AIM: To investigate the decentration of the treatment zone(TZ)and the early impact on corneal higher-order aberrations(HOAs)induced by orthokeratology(OK)lenses fitted with digital corneal topography.METHODS: A retrospective longitudinal clinical study was conducted on 28 patients(28 right eyes)who were digitally fitted with OK lenses at the Laser Vision Center of Xi'an No.1 Hospital since 2023. Longitudinal measurements were taken at baseline, 1 wk, 1 and 3 mo post-treatment to assess changes in TZ diameter, decentration magnitude and direction. Furthermore, changes in corneal HOAs were observed, and correlations of decentration with each HOAs were also analyzed.RESULTS: The mean age of patients was 10.29±2.00 years, with 15 males and 13 females, and the average baseline spherical equivalent was -2.92±0.94 D. The average TZ diameters at 1 wk, 1, and 3 mo were 3.64±0.58, 3.83±0.57, and 3.69±0.55 mm, respectively, with no statistically significant differences between 1 wk and 3 mo. Horizontal decentration values were -0.43±0.28, -0.38±0.33, and -0.31±0.37 mm after wearing lenses for 1 wk, 1 and 3 mo, respectively, while vertical decentration values were -0.33±0.20, -0.33±0.23, and -0.36±0.23 mm across the same time points. The TZ consistently decentered inferotemporally, and changes in both horizontal and vertical decentration over time were not statistically significant(Fhorizontal=1.416, Phorizontal=0.252; Fvertical=0.126, Pvertical=0.882). Significant increases in total corneal HOAs, coma, and spherical aberration were observed at 5 mm optical zone post-wear(F=45.695, 33.401, and 45.091, all P<0.001). Vertical decentration at 1 wk and 1 mo was negatively correlated with total HOAs and coma(all P<0.05), while horizontal decentration at 3 mo showed a weak negative correlation with spherical aberration(P=0.037).CONCLUSION: Digitally-fitted OK lenses achieved stable TZ diameter by 1 wk post-wear, with minor inferotemporal decentration. Early post-wear corneal total HOAs, coma and sphercal aberration increased significantly, and vertical downward decentration was associated with elevated total HOAs and coma. However, correlations between decentration and HOAs weakened by 3 mo.

Objective To retrospectively analyze multicenter data from domestic sources, aiming to explore the link between intrahepatic cholangiocarcinoma (ICC) tumor size and prognosis, establishing a classification system based on tumor size. Methods Between December 2011 and September 2018, 280 ICC patients from 13 hospitals were included. The tumor size prognosis cutoff was identified by the minimum P-value method, and the classification's overall survival related effectiveness was assessed by Kaplan-Meier analysis. Results All 280 patients were divided into the group of tumor maximum diameter ≤4 cm and >4 cm. Tumor size was confirmed as an independent prognosis factor by multivariate COX regression analysis (HR=2.110, 95% CI: 1.358-3.280). Conclusions The tumor size dichotomy classification system based on the Chinese patient group can expediently predict ICC prognosis and offers an important basis for selecting post-operative individualized adjuvant therapy and follow up plans.

Objective To analyze the effects of the histone deacetylase inhibitor suberoylanilide hydroxamic acid(SAHA)on the secondary metabolites of the entomopathogenic fungus Samsoniella hepiali CDB9-31 using thin-layer chromatography(TLC)and high-performance liquid chromatography(HPLC).Methods The fermentation products of Samsoniella hepiali CDB9-31 treated with epigenetic modifiers were separated and purified using methods such as silica gel column chromatography,Sephadex column chromatography and reversed-phase column chromatography.The structures of the compounds were elucidated using modern spectroscopic analysis methods.The antimicrobial activity of the obtained monomeric compounds was determined using the filter paper disc diffusion method.Results The TLC and HPLC analyses of its fermentation extracts revealed that SAHA could induce the strain to produce more diverse array of secondary metabolites,and 11 monomeric compounds were isolated and identified as follows:N'-phenyloctanediamide(1),5-Phenylcarbamoyl-pentanoic(2),ergosterol(3),5,8-Epidioxy-5α,8α-ergosta-6,22E-diene-3β-ol(4),1-monolinolein(5),(4E,8E)-2-N-(2-Hydro-xypalmitoyl)-1-O-(β-D-glucopyranosyl)-9-methyl-4,8-sphingadienine(6),Ergosterol peroxide 3-O-β-D-glucopyranoside(7),(22E,24R)-7,22-diene-3β,5α,6β-ergostatriol(8),(2S,2'R,3R,4E,8E)-N-2'-Hydroxyhexadecanoyl-2-amion-9-methyl-4,8-octadecadiene-1,3-diol(9),Adenosine(10),D-Glulopyranose(11).Compounds 1 and 2 were derivatives of SAHA,and it was speculated that the special metabolic environment of CDB9-31 caused the biotransformation of SAHA.Except for compound 3,all other compounds were isolated from this genus for the first time.The antibacterial activity results showed that six of these compounds exhibited varying degrees of inhibitory effects against at least one pathogenic bacterium.Conclusion This study has enriched the chemical diversity of secondary metabolites from the entomopathogenic fungus Samsoniella hepiali.

