AIM:To compare the efficacy and safety of early combination therapy with ranibizumab and dexamethasone intravitreal implants versus ranibizumab monotherapy for the treatment of macular edema secondary to retinal vein occlusion(RVO-ME).METHODS: A retrospective cohort study was conducted on a total of 62 cases(64 eyes)of patients who were first diagnosed with RVO-ME at the Eye Centre of the Affiliated Hospital of Shandong Second Medical University between February 2022 and February 2023. The subjects were divided into two groups according to the different treatment regimens: 32 cases(34 eyes)in the monotherapy group received only ranibizumab [3+pro re nata(PRN)regimen], and 30 cases(30 eyes)in the combination therapy group were injected with ranibizumab once first, followed by dexamethasone intravitreal implant 3 wk later(1+DEX regimen). The best corrected visual acuity(BCVA), central retina thickness(CRT), foveal avascular zone(FAZ)area, macular vascular density(MVD)at the level of the deep vascular complex(DVC)of the retina, the incidence of ocular adverse effects, the number of drug injections, and the total cost between the two groups were compared before and after treatment.RESULTS: At 3 wk, 3 and 6 mo, and at the final follow-up of the two groups of patients, the improvement in BCVA, CRT, and MVD in the DVC layer was significantly better than that before treatment(all P<0.05); there were differences in the comparisons of BCVA and CRT between the two groups at 6 mo and the final follow-up(all P<0.05), and the increase in the number of letters of BCVA was the most pronounced in the combination therapy group at 6 mo of treatment. Statistical significant difference was observed in the comparison of MVD in the DVC layer between the two groups at 3 and 6 mo after treatment and at the final follow-up(all P<0.05). However, no significant change in FAZ area was evident before and after treatment in both groups(P>0.05). The combination therapy group exhibited a reduced number of injections and total cost in comparison to the monotherapy group. The combination therapy group exhibited a slightly higher incidence of high intraocular pressure and cataract progression compared to the monotherapy group, with no statistical significant difference(all P>0.05). Furthermore, no serious adverse events were observed in either group following treatment.CONCLUSION:Compared with ranibizumab alone, ranibizumab combined with dexamethasone intravitreal implant significantly improved vision, reduced macular edema, and lowered the frequency of injections and total treatment cost in patients with RVO-ME. CRT and MVD in the DVC layer are reliable prognostic indicators for patients with RVO-ME.

This study aims to prepare monoclonal antibody to S1 protein of porcine epidemic diar-rhea virus(PEDV).E.coli expression system and affinity chromatography were used to success-fully obtain purified recombinant PEDV S1 protein.After immunizing BALB/c mice,hybridoma technology and indirect ELISA were used to prepare and screen positive hybridoma cells.Finally,ascites antibodies were prepared by in vivo induction method.ELISA results showed that a total of 4 hybridoma cell lines with anti-PEDV S1 monoclonal antibody were screened,and they were named E6,G3,H6 and F2.The supernatant titers of all 4 hybridoma cell lines reached 1∶6 400.The monoclonal antibody H6 with higher antibody titers and more stable antibody secretion was selected for antibody type identification.It was found that monoclonal antibody H6 belongs to the IgG1 subclass and the light chain is the λ chain.The antibody titers that induced mouse ascites were 1∶106 and without cross-reaction with other proteins.Western blot results showed that the monoclonal antibody exhibited specific bands at 38 kDa with the recombinant S1 protein,PEDV QY2016,and PEDV CV777 strains.The IFA results also showed that the monoclonal antibody reacted with cells infected with PEDV QY2016 and PEDV CV777 strains,exhibiting a green fluo-rescent signal.The affinity constant of monoclonal antibody H6 was K=1.75×107 moL/L,indica-ting that the H6 strain had a good affinity and could be used for the development of subsequent di-agnostic antibodies.In summary,this study successfully prepared monoclonal antibodies that can specifically recognize PEDV S1 protein,which can be used for the antigen detection of PEDV and providing important test materials for the research of PEDV detection methods.

Aiming at the problems of tongue diagnosis instruments relying on manual operation,uneven illumination,color distortion and lack of dynamic information,an automated operation black box tongue diagnosis instrument based on machine vision is proposed.This instrument utilizes machine vision technology and image processing algorithms to achieve automatic positioning and automatic acquisition of tongue manifestations.High-resolution camera technology enables the acquisition of 3-second dynamic videos and high-quality static images.The performance test results show that,based on the dual-camera geometric projection calibration algorithm,the average time for tongue recognition is less than 0.15 seconds.The diffuse reflection light source improves the gray uniformity to 76.74%,and the maximum color difference in color reproduction degree is 19,which is better than the industry standard value of 25.The developed tongue diagnosis instrument will promote the objective,efficient and precise acquisition of tongue diagnosis in traditional Chinese medicine.

