AIM: To investigate the alterations in corneal aberration and relative refractive power following the reduction of back optic zone diameters(BOZD)of orthokeratology lenses.METHODS: Myopic children aged 8-12 years, deemed suitable and willing to wear orthokeratology lenses, were randomly allocated to wear lenses with a 6.0 mm BOZD or a 5.0 mm BOZD. Data collection included changes in higher-order aberrations, relative refractive power and the treatment zone diameter of the two groups after wearing lenses for 1 d, 1 wk, 1, and 3 mo. The correlation of increase in corneal higher-order aberrations with refractive power was analyzed.RESULTS: The increases in total higher-order aberrations, spherical aberrations and coma aberrations varied over time following lens wear(all P<0.001), and there were no statistically significant differences in the changes of total higher-order aberrations and coma aberrations between the two groups of patients(all P>0.05). A significant difference was observed in the increment of spherical aberrations in the 5 mm range between the two groups of patients, which varied over time(Ftime=40.179, Ptime<0.001; Fgroup=11.948, Pgroup=0.001; Finteraction=3.262, Pinteraction=0.03). A significant difference was observed in the increment of spherical aberrations in the 4 mm range between the two patient groups(Ftime=34.462, Ptime<0.001; Fgroup=13.094, Pgroup<0.001; Finteraction=1.372, Pinteraction=0.25). There was no statistically significant distinction in relative refractive power between the two groups(Fgroup=0.048, Pgroup=0.83; Finteraction=1.208, Pinteraction=0.31); however, relative refractive power changed over time(Ftime=40.030, Ptime<0.001). The difference in treatment zone diameter between the two groups was statistically significant, with changes over time(Ftime=11.212, Ptime<0.001; Fgroup=74.073, Pgroup<0.001; Finteraction=0.312, Pinteraction=0.82). The total higher-order aberrations, spherical aberrations, and coma aberrations in 4, 5 and 6 mm range showed a positive correlation with relative refractive power values(all P<0.001). Statistically significant difference was observed in the axial length between the two groups after wearing lenses for 3, 6 and 12 mo(Ftime=185.398, Ptime<0.001; Fgroup=5.618, Pgroup=0.02; Finteraction=2.315, Pinteraction=0.11).CONCLUSION: Orthokeratology lenses leaded to elevated higher-order aberrations. Orthokeratology lenses with smaller BOZD produced significantly greater spherical aberrations at 4 and 5 mm range and smaller treatment zone diameters. The corneal total higher-order aberration was positively correlated with relative refractive power. Wearing orthokeratology lenses with a smaller BOZD can cause slower axial growth and better myopia control.

Objective To investigate the potential mechanism by which dihydromyricetin(DHM)ameliorates diabetic nephropathy(DN),and to screen and validate its possible key molecular targets.Methods A DN model was established using db/db mice,and 100 mg/(kg·d)DHM was administered via gavage 5 d per week for totally 10 weeks.Renal morphological changes were observed after staining to evaluate the effects of DHM.GSE161885 and GSE270526 datasets were obtained from the Gene Expression Omnibus(GEO)database and analyzed in combination with the GeneCards database to screen for DN-related differentially expressed genes(DEGs).Protein-protein interaction(PPI)network and molecular docking were employed to predict potential DHM targets.Western blotting and immunofluorescence staining were performed to detect the effects of DHM on pyroptosis-related pathways in the renal tissues of db/db mice and in high glucose(HG)-induced human renal tubular epithelial cells(HK-2).The specific NLR family pyrin domain containing protein 3(NLRP3)inhibitor MCC950 was also used to validate the predicted mechanism.Results In vivo experiments showed that DHM significantly ameliorated renal pathological damage in db/db mice,alleviated glomerular hypertrophy and mesangial expansion,and markedly reduced Paller scores(P<0.001).Immunofluorescence staining revealed significantly weakened fluorescence signals for α-smooth muscle actin(α-SMA),fibronectin,and collagen Ⅰ in renal tissues.Western