Objective:To evaluate the imaging stability of a portable boom-type ophthalmic ultra-high-resolution optical coherence tomography (OCT) device in multiple application scenarios.Methods:The boom-type mode and handheld mode of the portable boom-type OCT and the desktop OCT were used to perform three-dimensional imaging tests on three healthy adults undergoing physical examinations at the Zhongshan Ophthalmic Center, Sun Yat-sen University as well as on OEMI-7 model eyes in a sitting position.The same two modes of the portable boom-type OCT were used to perform three-dimensional imaging on four awake non-sedated infants, two sedated infants and four healthy adults in the supine position.The obtained 3D imaging data were processed using a correlation analysis method between adjacent B-scans, and the offset of B-scan in the axial (z-axis) and the fast axis transverse (x-axis) were calculated.The procedures for in vivo human eye experiments followed the Declaration of Helsinki and were approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University (No.2020 KYPJ154).All subjects and infant guardians signed the informed consent form. Results:Compared with the handheld imaging mode, the axial and fast axis lateral motion offsets of the model eye were significantly reduced in the boom-type imaging mode from (124.00±12.49)μm to (48.00±15.87)μm and from (24.00±1.00)μm to (2.67±0.57)μm, respectively ( t=2.932, 4.337; both P<0.001).In both human and model eyes, the axial and fast axis lateral motion offsets of the boom-type mode were significantly lower than in the traditional handheld operation mode (both P<0.001).The axial and lateral motion offsets between the boom-type mode and desk-top OCT imaging were comparable, without significant differences (both P>0.05).In both sedated and awake, non-sedated infants in the supine position, the axial offset of the portable boom-type OCT system was similar to that of the healthy adults, without significant difference in the overall comparison ( P=0.385), and the lateral offsets were higher than those of healthy adults, with statistically significant differences (both P=0.013).There was no significant difference in axial deviation between sedated and non-sedated infants ( P>0.05).The lateral deviation of non-sedated infants was higher than that of sedated infants, though the difference was not statistically significant ( P=0.247). Conclusions:The portable boom-type OCT system can maintain high-speed, high-resolution imaging performance while achieving imaging stability comparable to traditional desktop OCT systems.It is more suitable for bedside imaging of supine subjects, especially uncooperative infants, and has good clinical application prospects.

Objective:To evaluate the imaging stability of a portable boom-type ophthalmic ultra-high-resolution optical coherence tomography (OCT) device in multiple application scenarios.Methods:The boom-type mode and handheld mode of the portable boom-type OCT and the desktop OCT were used to perform three-dimensional imaging tests on three healthy adults undergoing physical examinations at the Zhongshan Ophthalmic Center, Sun Yat-sen University as well as on OEMI-7 model eyes in a sitting position.The same two modes of the portable boom-type OCT were used to perform three-dimensional imaging on four awake non-sedated infants, two sedated infants and four healthy adults in the supine position.The obtained 3D imaging data were processed using a correlation analysis method between adjacent B-scans, and the offset of B-scan in the axial (z-axis) and the fast axis transverse (x-axis) were calculated.The procedures for in vivo human eye experiments followed the Declaration of Helsinki and were approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University (No.2020 KYPJ154).All subjects and infant guardians signed the informed consent form. Results:Compared with the handheld imaging mode, the axial and fast axis lateral motion offsets of the model eye were significantly reduced in the boom-type imaging mode from (124.00±12.49)μm to (48.00±15.87)μm and from (24.00±1.00)μm to (2.67±0.57)μm, respectively ( t=2.932, 4.337; both P<0.001).In both human and model eyes, the axial and fast axis lateral motion offsets of the boom-type mode were significantly lower than in the traditional handheld operation mode (both P<0.001).The axial and lateral motion offsets between the boom-type mode and desk-top OCT imaging were comparable, without significant differences (both P>0.05).In both sedated and awake, non-sedated infants in the supine position, the axial offset of the portable boom-type OCT system was similar to that of the healthy adults, without significant difference in the overall comparison ( P=0.385), and the lateral offsets were higher than those of healthy adults, with statistically significant differences (both P=0.013).There was no significant difference in axial deviation between sedated and non-sedated infants ( P>0.05).The lateral deviation of non-sedated infants was higher than that of sedated infants, though the difference was not statistically significant ( P=0.247). Conclusions:The portable boom-type OCT system can maintain high-speed, high-resolution imaging performance while achieving imaging stability comparable to traditional desktop OCT systems.It is more suitable for bedside imaging of supine subjects, especially uncooperative infants, and has good clinical application prospects.

