In recent years, with the endless emergence of meibomian gland dysfunction(MGD)diagnostic equipment, rich treatment methods, and in-depth clinical and basic research on MGD at home and abroad, the understanding of MGD has entered a new stage. MGD-related dry eye is considered to be the main cause of lipid abnormal dry eye, and its occurrence and development is a chronic and multi-factorial pathological process. This article reviews the pathogenesis, imaging analysis and clinical treatment progress of MGD-related dry eye, in order to provide scientific evidence and ideas for clinical diagnosis and therapy of MGD-related dry eye.

[This corrects the article DOI: 10.1016/j.jpha.2023.08.006.].

Objective:To explore the clinical phenotype and genetic characteristics of a child with Hypotrichosis 14.Methods:A child who had presented at the Henan Provincial People′s Hospital on May 4, 2020 due to hair thinning was selected as the study subject. Clinical data of the child was collected. Peripheral venous blood samples were collected from the child and her parents. Genomic DNA was extracted and subjected to whole exome sequencing. Candidate variants were validated by Sanger sequencing and bioinformatic analysis.Results:The child, a 5-year-old female, had presented with thin, soft lanugo-like hair which was easy to fall off. The child was found to harbor compound heterozygous missense variants of the LSS gene, namely c. 1609G>A (p.V537M) in exon 17 and c. 802T>G (p.F268V) in exon 8, which were respectively inherited from her father and mother. Both variant sites were highly conserved, though based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), both variants were rated as variants of unknown significance (PM2_Supporting+ PP3+ PP4). Conclusion:The c. 1609G>A (p.V537M) and c. 802T>G (p.F268V) compound heterozygous variants of the LSS gene probably underlay the clinical phenotype in this patient.

Objective To explore the application value of deep learning image reconstruction(DLIR)combined with Smart metal artifact reduction(Smart MAR)algorithm in maxillofacial CT images.Methods A total of 34 patients with maxillofacial lesions affected by oral metal implants who underwent maxillofacial enhanced CT scans were included.The images of four groups in venous phase were reconstructed with 50％adaptive statistical iterative reconstruction(ASIR-V)(IR group),50％ASIR-V combined with Smart MAR(IR+S group),DLIR(at medium strength)combined with Smart MAR(D-M+S group)and DLIR(at high strength)combined with Smart MAR(D-H+S group)respectively.The artifact index(AI)was worked out by measuring the standard deviation(SD)of CT values in maxillofacial lesions and longhead muscle.The subjective scores of overall image quality,lesion conspicuity and diagnostic confidence were assessed.The image quality of different algorithms was compared.Results Compared with IR+S group,the AI value of IR group was significantly increased(P＜0.05),while the noise had no significant difference(P＞0.05).Compared with IR+S group,the AI value and noise of D-M+S group and D-H+S group both were significantly decreased(P＜0.05),and the AI value of D-M+S group and D-H+S group reduced by 13.70％and 19.06％respectively,the noise reduced by 16.37％and 30.78％respectively.The subjective scores of overall image quality,lesion conspicuity and diagnostic confidence in IR+S group were significantly lower than those in D-M+S group and D-H+S group,but significantly higher than those in IR group(P＜0.05).There were 6 patients'(17.64％)lesions were detected only in the groups with Smart MAR algorithm,while 9 patients(26.47％)had introduced new artifacts in the tongue with Smart MAR algorithm.Conclusion DLIR combined with Smart MAR can improve the CT image quality of maxillofacial region,enhance the conspicuity and diagnosis confidence of maxillofacial lesions in patients with oral metal implants.Smart MAR algorithm may produce new artifacts that need to be analyzed along with the images not added Smart MAR algorithm.