blot results showed that the expression levels of collagen Ⅰ,collagen Ⅲ,α-SMA,and transforming growth factor beta 1(TGF-β1)were significantly decreased(P<0.05).A total of 16 DN-related DEGs were identified.Enrichment analysis revealed that these genes were primarily enriched in pathways such as viral protein interactions,cytokine-cytokine receptor interaction,and the AGE-RAGE signaling pathway in diabetic complications,and were primarily involved in gene functions such as the positive regulation of lymphocyte-mediated immunity,positive regulation of adaptive immune response,and chemokine activity.Molecular docking confirmed NLRP3 as a potential target of DHM.In vivo validation showed that DHM significantly down-regulated gasdermin-D(GSDMD)fluorescence signals and inhibited the expression of pyroptosis-related proteins including NLRP3,Caspase 1,Cleaved-Caspase 1,interleukin 18(IL-18),and GSDMD(P<0.05).In vitro studies further confirmed that both DHM and the specific NLRP3 inhibitor MCC950 alleviate high glucose-induced fibrosis and pyroptosis in HIC-2 cells.Conclusion DHM can ameliorate the progression of DN,and its mechanism is related to inhibiting NLRP3 inflammasome-mediated pyroptosis,thereby alleviating renal inflammation and fibrosis.

Objective To analyze the predictive value of apolipoprotein B(apoB)and apoB to apolipoprotein A1(apoA1)ratio(apoB/A1)in acute myocardial infarction(AMI)of phlegm blended with blood stasis syndrome.Methods A total of 200 patients with AMI confirmed by coronary angiography in Foshan Hospital of Traditional Chinese Medicine during the trial period were collected.Data collection covered the basic information of gender,age,medical history of hypertension,coronary heart disease and diabetes mellitus,and smoking history,the information of four diagnostic methods of traditional Chinese medicine(TCM),and relevant indicators of blood lipids,the number of lesioned branches of coronary arteries and the Gensini scores.The predictive value of apoB and apoB/A1 for AMI of phlegm blended with blood stasis syndrome was explored by univariate Logistic regression analysis and multivariate Logistic regression analysis as well as by plotting the Receiver Operating Characteristic(ROC)curves.Results(1)Among the 200 AMI patients,41 cases were differentiated as qi deficiency and blood stasis syndrome,36 cases as qi stagnation and blood stasis syndrome,74 cases as phlegm blended with blood stasis syndrome,and 49 cases as other syndromes(including 16 cases of cold accumulation in heart vessels syndrome,22 cases of qi and yin deficiency syndrome,and 11 cases of healthy-qi deficiency and yang collapse syndrome).(2)The difference of Gensini scores among the patients with various TCM syndrome types were statistically significant(H=43.735,P=0.000<0.001).And the Gensini scores in the patients with syndromes of qi deficiency and blood stasis,qi stagnation and blood stasis,and phlegm blended with blood stasis were relatively high,being 60.0(43.0,87.0),70.0(48.5,84.0)and 65.0(40.0,95.0)points,respectively,which were higher than that of the other TCM syndrome types[44.0(32.0,64.0)points].The pairwise comparison between various TCM syndrome types showed that the differences were statistically significant(P<0.05).However,there was no statistically significant difference in the number of lesioned branches of coronary arteries among the patients with various TCM syndrome types(H=1.180,P=0.758>0.05).(3)The results of correlation analysis showed that the number of lesioned branches of coronary arteries,Gensini score and apoB/A1 were significantly and positively correlated(r=0.140,P=0.049<0.05;r=0.205,P=0.004<0.01).(4)The results of univariate Logistic regression analysis and multivariate Logistic regression analysis showed that apoB and apoB/A1 were the independent risk factors for phlegm blended with blood stasis syndrome(P<0.01).ROC curve analysis showed that apoB/A-1 exerted a high predictive value for AMI of phlegm blended with blood stasis syndrome,with high sensitivity and specificity.Conclusion It is indicated that ApoB/A1 can be used as an objective indicator for predicting AMI of phlegm blended with blood stasis syndrome in clinical practice.