Objective To explore the application value of intravoxel incoherent motion(IVIM)imaging parameters in the differential diagnosis of benign and malignant breast nodules and their correlation with the expression of Ki-67 receptor in breast cancer.Methods The data of 41 female patients who completed 3.0 T breast magnetic resonance imaging(MRI)with complete surgical pathology results in the Second Hospital of Jiaxing City from October 2022 to January 2025 were analysed and evaluated.Conventional images and diffusion-weighted images with 11 b values were collected.The IVIM imaging parameters of real diffusion coefficient(D),perfusion related diffusion coefficient(D*)and perfusion fraction(f)were measured and calculated in the region of interest of each lesion.The receiver operating characteristic curve were plotted to quantify the differential diagnostic efficacy of each parameter of IVIM imaging in benign and malignant breast nodules.The differences of parameters between benign and malignant breast nodules and between the groups with different expression levels of Ki-67 receptor in breast cancer were analysed,and the correlation between each parameter and the expression level of Ki-67 in breast cancer was counted.Results The D value of benign breast nodules group(benign groups)was significantly higher than that of malignant breast nodules group(malignant groups),and the D*value was significantly lower than that of malignant group,and the differences between benign group and malignant group were statistically significant(t=-4.773,t=2.063,P＜0.05);Thefvalue of benign group was slightly lower than that of malignant group,and the differences between two groups were not statistically significant(t=0.035,P＞0.05).Among the parameters of IVIM imaging,D value had the best differential diagnostic efficacy for benign and malignant breast nodules,with area under the curve(AUC)of 0.870(95％CI:0.755-0.985)and a specificity of 75.0％;D*value had the second best differential diagnostic efficacy after D value,with an AUC of 0.789(95％CI:0.658-0.920),but it had the highest sensitivity of 88.2％;And the differential diagnosis efficiency off value was the worst,much less than D and D*values.The D value in the high Ki-67 expression group of breast cancer was lower than that in the low expression group,while the D* and f values in the high expression group were higher than that in the low expression group,and the differences of each imaging parameter of IVIM were not statistically significant between two groups(t=-2.617,t=2.169,t=0.647,P＞0.05).There was a significant negative correlation between the expression of the Ki-67 receptor and the D value(r=-0.615,P＜0.05),and no significant correlation was seen with either D *or f value(r=0.223,r-0.031,P＞0.05).Conclusion The D and D*values of IVIM imaging parameters have great clinical value in the differential diagnosis of benign and malignant breast nodules.

Objective To conduct a scoping review of the application of gamification programs in exercise rehabilitation for knee osteoarthritis,examining the application carriers,game content,outcome indicators,measurement tools,and application effects of gamification programs,to provide references for future practice and related research in this field.Methods The search was conducted in PubMed,Web of Science,Cochrane Library,Scopus,CIN AHL,China National Knowledge Infrastructure,CNKI,and Wanfang Data from their inception to December 28,2024.The included studies were summarized and analyzed.Results A total of 28 studies were included in the review.The game carriers encompassed virtual reality technology,sensor devices,and mobile applications.The game content covered interactive motion games,aerobic exercises,and goal-motivated games.Outcome indicators included functional performance,physical activity,pain,psychological and health status,and user experience.Gamification programs were found to effectively enhance user engagement,improve physical function,reduce negative emotions,and improve quality of life.However,there remains controversy regarding their efficacy in pain relief.Conclusion Gamification programs have shown positive effects in exercise rehabilitation for knee osteoarthritis.Future efforts should focus on developing gamification programs that are culturally appropriate for China,creating"digital therapeutics",continuously updating systems,conducting economic evaluations,and ensuring digital equity to enhance patients'rehabilitation experiences and improve health outcomes.

Objective To explore the application value of intravoxel incoherent motion(IVIM)imaging parameters in the differential diagnosis of benign and malignant breast nodules and their correlation with the expression of Ki-67 receptor in breast cancer.Methods The data of 41 female patients who completed 3.0 T breast magnetic resonance imaging(MRI)with complete surgical pathology results in the Second Hospital of Jiaxing City from October 2022 to January 2025 were analysed and evaluated.Conventional images and diffusion-weighted images with 11 b values were collected.The IVIM imaging parameters of real diffusion coefficient(D),perfusion related diffusion coefficient(D*)and perfusion fraction(f)were measured and calculated in the region of interest of each lesion.The receiver operating characteristic curve were plotted to quantify the differential diagnostic efficacy of each parameter of IVIM imaging in benign and malignant breast nodules.The differences of parameters between benign and malignant breast nodules and between the groups with different expression levels of Ki-67 receptor in breast cancer were analysed,and the correlation between each parameter and the expression level of Ki-67 in breast cancer was counted.Results The D value of benign breast nodules group(benign groups)was significantly higher than that of malignant breast nodules group(malignant groups),and the D*value was significantly lower than that of malignant group,and the differences between benign group and malignant group were statistically significant(t=-4.773,t=2.063,P＜0.05);Thefvalue of benign group was slightly lower than that of malignant group,and the differences between two groups were not statistically significant(t=0.035,P＞0.05).Among the parameters of IVIM imaging,D value had the best differential diagnostic efficacy for benign and malignant breast nodules,with area under the curve(AUC)of 0.870(95％CI:0.755-0.985)and a specificity of 75.0％;D*value had the second best differential diagnostic efficacy after D value,with an AUC of 0.789(95％CI:0.658-0.920),but it had the highest sensitivity of 88.2％;And the differential diagnosis efficiency off value was the worst,much less than D and D*values.The D value in the high Ki-67 expression group of breast cancer was lower than that in the low expression group,while the D* and f values in the high expression group were higher than that in the low expression group,and the differences of each imaging parameter of IVIM were not statistically significant between two groups(t=-2.617,t=2.169,t=0.647,P＞0.05).There was a significant negative correlation between the expression of the Ki-67 receptor and the D value(r=-0.615,P＜0.05),and no significant correlation was seen with either D *or f value(r=0.223,r-0.031,P＞0.05).Conclusion The D and D*values of IVIM imaging parameters have great clinical value in the differential diagnosis of benign and malignant breast nodules.

