Retinal microcirculatory disorder is a key factor in the occurrence and development of diabetic retinopathy （DR）， and also an important link in the prevention and treatment of DR. The theory of "Gaozhuo" holds that the microcirculatory disorder in DR is based on the deficiency of spleen Qi and is characterized by the obstruction caused by "Gaozhuo" and blood stasis. The deficiency of spleen Qi is an essential precondition for the endogenous formation and accumulation of Gaozhuo， while Gaozhuo invasion is the direct cause of microcirculatory disorders in DR. The deficiency of spleen Qi and the endogenous formation of Gaozhuo mean the process in which glucose metabolism dysfunction induces an excessive production of inflammatory factors and lipid metabolites. The obstruction caused by "Gaozhuo" and blood stasis is the direct pathogenesis of microcirculatory disorders in DR， encompassing two stages： Gaozhuo obstruction and turbidity and stasis stagnation. Gaozhuo obstruction and turbidity and stasis stagnation represent the process in which inflammatory factors and lipid metabolites damage the retinal microcirculation and induce thrombosis， thus mediating microcirculatory disorders. Turbidity and stasis stagnation and blood extravasation outside the vessels reveal the progression to microvascular rupture and hemorrhage resulting from the microcirculatory disorders. According to the pathogenesis evolution of the theory of "Gaozhuo"， microcirculatory disorders in DR can be divided into deficiency of spleen Qi with Gaozhuo obstruction， deficiency of spleen Qi with turbidity and stasis stagnation， and turbidity and stasis stagnation with blood extravasation outside the vessels. Clinically， treatment principles should focus on strengthening the spleen and benefiting Qi， resolving turbidity， and dispersing stasis. Different syndrome patterns should be addressed with tailored therapies， such as enhancing the spleen and benefiting Qi while regulating Qi and reducing turbidity， strengthening the spleen and benefiting Qi while resolving turbidity and dispelling stasis， and strengthening the spleen and resolving turbidity while removing stasis and stopping bleeding. Representative prescriptions include modified Wendantang， modified Buyang Huanwutang， modified Danggui Buxuetang， Zhuixue Mingmu decoction， Tangmuqing， Shengqing Jiangzhuo Tongluo Mingmu prescription， Danhong Huayu decoction， and Yiqi Yangyin Huoxue Lishui formula.

ObjectiveTo evaluate the clinical efficacy and safety of Jingmaiyan granules （composed of Lonicerae Japonicae Flos， Sedi Herba， Paeoniae Radix Rubra， Moutan Cortex， Rhei Radix et Rhizoma Praeparata， and Glycyrrhizae Radix et Rhizoma） combined with external application of Jinhuang Ointment in treating acute-stage blood heat stasis type superficial thrombophlebitis （ST） of lower extremities， and to explore their effects on hemorheology and serum inflammatory factors. MethodsA randomized， double-blind， placebo-controlled clinical trial was conducted. A total of 124 patients with lower extremity ST were randomized into two groups（62 cases in each group）. The control group received external application of Jinhuang ointment and oral placebo treatment， while the observation group received external application of Jinhuang ointment and oral Jingmaiyan granules. Both groups were treated for 2 weeks. The clinical symptom scores， therapeutic efficacy of traditional Chinese medicine （TCM） syndrome， pain visual analog scale （VAS） scores， hemorheological indices ［including whole blood high-shear， medium-shear， and low-shear viscosity， as well as plasma viscosity （PV）］， and inflammatory factors ［C-reactive protein （CRP）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）］ were compared before and after treatment. ResultsAfter 2 weeks of treatment， the total effective rate in the observation group （98.3%， 60/62） was significantly higher than that in the control group （83.8%， 52/62）， with a statistically significant difference （Z=3.512 1， P<0.05）. Compared with pre-treatment scores， the scores for skin color， skin temperature， swelling， pain， and cord or nodules were significantly reduced in both groups （P<0.05）， with more pronounced improvement in the observation group （P<0.05）. Additionally， compared with pre-treatment levels， the whole blood viscosity （low-， medium-， and high-shear） significantly improved in both groups after treatment （P<0.05）， with more marked improvement in the observation group （P<0.05）. Furthermore， the plasma viscosity， CRP， IL-6， and TNF-α levels were significantly reduced in both groups after treatment （P<0.05）， with more pronounced improvement observed in the observation group （P<0.05）. ConclusionThe combination of external application of Jinhuang ointment and oral Jingmaiyan granules effectively improves clinical symptoms， hemorheological abnormalities， and inflammatory responses in patients with acute stage blood heat stasis type ST of lower extremities. The treatment is safe and holds clinical promotion value.