Iron overload is strongly associated with heart disease. Ferroptosis is a new form of regulated cell death indicated in cardiac ischemia-reperfusion (I/R) injury. However, the specific molecular mechanism of myocardial injury caused by iron overload in the heart is still unclear, and the involvement of ferroptosis in iron overload-induced myocardial injury is not fully understood. In this study, we observed that ferroptosis participated in developing of iron overload and I/R-induced cardiomyopathy. Mechanistically, we discovered that Parkin inhibited iron overload-induced ferroptosis in cardiomyocytes by promoting the ubiquitination of long-chain acyl-CoA synthetase 4 (ACSL4), a crucial protein involved in ferroptosis-related lipid metabolism pathways. Additionally, we identified p53 as a transcription factor that transcriptionally suppressed Parkin expression in iron-overloaded cardiomyocytes, thereby regulating iron overload-induced ferroptosis. In animal studies, cardiac-specific Parkin knockout mice (Myh6-CreER ^T2 /Parkin ^fl/fl ) fed a high-iron diet presented more severe myocardial damage, and the high iron levels exacerbated myocardial I/R injury. However, the ferroptosis inhibitor Fer-1 significantly suppressed iron overload-induced ferroptosis and myocardial I/R injury. Moreover, Parkin effectively protected against impaired mitochondrial function and prevented iron overload-induced mitochondrial lipid peroxidation. These findings unveil a novel regulatory pathway involving p53-Parkin-ACSL4 in heart disease by inhibiting of ferroptosis.

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Objective:To investigate the effect of oral administration of vitamin D3 on intestinal barrier function in patients after gastric cancer surgery,and to provide a reference for perioperative nutritional therapy in patients with gastric cancer.Methods:The conve-nience sampling method was used to select 80 patients with gastric cancer who were admitted to Department of Gastrointestinal Surgery in a grade A tertiary hospital in Xiamen,China,from June 2021 to May 2023,and the patients were divided into intervention group and control group using a random number table.The patients in the intervention group were given oral administration of vitamin D3 800 IU/d for 14 consecutive days before surgery.ELISA was used to measure the serum levels of 25-hydroxyvitamin D3[25(OH)D3],intestinal barrier indicators(D-lactate,Zonulin),and inflammatory indicators(C-reactive protein,interleukin-6)within 24 hours after admis-sion and on days 1,4,and 7 after surgery,and the changes in these indicators were compared between the two groups.Results:A total of 71 patients were enrolled finally,with 34 in the intervention group and 37 in the control group.On days 1,4,and 7 after surgery,the intervention group had a significantly lower level of D-lactate than the control group(F=3.978,P=0.026;F=9.649,P=0.005;F=4.389,P=0.021).On day 4 after surgery,the intervention group had a significantly lower level of Zonulin than the control group(F=3.198,P=0.035).Conclusion:Oral administration of vitamin D3 before surgery may accelerate the recovery of intestinal barrier function in pa-tients with gastric cancer.

