AIM: To analyze the influencing factors of capsular constriction syndrome(CCS)in cataract patients after phacoemulsification(Phaco)combined with intraocular lens(IOL)implantation.METHODS: Retrospective study. The data of 2 900 cataract patients(2 900 eyes)in our hospital's information system from January 2021 to January 2024 were collected. All patients were treated with Phaco combined with IOL implantation, and the incidence of CCS within 30 wk after surgery was recorded. Patients were categorized into CCS(116 cases, 116 eyes)and N-CCS group(2 784 cases, 2 784 eyes)based on the occurrence of CCS. The basic data of the two groups were compared, and the influencing factors of CCS within 30 wk after Phaco combined with IOL implantation in cataract patients were analyzed by multivariate Logistic regression.RESULTS: Among 2 900 patients(2 900 eyes)included, 116 cataract patients(116 eyes)developed CCS within 30 wk after Phaco combined with IOL implantation, with an incidence rate of 4.00%. The single factor and multi-factor Logistic regression analysis showed that the complicated diabetes, high myopia, complicated glaucoma, and axial length(AL)>30 mm were the risk factors for the occurrence of CCS after Phaco IOL implantation in cataract patients(all P<0.05).CONCLUSION: Attention should be paid to cataract patients with diabetes, high myopia, glaucoma and AL>30 mm, which will increase the risk of CCS within 30 wk after Phaco combined with IOL implantation in cataract patients.

Objective:To investigate the effects of Huaiqihuang Granules on airway remodeling and immune function in asthmatic young rats through IL36/lL36R/MyD88 signaling pathway.Methods:The young mice were divided into normal group, model group, Chinese materia medica low-, medium-, and high-dosage groups using a random number table method, with 10 mice in each group. Except for the normal group, asthma models were established in all other groups. Chinese materia medica low-, medium-, and high-dosage groups were orally administered with 2, 4, and 8 g/kg Huaiqihuang Granules, respectively. The normal group and model group were orally administered with an equal volume of physiological saline once a day for 2 consecutive weeks of intervention. Pulmonary function apparatus was used to detect inspiratory resistance (Ri), expiratory resistance (Re) and dynamic compliance (Cdyn) of the pups; flow cytometry was used to detect interleukin 2/4 (IL-2, IL-4), interferon (IFN-γ) and immunoglobulin E (IgE) in peripheral blood; HE staining was used to observe the changes of lung tissue cases of the pups; Western blotting was used to detect the protein expressions of IL-36, IL-36R and MyD88.Results:Compared with the model group, the Chinese materia medica medium- and high-dosage groups showed a decrease in Ri and Re ( P<0.05), and an increase in Cdyn ( P<0.05); the thickness of airway wall and the number of smooth muscle cells decreased ( P<0.05); the levels of IL-4 and IgE in peripheral blood decreased ( P<0.05), while the levels of IFN-γ and IL-2 increased ( P<0.05); the expressions of IL-36, IL-36R, and MyD88 proteins in lung tissue decreased ( P<0.05), and there was a certain dosage-dependent relationship among the Chinese materia medica low-, medium-, and high-dosage groups ( P<0.05). The HE staining results showed that the airway and lung tissues of the model group mice were accompanied by a large number of inflammatory pathological changes. The alveolar cavities and inflammatory infiltration of the mice in each treatment group were improved, with the Chinese materia medica high-dosage group showing the most significant improvement. Conclusion:Huaiqihuang Granules can improve airway remodeling and immune function in asthmatic model mice, and its mechanism may be related to regulating IL36/lL36R/MyD88 signaling pathway, improving airway remodeling and reducing inflammatory response.

