Cardiovascular diseases is the leading cause of threat to human life and health worldwide. Early risk assessment, timely diagnosis, and prognosis evaluation are critical to the treatment of cardiovascular diseases. Currently, the evaluation of diagnosis and prognosis of cardiovascular diseases mainly relies on imaging examinations such as coronary CT and coronary angiography, which are expensive, time-consuming, partly invasive, and require high professional competence of the operator, making it difficult to promote in the community or in areas where medical resources are scarce. The fundus microcirculation is a part of the human microcirculation and has similar embryological origins and physiopathological features to cardiovascular circulation. Several studies have revealed fundus imaging biomarkers associated with cardiovascular diseases, and developed and validated intelligent diagnosis and treatment models for cardiovascular diseases based on fundus imaging data. Fundus imaging is expected to be an important adjunct to cardiovascular disease diagnosis and treatment given its noninvasive and convenient nature. The purpose of this review is to summarize the current research status, challenges, and future prospects of the application of artificial intelligence based on multimodal fundus imaging data in cardiovascular disease diagnosis and treatment.

Previously, the diagnosis of schizophrenia was empirical since it relied on the patient′s subjective symptoms and the practitioner′s clinical experience. There is an urgent need for objective and reproducible assessment tools to aid its diagnosis. Changes in brain structure and function are closely related to the development of schizophrenia. The retina, a part of the central nervous system, is highly similar to the brain morphologically and neurophysiologically and can be assessed by a non-invasive and convenient fundus examination. There have been studies using optical coherence tomography, fundus photography, optical coherence tomography angiography, and electroretinography to identify significant changes in the structure and function of the fundus in patients with schizophrenia. However, there is still a lack of generalization in these studies. This article summarises and discusses the findings in this area and presents a vision for future studies to explore the application value of fundus in the management of schizophrenia.

Previously, the diagnosis of schizophrenia was empirical since it relied on the patient′s subjective symptoms and the practitioner′s clinical experience. There is an urgent need for objective and reproducible assessment tools to aid its diagnosis. Changes in brain structure and function are closely related to the development of schizophrenia. The retina, a part of the central nervous system, is highly similar to the brain morphologically and neurophysiologically and can be assessed by a non-invasive and convenient fundus examination. There have been studies using optical coherence tomography, fundus photography, optical coherence tomography angiography, and electroretinography to identify significant changes in the structure and function of the fundus in patients with schizophrenia. However, there is still a lack of generalization in these studies. This article summarises and discusses the findings in this area and presents a vision for future studies to explore the application value of fundus in the management of schizophrenia.

Sudden sensorineural hearing loss (SSNHL) refers to the sudden and unexplained sensorineural hearing loss within 72 h and a decrease in hearing of ≥30 dB affecting at least 3 consecutive frequencies. It is one of the common emergencies in neurology and otolaryngology. Early etiological evaluation and systematic and targeted treatment are very important for delaying the progression of SSNHL and restoring hearing. Recent studies have shown that SSNHL overlaps with vascular risk factors of ischemic stroke, and may predict the risk of ischemic stroke. SSNHL may be one of the clinical manifestation and even the prodromal symptoms of ischemic stroke, especially the infarction of the blood supply area of the anterior inferior cerebellar artery or its branch internal auditory artery. Although these factors can not fully reveal the relationship between SSNHL and ischemic stroke, they are enough to warn clinicians that they should consider the possibility of ischemic stroke when receiving patients with SSNHL. Screening of vascular risk factors for patients with SSNHL as early as possible is helpful to avoid the risk of recurrence of ischemic stroke.