BACKGROUND:Pulsed electromagnetic fields,as an important physical therapy,are exactly effective in the treatment of osteoarthritis,but the mechanism has not been fully clarified. OBJECTIVE:To observe the effect of pulsed electromagnetic field on the degeneration of knee joint cartilage in aged rats. METHODS:Eight 6-month-old Sprague-Dawley rats were selected as the young group and were subjected to normal diet with no treatment.Sixteen 22-month-old Sprague-Dawley rats were randomly divided into old group(n=8)and pulsed electromagnetic field group(n=8).The rats in the pulsed electromagnetic field group were subjected to a pulsed electromagnetic field intervention,once a day,5 days per week for continuous 8 weeks.The rats in the old group were given no treatment.All rats were anesthetized and executed after 8 weeks for the detection of relevant indexes. RESULTS AND CONCLUSION:Compared with the young group,serum type Ⅱ collagen C-terminal peptide level was increased in the old group(P<0.05);compared with the old group,serum type Ⅱ collagen C-terminal peptide level was decreased in the pulsed electromagnetic field group(P<0.05).Micro-CT showed that the bone volume fraction,bone mineral density,and number of bone trabeculae decreased(P<0.05)and the trabecular separation increased(P<0.05)in the tibia of rats in the aged group compared with the young group;and the bone volume fraction,bone density,and number of trabeculae increased(P<0.05)and the trabecular separation decreased(P<0.05)in the tibia of rats in the pulsed electromagnetic field group compared with the aged group.The tibial plateau Safranin O-fast green staining showed that the articular cartilage structure of rats in the aged group was disorganized,and the number of chondrocytes was obviously reduced,and the tidal line could not be distinguished.The above results were improved in the pulsed electromagnetic field group.RT-qPCR and western blot assay showed that the mRNA and protein expression levels of matrix metalloproteinase 1,matrix metalloproteinase 13,P53 and P21 in the articular cartilage and subchondral bone of rats were elevated in the aged group compared with the young group(P<0.05)and decreased in the pulsed electromagnetic field group compared with the old group(P<0.05).To conclude,pulsed electromagnetic fields may improve osteoarthritis in aged rats by inhibiting chondrocyte senescence,alleviating articular cartilage degradation and inhibiting subchondral bone osteoporosis through suppressing the expression of P53/P21.

Objective:To explore the incidence of sudden deafness accompanied with tinnitus, the selection of examination protocols and treatment, and to provide reference for the establishment of new guidelines for sudden deafness.Methods:CiteSpace software was used for analysis and data mining to analyze and summarize the computer-retrieved articles on diagnostic examination and treatment of sudden deafness accompanied with tinnitus collected from CNIC, Wanfang and Web of Science databases from 2011 to 2021.Results:A total of 207 randomized controlled studies were retrieved in this study, including 121 in Chinese and 86 in English. Finally, 74 Chinese literatures and 16 English literatures were included. Among the 74 valid Chinese literatures, 64 (86.5%) were accompanied with tinnitus, 58 (78.4%) with dizziness/vertigo, 25 (33.8%) with aural fullness, 10 (13.5%) with headache, 4 (5.4%) with insomnia, 4 (5.4%) with a mixture of dizziness and tinnitus, and 2 (2.7%) with vomiting. Among the 16 English literatures, 15 (93.8%) were accompanied with tinnitus, 12 (75.0%) with vertigo, 1 (6.3%) with aural fullness, and 1 (6.3%) with a mixture of various symptoms. Among the 64 Chinese articles mentioning tinnitus, only 9 mentioned tinnitus matching tests, and 1 mentioned that the treatment for tinnitus accompanying symptoms was sound therapy and psychological counseling. The incidence rates of tinnitus accompanying four different types of sudden deafness, from low to high, are as follows: low-to-mid frequency, 82.4%; mid-to-high frequency, 90.7%; complete deafness, 92.4%; and flat type, 92.8%.Conclusion:Tinnitus is the most common accompanying symptom of sudden deafness, and tinnitus matching test is an effective evaluation method. When establishing a scientific, comprehensive, and systematic diagnosis and treatment system or guidelines for sudden deafness, attention should be paid to the diagnosis and treatment of tinnitus symptoms and their adverse psychological reactions, in order to reduce the incidence of tinnitus patients in the later stage of recovery from sudden deafness.