AIM: To investigate the effect of corneal topography-guided phacoemulsification with transparent corneal incision on cataract patients.METHODS:A total of 92 cataract patients(92 eyes)admitted to our hospital from February 2021 to February 2023 were prospectively selected and randomly divided into two groups: the control group(46 eyes)received the conventional 11:00 clear corneal incision scheme, and the study group(46 eyes)received the steepest meridian clear corneal incision scheme. The uncorrected visual acuity, corneal surface morphology indicators, including surface regularity index(SRI), surface asymmetry index(SAI), and cylinder(CYL), subjective dry eye symptoms questionnaire scoring scale(SDES), tear film break-up time(BUT), and complications were compared between the two groups.RESULTS:All patients completed the follow-up. The uncorrected visual acuity of the study group was significantly better than that of the control group at 1 wk, 1 and 3 mo after surgery(all P<0.05); there were statistical significance in the SAI and CYL of both groups of patients at 3 mo after surgery(all P<0.05); the fluctuation levels of SDES and BUT in the study group were significantly lower than those in the control group at different time points after surgery(all P<0.05); and there was no statistical difference in complications between the two groups(P>0.05).CONCLUSION:Under the guidance of corneal topography, phacoemulsification through the transparent corneal incision of the steepest meridian of the cornea can improve the uncorrected visual acuity of cataract patients, restore the corneal surface morphology, and have few complications.

AIM: To investigate the effect of corneal topography-guided phacoemulsification with transparent corneal incision on cataract patients.METHODS:A total of 92 cataract patients(92 eyes)admitted to our hospital from February 2021 to February 2023 were prospectively selected and randomly divided into two groups: the control group(46 eyes)received the conventional 11:00 clear corneal incision scheme, and the study group(46 eyes)received the steepest meridian clear corneal incision scheme. The uncorrected visual acuity, corneal surface morphology indicators, including surface regularity index(SRI), surface asymmetry index(SAI), and cylinder(CYL), subjective dry eye symptoms questionnaire scoring scale(SDES), tear film break-up time(BUT), and complications were compared between the two groups.RESULTS:All patients completed the follow-up. The uncorrected visual acuity of the study group was significantly better than that of the control group at 1 wk, 1 and 3 mo after surgery(all P<0.05); there were statistical significance in the SAI and CYL of both groups of patients at 3 mo after surgery(all P<0.05); the fluctuation levels of SDES and BUT in the study group were significantly lower than those in the control group at different time points after surgery(all P<0.05); and there was no statistical difference in complications between the two groups(P>0.05).CONCLUSION:Under the guidance of corneal topography, phacoemulsification through the transparent corneal incision of the steepest meridian of the cornea can improve the uncorrected visual acuity of cataract patients, restore the corneal surface morphology, and have few complications.

ObjectiveTo observe the effects of the Fuyuan Tongluo prescription （composed of Astragali Radix， Carthami Flos， Spatholobi Caulis， Liquidambaris Fructus， Lycopodii Herba， Centellae Herba， etc.） in the treatment of restenosis with collateral obstruction syndrome after interventional operation of lower limb arteriosclerosis obliterans， and its impact on the primary patency rate. MethodsA total of 88 patients with collateral obstruction syndrome after interventional surgery for lower limb arteriosclerosis obliterans were randomly divided into two groups. The control group （n₁=44） received dual antiplatelet therapy with aspirin and clopidogrel. The observation group （n₂=44） was treated with Fuyuan Tongluo prescription non-decocted granules in addition to aspirin and clopidogrel. Both groups received treatment for 24 weeks and were followed up for 36 weeks. The changes in primary patency rate， symptom scores， ankle-brachial index （ABI）， coagulation function， and inflammatory markers before and after treatment were compared between the two groups. ResultsFor primary patency rate， after 36 weeks of treatment， the observation group had a significantly better primary patency rate than the control group （χ²=4.14，P<0.05）. After 24 weeks of treatment， there was no significant difference in primary patency rate between the two groups. Clinical efficacy comparison： Based on symptom quantification scores， and using the Nimodipine method as a reference， the overall efficacy of the observation group was superior to that of the control group after 24 weeks of treatment （χ²=2.24，P<0.05）. ABI levels： The observation group had a higher ABI than the control group after 24 and 36 weeks of treatment （P<0.05）. Coagulation function indicators： After 24 and 36 weeks of treatment， D-dimer and fibrinogen levels in both groups were lower than before treatment （P<0.05）. Inflammatory markers： After 24 and 36 weeks of treatment， CRP levels in the observation group were lower than those in the control group （P<0.05）. There were no significant differences in white blood cell （WBC） and erythrocyte sedimentation rate （ESR） levels before and after treatment between the two groups. ConclusionAdding Fuyuan Tongluo prescription non-decocted granules to dual antiplatelet therapy can improve the primary patency rate of the affected vessels in patients with lower limb arteriosclerosis obliterans after interventional surgery. Longer use of Fuyuan Tongluo prescription can significantly improve clinical symptoms， demonstrating clinical application value.

