AIM: To observe the manifestations and distribution patterns of visual field in non-arteritic anterior ischemic optic neuropathy(NAION).METHODS: Retrospective observational study. The investigation encompassed 183 patients(246 eyes)diagnosed with NAION who were evaluated at the Neuro-Ophthalmology/Acupuncture Department within the Eye Hospital, China Academy of Chinese Medical Sciences from June 2018 to December 2023. Recorded clinical data covered demographic details, incidence, disease duration, presence of systemic diseases, and histories of tobacco and alcohol use, along with best-corrected visual acuity(BCVA), visual field index(VFI), type of visual field defect, and thickness of the peripapillary retinal nerve fiber layer(pRNFL).RESULTS: A total of 183 patients(246 eyes)were enrolled. The cohort consisted of 101 males and 82 females; 120 exhibited unilateral symptoms, while 63 showed bilateral symptoms, with a mean age of 56.20±9.78 years(range 29-81 years). The types of visual field defects observed were varied: 90 eyes(36.6%)had diffuse loss, 63 eyes(25.6%)experienced inferior hemifield loss, 32 eyes(13.0%)displayed ring scotomas, 22 eyes(8.9%)had arcuate scotomas, 11 eyes(4.5%)presented with quadrant defects, 15 eyes(6.1%)had sectorial or wedge defects, and 13 eyes(5.3%)showed superior hemifield loss. The BCVA(LogMAR)and VFI of patients with diffuse visual field loss were poorer than patients with other types of visual defects(all P<0.05). There were statistically significant differences in visual field defects among patients of different genders and ages(all P<0.05). However, history of hypertension, diabetes, hyperlipidemia, sleep apnea and other systemic diseases, history of smoking and alcohol, and course of disease did not show specificity in the NAION visual field(all P>0.05).CONCLUSION:NAION manifests with a broad spectrum of visual field impairments across different genders, age, and levels of visual functionality. Extensive future research is necessary to identify additional reasons influencing the types of visual field damage in NAION.

Objective:To observe the clinical characteristics of non arteritic anterior ischemic optic neuropathy (NAION) in patients of different genders.Methods:A retrospective clinical analysis. A total of 183 cases (246 eyes) of NAION with complete diagnosis and treatment confirmed by Departments of Neuro-ophthalmology/Acupuncture and Moxibustion of Eye Hospital, China Academy of Chinese Medical Sciences from June 2018 to December 2023 were included. Among them, 101 cases (138 eyes) were male and 82 cases (108 eyes) were female. Their age was (59.2±9.8) years. The number of right and left eyes were 120 and 126, respectively. The patient's gender, age, disease course, history of hypertension, history of diabetes, history of hyperlipidemia, history of smoking and drinking, best corrected visual acuity (BCVA), intraocular pressure, and peripapillary Retinal Nerve Fiber Layer (pRNFL) thickness were recorded in detail. Visual field defects were classified into diffuse defects, ring scotoma, fan-shaped or wedge-shaped defects, upper and lower half defects, arcuate scotoma, and quadrantanopia. Logistic regression analysis was utilized to determine whether gender was an independent factor affecting the degree of visual field impairment in NAION.Results:Compared with female patients, male patients showed earlier onset age, a shorter interval between binocular onsets, a higher morbidity rate of hyperlipidemia, and a higher proportion with history of smoking and drinking, with statistically significant differences ( P<0.05). There was no statistically significant difference in disease duration, intraocular pressure, pRNFL thickness, and intraocular perfusion pressure between patients of different genders ( P>0.05). Female patients exhibited better BCVA than male patients, but the difference was not statistically significant ( P>0.05). The degree of visual field impairment in female patients was significantly better than that in males. Males' visual field defects were mostly in the lower half, while females' defects were mostly of arcuate scotoma, with statistically significant differences ( P<0.05). The results of multiple logistic regression analysis showed that the gender of male was an independent risk factor for severe visual field impairment in NAION patients (odds ratio=2.936, 95% confidence interval 1.275-6.763, P=0.011). Conclusions:Male NAION patients have an earlier onset age and a shorter interval between the initial and contralateral eye onset. Male patients exhibit a more severe degree of visual field impairment, which is mostly manifested as lower half visual field defect. While female patients tend to develop arcuate scotoma. After adjusting for other influencing factors, the gender of male remains an independent risk factor for severe visual impairment in NAION patients.