Objective To analyze the correlation of inflammatory indicators of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR),and systemic immune-inflammation index(SII)with traditional Chinese medicine(TCM)syndrome types and Chinese version of Thyroid Imaging Reporting and Data System(C-TIRADS)classification and properties of nodules in the patients with thyroid nodules(TN),thus to provide evidence for guiding TCM syndrome differentiation and treatment,and for assessing C-TIRADS classification and properties of the nodules in patients with TN.Methods A retrospective analysis was carried out in 140 inpatients who were diagnosed as TN and had underwent thyroidectomy during the period of January 2021 to January 2024 in the Department of General Surgery of Guangzhou Integrated Chinese and Western Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine(Guangzhou Hospital of Integrated Traditional and West Medicine).The patients were allocated to various group with reference to TCM syndrome types,C-TIRADS classification,and the properties of TN.The correlation of each clinical indicator with TCM syndrome types and C-TIRADS classification and properties of TN was analyzed.The Spearman correlation coefficient was employed for evaluating the correlation of clinical indicators with the C-TIRADS classification and properties of TN,receiver operating characteristic curve(ROC)was used to analyze the predictive value of NLR,MLR,PLR,and SII for the properties of nodules in patients with TN,and the Youden's Index was used to determine the cutoff value for optimal prediction.Results(1)According to the criteria of TCM syndrome differentiation,72 cases were differentiated as qi stagnation and phlegm obstruction syndrome,65 cases as phlegm accumulation and blood stasis syndrome,and 3 cases as heart-liver yin deficiency syndrome.For the number of cases of heart-liver yin deficiency syndrome was too small,only the first two syndromes were included for the analysis.(2)The levels of free T3(FT3)and free T4(FT4)in the patients of qi stagnation and phlegm obstruction syndrome were higher,and the levels of anti-thyroid peroxidase antibody(A-TPO),anti-thyroglobulin antibody(A-TG),neutrophil(NEU),NLR,and SII were lower than those in the patients of phlegm accumulation and blood stasis syndrome,the differences being all statistically significant(P<0.05 or P<0.01).(3)The levels of NLR,PLR,and SII in the patients with C-TIRADS3 classification were lower than those in the patients with C-TIRADS4 classification,the differences being all statistically significant(P<0.05 or P<0.01);no statistically significant difference of MLR was presented between the patients with C-TIRADS3 classification and those with C-TIRADS4 classification(P>0.05).(4)The levels of NLR,PLR,MLR,and SII in patients with benign nodules were lower than those in patients with malignant nodules,the differences being statistically significant(P<0.05 or P<0.01).(5)The Spearman correlation analysis showed that NLR,PLR,and SII were positively correlated with the C-TIRADS classification of the nodules,and NLR,PLR,MLR,and SII were positively correlated with the properties of the nodules,the differences being all statistically significant(P<0.05 or P<0.01).(6)The levels of NLR,MLR,PLR,and SII in patients with high-risk TN exerted a certain predictive value for the properties of the nodules,and their area under the curve(AUC)was 0.645,0.641,0.604,and 0.716,respectively,the differences being statistically significant(P<0.05 or P<0.01).For the prediction of nodule properties by NLR,MLR,PLR,and SII levels in patients with high-risk TN,their cutoff values and the corresponding sensitivities and specificities were 2.261(0.551,0.791),138.108(0.735,0.527),5.132(0.714,0.495),493.114(0.776,0.615),respectively;and their Youden's Index was 0.342,0.262,0.209,0.391,respectively.Conclusion The results indicated that in patients with TN,the FT3 and FT4 levels are positively correlated with the qi stagnation and phlegm obstruction syndrome;the values of A-TPO,A-TG,NEU,NLR,and SII are positively correlated with the phlegm accumulation and blood stasis syndrome;NLR,PLR and SII values are positively correlated with C-TIRADS classification;NLR,PLR,PLR,SII values are positively correlated with malignant TN.NLR,MLR,PLR,SII values exert high efficiency for the prediction of the properties of nodules in patients with TN.

Objective To establish an intelligent detection algorithm model for acute promyelocytic leukemia(M3 model)based on a contrast large model using machine learning statistical software and validate its effectiveness.Methods The data from 8 256 outpa-tients and inpatients who underwent complete blood cell analysis at Peking Union Medical College Hospital were retrieved and analyzed using the laboratory information system(LIS)and hospital information system(HIS).A M3 screening model was established and vali-dated using the data from outpatients and inpatients who underwent complete blood cell analysis at our hospital from July to October 2023.Results The M3 model demonstrated potential application value in screening for M3 disease in complete blood cell analysis,which showed certain efficacy in screening for neutrophil toxicity changes,particularly in identifying two cases of blue-green inclusion bodies in neutrophils.Conclusion The M3 model exhibited low specificity for M3 diagnosis.Future research should focus on increas-ing the number of M3-positive cases to optimize the model,ensuring high sensitivity while improving specificity.This model will provide assistance for the intelligent review of complete blood cell analysis.