Objective:To investigate the frequency and severity of systemic adverse reactions in children with allergic rhinitis (AR) undergoing subcutaneous immunotherapy (SCIT).Methods:The clinical data of 321 children with allergic rhinitis receiving SCIT at Department of Otorhinolaryngology, Changzhou Third People′s Hospital from January 2016 to January 2020 were retrospectively analyzed. There were 180 boys and 141 girls aged 5 to 14 years. Patients were injected subcutaneously with standardized dust mites allergen extract. The onset time, symptoms and signs and treatment of adverse reactions were documented. The relationship of adverse reactions with gender, age, treatment course and dosage of allergen injection were analyzed.Results:Patients received total 13 053 injections, and 115 adverse reactions (0.88%) occurred in 56 cases (17.45%). The incidence of adverse reactions in children aged 5-9 years was higher than in those aged 10-14 years, for both the number of cases and injections (χ2=4.41, P=0.04; χ2=9.13, P<0.01), but no significant differences were observed in gender of patients. The incidence of adverse reactions in the age group 2-3 years was lower than that in age groups<1 year and 1-<2 years in both of cases and injections (χ2=22.86, P<0.01; χ2=6.43, P=0.01; χ2=12.14, P<0.01; χ2=13.74, P<0.01). The incidence of adverse reactions in the high-dosage phase (100 000 SQ-U) was higher than that in the low-dosage phase (<100 000 SQ-U) (χ2=4.35, P=0.04). Conclusions:The study shows that the incidence of adverse reactions in children with allergic rhinitis receiving subcutaneous immunotherapy is less than 1% in the number of injections and most of them are grade Ⅰ adverse reactions. The study also shows that younger age, the early course of treatment and the high dosage of allergens are risk factors for adverse reactions.

Objective:To understand the occurrence of systemic adverse reactions in patients with simple allergic rhinitis (AR) after receiving subcutaneous immunotherapy (SCIT) with standardized dicid allergen injection.Methods:The clinical data of AR patients who completed the whole course of SCIT with standardized mite allergen injection in AR Diagnosis and Treatment Center in Department of Otolaryngology, the Third People′s Hospital of Changzhou from August 1st, 2015 to July 31st, 2020 were analyzed retrospectively. The course of SCIT was 156 weeks, comprising 4 stages. The first 14 weeks was the dose increase phase, in which standardized mite allergen injection was given once a week and the dose was gradually increased from 5 TU in the 1st week to 5 000 TU in the 14th week; the weeks 15-52, 53-104, and 105-156 were the dose maintenance phase, in which the injection was given once every 5 weeks at the dose of 5 000 TU. According to the number of injections, the incidence of systemic adverse reactions in patients of different gender and age at different stages of the course of treatment and after injection at different doses were counted, and the types [according to the time of occurrence, the adverse reactions were divided into immediate type(≤30 min) and delayed type(>30 min)], classification (grade 1-5), clinical manifestations, and outcome of adverse reactions were analyzed.Results:A total of 302 patients were enrolled in the study, including 175 males and 127 females, aged from 5 to 60 years. Of them, 187 patients were ≤14 years old and 115 were>14 years old. Three hundred and two patients received 13 687 subcutaneous injections totally and 46 patients in 120 times of injection had systemic adverse reactions. The incidence of adverse reactions was 15.23% (46/302) according to the number of cases and 0.88% (120/13 687) according to the number of injections. Among the 120 times of systemic adverse reactions, 55 (45.83%) were immediate type and 65 (54.17%) were delayed type. The adverse reactions belonged to grade 1 in 94 times of injections (78.33%, mainly manifested as nasal itching, eye itching, cough, pruritus, etc), grade 2 in 23 times of injections (19.17%, mainly manifested as asthma, diarrhea, etc), and grade 3 in 3 times of injections (2.50%, 2 mainly manifested as no response to inhaled bronchodilator and 1 as laryngeal edema). There was no significant difference in the incidences of systemic adverse reactions between the male and female patients [0.94% (76/8 091) vs. 0.79% (44/5 596), χ2=0.89, P=0.35]. The incidence of systemic adverse reactions in patients ≤14 years old was higher than that in patients >14 years old [1.14% (97/8 536) vs. 0.45% (23/5 151), χ2=17.59, P<0.01]. The incidence of systemic adverse reactions in weeks 16-52 [1.86% (40/2 153) ] was higher than those in the first 14 weeks [0.99% (51/5 169)], weeks 53-104 [0.72% (23/3 194) ], and weeks 105-156 [0.19% (6/3 171) ], and the differences were statistically significant ( χ2=9.40, P<0.01; χ2=14.30, P<0.01; χ2=41.69, P<0.01). The incidence of systemic adverse reactions at the injection dose o f <5 000 TU was higher than that at the injection dose of 5 000 TU [1.11% (51/4 579) vs. 0.76% (69/9 108) , χ2=4.45, P=0.04]. The systemic adverse reactions were self-relieved or could be relieved after the intervention and the outcome was good. Conclusions:The incidence of systemic adverse reactions in AR patients who completed the whole course of SCIT with standardized dicid allergen injection was 0.88%, which mainly belonged to grade 1 adverse reactions. Children of ≤14 years old, during the week 16 to 52 of treatment, at the injection dose of <5 000 TU were more likely to have systemic adverse reactions.

