AIM: To investigate the value of optical coherence tomography angiography(OCTA)parameters and serum caspase-1 for assessing the severity of diabetic retinopathy(DR).METHODS:Patients diagnosed with DR in our hospital from June 2024 to December 2025 were retrospectively enrolled and were divided into early non-proliferative DR(NPDR)and advanced proliferative DR(PDR)groups according to fundus fluorescein angiography(FFA)findings. Patients with diabetes mellitus but without DR were selected as the control group. OCTA parameters included macular vascular density, the perimeter and area of the foveal avascular zone(FAZ), mean retinal thickness, hyperreflective foci(HRF), and internal limiting membrane abnormalities. Blood biochemical indicators contained fasting blood glucose, glycated hemoglobin(HbA1c), systemic immune-inflammation index(SII), triglyceride/high-density lipoprotein(TG/HDL)ratio, urinary albumin/creatinine ratio(UACR), and caspase-1.RESULTS: Totally 128 DR patients(151 eyes)were enrolled in this study, including 75 patients(90 eyes)in the NPDR group(40 males and 35 females, mean age: 74.3±5.6 y)and 53 patients(61 eyes)in the PDR group(27 males and 26 females, mean age: 75.9±5.8 y). Meanwhile, 60 diabetic patients(120 eyes)without DR were recruited as the control group(33 males and 27 females, mean age: 72.6±5.4 y).The macular vascular density gradually decreased in the control, NPDR and PDR groups, while perimeter and area of FAZ, and mean retinal thickness gradually increased, and the incidence of HRF and internal limiting membrane abnormalities gradually increased(all PSymbol|@@0.001). The levels of SII, UACR and caspase-1 gradually increased(all PSymbol|@@0.001). The duration of diabetes mellitus was longer in the NPDR and PDR groups than in the control group(all PSymbol|@@0.001).Multivariate logistic regression analysis demonstrated that diabetic duration, HRF, and caspase-1 were risk factors for the occurrence of DR, while macular vascular density served as a protective factor(all P<0.001). Moreover, caspase-1 was identified as a risk factor for the progression of DR to PDR, and macular vascular density was a protective factor against DR progression(all P<0.001). Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of caspase-1 combined with macular vascular density for predicting DR occurrence and PDR was 0.864 and 0.890, respectively, both higher than those of single indicators(all PSymbol|@@0.05).CONCLUSION: The combination of macular vascular density from OCTA parameters and serum caspase-1 has important clinical value in assessing severity of DR.

Objective:To investigate the correlation between systemic immune inflammatory index (SII) and other metabolic indicators and diabetic epiretinal membranes (dERM).Methods:A retrospective case-control study. From March 2022 to July 2023, 81 patients (81 eyes) with dERM in Department of Ophthalmology, Affiliated Jinhua Hospital of Zhejiang University of Medicine School diagnosed by fundus screening were included in the study. A total of 81 patients (81 eyes) with diabetes who were matched in age, gender, and duration of diabetes and had no dERM or diabetic macular edema in both eyes during fundus screening were selected as the control group. All patients underwent optical coherence tomography (OCT) examination and laboratory tests for peripheral blood neutrophil, lymphocyte, platelet counts, serum albumin, blood lipids, uric acid, and glycosylated hemoglobin (HbA1c). SII was calculated. Random urine samples were collected for urinary albumin/creatinine ratio (ACR) testing. The OCT device's own analysis software obtained the macular volume coefficient, including central foveal thickness (CMT), macular volume, and average macular thickness. The macular volume coefficient, SII, serum albumin, blood lipids, uric acid, HbA1c, and ACR between the two groups were compared using paired t tests or Mann-Whitney U tests. Conditional logistic regression analysis was performed to evaluate the risk factors for dERM; Spearman correlation test was used to analyze the correlation between CMT, SII, ACR, disorganization of retinal inner layers (DRIL), intraretinal cyst (IRC), and hyper-reflective foci (HRF) in patients with dERM. Results:There were significant differences in CMT, macular volume, average macular thickness, SII, serum albumin, and ACR between the dERM group and the control group ( Z=-7.234, -6.306, -6.400, -3.063, -2.631, -3.868; P<0.05). Conditional logistics regression analysis showed that high SII [odds ratio (OR)= 3.919, 95% confidence interval ( CI) 1.591-9.654, P=0.003] and ACR ( OR=4.432, 95% CI 1.885-10.420, P=0.001) were risk factors for dERM. Spearman correlation analysis showed that HRF, IRC, DRIL were positively correlated with CMT ( Rs=0.234, 0.330, 0.248; P=0.036, 0.003, 0.026); HRF was positively correlated with SII and ACR ( Rs=0.233, 0.278; P=0.036, 0.012). Conclusion:Elevated SII and ACR are independent risk factors for the occurrence of dERM.

BACKGROUND:Alveolar distraction osteogenesis is an important method for treating alveolar bone atrophy, the osteogenesis process and biomechanics play a crucial role in the fol owing implantation and repair. At present, no related experimental studies are found.
OBJECTIVE:To analyze the biomechanical and histological characteristics of alveolar distraction osteogenesis in a canine model.
METHODS:Twelve adult mongrel canines received premolars extraction and alveoloplasty in mandible to establish an atrophy alveolar model. After 3 months, a segmental alveolar osteotomy was performed in the randomly selected unilateral atrophy alveolar and two intra-osseous distractors were placed. After a 7-days latency period, the alveolar ridge was augmented at a rate of 1.0 mm/d for 5 days. After a consolidation of 1, 2, and 3 months, the canines were sacrificed and the specimens of the distracted alveolar bone were harvested for clinical, radiographic, histological and biomechanical analysis.
RESULTS AND CONCLUSION:The alveolar distractors obtained good healing with surrounding tissue. The atrophy alveolar bones were augmented for (4.80±0.50) mm and (5.12±0.47) mm by clinical and radiographic findings immediately after distraction, respectively. The bone trabeculae in the distracted chamber matured from 1 to 3 months of consolidation by histological analysis. The shearing force of alveolar distraction chamber increased from 1 to 3 months. After 3 months’ consolidation, the shearing force of distracted chamber was comparable to host bone. The histological and biomechanical property of distracted alveolar chamber is comparable to host bone after 3 months’ consolidation.

Objective To investigate the effect of preemptive analgesia on postoperative cognitive function in elderly patients with abdominal surgery .Methods Totals of 127 cases of elderly patients with open major surgery were randomly divided into two groups:the experimental group (63 cases) and the control group (64 cases).The patients underwent preemptive analgesia in the experimental group , while the control group underwent conventional analgesia .VAS and MMSE were used to compare their pain and cognitive function between two groups , and dosages of fentanyl and adverse reactions were also observed .Results There were finally 60 cases in each group who had finished the study .The pain score was ( 1.86 ±0.62 ) in the experimental group and (4.03 ±0.48) in the control group six hours after operation , with statistically significant difference (t=3.67,P<0.0).The score of cognitive function was (25.42 ±0.63) in the experimental group and (21.77 ±0.50) in the control group 24 hours after operation, and the difference was statistically significant (t=3.54,P<0.05).The dosages of fentanyl was (597.94 ±82.41) μg in the experimental group and (826.47 ±113.28) μgin the control group, with statistically significant difference (t=5.42,P<0.01).The incidence of POCD was 20.00%in the experimental group and 38.33%in the control group, and the difference was statistically significant (χ2 =3.03,P<0.05).Conclusions Preemptive analgesia of electroacupunctureon elderly patients with abdominal surgery can significantly reduce their postoperative pain and improve cognitive dysfunction .