AIM:To analyze the influencing factors of postoperative malignant glaucoma(MG)in patients with primary angle-closure glaucoma(PACG)using logistic regression and decision tree models.METHODS:A retrospective study was conducted on PACG patients who underwent surgery at Eye Hospital of Handan City from March 2020 to March 2025. Patients were divided into two groups: the MG group, who developed MG within 6 mo postoperatively, and the non-MG group. Data were collected from the electronic medical record system. Univariate analysis was performed, followed by multivariate logistic regression to identify independent risk factors. A classification and regression tree model was constructed to visualize the hierarchical relationships among predictors. The predictive performance of the two models was evaluated and compared using receiver operating characteristic(ROC)curve analysis.RESULTS:Totally 182 cases(182 eyes)with PACG were enrolled in this study, including 91 cases(91 eyes)in the MG group and 91 cases(91 eyes)in the non-MG group. In the MG group, there were 53 males and 38 females; 69 cases were aged ≥60 y and 22 cases were aged <60 y. In the non-MG group, there were 47 males and 44 females; 33 cases were aged ≥60 y and 58 cases were aged <60 y. The non-MG group comprised 91 patients, including 47 males and 44 females. Among them, 33 cases were aged ≥60 y, and 58 cases were aged<60 y. The MG group had significantly higher proportions of patients aged ≥60 y, diabetes, moderate-stage PACG, persistent high intraocular pressure(IOP), complete anterior chamber angle closure, lens thickness <4.5 mm, axial length <22 mm, and severe postoperative inflammation compared to the non-MG group(all P<0.01). Multivariate Logistic regression identified the following as independent influencing factors for postoperative MG: age [OR (95%CI)=2.136(1.401-3.255)], PACG stage [OR (95%CI)=2.996(2.044-4.391)], IOP [OR (95%CI)=3.527(1.604-7.755)],anterior chamber angle [OR (95%CI)=4.826(2.498-9.324)], axial length [OR (95%CI)=5.125(1.265-20.771)], and severe postoperative inflammation [OR (95%CI)=2.338(1.478-3.699)](all P<0.05). The decision tree model selected six explanatory variables: age, PACG stage, IOP, anterior chamber angle status, axial length, and severe postoperative inflammation. Axial length was the primary splitting factor at the root node. The areas under the ROC curve(AUC)for the logistic regression and decision tree models were 0.913(0.863-0.950)and 0.921(0.872-0.956), respectively, with no significant difference between them(Z=0.561, P=0.575).CONCLUSION:Both the logistic regression and decision tree models effectively identify key influencing factors for postoperative MG in PACG patients, including age, PACG stage, IOP, anterior chamber angle status, axial length, and severe postoperative inflammation. The decision tree model offers an intuitive, visual representation of risk stratification, facilitating clinical decision-making. Both models are applicable for clinical risk assessment.

AIM: To investigate and analyze serum nitric oxide synthase 4(NOX4)and matrix metalloproteinase(MMP)-2 expressions in patients with diabetes mellitus(DM)complicated with neovascular glaucoma(NVG)and their clinical significance.METHODS: A prospective study was conducted on 161 patients with DM complicated with NVG admitted to Handan City Eye Hospital(The Third Hospital of Handan)from June 2020 to June 2023. Based on whether complications occurred 1 a after trabeculectomy in the study group patients, they were divided into a group with good prognosis(n=90)and a group with poor prognosis(n=71). During the same period, 161 patients with chronic angle-closure glaucoma without iris neovascularization were selected as the control group. ELISA method was applied to detect the expression levels of serum NOX4 and MMP-2. ROC curve was plotted to evaluate the diagnostic value and postoperative complication prediction value of NOX4 and MMP-2 in patients with DM complicated with NVG. Pearson method was applied to analyze the correlation of NOX4 and MMP-2 with vascular endothelial growth factor(VEGF)and interleukin-6(IL-6). Multivariate Logistic regression was applied to analyze the influencing factors of postoperative complications in the study group.RESULTS:The general information of the study group and control group of patients is comparable. Compared with the control group, the expression levels of serum NOX4, MMP-2, VEGF, and IL-6 in the study group were significantly increased(P<0.001). According to Pearson analysis, serum NOX4 and MMP-2 levels significantly positively correlated with VEGF and IL-6 levels, respectively(P<0.001). According to ROC curve, the AUC of NOX4 combined with MMP-2 in the diagnosis of DM complicated with NVG was better than that of individual diagnosis of NOX4(Z=3.341, P<0.05)and MMP-2(Z=2.788, P<0.05). The duration of DM, the proportion of people with intraocular pressure >21 mmHg, and the expression levels of NOX4, MMP-2, VEGF, and IL-6 in the poor prognosis group were all higher than those in the good prognosis group(P<0.001). The duration of DM, intraocular pressure >21 mmHg, the levels of NOX4, MMP-2, VEGF, and IL-6 were all risk factors for poor prognosis in DM patients with NVG(P<0.001). According to ROC curve, the combined prediction of NOX4 and MMP-2 for postoperative complications in patients with DM complicated by NVG was superior to the AUC predicted by NOX4(Z=3.727, P<0.05)and MMP-2(Z=2.219, P<0.05), respectively.CONCLUSION:NOX4 and MMP-2 are upregulated in the serum of patients with DM complicated by NVG. Combined detection of these two markers holds significant clinical value for the early diagnosis and prognosis of patients with DM complicated by NVG.

