC than in the control group ( P<0.001). According to subgroup analysis, the prognosis of pathological stage I/II/III EOGC was better than that of the control group. Recurrence rates were similar in the two groups, whereas patients with EOGC had a higher proportion of peritoneal recurrence (7.8% [33/425] vs. 3.2% [146/4621], χ 2=23.741, P<0.001) and a lower proportion of distant metastasis (4.9% [21/425] vs. 8.3% [385/4621], χ 2=6.247, P=0.012). Conclusion:EOGC has unique clinicopathological features and recurrence patterns and resectable EOGC has a better prognosis, suggesting that patients with EOGC should be actively treated with the focus on preventing peritoneal recurrence.
4.Genetic Diversity Analysis and Molecular ID Card Construction of Pinellia ternata Based on Phenotypic Traits and SSR Markers
Yike XU ; Shuang LI ; Peiwen KOU ; Changle LIU ; Xiaochun SUN ; Wenjing HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(5):134-142
ObjectiveTo study the genetic diversity and genetic relationship of Pinellia ternata germplasm resources and provide the basis for germplasm identification, variety breeding, and resource conservation. MethodIn this study, 27 P. ternata were used as experimental materials to determine seven phenotypic characters, such as plant height, leaf length, and leaf width. Simple sequence repeats (SSR) primers were designed based on P. ternata transcriptome data, and polymerase chain reaction (PCR) amplification was performed on 27 P. ternata samples. The genetic diversity of P. ternata germplasm was analyzed by POPGENE32, PowerMarker V3.25, and NTSYS-PC 2.10e software. ResultA total of 10 pairs of highly polymorphic primers (PIC>0.5) and four pairs of moderately polymorphic primers (0.25
5.Clinicopathological features and prognosis of early-onset gastric cancer: a large-scale retrospective real-world study
Jingdong LIU ; Changle YANG ; Peili JIN ; Bosen LI ; Junjie ZHAO ; Haojie LI ; Xuefei WANG ; Yihong SUN
Chinese Journal of Gastrointestinal Surgery 2024;27(5):452-456
Objective:To clarify the clinicopathological features, prognosis, and recurrence pattern of early-onset gastric cancer (EOGC).Methods:Using data from the gastric cancer database of Zhongshan Hospital, Fudan University, we performed a retrospective, large-scale, real-world study of 5046 patients with gastric cancer who had undergone redical or palliative gastrectomy from January 2013 to December 2018, including 425 patients with EOGC (age ≤45 years) and 4621 controls. All those patients were pathologically confirmed adenocarcinoma with complete follow-up of five years. Residue gastric cancer and patients without complete clinical or follow-up data were excluded. We used a combination of outpatient and telephone follow-up, ending in October 2022 (median duration of follow-up 60 months), and compared the clinicopathological features and prognosis of the two groups.Results:The clinicopathological features of EOGC included female predominance (61.1% [262/425 vs. 26.3% [1217/4621], χ 2=234.215, P<0.001), fewer comorbidities (31.3% [133/425] vs. 58.5% [2703/4621], χ 2=34.378, P<0.001), poorer differentiation (90.6% [385/425] vs. 78.2% [3614/4621], χ 2=30.642, P<0.001), higher proportion of diffuse type (53.9% [229/425] vs. 18.3% [846/4621], χ 2=274.474, P<0.001), higher proportion of T4 stage (44.7% [190/425] vs. 37.5% [1733/4621], χ 2=17.535, P=0.001), more lymph node metastases (60.5% [257/425] vs. 53.9% [2491/4621], χ 2=6.764, P=0.009), and higher proportion of pathological stage III/IV (47.5% [202/425] vs. 42.4% [1959/4621], χ 2=4.093, P=0.043). The 5-year overall survival rates of the EOGC and control groups were 55.1% and 49.1%, respectively. Overall survival was significantly better in the EOGC than in the control group ( P<0.001). According to subgroup analysis, the prognosis of pathological stage I/II/III EOGC was better than that of the control group. Recurrence rates were similar in the two groups, whereas patients with EOGC had a higher proportion of peritoneal recurrence (7.8% [33/425] vs. 3.2% [146/4621], χ 2=23.741, P<0.001) and a lower proportion of distant metastasis (4.9% [21/425] vs. 8.3% [385/4621], χ 2=6.247, P=0.012). Conclusion:EOGC has unique clinicopathological features and recurrence patterns and resectable EOGC has a better prognosis, suggesting that patients with EOGC should be actively treated with the focus on preventing peritoneal recurrence.