Objective To investigate the safety and feasibility of modified gasless trans-subclavian approach endoscopic total thyroidectomy for papillary thyroid carcinoma(PTC).Methods We retrospectively analyzed the clinical data of consecutive 82 patients with PTC who underwent the modified gasless trans-subclavian approach endoscopic total thyroidectomy in the Department of Head and Neck Surgery,Sir Run Run Shaw Hospital,Affiliated with the Zhejiang University School of Medicine,from March 2022 to June 2023.Results All operations were successfully completed under endoscopy approach without transfer to open surgery.The maximum diameter of PTC was(6.6±5.4)mm.The operation duration was(156.5±32.7)min,and the number of lymph nodes in the central compartment was(12.3±6.4).The postoperative hospital stay was(3.3±1.2)d.Postoperative complications included two cases of transient hypoparathyroidism and six cases of transient recurrent laryngeal nerve injury.All the patients recovered in one month.One case of postoperative bleeding was observed.No permanent laryngeal nerve injury,permanent hypoparathyroidism or incision infection occurred.Conclusion The gasless trans-subclavian approach endoscopic total thyroidectomy is a feasible and safety approach in selected PTC patients.The lymph nodes in the central compartment are thoroughly dissected.This approach has obvious advantages in functional protection of the anterior cervical region,and has clinical application value.

OBJECTIVE:Percutaneous sacroiliac screw internal fixation has become the main surgical procedure for the treatment of posterior pelvic ring fractures;however,the unassisted closure operation requires high operator experience and repeated fluoroscopy increases the radiation hazard for patients and medical personnel.This article compares the clinical efficacy of robot-assisted versus unassisted percutaneous sacroiliac screw placement for posterior pelvic ring fractures by meta-analysis. METHODS:Computer searches of CNKI,WanFang,VIP,CBM,PubMed,Embase,Cochrane Library and ClinicalTrials.gov were conducted from the time of database inception to December 2022.The literature on the clinical efficacy of robot-assisted versus freehand percutaneous sacroiliac screw placement in the treatment of posterior pelvic ring fractures was collected in and outside China.The data were independently screened and extracted by two investigators according to the inclusion and exclusion criteria,respectively.The quality of randomized controlled trials was evaluated using Cochrane risk assessment criteria.The quality of included cohort studies was assessed using the Newcastle-Ottawa Scale.Meta-analysis was performed using RevMan 5.4 software for inclusion metrics.Outcome metrics included operative time,intraoperative bleeding,fluoroscopy time,fluoroscopy frequency,number of holes drilled,Majeed postoperative function score,the excellent and good rates of Matta fracture reduction,the excellent and good rates of Gras screw position,fracture healing time and complications. RESULTS:(1)A total of 13 publications were included,2 were randomized controlled trials both referring to randomized methods,11 non-randomized controlled studies were evaluated for quality of literature according to the Newcastle-Ottawa Scale,1 scored 8,9 scored 7;and 1 scored 6;the quality of literature was good.A total of 748 patients were included,including 430 in the robot-assisted group and 318 in the freehand group.(2)The results of the meta-analysis showed that the operative time(MD=-28.30,95%CI:-40.20 to-16.40),intraoperative bleeding(MD=-6.36,95%CI:-10.06 to-2.66),intraoperative fluoroscopy time(MD=-12.13,95%CI:-19.54 to-4.72),intraoperative fluoroscopy frequency(MD=-17.39,95%CI:-29.00 to-5.78),number of intraoperative needle drillings(SMD=-9.50,95%CI:-14.27 to-4.73)and the excellent and good rates of Gras screw position(OR=8.65,95%Cl:3.26-22.92)in the robot-assisted group were significantly better than those in the freehand group(P<0.05).(3)In the robot-assisted group,the overall postoperative complication rate was significantly reduced(OR=0.10,95%Cl:0.02-0.48,P<0.05).(4)No significant difference was detected in fracture healing time(MD=-0.08,95%CI:-0.21,0.06),the excellent and good rates of Matta fracture repositioning rate(OR=2.06,95%Cl:0.97-4.39),and Majeed functional score(MD=0.91,95%CI:-0.31-2.13)between both groups(P>0.05). CONCLUSION:Compared with freehand sacroiliac joint nailing,robotic assistance shortens the operative time,reduces intraoperative bleeding,decreases radiation damage to patients and medical staff,improves the excellent and good rate of screw position,and reduces the overall incidence of postoperative complications in patients,but there was no significant improvement in fracture reduction quality,fracture healing time,and postoperative function.In the future,more large-sample,multicenter,and high-quality randomized controlled trials are still needed to verify.