Objective: To comprehensively evaluate the clinical efficacy of a single dose of tranexamic acid (TXA) in reducing perioperative blood loss in patients undergoing craniomaxillofacial plastic and cosmetic surgery through meta-regression analysis. Methods: Embase, PubMed, Wanfang Data, VIP database, China National Knowledge Infrastructure (CNKI), the Chinese Clinical Trial Registry (ChiCTR) and Cochrane Central Register of Controlled Trials (CENTRAL) were electronically retrieved to collect clinical studies evaluating efficacy of perioperative TXA administration in patients undergoing craniomaxillofacial plastic and cosmetic surgery, from inception to August 2024. Quality assessment of randomized controlled trials (RCTs) was performed using Cochrane Collaboration's Risk of Bias Tool. Based on the results of methodological heterogeneity, corresponding meta-analyses were conducted using either random-effects or fixed-effects models in R programming software. Results: Thirty-one articles were included, involving 2 072 patients who underwent craniomaxillofacial plastic and cosmetic surgeries. Among these patients, 1 051 were in the TXA treatment group, and 1 021 were in the control group. The paired meta-analysis showed that compared with the control group, the use of TXA significantly reduced bleeding volume in perioperative patients [standardized mean difference (SMD)=-1.13; 95%CI (-1.47, -0.80), P<0.001]. Subgroup analysis revealed that TXA significantly reduced intraoperative bleeding volume in patients across different surgeries, with the order of efficacy as follows: orthognathic surgery [SMD=-1.44; 95%CI (-2.07, -0.80), P<0.001], cleft palate repair [SMD=-1.32; 95%CI (-2.14, -0.50), P<0.001], rhinoplasty [SMD=-0.97; 95%CI (-1.63, -0.30), P<0.001], and craniosynostosis [SMD=-0.96; 95%CI (-1.40, -0.53), P=0.040]. The result of the meta regression showed there was no significant difference in the hemostatic effect of TXA on patients with increasing doses (5, 10, 15, 20, 25 mg/kg) (P=0.650). Sensitivity analysis verified that the pooled values were stable and reliable. The Egger's test indicated a certain degree of publication bias (Z=-3.40, P<0.001). Conclusion: Existing evidence suggests that TXA effectively reduces perioperative blood loss in patients undergoing craniofacial plastic surgery, regardless of its dosage administered.

Human aldehyde dehydrogenase(ALDH)gene family contains 19 functional members,which encode a class of nicotinamide adenine dinucleotide(NAD+)or nicotinamide adenine dinucleotide phos-phate(NADP+)dependent isoenzymes.Their primary function is to oxidise various aldehydes to the corre-sponding carboxylic acids,and act in a variety of pathways:ALDH 1 is used to transmit retinoic acid signals,ALDH2 is used for ethanol detoxification,ALDH1A1 and ALDH3A1 are used to maintain cellular homeosta-sis in the eye,ALDH4A1 participates in amino acid metabolism,ALDH2 and ALDH5A1 participate in the construction of neuronal function,ALDH1L participates in folate metabolism,etc.Mutations in the ALDH gene causing deletion of the ALDH enzyme or abnormal catalytic activity have been associated with a multi-tude of diseases,including type Ⅱ hyperprolainemia,Sj?gren-Larsson syndrome,γ-hydroxybutyric aciduria,cancer,cardiovascular disease,etc.This review provides a detailed and comprehensive overview of the 13 mem-bers belonging to the ALDH gene family that have been investigated in health and disease,focusing on their physiological and pathological functions.

