Objective:To observe the changes in choroidal morphology and blood perfusion in patients with macular edema secondary to retinal vein occlusion (RVO) after intravitreal injections of ranibizumab.Methods:A cohort study was performed.A total of 157 patients (157 eyes) with macular edema secondary to monocular acute retinal vein occlusion (RVO) were enrolled in the Third People's Hospital of Dalian from January 2022 to March 2023.There were 66 cases (66 eyes) with central retinal vein occlusion (CRVO) and 91 cases (91 eyes) with branch retinal vein occlusion (BRVO).All patients were treated with 3+ pro re nata (PRN) regimen of ranibizumab.Before and 1 month after each injection, the central retinal thickness of the macula was measured by optical coherence tomography (OCT).Clear images of the choroid were obtained using the OCT enhanced depth scan mode.Subfoveal choroidal thickness (SFCT), the nasal choroidal thickness at 1 500 μm of macula (CT N1.5 mm), the temporal choroidal thickness at 1 500 μm of macula (CT T1.5 mm) were measured and mean macular thickness (CT Mean) was calculated.Binarization of choroidal images processed by ImageJ software was used to analyze luminal area (LA), stromal area (SA) and total choroidal area (TCA), and choroidal vascularity index (CVI) was calculated.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of the Third People's Hospital of Dalian (No.2023-145-001).Results:SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, LA, SA, TCA and CVI of RVO eyes were higher than those of the contralateral eyes and the differences were statistically significant (all P<0.01).CT Mean in CRVO group was (326.99±64.92)μm, which was higher than (299.80±73.08)μm in BRVO group, with a statistically significant difference ( t=2.41, P=0.02).Baseline CVI values in CRVO group and BRVO group were (72.50±5.62)% and (72.33±5.85)%, respectively, with no significant difference ( t=0.187, P=0.85).In eyes with RVO, CRVO and BRVO, SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, LA, SA, TCA and CVI after every injection were lower than the baseline and the differences were statistically significant (all P<0.05).In eyes with CRVO, there was no significant difference in LA and CVI between first and second injections (both P>0.05), and SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, SA and TCA after second injection were lower than those after first injection with statistically significant differences (all P<0.05).In eyes with BRVO, there was no significant difference in SA and CVI between first and second injections (both P>0.05), and SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, LA and TCA after second injection were lower than those after first injection with statistically significant differences (all P<0.05).In eyes with RVO, CRVO and BRVO, there was no significant difference in SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, SA, TCA and CVI between second and third injections (all P>0.05). Conclusions:After intravitreal injection of ranibizumab, the choroidal thickness becomes thinner and CVI decreases in eyes with macular edema secondary to RVO, and remain relatively stable after the second injection.

Objective:To observe the changes in choroidal morphology and blood perfusion in patients with macular edema secondary to retinal vein occlusion (RVO) after intravitreal injections of ranibizumab.Methods:A cohort study was performed.A total of 157 patients (157 eyes) with macular edema secondary to monocular acute retinal vein occlusion (RVO) were enrolled in the Third People's Hospital of Dalian from January 2022 to March 2023.There were 66 cases (66 eyes) with central retinal vein occlusion (CRVO) and 91 cases (91 eyes) with branch retinal vein occlusion (BRVO).All patients were treated with 3+ pro re nata (PRN) regimen of ranibizumab.Before and 1 month after each injection, the central retinal thickness of the macula was measured by optical coherence tomography (OCT).Clear images of the choroid were obtained using the OCT enhanced depth scan mode.Subfoveal choroidal thickness (SFCT), the nasal choroidal thickness at 1 500 μm of macula (CT N1.5 mm), the temporal choroidal thickness at 1 500 μm of macula (CT T1.5 mm) were measured and mean macular thickness (CT Mean) was calculated.Binarization of choroidal images processed by ImageJ software was used to analyze luminal area (LA), stromal area (SA) and total choroidal area (TCA), and choroidal vascularity index (CVI) was calculated.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of the Third People's Hospital of Dalian (No.2023-145-001).Results:SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, LA, SA, TCA and CVI of RVO eyes were higher than those of the contralateral eyes and the differences were statistically significant (all P<0.01).CT Mean in CRVO group was (326.99±64.92)μm, which was higher than (299.80±73.08)μm in BRVO group, with a statistically significant difference ( t=2.41, P=0.02).Baseline CVI values in CRVO group and BRVO group were (72.50±5.62)% and (72.33±5.85)%, respectively, with no significant difference ( t=0.187, P=0.85).In eyes with RVO, CRVO and BRVO, SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, LA, SA, TCA and CVI after every injection were lower than the baseline and the differences were statistically significant (all P<0.05).In eyes with CRVO, there was no significant difference in LA and CVI between first and second injections (both P>0.05), and SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, SA and TCA after second injection were lower than those after first injection with statistically significant differences (all P<0.05).In eyes with BRVO, there was no significant difference in SA and CVI between first and second injections (both P>0.05), and SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, LA and TCA after second injection were lower than those after first injection with statistically significant differences (all P<0.05).In eyes with RVO, CRVO and BRVO, there was no significant difference in SFCT, CT T1.5 mm, CT N1.5 mm, CT Mean, SA, TCA and CVI between second and third injections (all P>0.05). Conclusions:After intravitreal injection of ranibizumab, the choroidal thickness becomes thinner and CVI decreases in eyes with macular edema secondary to RVO, and remain relatively stable after the second injection.