Objective To identify the biomarkers for early rheumatoid arthritis(RA)diagnosis and explore the possible immune regulatory mechanisms.Methods The differentially expressed genesin RA were screened and functionally annotated using the limma,RRA,batch correction,and clusterProfiler.The protein-protein interaction network was retrieved from the STRING database,and Cytoscape 3.8.0 and GeneMANIA were used to select the key genes and predicting their interaction mechanisms.ROC curves was used to validate the accuracy of diagnostic models based on the key genes.The disease-specific immune cells were selected via machine learning,and their correlation with the key genes were analyzed using Corrplot package.Biological functions of the key genes were explored using GSEA method.The expression of STAT1 was investigated in the synovial tissue of rats with collagen-induced arthritis(CIA).Results We identified 9 core key genes in RA(CD3G,CD8A,SYK,LCK,IL2RG,STAT1,CCR5,ITGB2,and ITGAL),which regulate synovial inflammation primarily through cytokines-related pathways.ROC curve analysis showed a high predictive accuracy of the 9 core genes,among which STAT1 had the highest AUC(0.909).Correlation analysis revealed strong correlations of CD3G,ITGAL,LCK,CD8A,and STAT1 with disease-specific immune cells,and STAT1 showed the strongest correlation with M1-type macrophages(R=0.68,P=2.9e-08).The synovial tissues of the ankle joints of CIA rats showed high expressions of STAT1 and p-STAT1 with significant differential expression of STAT1 between the nucleus and the cytoplasm of the synovial fibroblasts.The protein expressions of p-STAT1 and STAT1 in the cell nuclei were significantly reduced after treatment.Conclusion CD3G,CD8A,SYK,LCK,IL2RG,STAT1,CCR5,ITGB2,and ITGAL may serve as biomarkers for early diagnosis of RA.Gene-immune cell pathways such as CD3G/CD8A/LCK-γδ T cells,ITGAL-Tfh cells,and STAT1-M1-type macrophages may be closely related with the development of RA.

Objective To identify the biomarkers for early rheumatoid arthritis(RA)diagnosis and explore the possible immune regulatory mechanisms.Methods The differentially expressed genesin RA were screened and functionally annotated using the limma,RRA,batch correction,and clusterProfiler.The protein-protein interaction network was retrieved from the STRING database,and Cytoscape 3.8.0 and GeneMANIA were used to select the key genes and predicting their interaction mechanisms.ROC curves was used to validate the accuracy of diagnostic models based on the key genes.The disease-specific immune cells were selected via machine learning,and their correlation with the key genes were analyzed using Corrplot package.Biological functions of the key genes were explored using GSEA method.The expression of STAT1 was investigated in the synovial tissue of rats with collagen-induced arthritis(CIA).Results We identified 9 core key genes in RA(CD3G,CD8A,SYK,LCK,IL2RG,STAT1,CCR5,ITGB2,and ITGAL),which regulate synovial inflammation primarily through cytokines-related pathways.ROC curve analysis showed a high predictive accuracy of the 9 core genes,among which STAT1 had the highest AUC(0.909).Correlation analysis revealed strong correlations of CD3G,ITGAL,LCK,CD8A,and STAT1 with disease-specific immune cells,and STAT1 showed the strongest correlation with M1-type macrophages(R=0.68,P=2.9e-08).The synovial tissues of the ankle joints of CIA rats showed high expressions of STAT1 and p-STAT1 with significant differential expression of STAT1 between the nucleus and the cytoplasm of the synovial fibroblasts.The protein expressions of p-STAT1 and STAT1 in the cell nuclei were significantly reduced after treatment.Conclusion CD3G,CD8A,SYK,LCK,IL2RG,STAT1,CCR5,ITGB2,and ITGAL may serve as biomarkers for early diagnosis of RA.Gene-immune cell pathways such as CD3G/CD8A/LCK-γδ T cells,ITGAL-Tfh cells,and STAT1-M1-type macrophages may be closely related with the development of RA.