Objective To investigate the therapeutic mechanism of Shen Wu Yizhi Capsule in the treatment of post-stroke cognitive impairment(PSCI)by using network pharmacology methods and clinical trial validation.Methods A prospective trial was carried out in 90 cases of patients with PSCI admitted to Taihe Traditional Chinese Medicine Hospital Affiliated to Anhui University of Chinese Medicine from August 2022 to February 2024.The patients were randomly divided into the control group and the trial group by random number table method,with 45 cases in each group.The control group was treated with conventional treatment for PSCI,and the trial group was treated with Shen Wu Yizhi Capsule orally on the basis of treatment for the control group.The treatment course for the two groups covered 28 days.The changes of Mini-Mental State Examination(MMSE)score,Montreal Cognitive Assessment(MoCA)score,and the serum levels of inflammatory factors such as tumor necrosis factor α(TNF-α)and interleukin 6(IL-6)in the patients of the two groups were observed before and after treatment.Moreover,the incidences of adverse events in the two groups were recorded,thus to evaluate the safety of the treatment regimens in the two groups.And then the network pharmacological research was performed.TCMSP and literature review were used to obtain the active ingredients of Shen Wu Yizhi Capsule,GeneCards and other databases were used to obtain the PSCI disease targets,and the common targets were inputted into the STRING database to construct the PPI network.Cytoscape 3.9.0 was used to construct the network diagram of Shen Wu Yizhi Capsule-PSCI-targets,DAVID was used to perform GO and KEGG pathway enrichment analysis,and then molecular docking was used to verify the binding activity.Results(1)The results of clinical trial showed that after 28 days of treatment,the MMSE and MoCA scores of patients in the two groups were increased compared with those before treatment(P<0.05),and the increase of the scores in the trial group was significantly superior to that in the control group(P<0.05).The serum levels of TNF-α and IL-6 were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.05).During the trial,both groups of patients did not show obvious adverse reactions,with high safety.(2)The network pharmacological research of Shen Wu Yizhi Capsule yielded 92 active ingredients,803 targets,5 209 disease targets and 556 intersection targets.The core targets were AKT1,TNF,IL-6,TP53 and IL-1B,and the key compounds were deoxyharringtonine,senkyunone and genkwanin.The GO enrichment analysis obtained 1 812 GO entries,of which 154 entries were related with cellular component(CC),1 332 entries were related with biological process(BP),and 326 entries were related with molecular function(MF).The KEGG pathway enrichment analysis yielded 195 signaling pathways.The molecular docking results showed that the key compounds of Shen Wu Yizhi Capsule had good binding activities with the core targets.Conclusion The clinical efficacy of Shen Wu Yizhi Capsule in the treatment of PSCI is remarkable,and its therapeutic mechanism is probably related with multiple components through the signaling pathways such as AKT1,TNF,and IL-6.The results will provide reference for the in-depth study of Shen Wu Yizhi Capsule.

