Phacoemulsification represents the mainstream, efficient, and safe surgical modality for cataract treatment, and continuous technological advances have further improved the safety profile of this procedure in ordinary patients. However, patients with high myopia feature inherent anatomical abnormalities of the eyeball, leading to a fundamental incompatibility with conventional phacoemulsification protocols. Such patients face a markedly elevated risk of both anterior and posterior segment perioperative complications, posing a persistent clinical challenge in cataract surgery. Focusing on the unique ocular anatomical characteristics associated with high myopia, this review systematically summarizes the distinct traumatic effects and pathological impacts of phacoemulsification on the anterior and posterior ocular segments of affected patients. Moving beyond generalized discussions of routine cataract management, it consolidates clinical evidence specific to this special-population patients, aiming to provide refined references for perioperative risk prevention and control in cataract patients complicated with high myopia.

AIM: To design and construct recombinant epitope nucleotides vaccine of glycoprotein B(gB)and glycoprotein D(gD)of herpes simplex virus type 1(HSV-1), and to investigate its immunoprotective effects and tissue expression in animal models.METHODS: The HSV-1 gB and gD epitope genes were selected and tandem assembled to construct the recombinant protein-coding gene X, which was transducted into the prokaryotic expression vector pET28(a). The recombinant protein was synthesized and utilized to generate monoclonal antibodies, which were subsequently used to immunize New Zealand white rabbits. The immunogenicity of the purified protein and the presence of polyclonal antibodies in the serum were tested through separating serum from cardiac blood, and the serum antibody titers were determined. The pcDNA3.1-X was successfully constructed as a eukaryotic expression vector and immunized the female BALB/c mice aged 4 to 6 wk via intramuscular injection. Serum antibodies and immune-related cytokines were quantified using enzyme-linked immunosorbent assay(ELISA). The expression of the X protein in the ocular, trigeminal ganglion, and brain tissues of the mice was assessed.RESULTS: The target polyclonal antibody was identified with a serum antibody titer of 1:3200 in the rabbit serum after immunized by recombinant protein X. Upon immunizing mice with the eukaryotic recombinant plasmid pcDNA3.1-X, the concentration of HSV-1 serum IgM antibodies of the experimental group was 12.13±0.85 ng/L, which was significantly higher than that of the vector control group(0.49±0.44 ng/L; t=21.07, P<0.001). The concentrations of cytokines interleukin IL-2, IL-4, IL-10, and IFN-γ in the experimental group were 11.63±0.60, 22.65±1.47, 85.75±14.12, and 114.90±6.39 ng/L, respectively, all of which were significantly higher than those in the vector control group and the blank control group(all P<0.05). Immunohistochemical staining revealed the presence of target protein X in the eyeball, trigeminal ganglion, and brain tissue.CONCLUSION: The HSV-1 gB and gD tandem epitope nucleotides vaccine pcDNA3.1-X was successfully constructed, which activates a remarkable immune response and is stably expressed in the eyeball, trigeminal ganglion, and brain tissue. This study provides a foundation for further research of an HSV-1 recombinant antigen epitope tandem vaccine.

Objective To evaluate the safety and feasibility of laparoscopy in combination with fast track colorectal surgery (FTCS) in the treatment of colorectal cancer in the elderly.Methods A total of 123 patients were randomly divided into 3 groups:the laparoscopy plus FTCS group (n=41),the laparoscopy group (n=41) and the laparotomy group (n=41).Parameters for measuring surgical quality,recovery and postoperative complications were analysed.Results No significant differences were found in age,gender,tumor location,anesthesia ASA classification,American Joint Committee on Cancer (AJCC) Tumor Node Metastasis (TNM) staging,Eastern Cooperative Oncology Group (ECOG) score or complications between the three groups (P＞0.05 for all).There were no differences in blood loss,operative time,time required to resume defecation or number of lymph nodes dissected between the laparoscopy plus FTCS group and the laparoscopy or laparotomy group (P＞0.05 for all),but time taken to initiate postoperative ambulation,time taken to resume flatulence,time taken to start intake of liquid food and length of hospital stay were shorter in the laparoscopy plus FTCS group than in the other groups (P ＜ 0.05 for all).The incidence of postoperative complications was 12.2％ or 5/41 in the laparoscopy plus FTCS group,which was lower than in the laparoscopy group (34.1％ or 14/41) and in the laparotomy group (68.3％ or 28/41) (x2 =5.549 and 28.826,P=0.018 and 0.01,respectively),a statistically significant difference was also found between the latter two groups (x2 =9.567,P =0.002).Conclusions Laparoscopy in combination with FTCS is safe and effective in the treatment of colorectal cancer in the elderly.

BACKGROUND: Decoy receptor 1 (DcR1), which acts as decoy receptors, is resistant to apoptosis induction by related apoptosis inducing ligand (TRAIL). OBJECTIVE: To investigate the expression of the DcR1 (TRAIL-R3) protein in human herniated and normal lumbar intervertebral discs (IVD). METHODS: The expression and distribution of DcR1 proteins were assessed by using immunohistochemistry in 20 herniated lumbar IVD and 8 normal lumbar IVD tissues samples following discoidectomy from January to September 2010. RESULTS AND CONCLUSION: Percentage of nucleus pulposus and anulus fibrous cells with DCR1 expression was obviously more in the herniated group than in normal IVD group. The current results indicate that the expression of DCR1 rises after herniation.