ObjectiveTo observe the effects of the Fuyuan Tongluo prescription （composed of Astragali Radix， Carthami Flos， Spatholobi Caulis， Liquidambaris Fructus， Lycopodii Herba， Centellae Herba， etc.） in the treatment of restenosis with collateral obstruction syndrome after interventional operation of lower limb arteriosclerosis obliterans， and its impact on the primary patency rate. MethodsA total of 88 patients with collateral obstruction syndrome after interventional surgery for lower limb arteriosclerosis obliterans were randomly divided into two groups. The control group （n₁=44） received dual antiplatelet therapy with aspirin and clopidogrel. The observation group （n₂=44） was treated with Fuyuan Tongluo prescription non-decocted granules in addition to aspirin and clopidogrel. Both groups received treatment for 24 weeks and were followed up for 36 weeks. The changes in primary patency rate， symptom scores， ankle-brachial index （ABI）， coagulation function， and inflammatory markers before and after treatment were compared between the two groups. ResultsFor primary patency rate， after 36 weeks of treatment， the observation group had a significantly better primary patency rate than the control group （χ²=4.14，P<0.05）. After 24 weeks of treatment， there was no significant difference in primary patency rate between the two groups. Clinical efficacy comparison： Based on symptom quantification scores， and using the Nimodipine method as a reference， the overall efficacy of the observation group was superior to that of the control group after 24 weeks of treatment （χ²=2.24，P<0.05）. ABI levels： The observation group had a higher ABI than the control group after 24 and 36 weeks of treatment （P<0.05）. Coagulation function indicators： After 24 and 36 weeks of treatment， D-dimer and fibrinogen levels in both groups were lower than before treatment （P<0.05）. Inflammatory markers： After 24 and 36 weeks of treatment， CRP levels in the observation group were lower than those in the control group （P<0.05）. There were no significant differences in white blood cell （WBC） and erythrocyte sedimentation rate （ESR） levels before and after treatment between the two groups. ConclusionAdding Fuyuan Tongluo prescription non-decocted granules to dual antiplatelet therapy can improve the primary patency rate of the affected vessels in patients with lower limb arteriosclerosis obliterans after interventional surgery. Longer use of Fuyuan Tongluo prescription can significantly improve clinical symptoms， demonstrating clinical application value.

OBJECTIVE: To observe the effect of the direct stimulation of acupuncture at extraocular muscle attachment point on acquired extraocular muscle palsy. METHODS: Thirteen patients with acquired extraocular muscle palsy were treated with acupuncture directly at extraocular muscle (paralytic muscle) attachment point. Firstly, the intraocular conjunctival sac drops of topical anesthetic (procaine hydrochloride eye drops) were administered, 0.2 mL each time, once every 10 minutes, for a total of 3 times. Acupuncture was delivered immediately after the third drop. The sterile acupuncture needle for single use, 0.25 mm×25 mm, was inserted at the anatomical location of the corneal limbal attachment of paralytic extraocular muscle, with an angle of 10° to 15° formed between the needle tip and extraocular muscle, and a depth of 0.3 mm to 0.5 mm. Pivoted by the needle tip, the eyeball was moved passively towards the direction of normal action of orbital muscle, 30 to 50 times until the patient felt soreness of the eyeball; afterwards, the needle was removed. After acupuncture, levofloxacin eye drops were administered once (0.2 mL) at the affected eye. The treatment was given twice a week, and completed when diplopia disappeared. Before and after treatment, the diplopia and the synoptophore circumference were observed respectively. RESULTS: After 7 to 24 (15.46±5.56) times of direct stimulation with acupuncture at extraocular muscle attachment point, the symptoms of diplopia disappeared in 13 patients, the eye position restored to orthophoria, and the circumference of synoptophore was reduced to be (4.04±0.82)° from (19.38±3.98)° detected before treatment (P<0.05). CONCLUSION Acupuncture directly at extraocular muscle attachment can attenuate diplopia and improve ocular muscle function in patients with acquired extraocular muscle palsy.
Humans ; Acupuncture Therapy ; Male ; Female ; Middle Aged ; Adult ; Oculomotor Muscles/physiopathology* ; Aged ; Acupuncture Points ; Ophthalmoplegia/physiopathology*