6.The mechanism of Zizyphi Spinosae Semen in relieving benzodiazepine dependence based on the strategy of"enhancing efficacy and reducing toxicity"
Xinbo SHI ; Changle LIU ; Zhongxing SONG ; Zhishu TANG ; Hongbo XU ; Guolong LI ; Chen SUN ; Hongbo LIU ; Jiaxin CHEN
Journal of Xi'an Jiaotong University(Medical Sciences) 2024;45(5):828-836
Objective To investigate the active ingredients of Zizyphi Spinosae Semen(ZSS)in relieving benzodiazepine(BDZ)dependence and its molecular mechanism based on the integrated Traditional Chinese Medicine and chemical drugs idea of"enhancing effect and reducing toxicity"via the approach of network pharmacology and the technique of molecular dynamics simulation.Methods First,literature search was undertaken to find the main components of ZSS.Then,the major effective constituents of ZSS in relieving BDZ dependence and its target of action were explored on the basis of network pharmacology and molecular docking.Finally,the relationship between core components of ZSS and key proteins was further verified through the technique of molecular dynamics simulation.Results After literature search,a total of 24 chemical components in ZSS were found to act on 731 targets.Through establishing the network of"ingredients-targets-pathways",topology analysis was performed to obtain nine core components such as linoleic acid,palmitic acid,oleic acid,tetradecanoic acid,spinosin,oleanolic acid and jujuboside A,as well as five key targets including AR,PTGS2,PPARG,RXRA and CYP19A1.Bioinformation enrichment analysis was made to obtain critical pathways such as calcium signaling pathway,cAMP signaling pathway,IL-17 signaling pathway and TNF signaling pathway.The results of molecular docking revealed that there was a good combination between core components of ZSS and key targets,and it was mainly dominated by hydrogen bonding.Furthermore,the molecular dynamics simulation experiments indicated that the combinations between jujuboside A and RXRA,oleanolic acid and RXRA,spinosin and PPARG were stable,and these three active ingredients played an important role in improving BDZ dependence.Conclusion The active components in ZSS may exert multi-target and multi-pathway intervention effects on BDZ dependence by means of processes such as immunoregulation,anti-anxiety,and anti-insomnia.
7.Application of remote fundus image reading training in improving the diagnostic ability of ophthalmologists in Xinjiang Uygur Autonomous Region
Xufeng ZHAO ; Xiuyan MA ; Xuejing LI ; Li QIN ; Lina SUO ; Wenping MA ; Shihao LI ; Jiaxing CHEN ; Yaxin YANG ; Xinxia LI ; Tao XIE ; Juan LI ; Yuanshan XIONG ; Zhiyong WU ; Zhihuai CHANG ; Mowen FANG ; Ting WANG ; Hong LIU ; Pengju MA ; Pengpeng LIU ; Jing RAN ; Di YANG ; Changle XUE ; Zhen XIE ; Zhao FAN ; Yang WANG ; Peng LEI ; Qingjiang HUANG ; Bing LI ; Shi FENG ; Zhangwanyu WEI ; Yishuang MAO ; Weihong YU ; Linjun ZHANG
Chinese Journal of Ocular Fundus Diseases 2024;40(12):941-946
Objective:To explore the feasibility and effect of remote medical education model using online film reading training to improve the ability of ophthalmologists in the Xinjiang Uygur Autonomous Region (hereinafter referred to as "Xinjiang Region" ) in diagnosing fundus diseases.Methods:The three-level film reading training system of Xinjiang Production and Construction Corps system division hospital-Corps Hospital-Peking Union Medical College Hospital was established. From June 2022 to January 2023, 4 159 posterior color fundus images were continuously collected from Department of Ophthalmology of Xinjiang Corps Hospital and 4 divisional hospitals in the Corps medical system. Among them, hypertensive retinopathy, diabetic retinopathy, exudative age-related macular degeneration (AMD), atrophic AMD and retinal vein occlusion were 3 073, 651, 43, 186 and 206 cases, respectively. The images were divided into 3 rounds (first, second and last) according to the proportion of diseases. The doctors who participated in the training (hereinafter referred to as the "training") were 15 ophthalmologists from the Corps Hospital of Xinjiang Region and the division hospital of the Corps system. There were 7 male and 8 female. Age was (38.1±4.0) years. The titles of senior, deputy senior, intermediate and junior are 1, 6, 5 and 3 respectively; Bachelor's degree and master's degree are 13 and 2 respectively. The working time of fundus disease specialty was (9.6±3.3) years. The film reading system training was conducted before the first round of labeling, and after each round of film reading, the doctors of Peking Union Medical College Hospital gave feedback and explanation on the film reading results. The diagnostic consistency, sensitivity and specificity were compared by paired sample t test. Spearman or Pearson correlation analysis was conducted between the improvement of diagnostic level and professional title, education, age and working hours of ocular fundus disease. Results:All the participating doctors completed the first, second and last reading. After each round of film reading, the film reading summary was carried out for 2 hours. The average diagnostic agreement rates of participating physicians were 53.0%, 67.0% and 75.0%, respectively. The sensitivity and specificity were 0.38, 0.69, 