Background: Visual impairment is increasingly prevalent, underscoring the need for effective prevention strategies. This study investigated the association between cardiovascular health and visual impairment using three progressively developed metrics: Life’s Simple 7 (LS7), a cardiovascular health score developed by the American Heart Association based on 7 components, including physical activity, smoking status, body mass index (BMI), diet, blood glucose, blood pressure, and total cholesterol; Life’s Essential 8(LE8), which adds sleep health as an additional component; and Life’s Crucial 9 (LC9), which further incorporates mental health. We aimed to evaluate whether these expanded metrics provide additional explanatory value and to inform future public health strategies. Objective: To investigate the associations among LS7, LE8, and LC9 cardiovascular health scores and visual impairment in National Health and Nutrition Examination Survey 2013 to 2018, assess the added value of sleep and mental health components, and identify key contributing subcomponents using regression and machine learning methods. Methods: We analyzed data from 9891 participants in the 2013 to 2018 National Health and Nutrition Examination Survey. Multivariable logistic regression, restricted cubic spline modeling, and subgroup analyses were conducted to evaluate the association between cardiovascular health and visual impairment. Machine learning methods, including Random Forest and SHapley Additive exPlanations, a model interpretation approach used to assess feature importance, were applied. The Boruta algorithm, a feature selection method, was used to identify key subcomponents of cardiovascular health. Results: Participants with visual impairment were older, had lower poverty-to-income ratios, and exhibited lower cardiovascular health scores (LS7, LE8, and LC9). Higher cardiovascular health scores were negatively associated with visual impairment. Each one standard deviation increase in LS7, LE8, and LC9 was associated with approximately 8%, 2%, and 3% lower odds of visual impairment, respectively. LS7 showed the strongest negative association, whereas LE8 and LC9 emerged as the most important predictors in the machine learning models. Key subcomponents such as blood glucose, blood pressure, and BMI, as well as mental health status, were strongly associated with visual impairment. Conclusion: Higher cardiovascular health scores were negatively associated with visual impairment. LS7 demonstrated the strongest statistical association, whereas LE8 and LC9 were the most influential features in the machine learning models. Blood glucose, blood pressure, BMI, and mental health status were important correlates of visual impairment. From the perspective of the “prevention and treatment of diseases” in traditional Chinese medicine and the holistic concept, the aforementioned research findings confirm that severe visual impairment is indeed an external manifestation of overall health imbalance (such as organ dysfunction and Qi deficiency and blood stasis). The prevention strategy lies in comprehensively adjusting lifestyle, emotional factors, and metabolic indicators (corresponding to the key factors in the study) to restore the body’s internal balance and achieve prevention before disease arises.