Objective To investigate the differences in personality traits between the patients with anx-ious depression(AND)and non-anxious depression(NAD)in order to provide the possible basis for early find of the patients with AND.Methods A total of 572 adult patients with depression visiting in the psychiatric outpatient department of the First Affiliated Hospital of Chongqing Medical University from January 2022 to December 2022 were selected to conduct the questionnaire survey.General demographic questionnaire,Self-rating Depression Scale(SDS),Generalized Anxiety Disorder Scale(GAD-7)and Minnesota Multiphasic Per-sonality Inventory(MMPI)were collected and analyzed.The patients with GAD-7 total score ≥5 points served as the AND group(n=499)and those with GAD total score＜5 points served as the NAD group(n=73).The correlation between the general demographic questionnaire,SDS and GAD-7 with MMPI was ana-lyzed.Results There were statistically significant differences in the place of residence,number of children in a family,education years,MMPI total score and high score proportions of psychopathy,athopia,hysteria,depres-sion,hypochondriasis,paranoea,schizophrenia,social introversion and hypomania dimensions between the two groups(P＜0.05).The SDS and GAD-7 scores in the AND group were higher than those in the NAD group(P＜0.05).The MMPI total score,athopia,hysteria,depression,hypochondriasis,paranoea,schizophrenia,so-cial introversion and hypomania were positively correlated with SDS and GAD-7(P＜0.05).Conclusion The patients with depression accompanied by anxiety symptom could be early identified by the MMPI testing results.

Objective To explore the application effect of multimodal analgesia combined with goal-di-rected fluid therapy based on enhanced recovery after surgery(ERAS)in the anesthesia management of pa-tients undergoing orthopedic robot-assisted pedicle internal fixation.Methods Eighty patients with lumbar fractures who underwent robot-assisted surgery in Huai'an 82 Hospital from February 2024 to February 2025 were selected as the research objects and divided into the ERAS group and the control group according to the random number table method,with 40 cases in each group.The ERAS group received multimodal analgesia combined with goal-directed fluid therapy based on ERAS,while the control group adopted the traditional an-esthesia protocol.The hemodynamic indicators[heart rate,mean arterial pressure(MAP)]before the start of anesthesia(T0),immediately before the operation(T1),at the end of the operation(T2),and at the time of postoperative recovery(T3),as well as the IL-6 levels at T0,24 hours after the operation(T4),48 hours after the operation(T5),and 72 hours after the operation(T6)were compared between the two groups.Recorded the postoperative recovery time,visual analogue scale(VAS)score,incidence of complications and hospital stay,as well as perioperative infusion management parameters[total infusion volume,positive fluid balance volume,the compliance rate of stroke volume variation(SVV),etc.].Results Compared with the control group,the proportion of MAP fluctuations≤±10%(87.5%vs.62.5%),and the proportion of basal heart rate increase≤20%(95.0%vs.70.0%)in the ERAS group were higher than those in the control group(P<0.05).At T4,the IL-6 levels in both groups were the highest,while the IL-6 levels from T4 to T6 in the ERAS group were lower than those in the control group(P<0.05).Compared with control group,wake times[(18.5±3.2)min vs.(25.1±4.5)min],bed time for the first time[(8.2±2.1)h vs.(20.5±4.3)h],the length of time[(4.2±1.1)d vs.(6.5±1.3)d]in the ERAS group were shorter,24-hour resting VAS score(2.1±0.6 vs.3.8±0.9)and the incidence of complications(20.0%vs.57.5%)were lower,the total infusion volume[(1 850±220)mL vs.(2 550±310)mL],the amount of colloid solution[(620±95)mL vs.(850±120)mL],and the positive balance volume of liquid[(320±90)mL vs.(1 120±210)mL]were less,the intraoperative urine volume[(0.55±0.08)mL·kg-1·h-1 vs.(0.30±0.10)mL·kg-1·h-1]was more,the differences were statistically significant(P<0.05).The compliance rate of SVV in the ERAS group was 95.0%(38/40).Conclusion Multimodal analgesia combined with goal-directed fluid therapy based on ERAS can effectively stabilize the perioperative physiological state of patients undergoing robot-assisted spinal sur-gery,accelerate postoperative functional recovery and reduce complications.