Objective:To understand the occurrence of systemic adverse reactions in patients with simple allergic rhinitis (AR) after receiving subcutaneous immunotherapy (SCIT) with standardized dicid allergen injection.Methods:The clinical data of AR patients who completed the whole course of SCIT with standardized mite allergen injection in AR Diagnosis and Treatment Center in Department of Otolaryngology, the Third People′s Hospital of Changzhou from August 1st, 2015 to July 31st, 2020 were analyzed retrospectively. The course of SCIT was 156 weeks, comprising 4 stages. The first 14 weeks was the dose increase phase, in which standardized mite allergen injection was given once a week and the dose was gradually increased from 5 TU in the 1st week to 5 000 TU in the 14th week; the weeks 15-52, 53-104, and 105-156 were the dose maintenance phase, in which the injection was given once every 5 weeks at the dose of 5 000 TU. According to the number of injections, the incidence of systemic adverse reactions in patients of different gender and age at different stages of the course of treatment and after injection at different doses were counted, and the types [according to the time of occurrence, the adverse reactions were divided into immediate type(≤30 min) and delayed type(>30 min)], classification (grade 1-5), clinical manifestations, and outcome of adverse reactions were analyzed.Results:A total of 302 patients were enrolled in the study, including 175 males and 127 females, aged from 5 to 60 years. Of them, 187 patients were ≤14 years old and 115 were>14 years old. Three hundred and two patients received 13 687 subcutaneous injections totally and 46 patients in 120 times of injection had systemic adverse reactions. The incidence of adverse reactions was 15.23% (46/302) according to the number of cases and 0.88% (120/13 687) according to the number of injections. Among the 120 times of systemic adverse reactions, 55 (45.83%) were immediate type and 65 (54.17%) were delayed type. The adverse reactions belonged to grade 1 in 94 times of injections (78.33%, mainly manifested as nasal itching, eye itching, cough, pruritus, etc), grade 2 in 23 times of injections (19.17%, mainly manifested as asthma, diarrhea, etc), and grade 3 in 3 times of injections (2.50%, 2 mainly manifested as no response to inhaled bronchodilator and 1 as laryngeal edema). There was no significant difference in the incidences of systemic adverse reactions between the male and female patients [0.94% (76/8 091) vs. 0.79% (44/5 596), χ2=0.89, P=0.35]. The incidence of systemic adverse reactions in patients ≤14 years old was higher than that in patients >14 years old [1.14% (97/8 536) vs. 0.45% (23/5 151), χ2=17.59, P<0.01]. The incidence of systemic adverse reactions in weeks 16-52 [1.86% (40/2 153) ] was higher than those in the first 14 weeks [0.99% (51/5 169)], weeks 53-104 [0.72% (23/3 194) ], and weeks 105-156 [0.19% (6/3 171) ], and the differences were statistically significant ( χ2=9.40, P<0.01; χ2=14.30, P<0.01; χ2=41.69, P<0.01). The incidence of systemic adverse reactions at the injection dose o f <5 000 TU was higher than that at the injection dose of 5 000 TU [1.11% (51/4 579) vs. 0.76% (69/9 108) , χ2=4.45, P=0.04]. The systemic adverse reactions were self-relieved or could be relieved after the intervention and the outcome was good. Conclusions:The incidence of systemic adverse reactions in AR patients who completed the whole course of SCIT with standardized dicid allergen injection was 0.88%, which mainly belonged to grade 1 adverse reactions. Children of ≤14 years old, during the week 16 to 52 of treatment, at the injection dose of <5 000 TU were more likely to have systemic adverse reactions.

Blood pump is the core component of artificial ventricular assist device, and thrombosis is a severe complication of blood pump in clinical application. Methods of controlling and reducing thrombosis include materials surface modification, structure and parameters optimization of blood pump, and others. The typical symptoms of thrombosis and the hazard of various types of blood pump, the formation mechanism and primary factors for thrombosis, and the simulation prediction models for thrombosis were reviewed in this paper.