ObjectiveTo investigate the mechanism by which Mingshi prescription regulates the retinal melanopsin-dopamine （Opn4-DA） axis in myopic mice to inhibit endoplasmic reticulum （ER） stress in the retina and sclera， thereby delaying axial elongation associated with myopia. MethodsSixty 4-week-old male SPF-grade C57BL/6J mice were randomly divided into a normal group， a form-deprived myopia group （FDM group）， an intrinsically photosensitive retinal ganglion cells ablation group （ipRGCs group）， a Mingshi Prescription group （MSF group， 5.2 g·kg^-1）， and an ipRGCs + MSF group （5.2 g·kg^-1）. Except for the normal group， all other groups underwent FDM modeling. Additionally， the ipRGCs and ipRGCs + MSF groups received retinal ipRGC ablation. Three weeks after modeling， the MSF and ipRGCs + MSF groups were administered Mingshi prescription via continuous gavage for six weeks. After refraction and axial length were measured in all mice， eyeballs were collected along with retinal and scleral tissues. Pathological and morphological changes in the retina， choroid， and sclera were observed using periodic acid-Schiff （PAS） staining. Western blot was employed to detect the relative protein expression levels of dopamine D1 receptor （DRD1）， C/EBP homologous protein （CHOP）， and glucose-regulated protein 78 （GRP78） in the retina， and CHOP and GRP78 in the sclera. Real-time PCR was used to detect the relative mRNA expression of Opn4， CHOP， and GRP78 in the retina， and CHOP and GRP78 in the sclera. Immunofluorescence staining （IF） was performed to detect the expression of Opn4 and DRD1 in retinal tissues. ResultsCompared with the normal group， the FDM group showed a significant myopic shift in refraction （P<0.05） and a significant increase in axial length （P<0.05）. The retinal layers were thinner， the number of ganglion cells was reduced， and collagen fibers in the sclera were loosely arranged with evident gaps. Opn4 and DRD1 protein and mRNA expression in the retina were significantly decreased （P<0.05）， while CHOP and GRP78 protein and mRNA expression in both retinal and scleral tissues were significantly increased （P<0.05）. Compared with the FDM group， the ipRGCs group exhibited further increases in myopic refraction and axial length （P<0.05）， more pronounced thinning and looseness in the retinal， choroidal， and scleral layers， lower expression of Opn4 and DRD1 protein and mRNA in the retina （P<0.05）， and higher expression of CHOP and GRP78 protein and mRNA in the retina and sclera （P<0.05）. Compared with the FDM group， the MSF group showed significantly reduced refractive error and axial length （P<0.05）， with improved cellular number， arrangement， and thickness in ocular tissues， increased Opn4 and DRD1 protein and mRNA expression in the retina （P<0.05）， and reduced CHOP and GRP78 protein and mRNA expression in both retina and sclera （P<0.05）. Similarly， the ipRGCs + MSF group showed significant improvements in terms of the above items compared with the ipRGCs group （P<0.05）. ConclusionMingshi Prescription delays myopic axial elongation and refractive progression by regulating the Opn4-DA axis in the retina of myopic mice， thereby inhibiting ER stress in the retina and sclera. This intervention promotes Qi and blood nourishment of the eyes， softens the fascia， and restores ocular rhythm.

This study proposes a "two-stage" theoretical model for the thermal ablation treatment of thyroid diseases，highlighting its significant value in clinical practice. This theory categorizes thermal ablation treatment into two distinct stages：the treatment intervention stage and the clearance and absorption stage. The treatment intervention stage centers on ablation efficacy，with efficacy quantified by the ablation volume ratio（AVR），which is assessed immediately during the procedure. The clearance and absorption stage focuses on the immune-mediated clearance of necrotic tissue post-operation，with the absorption process characterized by the volume reduction rate（VRR）of the ablation area，evaluated repeatedly over an extended period. Additionally，the study introduces two key concepts：the immediate lesion volume（V 0）prior to ablation and the initial volume（V 1）of the ablation area immediately following the operation. It further develops and optimizes calculation methods for AVR and VRR. By analyzing the essential characteristics of both stages and identifying errors in traditional calculation methods，the study establishes an efficacy evaluation system and an absorption prognosis evaluation framework for thyroid thermal ablation treatment.

This study proposes a "two-stage" theoretical model for the thermal ablation treatment of thyroid diseases，highlighting its significant value in clinical practice. This theory categorizes thermal ablation treatment into two distinct stages：the treatment intervention stage and the clearance and absorption stage. The treatment intervention stage centers on ablation efficacy，with efficacy quantified by the ablation volume ratio（AVR），which is assessed immediately during the procedure. The clearance and absorption stage focuses on the immune-mediated clearance of necrotic tissue post-operation，with the absorption process characterized by the volume reduction rate（VRR）of the ablation area，evaluated repeatedly over an extended period. Additionally，the study introduces two key concepts：the immediate lesion volume（V 0）prior to ablation and the initial volume（V 1）of the ablation area immediately following the operation. It further develops and optimizes calculation methods for AVR and VRR. By analyzing the essential characteristics of both stages and identifying errors in traditional calculation methods，the study establishes an efficacy evaluation system and an absorption prognosis evaluation framework for thyroid thermal ablation treatment.