Objective:To establish an accurate retinal vascular network segmentation method for multiple fundus diseases, and to investigate the changing patterns of retinal vascular morphological parameters in these diseases.Methods:A retrospective study was conducted.Color fundus photography data of 829 patients with fundus diseases and 146 healthy adults were collected at Zhongshan Ophthalmic Center, Sun Yat-sen University from January 2020 to December 2023.The multi-path segmentation network was fine-tuned, and the color fundus photography data of diabetic retinopathy (DR), glaucoma and age-related macular degeneration (AMD) patients and healthy adults in the fundus image vessel segmentation public dataset were input for training until the loss value of the model stopped decreasing, and finally the trained multi-disease retinal vascular segmentation model was obtained.The retinal blood vessel morphological characteristics analysis method previously developed by our research group was used to analyze the subjects' color fundus images centered on the macula, the retinal blood vessel fractal dimension (D f), vascular area ratio (VAR), mean diameter (D m), tortuosity (τ) and other morphological characteristics parameters were extracted and compared among various disease groups.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University (No.2023KYPJ344).Written informed consent was obtained from each subject. Results:The accuracy of the multi-disease color fundus photography vessel segmentation model on the test set was 0.987, and the area under the receiver operating characteristic curve was 0.995.After adjustment for age and sex, there were statistically significant differences in adjusted D f, adjusted VAR, adjusted D m and τ among different groups ( F=27.87, 47.60, 26.48, 4.63; all at P<0.001).Adjusted D f in AMD group, DR group, diabetic macular edema (DME) group, retinitis pigmentosa (RP) group, branch retinal vein occlusion (BRVO) group and central retinal vein occlusion (CRVO) group was significantly decreased than in normal control group, and the differences were statistically significant (all at P<0.05).Adjusted VAR in all disease groups except optic neuritis group and central serous chorioretinopathy group was significantly decreased compared with normal control group, and the differences were statistically significant (all at P<0.05).The adjusted D m in DME, glaucoma, RP, BRVO and CRVO groups was significantly decreased than that in normal control group, and the differences were statistically significant (all at P<0.05).τ was not affected by age or sex and did not require adjustment.τ in DR group and DME group was significantly increased compared with normal control group, and the differences were statistically significant (both at P<0.05). Conclusions:An accurate retinal blood vessel segmentation method for various fundus diseases was successfully constructed.This method shows high accuracy in retinal blood vessel segmentation in color fundus photographs of various retinal diseases.There are significant differences in the morphological characteristics of retinal blood vessels among different retinal diseases.