054 and 0.66, 0.85, 0.96, respectively. There was significant difference between the first and last examination ( P<0.001). The sensitivity of the second reading was significantly higher than that of the first reading, and the sensitivity of the last reading was significantly lower than that of the second reading, with statistical significance ( P<0.05). The specificity of the second reading was significantly higher than that of the first reading, and the last reading was significantly higher than that of the second reading, with statistical significance ( P<0.05). There was no significant correlation ( P>0.05) between the improvement of diagnostic level of participating physicians and educational background ( Rho=0.07), professional title ( Rho=0.13), age ( r=0.20), and working time of ophthalmofundus disease specialty ( r=0.26). Conclusions:Relying on the three-level online telemedicine training, it can improve the ability of ophthalmologists in Xinjiang region to diagnose fundus diseases. The preliminary telemedicine education model has demonstrated potential for feasibility and effectiveness in remote areas with inadequate medical resources.
8.Application of remote fundus image reading training in improving the diagnostic ability of ophthalmologists in Xinjiang Uygur Autonomous Region
Xufeng ZHAO ; Xiuyan MA ; Xuejing LI ; Li QIN ; Lina SUO ; Wenping MA ; Shihao LI ; Jiaxing CHEN ; Yaxin YANG ; Xinxia LI ; Tao XIE ; Juan LI ; Yuanshan XIONG ; Zhiyong WU ; Zhihuai CHANG ; Mowen FANG ; Ting WANG ; Hong LIU ; Pengju MA ; Pengpeng LIU ; Jing RAN ; Di YANG ; Changle XUE ; Zhen XIE ; Zhao FAN ; Yang WANG ; Peng LEI ; Qingjiang HUANG ; Bing LI ; Shi FENG ; Zhangwanyu WEI ; Yishuang MAO ; Weihong YU ; Linjun ZHANG
Chinese Journal of Ocular Fundus Diseases 2024;40(12):941-946
Objective:To explore the feasibility and effect of remote medical education model using online film reading training to improve the ability of ophthalmologists in the Xinjiang Uygur Autonomous Region (hereinafter referred to as "Xinjiang Region" ) in diagnosing fundus diseases.Methods:The three-level film reading training system of Xinjiang Production and Construction Corps system division hospital-Corps Hospital-Peking Union Medical College Hospital was established. From June 2022 to January 2023, 4 159 posterior color fundus images were continuously collected from Department of Ophthalmology of Xinjiang Corps Hospital and 4 divisional hospitals in the Corps medical system. Among them, hypertensive retinopathy, diabetic retinopathy, exudative age-related macular degeneration (AMD), atrophic AMD and retinal vein occlusion were 3 073, 651, 43, 186 and 206 cases, respectively. The images were divided into 3 rounds (first, second and last) according to the proportion of diseases. The doctors who participated in the training (hereinafter referred to as the "training") were 15 ophthalmologists from the Corps Hospital of Xinjiang Region and the division hospital of the Corps system. There were 7 male and 8 female. Age was (38.1±4.0) years. The titles of senior, deputy senior, intermediate and junior are 1, 6, 5 and 3 respectively; Bachelor's degree and master's degree are 13 and 2 respectively. The working time of fundus disease specialty was (9.6±3.3) years. The film reading system training was conducted before the first round of labeling, and after each round of film reading, the doctors of Peking Union Medical College Hospital gave feedback and explanation on the film reading results. The diagnostic consistency, sensitivity and specificity were compared by paired sample t test. Spearman or Pearson correlation analysis was conducted between the improvement of diagnostic level and professional title, education, age and working hours of ocular fundus disease. Results:All the participating doctors completed the first, second and last reading. After each round of film reading, the film reading summary was carried out for 2 hours. The average diagnostic agreement rates of participating physicians were 53.0%, 67.0% and 75.0%, respectively. The sensitivity and specificity were 0.38, 0.69, 054 and 0.66, 0.85, 0.96, respectively. There was significant difference between the first and last examination ( P<0.001). The sensitivity of the second reading was significantly higher than that of the first reading, and the sensitivity of the last reading was significantly lower than that of the second reading, with statistical significance ( P<0.05). The specificity of the second reading was significantly higher than that of the first reading, and the last reading was significantly higher than that of the second reading, with statistical significance ( P<0.05). There was no significant correlation ( P>0.05) between the improvement of diagnostic level of participating physicians and educational background ( Rho=0.07), professional title ( Rho=0.13), age ( r=0.20), and working time of ophthalmofundus disease specialty ( r=0.26). Conclusions:Relying on the three-level online telemedicine training, it can improve the ability of ophthalmologists in Xinjiang region to diagnose fundus diseases. The preliminary telemedicine education model has demonstrated potential for feasibility and effectiveness in remote areas with inadequate medical resources.