Objective:To investigate the clinical efficacy of arthroscopic surgery for the treatment of femoral acetabular impingement (FAI) in athletes.Methods:A total of 18 FAI athletes (athlete group) who underwent hip arthroscopy in the Department of Sports Medicine, Peking University Third Hospital from April 2014 to June 2021 were retrospectively analyzed, including 12 males and 6 females, aged 20.44±3.45 years (range, 15-27 years). According to gender, age, body mass index and follow-up time, 36 non-athlete FAI patients (non-athlete group) were matched at a ratio of 1∶2 by propensity score matching method. There were 18 males and 18 females, aged 20.81±4.68 years (range 14-31 years). The hip pain visual analogue scale (VAS), modified Harris hip score (mHHS), hip outcome score-activity of daily living scale (HOS-ADL) and hip outcome score-sports scale (HOS-SS) scores were compared between the two groups before and after surgery. The minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) were also compared between the two groups.Results:All patients successfully completed the surgery and were followed up for 33.56±19.20 months (range, 24-77 months). The VAS score at the last follow-up decreased from 6.22±1.52 points before surgery to 1.28±1.67 points in the athletes group, and decreased from 6.28±1.37 points before surgery to 1.67±1.69 points in the non-athletes group. There was no significant difference between the two groups ( P>0.05). The mHHS score at the last follow-up increased from 65.53±12.90 points before surgery to 92.28±13.59 points in the athletes group, and increased from 61.01±11.96 points before surgery to 86.82±11.98 points in the non-athletes group. There was no significant difference between the two groups ( P>0.05). The HOS-ADL score at the last follow-up increased from 72.77±18.86 points before surgery to 94.00±11.36 points in the athletes group, and increased from 70.35±13.12 points before surgery to 90.78±9.36 points in non-athletes group. There was no significant difference between the two groups ( P>0.05). The HOS-SS score at the last follow-up increased from 49.77±22.93 points before surgery to 87.28±17.62 points in the athletes group, and increased from 44.08±19.66 before surgery to 72.57±20.16 in the non-athletes group. The HOS-SS scores in the athletes group at the last follow-up were higher than those in the non-athletes group ( P<0.05). Furthermore, 61% (11/18) in the athletes group achieved MCID in HOS-ADL after surgery, which was lower than the non-athletes group's 81% (31/36), with a statistically significant difference (χ 2=4.339, P=0.037). Conclusion:Hip arthroscopy in the treatment of FAI in athletes can achieve satisfactory pain relief and motor function.

ObjectiveTo observe the effectiveness and safety of the Chinese herbal medicine Mingshi Granules （明视方颗粒） for low myopia in children with heart yang insufficiency. MethodsA multicentre， prospective， double-blind randomised controlled study was conducted， in which 290 children with low myopia from 8 centres were randomly divided into 145 cases in the treatment group and 145 cases in the control group， and the treatment group was given education， dispensing glasses， and Chinese herbal medicine Mingshi Granules， while the control group was given education， dispensing glasses， and granules placebo. Both Mingshi Granules and placebo granules were taken orally， 1 bag each time， twice daily， 4 weeks of oral intake and 2 weeks of rest as 1 course of treatment， a total of 4 courses of treatment （24 weeks）. Equivalent spherical lenses， best naked-eye distance visual acuity， ocular axis， corneal curvature K1， adjustment amplitude， traditional Chinese medicine （TCM） symptom scores， calculate the amount of progression of equivalent spherical lenses， were observed at the 12th and the 24th week of treatment， at the 36th week and 48th week of follow-up， resectively， the control rate of myopia progression was evaluated at the 24th week， and safety indexes were observed before treatment. ResultsThe amount of progression of equivalent spherical lenses was lower in the treatment group than in the control group at the 48-week follow-up （P＜0.05）. The control rate of myopia progression at 24 weeks after treatment in the treatment group was higher （57.60%， 72/125） than that in the control group （44.63%， 54/121） （P＜0.05）. The best naked-eye distance visual acuity at 36-week follow-up in the treatment group was higher than that in the control group （P＜0.05）. Equivalent spherical lenses were significantly lower in both groups at all observation time points compared with pre-treatment （P＜0.05）， and were higher in the treatment group than in the control group at the 48-week follow-up （P＜0.05）. The ocular axes of both groups were significantly higher at each observation time point after treatment and at follow-up compared with before treatment （P＜0.05）. The amount of eye axis growth in the treatment group was lower than that in the control group at 24 weeks after treatment and at the 48-week follow-up （P＜0.05）. Corneal curvature K1 was significantly lower in the treatment group at the 24th week of treatment compared to pre-treatment （P＜0.05）. The magnitude of adjustment in the treatment group was significantly higher at the 36-week follow-up and at the 48-week follow-up than before treatment （P＜0.05）. The scores of white/dark complexion， white coating thin pulse， fatigue and total TCM symptom scores of children in both groups at the 12th， 24th， 36th and 48th weeks of follow-up were significantly lower than those before treatment （P＜0.05）； the scores of blurred vision at the 24th and 36th weeks of follow-up were significantly lower than those before treatment （P＜0.05）； and the scores of blurred vision in the treatment group at the 48th week of follow-up were signi-ficantly lower than those before treatment （P＜0.05）. In the treatment group， the score of fatigue was higher than that of the control group at the 36-week follow-up， and the score of blurred vision was lower than that of the control group at the 48-week follow-up （P＜0.05）. No adverse reactions or obvious abnormalities of the safety indexes were observed of the two groups during the treatment. ConclusionChinese herbal medicine Mingshi Granules showed the effect of controlling the progression of low myopia， improving the best naked eye distance visual acuity， slowing down the growth of the eye axis， improving some of the TCM symptoms， with good safety.