Objective:To explore the effects of tyrosine kinase inhibitors (TKI) on SARS-CoV-2 infection, the related symptoms, and recovery in patients with chronic myeloid leukemia (CML) during the SARS-CoV-2 epidemic.Methods:A retrospective case series study was conducted. The information including general data and SARS-CoV-2 infection of 319 CML patients treated in the First Affiliated Hospital of Soochow University from January 2021 to December 2021 and 547 co-residents during the SARS-CoV-2 epidemic was collected by telephone follow-up from December 2022 to January 2023. The differences in clinical characteristics, infection rate, symptom severity, and recovery time of the SARS-CoV-2 between CML patients and their co-residents, between patients whether getting vaccine for SARS-CoV-2, between patients whether receiving TKI and among CML patients receiving different types of TKI were compared. The multivariate logistic regression analysis was used to analyze the factors influencing the infection rate, symptom severity, and recovery time of SARS-CoV-2.Results:The median age [ M ( Q1, Q3)] of CML patients was 46 years (36 years, 57 years) and all 319 CML patients included 188 (59.0%) males and 131 (41.0%) females; the median age of co-residents of CML patients was 41 years (22 years, 55 years), and all 547 co-residents included 266 (48.6%) males and 281 (51.4%) females. There were statistically significant differences in age, gender, vaccination against SARS-CoV-2 or not, infection rate [83.7% (267/319) vs. 90.5% (495/547)], distribution of symptomatic patients at different severity levels (mild, moderate, severe, and fatal), and recovery time [7 d (5 d, 14 d) vs. 6 d (2 d, 8 d)] between CML patients and co-residents (all P < 0.05). There were statistically significant differences in age, gender, SARS-CoV-2 infection rate, distribution of symptomatic patients at different severity levels and recovery time between CML patients (143 cases) and their co-residents (517 cases) who received the SARS-CoV-2 vaccine (all P < 0.05); there were no statistically significant differences in age, gender, infection rate, distribution of symptomatic patients at different severity levels and recovery time between vaccinated and unvaccinated CML patients with SARS-CoV-2 vaccine (all P > 0.05). There were 297 (93.1%) CML patients who took TKI and 22 patients who did not take TKI. There were no statistically significant differences in age and gender distribution between patients taking TKI and those not taking TKI (all P > 0.05). The infection rate of SARS-CoV-2 in patients taking TKI was lower than that of patients not taking TKI [82.5% (245/297) vs. 100.0% (22/22)], and the difference was statistically significant ( P = 0.032); however, there were no significant differences in distribution of symptomatic patients at different severity levels and recovery time between patients taking TKI and those not taking TKI (all P > 0.05). The results of multivariate logistic regression analysis showed that TKI therapy was an independent protective factor for SARS-CoV-2 infection in CML patients (taking TKI vs. not taking TKI: OR = 1.970, 95% CI: 1.093-3.554, P = 0.024), and was an independent risk factor for severe symptoms of SARS-CoV-2 infection (assigning mild, moderate, severe and fatal levels the value of 0, 1, 2, 3; OR = 0.042, 95% CI: 0.004-0.421, P = 0.007) and recovery time exceeding 7 d (> 7 d vs. ≤ 7 d, OR = 0.649, 95% CI: 0.426-0.988, P = 0.044). The third TKI therapy was given in 1 patient, and there were no statistically significant differences in SARS-CoV-2 infection rate, the symptoms at different severity levels and recovery time > 7 d between CML patients receiving first generation TKI (63 cases) and those receiving second generation TKI (77 cases) who were vaccinated against SARS-CoV-2 (all P > 0.05). Conclusions:TKI can reduce the infection rate of SARS-CoV-2 in CML patients, but will aggravate the severity of symptoms and prolong the recovery time. TKI types may have no impact on whether infected with SARS-CoV-2, the severity level of symptoms after infection and recovery time.