Objective:The predictive model of cardiac arrest in the emergency room was constructed and validated based on Logistic regression.Methods:This study was a retrospective cohort study. Patients admitted to the emergency room of the First Affiliated Hospital of Xinjiang Medical University from January 2020 to July 2021 were included. The general information, vital signs, clinical symptoms, and laboratory examination results of the patients were collected, and the outcome was cardiac arrest within 24 hours. The patients were randomly divided into modeling and validation group at a ratio of 7:3. LASSO regression and multivariable logistic regression were used to select predictive factors and construct a prediction model for cardiac arrest in the emergency room. The value of the prediction model was evaluated using the area under the receiver operator characteristic curve (AUC), calibration curve, and decision curve analysis (DCA).Results:A total of 784 emergency room patients were included in the study, 384 patients occurred cardiac arrest. The 10 variables were ultimately selected to construct a risk prediction model for cardiac arrest: Logit( P)= -4.503+2.159×modified early warning score (MEWS score)+2.095×chest pain+1.670×abdominal pain+ 2.021×hematemesis+2.015×cold extremities+5.521×endotracheal intubation+0.388×venous blood lactate-0.100×albumin+0.768×K ++0.001×D-dimer. The AUC of the model group was 0.984 (95% CI: 0.976-0.993) and that of the validation group was 0.972 (95% CI: 0.951-0.993). This prediction model demonstrates good calibration, discrimination, and clinical applicability. Conclusions:Based on the MEWS score, chest pain, abdominal pain, hematemesis, cold extremities, tracheal intubation, venous blood lactate, albumin, K +, and D-dimer, a predictive model for cardiac arrest in the in-hospital emergency room was constructed to predict the probability of cardiac arrest in emergency room patients and adjust the treatment strategy in time.

Objective:To investigate the nutritional risk, incidence of malnutrition, and intake of three major energy-supplying nutrients, analyze changes in their body composition and the possible influencing factors in patients with stomach neoplasms during perioperative period in order to provide a theoretical basis for the nutritional management of patients with stomach neoplasms during perioperative period.Methods:This was a cross-sectional study. A total of 105 patients who underwent gastric cancer radical surgery in the Gastrointestinal Department of Zhongshan Hospital Affiliated to Xiamen University from June 2021 to May 2023 were taken as the research subjects using fixed-point continuous sampling method. They were recruited for screening and assessment using Nutritional Risk Screening 2002 (NRS 2002) and Patient-Generated Subjective Global Assessment (PG-SGA). Nutrients intake during the perioperative period were investigated using the 24-h recall method and dietary diary method, etc. Body compositions were measured using the bioelectrical resistance method.Results:Among the 105 patients, there were 78 males and 27 females, with an average age of (61.5 ± 10.3) years. About 83.8% (88/105) gastric cancer patients were at nutritional risk and 82.9% (87/105) were malnourished. The preoperative and postoperative energy intake were (1 646.1 ± 321.5) and (1 317.2 ± 365.8) kcal (1 kcal=4.184 kJ), respectively, which were significantly lower than the target amount of (1 896.7 ± 262.9) kcal, the difference was statistically significant ( t=6.23, 8.29, both P<0.05).The preoperative body mass, muscle mass, skeletal muscle, fat mass, and skeletal muscle index were (51.5 ± 9.6), (40.8 ± 6.0), (23.6 ± 4.0), (8.3 ± 4.9) kg, and 6.7 ± 0.8 respectively, while the postoperative values were (50.0 ± 9.1), (39.8 ± 6.0), (22.8 ± 3.6), (7.8 ± 5.2) kg, and 6.5 ± 0.8 respectively, with statistically significant differences between the two groups ( t values were 2.89-10.61, all P<0.05). Logistic multivariate regression analysis showed that the operation time ( OR=3.984, 95% CI 1.433-11.080, P<0.05) and energy satisfaction ( OR=0.053, 95% CI 0.005-0.610, P<0.05) were independent influencing factors for the degree of skeletal muscle loss. Conclusions:During perioperative period, the gastric cancer patients had poor nutritional status with insufficient nutrient intake and accelerated loss of body muscle and fat. Therefore, it was necessary to conduct a comprehensive nutritional evaluation for patients with stomach neoplasms during perioperative period in time and take steps to promote recovery by providing individualized nutritional therapy.