Objective:To systematically evaluate the bias risk and applicability of short-term mortality risk prediction models within 30 days after stroke, providing a basis for selecting or developing standardized risk prediction models.Methods:Research on short-term mortality risk prediction models within 30 days after stroke was electronically retrieved from China National Knowledge Infrastructure, WanFang Data, VIP, and China Biomedical Database, PubMed, Web of Science, Embase, Cochrane Library and CINAHL. The search period was from database establishment to December 5, 2023. Two researchers independently conducted literature screening and quality evaluation.Results:Twelve studies were included, and a total of 31 models were internally validated, with 7 models undergoing external validation based on internal validation. 26 models reported discriminative power, and 18 models reported calibration methods. The most frequent predictors of modeling were age, hypertension, atrial fibrillation, diabetes and admission Glasgow Coma Scale score. Due to methodological problems such as insufficient sample size, improper handling of missing variables, and inadequate reporting of modeling information, all included studies were rated as high risk of bias.Conclusions:The research on short-term mortality risk prediction models for stroke patients is still in the development stage. Although it has good applicability, the risk of bias is relatively high. Future research should be designed and reported based on prediction model risk of bias assessment tool (PROBAST) and transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) to avoid common problems summarized in this study and reduce the risk of bias.

Objective:The aim of this study was to develop and validate a new liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay for the quantification of melatonin in human serum.Methods:We describe the performance and validation of melatonin by LC-MS/MS. 182 serum samples from the patients diagnosed with Sleep disturbance who visited the Department of Psychiatry at Zhongshan Hospital affiliated to Fudan University from February 2022 to March 2023(56 males,162 females,mean age [45.51±16.31]years), as well as 182 healthy individuals were included(87 males,95 females,mean age [48.55±11.93]years). The two groups were used to assess the application of serum melatonin levels as a diagnostic indicator for sleep disorders (SDs). The liquid chromatography mass spectrometry (LC-MS) system with an chromatography column (2.1×100 mm, 1.8 μm) was used for separation. The column temperature was set at 35 ℃, as well as the mobile phase consisting of a 0.1% formic acid aqueous solution and pure acetonitrile. The flowing rate was set at 0.4 ml/min for gradient elution. The LC-MS/MS method was validated according to guidance documents, including the following parameters: specificity, selectivity, matrix effect, carryover contamination and reproducibility, lower limit of measuring interval, linearity, precision, recovery rate, dilution consistency, and serum sample stability. Then, it was subsequently employed to profile melatonin changes in Sleep disturbance.Results:The lower limit of quantification for melatonin was 1 pg/ml, and the linear range of detection was 1 pg/ml to 500 pg/ml ( r=0.999). The intra-day and intra-batch precision, expressed as the coefficient of variation ( CV), was within the range from 3.07% to 6.86%, which met the requirement of less than 15%. The recovery rate of the spiked samples ranged from 105.91% to 116.30%. The level of serum melatonin in the sleep disturbance group was significantly lower than that in the healthy control group ([2.00(1.00,3.28)] vs [8.35(4.28,14.80)] pg/ml, P<0.001). Conclusions:The LC-MS/MS method we developed for the quantification of melatonin is clinical practicable.

【Objective】 To analyze the profile of perioperative allogenic blood transfusion for single disease in patients who underwent spinal deformity correction surgery and risk factors of the blood transfusion, in order to provide reference for clinical decision making. 【Methods】 Clinical data from medical record homepage of 292 patients who underwent elective spinal deformity correction surgery at Chengdu Third People′s Hospital from January 2015 to December 2017 were retrospectively analyzed. Statistical analysis of the transfusion profile of allogeneic blood based on the type of single disease in patients undergoing correction surgery was performed. Multiple factor linear regression analysis was used to identify the risk factors of perioperative allogenic blood transfusion in patients with spinal deformity correction surgery. Hospital length of stay and discharge status were compared between transfusion group and non-transfusion group using Mann Whitney U test and chi-square test respectively. 【Results】 The year prevalence of perioperative allogeneic blood transfusion from 2015 to 2017 were 90.38%(47/52), 93.62%(44/47) and 81.35%(157/193), respectively. The prevalence of perioperative allogeneic blood transfusion in patients with kyphotic deformity in ankylosing spondylitis, kyphosis, adolescent idiopathic scoliosis, scoliosis and spinal stenosis were 89.08%(106/119)、79.49%(62/78)、95.24%(40/42)、84.38%(27/32) and 61.90%(13/21), respectively. Multivariate linear regression analysis showed that the regression coefficients for age and osteotomy were -0.060 (P<0.05) and 2.060 (P<0.05), respectively. Compared with non-transfusion group, the transfusion group had longer hospital length of stay (P<0.05). 【Conclusion】 Perioperative allogeneic blood transfusion in patients with spinal deformity correction surgery is closely related to the type of single disease. Age is a protective factor for perioperative allogeneic blood transfusion, while osteotomy is a risk factor for perioperative allogeneic blood transfusion in patients undergoing the spinal deformity correction surgery. Perioperative blood transfusion can also prolong the hospital length of stay of the patients.