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome

Objective To compare the efficacy and safety of three kinds of endoscopic minimally invasive treatment of internal hemorrhoids.Methods The clinical data of 222 patients with internal hemorrhoids who underwent endoscopic treatment in Shangyu People's Hospital of Shaoxing from January 2020 to June 2023 were retrospectively analyzed.According to the treatment method,the patients were divided into simple sclerotherapy group(40 cases),simple ligation group(114 cases)and combined group(68 cases).The perioperative indexes,postoperative adverse events,effective rate and satisfaction of three groups were compared.Results There was significant difference in operation time among three groups(P＜0.05),and the operation time of simple ligation group was the shortest.There was no significant difference in postoperative hospital stay among three groups(P＞0.05).The incidences of anal distention,postoperative pain and dysuria in simple ligation group and combined group were significantly higher than those in simple sclerotherapy group(P＜0.05).The incidence of postoperative bleeding in simple ligation group was significantly higher than that in simple sclerotherapy group and combined group(P＜0.05).There was significant difference in treatment effectiveness among three groups(P＜0.05),and combined treatment had the best effect.The satisfaction of three groups was higher,and the difference was not statistically significant(P＞0.05).Conclusion The three endoscopic minimally invasive treatment methods for internal hemorrhoids are safe and effective.Ligation combined with sclerotherapy can effectively improve symptoms,and the postoperative delayed bleeding are low,which is a safe and efficient treatment method.

Objective:To explore the causes of the crosstalk in the gross α and gross β measurement using an MPC 9604 low background α/β counter.Methods:With the A4 copy paper (70 g/m 2), polyethylene (PE) films (8.7 g/m 2), and 304 stainless steel seperately as shielding materials, the gross α and gross β experiments, gamma spectrometry experiments and solid state nuclear track detection (SSNTD) experiments were conducted by using 241Am and 40K standard materials. A comprehensive analysis encompassing statistical analysis and nuclear physics analysis was performed to reveal the impact of contributing factors on the crosstalk in the gross α and gross β measurement with an MPC 9604 low background α/β counter. Results:241Am powder source experimental result: when two sheets of copy paper were used in the experiment, α-rays did not generate one count in the β channel of the low background α/β counter. The same test with the shielding material of two layers of PE films showed that the α count rate further decreased by about 36.5%, while the β count rate hardly changed. The gross α and gross β experiments and γ spectrometry with the shielding material of stainless steel demonstrated that the characteristic γ ray peaking at 59.5 keV of the 241Am powder source did not generate one count in the β channel. 40K powder source experimental result: when the source was covered with steel of total thickness of 0.965 mm in the gross α and gross β experiments, the γ rays of 40K did not generate one count in the β channel. Compared with naked 40K powder source, when source was covered with one and two sheets of copy paper, the gross α count rate decreased approximately from 3.30 × 10 -3 to 1.50 × 10 -3 and 1.75 × 10 -3, respectively. The SSNTD indicated the presence of other α nuclides in 40K powder source. Conclusions:The β counting in the β channel with the 241Am powder source using MPC 9604 low background α/β counter was, instead of α-rays, caused by the internal conversion electrons and the characteristic X rays of 11.870-22.402 keV emitted from the 241Am powder source, thus this is not a true α/β crosstalk. The α counting in α channel with the 40K powder source, except the contribution of impurity α nuclides, was mainly attributed to the α signals arising from β particles when the amplitude of the piled-up β pules exceeded the discrimination threshold of the detector, therefore it is a true crosstalk.