Objective To investigate the relationship between platelet distribution width(PDW)and coronary artery calcification(CAC)in overweight and obese populations.Methods Clinical and chest CT data of 10 838 subjects with overweight or obesity(body mass index[BMI]≥24 kg/m2)were retrospectively analyzed.The subjects were divided into CAC group(n=4 237)and non-CAC group(n=6 601)based on CAC scores obtained from chest CT.The relationship between PDW and CAC in overweight and obese populations was analyzed after controlling confounding variables.A threshold effect analysis was conducted using a two-stage logistic model to find the non-linear inflection point.Subgroup analyses and interaction tests were conducted to validate the stability of the relationship between PDW and CAC.Results Non-linear relationship was observed between PDW and CAC risk in overweight and obese populations.The risk of CAC decreased with the increase of PDW which ≤17.80％(OR=0.82),but increased with the increase of PDW(OR=1.04)which＞17.80％.Subgroup analysis showed that the relationship between PDW and CAC remained stable in subgroups of different genders,BMI(＜28 kg/m2,≥28 kg/m2)and hypertension(all P＞0.05).Compared with aged＜40 years or ≥60 years subgroups,under the same PDW,aged≥40 and＜60 years subgroups had higher risk of CAC(interaction P=0.015).Conclusion Nonlinear relationship existed between PDW and CAC in overweight and obese populations.Both excessively high and low PDW were risk factors of CAC.

Objective To investigate the relationship between platelet distribution width(PDW)and coronary artery calcification(CAC)in overweight and obese populations.Methods Clinical and chest CT data of 10 838 subjects with overweight or obesity(body mass index[BMI]≥24 kg/m2)were retrospectively analyzed.The subjects were divided into CAC group(n=4 237)and non-CAC group(n=6 601)based on CAC scores obtained from chest CT.The relationship between PDW and CAC in overweight and obese populations was analyzed after controlling confounding variables.A threshold effect analysis was conducted using a two-stage logistic model to find the non-linear inflection point.Subgroup analyses and interaction tests were conducted to validate the stability of the relationship between PDW and CAC.Results Non-linear relationship was observed between PDW and CAC risk in overweight and obese populations.The risk of CAC decreased with the increase of PDW which ≤17.80％(OR=0.82),but increased with the increase of PDW(OR=1.04)which＞17.80％.Subgroup analysis showed that the relationship between PDW and CAC remained stable in subgroups of different genders,BMI(＜28 kg/m2,≥28 kg/m2)and hypertension(all P＞0.05).Compared with aged＜40 years or ≥60 years subgroups,under the same PDW,aged≥40 and＜60 years subgroups had higher risk of CAC(interaction P=0.015).Conclusion Nonlinear relationship existed between PDW and CAC in overweight and obese populations.Both excessively high and low PDW were risk factors of CAC.

Objective:To explore the efficacy and adverse effects of docetaxel combined with capecitabine on the basis of anthracycline in the treatment of breast cancer patient on the basis of anthracycline,and to provide evidence-based medicine evidence for the clinical application of capecitabine.Methods:PubMed,EMBase,CNKI,VIP and Wanfang database were used to search the randomized controlled trials in which the breast cancer patients were treated by docetaxel combined with capecitabine and docetaxel alone.The qualities of the included studies were assessed by the modified Jadad scale.The effective data were extracted and the pathologic complete remission (pCR),recurrence-free survival (RFS),disease-free survival (DFS)and safety were evaluated by RevMan 5.3 software.Results:A total of 10 articles were included,including 12012 patients.The Meta-analysis results showed that there were no statistically significant differences in pCR (RR=1.04,95%CI:0.91-1.18,P =0.59),RFS (RR=0.86,95%CI:0.71 - 1.03,P = 0.10)and DFS (RR= 0.98,95% CI:0.86 - 1.11,P = 0.71)between docetaxel combined with capecitabine and docetaxel alone. The clinical safety analysis results showed that the patients treated with docetaxel combined with capecitabine were susceptible to hand-foot syndrome (OR= 7.13, 95%CI:4.76-10.69,P <0.001)and stomatitis (OR = 1.93,95%CI:1.10-3.40,P =0.02).Conclusion:On the basis of anthracycline treatment,the efficacies of docetaxel combined with capecitabine and docetaxel alone in the treatment of the breast cancer patients are similar.The former is more likely to cause the hand-foot syndrome and stomatitis.