Objective To conduct a scoping review of the application of gamification programs in exercise rehabilitation for knee osteoarthritis,examining the application carriers,game content,outcome indicators,measurement tools,and application effects of gamification programs,to provide references for future practice and related research in this field.Methods The search was conducted in PubMed,Web of Science,Cochrane Library,Scopus,CIN AHL,China National Knowledge Infrastructure,CNKI,and Wanfang Data from their inception to December 28,2024.The included studies were summarized and analyzed.Results A total of 28 studies were included in the review.The game carriers encompassed virtual reality technology,sensor devices,and mobile applications.The game content covered interactive motion games,aerobic exercises,and goal-motivated games.Outcome indicators included functional performance,physical activity,pain,psychological and health status,and user experience.Gamification programs were found to effectively enhance user engagement,improve physical function,reduce negative emotions,and improve quality of life.However,there remains controversy regarding their efficacy in pain relief.Conclusion Gamification programs have shown positive effects in exercise rehabilitation for knee osteoarthritis.Future efforts should focus on developing gamification programs that are culturally appropriate for China,creating"digital therapeutics",continuously updating systems,conducting economic evaluations,and ensuring digital equity to enhance patients'rehabilitation experiences and improve health outcomes.

This study aims to prepare monoclonal antibody to S1 protein of porcine epidemic diar-rhea virus(PEDV).E.coli expression system and affinity chromatography were used to success-fully obtain purified recombinant PEDV S1 protein.After immunizing BALB/c mice,hybridoma technology and indirect ELISA were used to prepare and screen positive hybridoma cells.Finally,ascites antibodies were prepared by in vivo induction method.ELISA results showed that a total of 4 hybridoma cell lines with anti-PEDV S1 monoclonal antibody were screened,and they were named E6,G3,H6 and F2.The supernatant titers of all 4 hybridoma cell lines reached 1∶6 400.The monoclonal antibody H6 with higher antibody titers and more stable antibody secretion was selected for antibody type identification.It was found that monoclonal antibody H6 belongs to the IgG1 subclass and the light chain is the λ chain.The antibody titers that induced mouse ascites were 1∶106 and without cross-reaction with other proteins.Western blot results showed that the monoclonal antibody exhibited specific bands at 38 kDa with the recombinant S1 protein,PEDV QY2016,and PEDV CV777 strains.The IFA results also showed that the monoclonal antibody reacted with cells infected with PEDV QY2016 and PEDV CV777 strains,exhibiting a green fluo-rescent signal.The affinity constant of monoclonal antibody H6 was K=1.75×107 moL/L,indica-ting that the H6 strain had a good affinity and could be used for the development of subsequent di-agnostic antibodies.In summary,this study successfully prepared monoclonal antibodies that can specifically recognize PEDV S1 protein,which can be used for the antigen detection of PEDV and providing important test materials for the research of PEDV detection methods.

Aiming at the problems of tongue diagnosis instruments relying on manual operation,uneven illumination,color distortion and lack of dynamic information,an automated operation black box tongue diagnosis instrument based on machine vision is proposed.This instrument utilizes machine vision technology and image processing algorithms to achieve automatic positioning and automatic acquisition of tongue manifestations.High-resolution camera technology enables the acquisition of 3-second dynamic videos and high-quality static images.The performance test results show that,based on the dual-camera geometric projection calibration algorithm,the average time for tongue recognition is less than 0.15 seconds.The diffuse reflection light source improves the gray uniformity to 76.74%,and the maximum color difference in color reproduction degree is 19,which is better than the industry standard value of 25.The developed tongue diagnosis instrument will promote the objective,efficient and precise acquisition of tongue diagnosis in traditional Chinese medicine.