Objective:To observe the clinical characteristics of non arteritic anterior ischemic optic neuropathy (NAION) in patients of different genders.Methods:A retrospective clinical analysis. A total of 183 cases (246 eyes) of NAION with complete diagnosis and treatment confirmed by Departments of Neuro-ophthalmology/Acupuncture and Moxibustion of Eye Hospital, China Academy of Chinese Medical Sciences from June 2018 to December 2023 were included. Among them, 101 cases (138 eyes) were male and 82 cases (108 eyes) were female. Their age was (59.2±9.8) years. The number of right and left eyes were 120 and 126, respectively. The patient's gender, age, disease course, history of hypertension, history of diabetes, history of hyperlipidemia, history of smoking and drinking, best corrected visual acuity (BCVA), intraocular pressure, and peripapillary Retinal Nerve Fiber Layer (pRNFL) thickness were recorded in detail. Visual field defects were classified into diffuse defects, ring scotoma, fan-shaped or wedge-shaped defects, upper and lower half defects, arcuate scotoma, and quadrantanopia. Logistic regression analysis was utilized to determine whether gender was an independent factor affecting the degree of visual field impairment in NAION.Results:Compared with female patients, male patients showed earlier onset age, a shorter interval between binocular onsets, a higher morbidity rate of hyperlipidemia, and a higher proportion with history of smoking and drinking, with statistically significant differences ( P<0.05). There was no statistically significant difference in disease duration, intraocular pressure, pRNFL thickness, and intraocular perfusion pressure between patients of different genders ( P>0.05). Female patients exhibited better BCVA than male patients, but the difference was not statistically significant ( P>0.05). The degree of visual field impairment in female patients was significantly better than that in males. Males' visual field defects were mostly in the lower half, while females' defects were mostly of arcuate scotoma, with statistically significant differences ( P<0.05). The results of multiple logistic regression analysis showed that the gender of male was an independent risk factor for severe visual field impairment in NAION patients (odds ratio=2.936, 95% confidence interval 1.275-6.763, P=0.011). Conclusions:Male NAION patients have an earlier onset age and a shorter interval between the initial and contralateral eye onset. Male patients exhibit a more severe degree of visual field impairment, which is mostly manifested as lower half visual field defect. While female patients tend to develop arcuate scotoma. After adjusting for other influencing factors, the gender of male remains an independent risk factor for severe visual impairment in NAION patients.

Objective:To explore the effect of different salt intake levels on clinical outcomes after the first embryo transfer in women undergoing assisted reproductive technology.Methods:This was a retrospective cohort study. A total of 163 patients with the first in vitro fertilization/intracytoplasmic sperm injection and embryo transfer from January 2021 to July 2021 in Reproductive Medical Center, Henan Provincial People's Hospital were recruited. The spot urine method was used to estimate the 24 h salt intake of patients, and all patients were divided into three groups based on their 25th and 75th percentiles: low-salt group (≤9.21 g, n=41), medium-salt group (9.22-13.31 g, n=81), and high-salt group (≥13.32 g, n=41). Baseline data and clinical outcomes were analyzed and compared among the three groups. Results:The rate of MII oocyte [72.7% (410/564)], and the rate of high-quality embryos [42.1% (109/259)] in the high-salt group were lower than those in the low-salt group [82.5% (461/559), P<0.05; 52.4% (154/294), P<0.05], the differences among the three groups were statistically significant ( P<0.001, P=0.048). The rate of normal cleavage [99.1% (568/573)] in the medium-salt group was higher than that in the low-salt group [96.1% (294/306), P<0.05], and the difference among the three groups was statistically significant ( P=0.003). After adjusting for potential confounding factors by using multivariate logistic regression, the clinical pregnancy rate ( OR=0.520, 95% CI: 0.221-1.221, P=0.133), the early miscarriage rate ( OR=1.226, 95% CI: 0.219-6.851, P=0.817), and the live birth rate ( OR=0.730, 95% CI: 0.323-1.647, P=0.448) in the medium-salt group, the clinical pregnancy rate ( OR=0.659, 95% CI: 0.246-1.762, P=0.406), the early miscarriage rate ( OR=1.080, 95% CI: 0.162-7.180, P=0.937), and the live birth rate ( OR=1.012, 95% CI: 0.396-2.588, P=0.980) in the high-salt group were comparable with the low-salt group (all P>0.05). Conclusion:High level of salt intake does not affect the clinical pregnancy outcomes of infertile women in their first transplantation cycle. However, it has an adverse effect on oocyte maturation, normal cleavage, and high-quality embryo formation.