Objective:To comprehensively evaluate the clinical effectiveness with respect to a single dose of tranexamic acid (TXA) given preoperatively for blood loss control in perioperative patients accepted craniomaxillofacial plastic and cosmetic surgery.Methods:Embase, PubMed, WanFang Data, VIP, China National Knowledge Infrastructure (CNKI), the Chinese Clinical Trial Registry (ChiCTR) and Cochrane Central Register of Controlled Trials (CENTRAL) were electronically retrieved to collect randomized controlled trials (RCTs) related to appraise the efficacy in perioperative craniomaxillofacial plastic and cosmetic surgery patients used TXA from inception to August 2024. Based on the result of methodological heterogeneity, corresponding paired meta-analyses were carried out with a random-effects or fixed-effects model applying R 4.0.4 software. Subgroup analysis was performed based on type of surgery, patient age, regional distribution of patients, and sample size included in the studies. A meta-regression analysis was performed on studies that reported the effect of different doses of TXA on reducing perioperative bleeding. Sensitivity analysis was performed to verify the stability of the meta result. Egger’s test was used to analyze potential publication bias.Results:A total of 31 RCTs were included, involving 2 072 patients, with 1 051 in the TXA group and 1 021 in the placebo group. The paired meta-analysis random-effects model ( I2=90%) showed that compared with the control group, the use of TXA significantly reduced the amount of bleeding in perioperative patients[standardized mean difference ( SMD)=-1.13, 95% CI -1.47 to -0.80, P < 0.01]. Subgroup analysis revealed that TXA had a significant effect on reducing intraoperative bleeding in patients with different surgeries, ages, regions, and sample sizes. The most effective subgroups were cases in orthognathic surgery ( SMD=-1.44, 95% CI -2.07 to -0.80, P< 0.01), less than 30 year-old( SMD=-1.32, 95% CI -1.68 to -0.96, P< 0.01], Asian patients( SMD=-1.29, 95% CI -1.72 to -0.86, P< 0.01), less than 30 individuals ( SMD=-1.16, 95% CI -1.50 to -0.82, P< 0.01). The result of the meta regression showed there was no significant difference in the hemostatic effect of TXA on patients with increasing doses (5, 10, 15, 20, 25 mg/kg) ( P>0.05). Sensitivity analysis verified that the pooled values were stable and reliable. The Egger’s test indicated a certain degree of publication bias ( P < 0.01). Conclusion:Taken as a whole, existing evidence suggests that TXA can effectively reduce perioperative bleeding in patients undergoing craniofacial plastic surgery, regardless of its dosage administered. However, further clinical researches are still needed to provide more baselined data, transfusion-related indicators, and information on adverse events such as vascular embolism, in order to comprehensively evaluate and analyze the efficacy and safety of a single dose of TXA for perioperative blood loss control in patients treated with craniomaxillofacial plastic and cosmetic surgery.

Objective:To explore the effectiveness of designing a training program for faculty supervisory specialists guided by adult learning theory.Methods:Based on the theory of adult learning, we designed a training program for faculty supervisory specialists in standardized residency training. A questionnaire survey was conducted to collect satisfaction and learning outcomes from 31 trainees who participated in this training program from 2019 to 2022. SPSS 25.0 was used to conduct nonparametric tests of supervisory course ratings for four core teaching activities in 2019 and 2022.Results:The study showed that 100.00% (31/31) of training participants were very satisfied or satisfied with the training content and training methods, 96.77% (30/31) were very satisfied or satisfied with the training sessions, and 90.32%(28/31) of training participants felt that they had mastered the supervisory requirements. The course grades for mini-lectures ( Z=-3.01, P<0.05) and overall course supervision ( Z=-2.47, P<0.05) were significantly different between 2019 and 2022. Compared with 2019, the number of externally assigned instructors and externally assigned assessment experts increased significantly in 2022. The training program for faculty supervisory specialists has a high value for promotion. Conclusions:The supervisory specialist training program designed under the guidance of adult learning theory helps increase the interest of training participants in the training program and ultimately improves the effectiveness of the training program.

Objective:The transcriptome data was utilized to screen cuproptosis-related genes(CRGs)in oral squamous cell car-cinoma(OSCC),and the characteristic genes were identified for constructing a prognostic model for predicting patients'survival time.Methods:OSCC transcriptome gene expression and clinical data were obtained from TCGA and GEO.Through Lasso regres-sion analysis and Cox regression analysis,relevant prognostic genes were screened and prognostic models were constructed.Ac-cording to the median value of risk scores,patients were divided into high and low risk groups,and their survival rates were com-pared.Finally,the predictive performance of the model was verified.Results:In this study,9 characteristic genes with prognostic value(ENO2,P4HA1,SLC2A3,AQP1,PLS1,NXPH4,CTSG,TRAC,THBS1)were screened out and a 9-gene prognostic model was constructed.The survival rate of high-risk group based on prognostic model was significantly lower than that of low-risk group.The area under curve(AUC)of receiver operating characteristic curve(ROC)was 0.701,0.729 and 0.702 at 1 year,3 years and 5 years,respectively,which verifies that the risk model has good predictive performance.The nomogram predicted that the 1-year,3-year,and 5-year survival probabilities of OSCC patients are 89.6％,72.4％,and 63.9％respectively,and the cal-ibration curve confirmed the accuracy of the nomogram prediction.Conclusion:The 9-gene prognostic model based on CRGs screening could predict the prognosis of OSCC patients,which is helpful for clinical personalized treatment of OSCC patients and prediction of their survival rate.