Objective To compare the effectiveness of loop-mediated isothermal amplification (LAMP) assay and microscopic examinations for detection of Schistosoma japonicum infections in Oncomelania hupensis in transmission-interrupted regions, so as to provide insights into the optimization of snail surveillance tools in these regions. Methods Four hilly schistosomiasis-endemic villages where transmission interruption was achieved were selected in Heqing County of Yunnan Province as the study villages, including Xinzhuang and Gule villages in hilly regions and Lianyi and Yitou villages in dam regions. Snail survey was performed by means of systematic sampling combined with environmental sampling in July 2018. All captured snails were identified for S. japonicum infections using microscopy. In addition, 10 to 20 snails were randomly sampled from each snail habitat following microscopy, numbered according to environments and subjected to LAMP assay. The positive rate of settings with S. japonicum-infected snails was compared among villages. Results A total of 7 949 living snails were captured from 83 snail habitats in 4 villages, and no S. japonicum infection was detected in snails. There were 226 mixed samples containing 1 786 snails subjected to LAMP assay, and positive LAMP assay was found in 3 mixed samples from 3 snail habitats in 2 dam villages. The positive rates of settings with S. japonicum-infected snails were comparable between Lianyi Village (one setting) and Yitou Village (2 set tings) (5.89% vs. 14.29%, P = 0.344). However, the overall positive rate of settings with S. japonicum-infected snails was significantly higher in dam villages (9.67%, 3/31) than in hilly villages (0) (P = 0.048). Conclusions LAMP assay is more sensitive to detect S. japonicum infections in O. hupensis than conventional microcopy method, which may serve as a supplementary method for detection of S. japonicum infections in O. hupensis in high-risk snail habitats in hilly transmission-interrupted regions.

Background::As a non-invasive and effective diagnostic method for small intestinal bacterial overgrowth (SIBO), wild-use of breath test (BT) has demonstrated a high comorbidity rate in patients with diarrhea-predominant irritable bowel syndrome (IBS-D) and SIBO. Patients overlapping with SIBO respond better to rifaximin therapy than those with IBS-D only. Gut microbiota plays a critical role in both of these two diseases. We aimed to determine the microbial difference between IBS-D overlapping with/without SIBO, and to study the underlying mechanism of its sensitivity to rifaximin.Methods::Patients with IBS-D were categorized as BT-negative (IBSN) and BT-positive (IBSP). Healthy volunteers (BT-negative) were enrolled as healthy control. The patients were clinically evaluated before and after rifaximin treatment (0.4 g bid, 4 weeks). Blood, intestine, and stool samples were collected for cytokine assessment and gut microbial analyses.Results::Clinical complaints and microbial abundance were significantly higher in IBSP than in IBSN. In contrast, severe systemic inflammation and more active bacterial invasion function that were associated with enrichment of opportunistic pathogens were seen in IBSN. The symptoms of IBSP patients were relieved in different degrees after therapy, but the symptoms of IBSN rarely changed. We also found that the presence of IBSN-enriched genera ( Enterobacter and Enterococcus) are unaffected by rifaximin therapy. Conclusions::IBS-D patients overlapping with SIBO showed noticeably different fecal microbial composition and function compared with IBS-D only. The better response to rifaximin in those comorbid patients might associate with their different gut microbiota, which suggests that BT is necessary before IBS-D diagnosis and use of rifaximin.Registration::Chinese Clinical Trial Registry, ChiCTR1800017911.

Objective:To summarize and compare the characteristics of oral microbiota in women during the preconception period and the third trimester.Methods:This retrospective cohort study involved 55 women who were recruited in the Preconceptional Offspring Trajectory Study (PLOTS) conducted by Fudan University and followed up to the third trimester in the Maternal and Child Health Care Hospital of Jiading District of Shanghai from September 2016 to December 2019. A total of 110 unstimulated saliva samples were collected in the preconception period ( n=55) and the third trimester ( n=55). Features of oral microbiota in the samples were analyzed by 16S rRNA gene-based sequencing. Moreover, the related factors were also analyzed. Paired t test or Wilcoxon matched-pairs signed-ranks test were used to analyze the differences in α-diversity during preconception and the third trimester; t test, analysis of variance (ANOVA), Kruskal-Wallis test and Mann-Whitney U test for comparison between groups with different characteristics and permutational multivariate analysis of variance (PerMANOVA) for β-diversity were used; Linear discriminant analysis (LDA) effect size (LEfSe 1.0) was used to identify the iconic oral flora. Results:(1) The Ace index of oral microbiota was significantly lower in the third trimester than that in the preconception period [661.14(578.15-752.85) vs 730.64 (632.40-911.00), T=1 077.00, P=0.010]. There was also a significance difference in β-diversity ( F=12.539, R2=0.104, P=0.001). Some species such as Saccharibacteria_TM7_G3, Prevotella_7, Absconditabacteria_SR1_G1, Porphyromonas, Ruminococcaceae_UCG_014, Prevotella, Peptostreptococcus, Prevotella_2, Alloprevotella, Parvimonas, Solobacterium and Eubacterium_nodatum_group in saliva were statistically more abundant in the third trimester than those in the preconception period (all P<0.05). (2) The third-trimester Shannon index was lower among those with lower income [5.44 (5.08-5.77) vs 5.75 (5.44-6.12), U=219.00, P=0.029] and those with gargle habit after meal or dessert [5.36 (4.91-5.48) vs 5.72 (5.44-6.05), U=374.00, P=0.046]. Conclusions:The features of oral microbiota vary in women during the preconception period and the third trimester. There is a significant increase in the abundance of oral pathogenic and opportunistic bacteria in the third trimester.