Objective:To explore the effect of different salt intake levels on clinical outcomes after the first embryo transfer in women undergoing assisted reproductive technology.Methods:This was a retrospective cohort study. A total of 163 patients with the first in vitro fertilization/intracytoplasmic sperm injection and embryo transfer from January 2021 to July 2021 in Reproductive Medical Center, Henan Provincial People's Hospital were recruited. The spot urine method was used to estimate the 24 h salt intake of patients, and all patients were divided into three groups based on their 25th and 75th percentiles: low-salt group (≤9.21 g, n=41), medium-salt group (9.22-13.31 g, n=81), and high-salt group (≥13.32 g, n=41). Baseline data and clinical outcomes were analyzed and compared among the three groups. Results:The rate of MII oocyte [72.7% (410/564)], and the rate of high-quality embryos [42.1% (109/259)] in the high-salt group were lower than those in the low-salt group [82.5% (461/559), P<0.05; 52.4% (154/294), P<0.05], the differences among the three groups were statistically significant ( P<0.001, P=0.048). The rate of normal cleavage [99.1% (568/573)] in the medium-salt group was higher than that in the low-salt group [96.1% (294/306), P<0.05], and the difference among the three groups was statistically significant ( P=0.003). After adjusting for potential confounding factors by using multivariate logistic regression, the clinical pregnancy rate ( OR=0.520, 95% CI: 0.221-1.221, P=0.133), the early miscarriage rate ( OR=1.226, 95% CI: 0.219-6.851, P=0.817), and the live birth rate ( OR=0.730, 95% CI: 0.323-1.647, P=0.448) in the medium-salt group, the clinical pregnancy rate ( OR=0.659, 95% CI: 0.246-1.762, P=0.406), the early miscarriage rate ( OR=1.080, 95% CI: 0.162-7.180, P=0.937), and the live birth rate ( OR=1.012, 95% CI: 0.396-2.588, P=0.980) in the high-salt group were comparable with the low-salt group (all P>0.05). Conclusion:High level of salt intake does not affect the clinical pregnancy outcomes of infertile women in their first transplantation cycle. However, it has an adverse effect on oocyte maturation, normal cleavage, and high-quality embryo formation.

Humans ; Endovascular Aneurysm Repair ; Endovascular Procedures ; Blood Vessel Prosthesis Implantation ; Aortic Aneurysm, Abdominal/surgery* ; Treatment Outcome ; Postoperative Complications ; Risk Factors ; Aortic Rupture/surgery* ; Retrospective Studies

In order to deal with the shortage of medical talents in Tibet, medical group assistance to Tibet is started as an innovative move in a new era, not only providing high-quality medical resources to Tibet, but also training local medical personnel by drawing on the "Master-Apprentice" model in traditional Chinese medicine. During the past three-year, the Shanghai Medical Team took advantage of medical group assistance to Tibet, enriched the types, methods and contents of teaching and mentoring tasks, and highlighted the role of "experts leading the backbone" and "team leading the team" in the "Master-Apprentice" model. The total amount and quality of local medical talents have thus been significantly improved. On the basis of summarizing experience, this study proposes a number of measures to optimize the current "Master-Apprentice" training model, evaluate the implementation process, and improve the feedback and quality management, so as to speed up the construction of the Tibetan medical talent team.

Objective:To evaluate the safety and efficacy of carotid artery stenting (CAS) in the treatment of non-circumferential severe calcification using the distal embolic protection device.Methods:Clinical data of patients with severe calcification lesions in cervical carotid artery treated by CAS from Jan 2018 to Dec 2020 at our center was analyzed retrospectively.Results:226 consecutively admitted patients of cervical carotid artery stenosis and non-circumferential severe calcification (CR>270°) underwent CAS using the distal embolic protection device. The technical success rate was 90.26%. No death or myocardial infarction occurred during the perioperative period. Two patients had ipsilateral hemiparesis ischemic stroke during post-dilatation. The incidence of perioperative bradycardia/hypotension was 25.34%. Patients were followed up for 6-36 months, with median follow-up period of 17.3 months. The incidence of mild or moderate in-stent restenosis (<70%) was 16.59%, and the incidence of severe in-stent restenosis or occlusion (>70%) was 3.22%.Conclusions:For carotid artery stenosis with non-circumferential severe calcification in high risk for CEA patients, carotid artery stenting is safe and effective with the aggressive pre-dilation strategies, strict stent selections and implantation standards. The incidence of perioperative death, myocardial infarction or ipsilateral hemiparesis ischemic stroke was low. The patency rate of the carotid stent in the calcification lesion is satisfactory during the mid-term follow-up.