Diabetic retinopathy(DR)is one of the major complications of diabetes mellitus, characterized by neurodegeneration and microangiopathy. Currently, the treatment of DR is mainly focused on the management of late complications and has not achieved the desired clinical outcome. Evidence suggests that the PI3K/AKT pathway, as one of the important intracellular signaling pathways during the cell cycle, is involved in the whole process of DR pathogenesis. This article focuses on the structural composition, activation and blocking pathways, conduction pathways, regulatory mechanisms and biological functions of the PI3K/AKT signaling pathway to review its role in DR and to explore the potential of targeting the PI3K/AKT pathway for the treatment of DR.

Femoral acetabular impingement (FAI) is a condition characterized by abnormal anatomical structures of the femoral head and/or acetabulum, leading to impingement between the proximal femur and the rim of the acetabulum during hip movement. This impingement causes damage to the acetabular cartilage, labrum, chronic hip pain, and limited range of motion. The diagnosis of this condition requires evaluation based on symptoms, physical signs, and imaging examinations. Among these, imaging plays a crucial role in assessing the pathology of FAI. In recent years, imaging techniques have contributed to a deeper understanding of the mechanisms underlying FAI and the development of hip-preserving surgeries. The purpose of this paper is to provide a reference for the imaging-related diagnosis and measurement of FAI. X-ray films include pelvic anteroposterior view, false-profile view and 45°Dunn view. Doctors can understand the anatomical morphology of the femur and acetabulum by measuring relevant indicators in the X-ray films. For example, the α Angle of the femur >50°-60 ° in the pelvic anteroposterior view can indicate CAM-type FAI. However, the crisscross sign, posterior wall sign and LCE Angle >40° suggest Pincer type FAI. The ACE Angle, which reflects the anterior coverage of the acetabulum, was mainly measured on the false-profile view. The ACE Angle <20° is considered as insufficient anterior acetabular coverage, and acetabular dysplasia may be present.If it >40° is the anterior acetabular overcoverage, suggesting pincer-type FAI. The 45°Dunn view is mainly used to show the femoral head and neck deformity at 3 o'clock, where the femoroacetabular impingement is obvious. This position has a good indication effect for CAM-type FAI. CT can show the shape of the hip joint more intuitively by three-dimensional reconstruction of the patient's hip joint, which is convenient for surgical planning and postoperative evaluation. In addition, CT can also be used for the differential diagnosis of external hip impingement, such as ischiofemoral impingement, anterior inferior iliac spine impingement and greatertrochanteric impingement. MR Has excellent soft tissue imaging ability and can show other lesions that are difficult to be found by X-ray and CT, such as acetabular labrum and cartilage injury. It is essential for preoperative evaluation. Appropriate imaging examination plays a key role in the diagnosis and treatment of FAI.