Objective:To explore the predictive value of Montreal Cognitive Assessment(MoCA)score for weaning out-comes in patients with mechanically ventilation in ICU. Method:The study enrolled 127 mechanically ventilated patients admitted to the intensive care unit of Guang-dong provincial people's hospital from October 2022 to August 2023,including 85 males and 42 females.All patients were evaluated within 24 hours of ICU admission for general information and clinical data such as MoCA score,ventilation volume(MV),Apache Ⅱ score,tidal volume(VT),shallow rapid breathing index(RSBI),oxygenation index(OI),blood gas analysis,and the duration of mechanical ventilation before a spon-taneous breathing trial.Outcomes of weaning were then evaluated,dividing patients into a successful weaning group(92 patients)and a weaning failure group(35 patients).Univariate analysis identified factors related to weaning failure;multivariable binary logistic regression determined risk and protective factors affecting the weaning outcome,calculating odds ratio(OR),95％confidence interval(95％CI)and accuracy(Acc).The receiver operating characteristic(ROC)curve of MoCA score was drawn to calculate the area under the curve(AUC),Yolden index(YI),cutoff value(Cut off),sensitivity(Se),specificity(Sp)to analyze the predic-tive value of the MoCA score in weaning mechanically ventilated patients. Result:There were no significant differences between the two groups in general data except for BMI index(P＞0.05).Significant differences were observed in Apache-Ⅱ scores,MoCA scores,PaO2,VT,MV,and the dura-tion of mechanical ventilation(P＜0.05).Binary logistic multivariate regression analysis showed that a higher Mo-CA score(OR=0.824,95％CI:0.720-0.944,P=0.005)was an independent protective factor for weaning out-comes.Higher minute ventilation(OR=0.600,95％CI:0.416-0.865,P=0.006)was also an independent protec-tive factor for weaning outcomes.AUC for MoCA score was 0.746(95％CI:0.661-0.819,P=0.001)with an optimal cutoff value of 20 points,corresponding sensitivity(Se)of 77.14％,specificity(Sp)of 68.48％and pre-diction accuracy(Acc)of 74.02％. Conclusion:A higher MoCA score is an independent protective factor influencing weaning outcomes.A MoCA score ≤ 20 increases the risk of weaning failure.Higher MoCA scores correlate with higher success rate of weaning;each one-point increase in MoCA score increases the success rate of 17.6％.

With the continuous development of cancer treatment technology, the cure rate for tumors in children is increasing. However, the irreversible damage to ovarian development and function by chemotherapy and radiation in surviving children often leads to iatrogenic premature ovarian failure and even infertility. Therefore, it is of great significance to develop fertility preservation techniques for children with tumors. International and domestic guidelines indicate that ovarian tissue cryopreservation and transplantation should be considered first for female children. However, the application of this technique in children is not yet mature. Current research suggests that there are significant structural and functional differences between children's ovaries and adults', and fertility preservation strategies for adults are not fully applicable to children. Therefore, this paper analyzes and reviews the structure and function of children's ovaries, the mechanism of damage to ovarian tissues by chemotherapy and radiation, and the current research and application status of fertility preservation techniques for female children. It also looks forward to the development direction of fertility preservation techniques for female children.

With the continuous development of cancer treatment technology, the cure rate for tumors in children is increasing. However, the irreversible damage to ovarian development and function by chemotherapy and radiation in surviving children often leads to iatrogenic premature ovarian failure and even infertility. Therefore, it is of great significance to develop fertility preservation techniques for children with tumors. International and domestic guidelines indicate that ovarian tissue cryopreservation and transplantation should be considered first for female children. However, the application of this technique in children is not yet mature. Current research suggests that there are significant structural and functional differences between children's ovaries and adults', and fertility preservation strategies for adults are not fully applicable to children. Therefore, this paper analyzes and reviews the structure and function of children's ovaries, the mechanism of damage to ovarian tissues by chemotherapy and radiation, and the current research and application status of fertility preservation techniques for female children. It also looks forward to the development direction of fertility preservation techniques for female children.

As one of notable works of HUANG Yuanyu， a renowned physician from the Qing Dynasty， The Indications of Classics by Four Medical Sage emphasize the theoretical paradigm of “one qi circulation” with a particular focus on the middle qi. Building upon disease differentiation and treatment， HUANG Yuanyu attaches great importance to understanding the underlying cause of the disease. It is believed that the imbalance of the six climatic factors is the fundamental cause of diseases. The concept of mutual interaction between the physiological and pathological aspects of the six climatic factors is proposed to grasp the basic pathogenesis. Based on the individual's specific condition of six climatic factors， excess or deficiency， specific prescriptions are formulated. The diagnosis and treatment system can be summarized as a “differentiation of diseases → disease etiology → differentiation of the condition of six climatic factors → individualized pathogenesis of traditional Chinese medicine （TCM） → prescription of TCM” model based on the holistic view. HUANG Yuanyu' s diagnosis and treatment system is highly practical and can provide reference for clinical diagnosis and treatment of diseases in TCM.