9.Association of N-cadherin (CDH2) polymorphisms with schizophrenia susceptibility and clinical symptoms in Han Chinese population
Changle ZHAO ; Xi SU ; Yongfeng YANG ; Meng SONG ; Minglong SHAO ; Yan ZHANG ; Luxian LYU ; Wenqiang LI
Chinese Journal of Behavioral Medicine and Brain Science 2022;31(12):1080-1085
Objective:A case-control association analysis was performed to investigate if the single nucleotide polymorphisms (SNPs) of N-cadherin(CDH2) gene is implicated in schizophrenia in a Han Chinese population.Methods:A total of 528 patients with paranoid schizophrenia and 528 healthy controls were recruited from northern Henan province to analyze 25 SNPs located in CDH2 gene.The clinical symptoms of 267 first-episode schizophrenia patients were evaluated with positive and negative syndrome scale (PANSS), and the correlation between CDH2 gene and clinical symptoms was analyzed by SNPStats software online.Results:Allele frequencies of rs9951577 and rs1231268 were significantly correlated with schizophrenia( P<0.05), genotype frequency of rs1639387 was significantly correlated with schizophrenia( P=0.044). After gender classification, SNPs rs1789470 and rs28365328 were found to be significantly correlated with schizophrenia in female patients ( P=0.044, 0.019). In addition, the study found that CDH2 was correlated with the clinical characteristics of schizophrenia( P<0.05), and the negative factor score of patients between GG type rs1231268 and the other two genotypes (AG+ AA) ((21.12±8.41) vs (18.87±7.52)) was statistically significant ( P<0.05). Conclusion:CDH2 gene may be one of the susceptibility genes to SZ, and has definite correlation with clinical negative symptoms.
10.Cerebral blood flow perfusion imaging in patients with laughing gas abuse
Lijie YIN ; Liping FU ; Chaoling JIN ; Renbin WANG ; Changle TIE ; Li WANG ; Yumin ZHENG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2021;41(3):136-139
Objective:To explore the changes of cerebral blood flow (CBF) perfusion caused by N 2O (laughing gas) abuse. Methods:From December 2017 to October 2018, the CBF perfusion images of 24 patients with laughing gas abuse (9 males, 15 females; age: 18-32(24.0±8.9) years) from China-Japan Friendship Hospital were analyzed retrospectively. The region uptake statistics of different brain regions of interest (ROI) (basal ganglia, central region, cerebellum, cingulate gyrus, frontal lobe, medial temporal lobe, occipital lobe, parietal lobe, temporal lobe) between patients with laughing gas abuse and normal people of the same age group from background software database were calculated automatically. Statistic>1.68 indicated the increase of local CBF perfusion, while statistic < -1.68 indicated the decrease of local CBF perfusion. The correlation between the statistics of bilateral brain regions and the correlation between statistical values and clinical indicators were analyzed by Pearson and Spearman correlation analyses.Results:The correlation of the statistics between bilateral regions of each brain area was significant( r values: 0.503-0.892, all P<0.05). The decreased CBF proportions of frontal and temporal lobes were 62.5%(15/24) and 70.8%(17/24), respectively. The highest proportion of increased CBF was cingulate gyrus (33.3%, 8/24). There were significant correlations between frontal lobe, central brain area and duration of laughing gas abuse ( rs values: 0.375, 0.305, both P<0.05). Conclusion:CBF perfusion imaging is helpful for understanding the changes of CBF in patients with laughing gas abuse.

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