Objective:To analyze the effect of PAK4 interruption by microRNA-199a/b-3p (miR-199a/b-3p) on migration and invasion of hepatocellular carcinoma (HCC).Methods: To test targeting of PAK4 by miR-199a/b-3p,we used luciferase assay in HEK293T cells cotransfected miR-199a/b-3p mimcs and pmirGLO-PAK4 3′UTR.The expression of PAK4 in SMMC-7721 transfected with miR-199a/b-3p was detected by Western blot.The biology behaviors of SMMC-7721 cells transfected with miR-199a/b-3p or PAK4 Si were analysed by cell migration assay and invasion assay.Results:MiR-199a/b-3p could suppress the mRNA and protein ex-pression of PAK4 by targeting PAK4 3′UTR,and the downregulating PAK 4 expression suppress the migration and invasion of SMMC-7721 cells.Conclusion: MiR-199a/b-3p could suppress the expression of PAK 4, which are considered key HCC suppressors and inhibit the migration and invasion of HCC cells.

Objective:To analyze the inhibiting mechanism of microRNA-199a/b-3p ( miR-199a/b-3p) on cell motility of breast cancer cells.Methods:The expression of PAK4 in MDA-MB-231 cells transfected with miR-199a/b-3p was detected by Western blot.The biology behaviors of MDA-MB-231 cells transfected with miR-199a/b-3p or PAK4 SiRNA were analysed by cell migration assay,invasion assay and protrusion dynamics.Results: MiR-199a/b-3p could suppress the expression of PAK 4 in MDA-MB-231 cells.Comparing with normal control ,miR-199a/b-3p or PAK4 SiRNA could suppress the migration ,invasion and membrane protrusion of MDA-MB-231 cells.Conclusion:miR-199a/b-3p could suppress the expression of PAK4,which are considered key breast cancer suppressors and inhibit the cell motility of breast cancer cells.

Objective To explore the influence of nifedipine controlled release tablets com-bined with indapamide on renal function of elderly patients with refractory isolated systolic hyper-tension.Methods 96 elderly patients with isolated systolic hypertension were randomly divided in-to two groups according to the admission odd and even day,48 cases in each group.Control group was treated with nifedipine controlled release tablets,while the observation group was treated with nifedipine controlled release tablets combined with indapamide on the basis of control group.Result After treatment,blood pressure in both groups decreased,and decreasing range of blood pressure in observation group was significantly greater than the control group(P <0.05).There were signif-icant differences of serum creatinine,creatinine clearance rate and microalbuminuria detection result before and after treatment in observation group (P <0.05).Conclusion Nifedipine controlled re-lease tablets combined with indapamide can effectively reduce blood pressure and promote renal func-tion in elderly patients with refractory isolated systolic hypertension,so it is worthy of clinical popu-larization.

Objective To explore the influence of nifedipine controlled release tablets com-bined with indapamide on renal function of elderly patients with refractory isolated systolic hyper-tension.Methods 96 elderly patients with isolated systolic hypertension were randomly divided in-to two groups according to the admission odd and even day,48 cases in each group.Control group was treated with nifedipine controlled release tablets,while the observation group was treated with nifedipine controlled release tablets combined with indapamide on the basis of control group.Result After treatment,blood pressure in both groups decreased,and decreasing range of blood pressure in observation group was significantly greater than the control group(P <0.05).There were signif-icant differences of serum creatinine,creatinine clearance rate and microalbuminuria detection result before and after treatment in observation group (P <0.05).Conclusion Nifedipine controlled re-lease tablets combined with indapamide can effectively reduce blood pressure and promote renal func-tion in elderly patients with refractory isolated systolic hypertension,so it is worthy of clinical popu-larization.

Objective To evaluate the outcome of incomplete revasculariszation by percutaneous coronary intervention (PCI) in elderly patients with coronary artery disease.Methods Data of 48 patients (age≥75 years old) underwent incomplete coronary revascularization during the period from 2008 to 2011 were collected.Their data before PCI and the 6 months follow-up results were comparatively analyzed.Results Six months after incomplete coronary revascularization,the LVEF was higher than that before revascularization ((48.10 ± 7.19)％ vs (39.82 ± 8.23)％) and BNP declined significantly ((575.17 ± 67.27) ng/L vs (793.57 ± 87.53)ng/L).T peak-T end (Tp-Te) √RR and Tp-Te/QT also declined significantly (Tp-Te √RR:(96.38 ± 10.79)ms vs (147.81 ± 17.32)ms;Tp-Te/QT:(0.25 ±0.05) vs (0.30 ±0.07)) (P ＜0.05).Six months after PCI,LVEDV and LVESV were higher than those before surgery,but there was no significant difference(P ＞ 0.05).Conclusion Incomplete coronary revascularization can improve heart function and stability of cardiac electrophysiology in elderly patients with coronary artery disease,but it can not prevent the development of left ventricular remodeling.