Objective:To focus on clinical mini-lectures characterized by flexible teaching formats and significant challenges in scoring during supervision, systematically explore the roles and characteristics of raw scores (directly assigned by supervisory experts) and standard scores (revealing the relative position of instructors withing the group through Z-score conversion) in evaluating the teaching level and development trends of residency training teachers, investigate the feasibility of flexibly combining these two scoring methods, and provide new ideas for comprehensive, scientific, and objective teaching evaluations. Methods:In May 2024, 24 teachers who were supervised by three or more experts at a standardized training base for residents from 2019 to 2023 were selected as the research subjects. The study analyzed differences in mean rankings and development trends between raw and standard scores. Excel and SPSS were used for score transformation and statistical analysis of differences.Results:The mean rankings of standard scores differed from those of raw scores for 17 (70.83%) teaching staff members, among which 8 (33.33%) had a lower mean ranking of standard scores than raw scores, and 9 (37.50%) had an improved mean ranking of standard scores. For 10 (41.67%) teaching staff members, the differences in raw scores given among different supervisors were reversed after standardization conversion. The changes in the trends of scores for 17 (70.83%) teaching staff members throughout the years were inconsistent before and after score conversion.Conclusions:There were significant differences between the statistical results of standard scores and raw scores, and the two types of results evaluated the teaching level of teachers in terms of absolute situation and their relative positions in the entire teaching staff group, respectively. Therefore, combining the two types of scores with distinct characteristics for teaching evaluation can help teaching management departments comprehensively and objectively reveal the teaching level of teachers, while enhancing the confidence of faculty in teaching.

Objective:To explore the effectiveness of designing a training program for faculty supervisory specialists guided by adult learning theory.Methods:Based on the theory of adult learning, we designed a training program for faculty supervisory specialists in standardized residency training. A questionnaire survey was conducted to collect satisfaction and learning outcomes from 31 trainees who participated in this training program from 2019 to 2022. SPSS 25.0 was used to conduct nonparametric tests of supervisory course ratings for four core teaching activities in 2019 and 2022.Results:The study showed that 100.00% (31/31) of training participants were very satisfied or satisfied with the training content and training methods, 96.77% (30/31) were very satisfied or satisfied with the training sessions, and 90.32%(28/31) of training participants felt that they had mastered the supervisory requirements. The course grades for mini-lectures ( Z=-3.01, P<0.05) and overall course supervision ( Z=-2.47, P<0.05) were significantly different between 2019 and 2022. Compared with 2019, the number of externally assigned instructors and externally assigned assessment experts increased significantly in 2022. The training program for faculty supervisory specialists has a high value for promotion. Conclusions:The supervisory specialist training program designed under the guidance of adult learning theory helps increase the interest of training participants in the training program and ultimately improves the effectiveness of the training program.

Objective:The transcriptome data was utilized to screen cuproptosis-related genes(CRGs)in oral squamous cell car-cinoma(OSCC),and the characteristic genes were identified for constructing a prognostic model for predicting patients'survival time.Methods:OSCC transcriptome gene expression and clinical data were obtained from TCGA and GEO.Through Lasso regres-sion analysis and Cox regression analysis,relevant prognostic genes were screened and prognostic models were constructed.Ac-cording to the median value of risk scores,patients were divided into high and low risk groups,and their survival rates were com-pared.Finally,the predictive performance of the model was verified.Results:In this study,9 characteristic genes with prognostic value(ENO2,P4HA1,SLC2A3,AQP1,PLS1,NXPH4,CTSG,TRAC,THBS1)were screened out and a 9-gene prognostic model was constructed.The survival rate of high-risk group based on prognostic model was significantly lower than that of low-risk group.The area under curve(AUC)of receiver operating characteristic curve(ROC)was 0.701,0.729 and 0.702 at 1 year,3 years and 5 years,respectively,which verifies that the risk model has good predictive performance.The nomogram predicted that the 1-year,3-year,and 5-year survival probabilities of OSCC patients are 89.6％,72.4％,and 63.9％respectively,and the cal-ibration curve confirmed the accuracy of the nomogram prediction.Conclusion:The 9-gene prognostic model based on CRGs screening could predict the prognosis of OSCC patients,which is helpful for clinical personalized treatment of OSCC patients and prediction of their survival rate.