A major impedance to neuronal regeneration after peripheral nerve injury(PNI)is the activation of various programmed cell death mechanisms in the dorsal root ganglion.Ferroptosis is a form of pro-grammed cell death distinguished by imbalance in iron and thiol metabolism,leading to lethal lipid peroxidation.However,the molecular mechanisms of ferroptosis in the context of PNI and nerve regeneration remain unclear.Ferroportin(Fpn),the only known mammalian nonheme iron export protein,plays a pivotal part in inhibiting ferroptosis by maintaining intracellular iron homeostasis.Here,we explored in vitro and in vivo the involvement of Fpn in neuronal ferroptosis.We first delineated that reactive oxygen species at the injury site induces neuronal ferroptosis by increasing intracellular iron via accelerated UBA52-driven ubiquitination and degradation of Fpn,and stimulation of lipid peroxidation.Early administration of the potent arterial vasodilator,hydralazine(HYD),decreases the ubiquitination of Fpn after PNI by binding to UBA52,leading to suppression of neuronal cell death and significant ac-celeration of axon regeneration and motor function recovery.HYD targeting of ferroptosis is a promising strategy for clinical management of PNI.

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Objective:To compare Al 18F-1, 4, 7-trizacyclononane-1, 4, 7-triacetic acid (NOTA)-fibroblast activation protein inhibitor (FAPI)-04 PET/CT with 18F-FDG PET/CT in the evaluation of patients with initial gastric cancer. Methods:Twenty patients (13 males, 7 females, age: 27-77 years) with histologically proven gastric cancer were recruited prospectively between March 2021 and July 2022 in the First Affiliated Hospital of Zhengzhou University. Each patient underwent both 18F-FDG and Al 18F-NOTA-FAPI-04 PET/CT within one week. SUV max, tumor background ratio (TBR) and positive detection rate of the two methods were compared (Wilcoxon signed rank sum test, McNemar χ2 test). Results:Al 18F-NOTA-FAPI-04 showed higher SUV max and TBR than those of 18F-FDG in primary tumors (10.2(8.0, 13.7) vs 5.2(3.3, 7.7), z=-3.47, P=0.001; 7.6(5.6, 10.3) vs 2.4(1.8, 3.0), z=-3.85, P<0.001). For the detection of primary gastric cancer, the positive detection rate of Al 18F-NOTA-FAPI-04 PET/CT showed the trend of being higher than that of 18F-FDG PET/CT (95%(19/20) and 75%(15/20); χ2=2.25, P=0.125). For assessing lymph node metastasis, the detection rate of Al 18F-NOTA-FAPI-04 PET/CT was higher than that of 18F-FDG PET/CT (78.9%(101/128) vs 64.8%(83/128); χ2=13.47, P<0.001). The SUV max and TBR of Al 18F-NOTA-FAPI-04 in lymph node were higher than those of 18F-FDG (5.3(3.5, 9.2) vs 2.8(1.8, 4.7), z=-7.31, P<0.001; 4.6(2.6, 6.5) vs 1.7(1.0, 3.0), z=-8.44, P<0.001). For the detection of peritoneal carcinomatosis, Al 18F-NOTA-FAPI-04 PET/CT showed higher peritoneal cancer index (PCI), SUV max, and TBR compared to 18F-FDG PET/CT (PCI: 12.0(3.0, 29.8) vs 5.5(0.5, 17.5), z=-2.22, P=0.026; SUV max: 8.2(4.4, 12.5) vs 2.7(1.9, 4.0); z=-2.52, P=0.012; TBR: 5.1(2.9, 13.3) vs 1.1(0.9, 2.0); z=-2.52, P=0.012). Conclusion:Al 18F-NOTA-FAPI-04 PET/CT outperforms 18F-FDG PET/CT in primary and metastatic lesions of gastric cancer and might be a potential novel modality for imaging patients with gastric cancer.

Myocardial fibrosis is an important pathological process in the development of cardiovascular diseases, which is closely related to the prognosis of patients. Activated cardiac fibroblasts (CFs) are the main effector cells, whose surface specifically overexpress fibroblast activation protein (FAP). Radionuclide-labeled FAP inhibitors (FAPIs) can specifically bind to FAP to visualize activated CFs in vivo, showing preliminary clinical application in the early diagnosis, prognosis prediction and interventional guidance of various cardiovascular diseases. This article reviews the progress of researches on the application of radionuclide-labeled FAPIs in cardiovascular diseases imaging.