Objective:To investigate the prevalence and risk factors of stroke in Xuzhou city.Methods:A total of 41 932 residents aged 18 years and above were selected using the multi-stage stratified cluster sampling method. A questionnaire survey was conducted to investigate the rate of stroke, and a physical examination was performed to investigate height, weight, blood pressure, etc. Univariate analyses of stroke were performed using the Chi square test and trend chi-square test. Logistic regression analysis was performed for multi-factor analysis.Results:A total of 39 854 participants (19 222 males, 10 323 from urban areas) from 41 932 eligible participants were included in the statistical analysis, and their average age was (52.1±16.8). In this study, 885 stroke patients (464 males, 302 from urban areas) were found among 39 854 participants. The prevalence of stroke was 2 220.61/100 000, which was separately 2 413.90/100 000 and 2 040.52/100 000 among males and females. The difference between males and females was significant (χ2=6.22, P=0.013). The prevalence of stroke in urban areas (2 925.51/100 000) was higher than in rural areas (1 974.20/100 000) (χ2 =31.45, P<0.001). The results of univariate analysis revealed that the risk factors for stroke were [ OR(95% CI)] smoking [1.82(1.53-2.08)], drinking [1.22(1.08-1.81)], sleep quality [1.42(1.13-1.96)], physical activities [1.44(1.11-2.14)], hypertension [3.53(2.44-6.02)], heart disease [1.23(1.11-1.75)], diabetes [1.42(1.31-2.05)], family history of hypertension [1.43(1.30-2.37)], family history of diabetes [1.22(1.10-1.65)], and family history of stroke [1.57(1.46-2.06)]. Logistic regression analysis showed that age [3.02(2.14-4.96)], smoking [1.59(1.12-3.85)], poor sleep quality [1.15(1.03-3.23)], lack of physical activity [1.22(1.08-3.38)], hypertension [4.53(3.07-7.36)], diabetes [1.08(1.02-3.23)], and family history of stroke [1.15(1.08-3.31)] were related to stroke. Conclusion:The epidemic of stroke in Xuzhou city was relatively high, and prevention and control measures of stroke should be taken according to the risk factors of stroke in the population distribution.

Objective: To investigate the diagnostic value of extracellular volume (ECV) imaging by magnetic resonance imaging for liver fibrosis of hepatitis B. Methods: A retrospective analysis was recruited in patients with chronic hepatitis B, who underwent liver surgery from April to October 2017 for pathological evaluation of liver tissues, and all patients underwent Gd-EOB-DTPA-enhanced T1 mapping to calculate the liver ECV score. The correlation between ECV and staging of hepatic fibrosis and inflammatory activity were compared to clarify the diagnostic value of staging of fibrosis. Results: 66 patients were enrolled in this study. Concerning the staging of liver fibrosis, there were 13, 4, 13, 10, and 26 cases with F0, F1, F2, F3 and F4 stages, respectively. ECV values had high interobserver consistency (correlation coefficient 0.860). The ECV difference between different stages of liver fibrosis was statistically significant (F = 15.02, P < 0.001). There was a significant positive correlation between ECV and fibrosis stage (r = 0.622, P < 0.001), and weak correlation with inflammatory activity (r = 0.332, P = 0.007). Fibrosis staging was an independent factor influencing ECV (P < 0.001). The area under the receiver operator characteristic curve for the diagnosis of liver fibrosis staging F≥1, F≥3 and F4 were 0.760, 0.846 and 0.873, respectively. The diagnostic sensitivity and specificity were 64.15%, 92.31%, 77.78%, 80.00% and 88.46, 72.50%, respectively. Conclusion MRI-ECV imaging has great value for staging hepatic fibrosis of hepatitis B, and it can provide an effective method for diagnosis, staging, and evaluating the curative effect of fibrosis.