Objective:To investigate the frequency and severity of systemic reactions (SRs) to standardized house dust mite subcutaneous immunotherapy (SCIT) in patients with perennial allergic rhinitis (AR), and to analyze the clinical risk factors.Methods:The clinical data of 362 patients including 209 males and 153 females, aged from 5 to 55 years old receiving SCIT at the Department of Otorhinolaryngology, the Third People′s Hospital of Changzhou were collected from May 2014 to July 2017. The SRs were classified as early-onset and delayed-onset, and 4 grades (grade Ⅰ to Ⅳ) to assess severity. The records of SRs were retrospectively analyzed, including the numbers/frequencies, symptoms and signs, onset of reaction and treatment. And the relationships between SRs and patient′s age, gender, allergen injection dose, accompanied allergic diseases were explored. All the statistical analyses were conducted using SPSS 19.0.Results:There were 57 cases (15.75%) of SRs in 362 patients. All the patients received a total of 12 308 injections and 111 SRs (0.90%) were observed. Among them, 31 (27.93%) were early-onset reactions and 80 (72.07%) were delayed-onset reactions; most of the SRs were grade Ⅰ reactions ( n=83, 74.78%), followed by grade Ⅱ ( n=25, 22.52%), grade Ⅲ ( n=3, 2.70%), and no fatal reactions occurred. The incidence of SRs in patients>14 years old was higher than that in patients ≤14 years old according to the number of cases and injections (35.14% vs 13.54%, 2.34% vs 0.76%, χ 2 value was 11.679, 28.162, respectively, all P<0.05), but no significant differences of SRs were observed in gender (18.66% vs 11.76%, 5.98% vs 5.62%, χ 2 value was 3.166, 0.095, respectively, all P>0.05). Fifteen SRs (13.51%) occurred during the build-up phase and 96 (86.49%) during the maintenance phases. SRs could occur in lots of dose phases, and 95 (85.59%) were distributed at high concentrations more than 40 000 SQ-U. The incidence of SRs in patients with multiple allergic diseases was significantly higher than that in patients with AR alone, with asthma or atopic dermatitis (30.67% vs 11.85%, χ 2=15.875, P<0.001). Meanwhile, the incidence of SRs in patients with pure AR was also significantly lower than that in patients with other allergic diseases (5.26% vs 20.56%, χ 2=13.783, P<0.001). Conclusions:The incidence of SRs is less than 1% according to the injection times, the severity of SRs is mostly slight, and the safety and tolerance are good during standardized house dust mite SCIT in perennial AR patients. Delayed-onset SRs are more common. The incidence of SRs is significantly correlated with age, high dose of allergen vaccine injection, and concomitant other allergic diseases (asthma, atopic dermatitis, etc).

Objective To evaluate the safety,feasibility of the application of "four-quadrant" tumor target-artery positioning in "zero-ischemia" retroperitoneal laparoscopic partial nephrectomy.Methods A retrospective study was conducted on 25 patients who underwent retroperitoneal laparoscopic partial nephrectomy from November 2016 to March 2017 by single surgeon.There were 15 males and 10 females with a mean age of (52.6 ± 11.9) years old.The mean diameter of the tumor was (3.8 ± 0.5) cm.The mean R.E.N.A.L.score was (9.0±1.3).The mean GFR of the operation side was (49.2±11.4) ml/(min · 1.73 m2) before the operation.All 25 patients underwent 3 Dimentional CT for the reconstruction of their renal models.The tumor target-artery was located in "four-quadrant" system,which based on the boundary between tumor and renal parenchyma.Perioperative outcomes including the estimated blood loss (EBL),operation time,complications and oncological outcomes were carefully collected and analyzed.Results Of all the 25 patients,21 patients underwent "zero-ischemia" retroperitoneal laparoscopic partial nephrectomy,the mean operation time was (106.1 ± 18.8) min,the mean EBL was (162.2 ±68.0) ml with no transfusion case.4 patients converted to conventional retroperitoneal laparoscopic partial nephrectomy,the operation time was 110-140 min,the EBL was 350-500 ml and the warm-ischemia time was 12-20 min respectively.The pathological outcome shows renal cell carcinoma in 24 patients and papillary renal cell carcinoma in 1 patient with all negative margins.The mean GFR of the operation side was (45.1 ± 10.2) ml/(min · 1.73 m2) after three months of the surgery and shows no statistical difference (P =0.268).Conclusion The application of the "four-quadrant" tumor target-artery positioning in " zeroischemia" retroperitoneal laparoscopic partial nephrectomy is a safety and feasible method in terms of accurate location of the target-artery,better postoperative renal function,low EBL and reasonable oncological outcomes.