Objective:To investigate the adverse reactions and postoperative inflammatory reactions of Bill-Roth Ⅱ (BⅡ) gastroenterostomy with jejunal anastomosis and jejunal nutrient tube placement using linear cutting and closing device in gastric cancer surgery.Methods:A retrospective case-control study was conducted on 93 patients undergoing gastric cancer surgery in The Affiliated Hospital of North China University of Science and Technology from February 2017 to April 2020. According to 2016 (American Joint Committee on Cancer/Universal Integrated Circuit Card) AJCC/UICC, (Tumor, Node, stage; Tumor lymph node metastasis; Distant metastasis) TNM, there were 11 cases in stage ⅠA, 14 cases in stage ⅠB, 13 cases in stage ⅡA, 15 cases in stage ⅡB, 11 cases in stage ⅢA, 13 cases in stage ⅢB, and 16 cases in stage ⅢC. There were 51 cases of gastric antrum carcinoma, 26 cases of gastric body carcinoma and 16 cases of gastric pylorus carcinoma. There were 27 cases of papillary adenocarcinoma, 26 cases of tubular adenocarcinoma, 22 cases of mucinous adenocarcinoma, 9 cases of signet-ring cell carcinoma, 7 cases of adenosquamous carcinoma, and 2 cases of squamous carcinoma. The patients were divided into experimental group (48 cases) and control group (45 cases) according to whether or not the linear cutting and closing device was added and jejunal anastomosis was performed and jejunal nutrition tube was placed. The gender composition, age, lesion site, pathological type, pathological stage, postoperative hospital stay and postoperative complications were compared between the two groups, and the white blood cell count WBC, C-reactive protein CRP on the 7th day after surgery, erythrocyte Sedimentation rate (ESR), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) inflammation indicators were compared between the two groups.Results:There was no significant difference in gender composition, age, lesion location, pathological type and pathological stage between the two groups (all P>0.05). The incidence of abdominal pain, abdominal distension, nausea, vomiting and pleural effusion in 93 patients were 18.3%(17/93), 21.5%(20/93), 23.7%(22/93), 17.2%(16/93) and 18.3%(17/93), respectively. The complication rates of the above indexes in the two groups were 10.4% (5/48) Compared with 26.7% (12/45), 12.5% (6/48) and 31.1% (14/45), 15.6%(7/48) and 33.3% (15/45), 8.3%(4/48) and 26.7% (12/45), 8.3% (4/48) and 28.9% (13/45) (χ 2 values were 4.11, 4.77, 4.52, 4.27 and 5.27, respectively; P values were 0.043, 0.029, 0.033, 0.039 and 0.022, respectively). There was no significant difference in lower extremity venous thrombosis, anastomotic bleeding, accumulated pneumonia and incision dehiscence between the two groups ( P>0.05). WBC on the 7th day after operation in the experimental group and the control group (7.02±1.83)×10 9/L and (8.39±2.27)×10 9/L ( t=3.22, P=0.002), TNF-α (2.44±0.70) μg/L and (3.56±1.14) μg/L ( t=5.71, P<0.001), IL-6 (235.31±41.72) μg/L and (365.91±73.16) μg/L ( t=10.66, P<0.001) there was significant difference between the two groups. There was no significant difference in CRP and ESR between the two groups on the 7th day after operation ( P>0.05). The postoperative hospital stay between the experimental group and the control group was (13.88±2.81) d and (22.78±2.51) d, the difference was statistically significant ( t=16.07, P<0.001). Conclusion:The application of side-to-side jejunostomy combined with jejunal nutrition tube for enteral nutrition in gastric cancer surgery can reduce the occurrence of adverse reactions such as postoperative abdominal pain, abdominal distension, accumulated pneumonia, nausea, vomiting and pleural effusion, reduce the postoperative hospital stay and reduce the postoperative inflammatory reaction to a certain extent.

Management of bone defects caused by fractures，bone tumors or infections is clinically difficult as well as a hot topic in current studies. With further researches over bone defects，the construction of tissue-engineered bone has played a great role in the treatment of bone defects. Blood vessels not only provide the necessary nutritional mineral salts，growth factors，hormones for bone formation，also are able to mediate the interaction among osteoblasts and osteoclasts，osteocytes，bone autonomic nerve and endothelial cells，since bone formation exist spatially and temporally connection with angiogenesis. Therefore，the authors make a systematic literature review on the research progress of the coupling mechanism of angiogenesis and osteogenic differentiation，blood vessels and related signal pathways on osteogenic differentiation and angiogenesis-related molecules in osteogenic differentiation during the process of traumatic bone defects，so as to provide new ideas for the treatment of bone defects.