Objective:To investigate the effectiveness of a hierarchical teaching model guided by "residency-specialty integration" in residency training and specialty training of oral and maxillofacial surgery with the training base of oral and maxillofacial surgery in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, as the research subject.Methods:A total of 144 trainees receiving residency training and 32 receiving specialist training were enrolled from June 2022 to April 2023 and were divided into experimental group and control group, with 72 trainees receiving residency training and 16 receiving specialist training in each group. Clinical and learning tasks were designed using the traditional model for the control group and the hierarchical teaching model guided by "residency-specialty integration" for the experimental group, and the performance of trainees in theoretical assessments and self-evaluations was recorded. SPSS 23.0 was used to perform the t-test. Results:The hierarchical teaching model guided by "residency-specialty integration" achieved a significant effect in both theoretical assessments and self-evaluations of the trainees. As for the trainees receiving specialty training, there was a significant difference in the score of theoretical assessment between the experimental group and the control group (84.56±4.05 vs. 81.13±2.78, P<0.05), and as for the trainees receiving residency training, there was also a significant difference in this score between the experimental group and the control group (84.74±4.85 vs. 82.10±4.34, P<0.01). The results of self-assessment questionnaire showed that compared with the control group, the experimental group had a higher proportion of trainees giving positive evaluations of various indicators. Conclusions:This study suggests that the hierarchical teaching model guided by "residency-specialty integration" provides an effective teaching model for residency training and specialty training of oral and maxillofacial surgery, and this model may help to enhance disciplinary interests and promote clinical practice abilities, thereby providing valuable insights for future medical education in China.

Objective: To compare the outcome of postoperative adjuvant chemotherapy and surgery alone for stage pT1b-3N0M0 squamous cell carcinoma (SCC) of the thoracic esophagus. Methods: Two hundred and thirty-eight patients who underwent esophagectomy for stage pT1b-3N0M0 SCC of the thoracic esophagus in Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University between January 2008 and February 2011 were analyzed retrospectively. These included postoperative adjuvant chemotherapy for 118 patients and surgery alone for 120 patients. In postoperative adjuvant chemotherapy arm, 3 or 4 cycles of taxol+ cisplatin (TP, n=33) or fluorouracil+ cisplatin (FP, n=85) regimens were given commencing from 4 to 6 weeks after surgery. Survival analysis was performed using Kaplan-Meier method. Univariate analysis for prognostic factors was performed by Log-rank test and multivariate by Cox regression model. Results: The 3- and 5-year disease-free survival (DFS) rates were 57.9% and 53.8%, respectively for postoperative adjuvant chemotherapy patients, compared to 40.4% and 32.5% for patients who underwent surgery alone (χ²=11.973, P=0.001). The 3- and 5-year overall survival (OS) rates were 64.4% and 55.9% in postoperative adjuvant chemotherapy patients, and 46.7% and 33.5% in surgery alone patients (χ²=13.110, P=0.000). Stratification analysis showed that there was significant difference in stage T3 patients (χ²=7.895, P=0.006), but not in stage T1b (χ²=0.762, P=0.383) and T2 (χ²=1.259, P=0.262) patients between adjuvant chemotherapy and surgery alone. Both DFS rate (χ²=1.748, P=0.186) and OS rate (χ²=2.200, P=0.138) of TP group were similar with FP group. Conclusion In lymph node negative esophageal SCC patients, postoperative adjuvant chemotherapy shows survival benefits in stage T3 patients.

Aim To investigate the mechanism of high mobility group protein B1(HMGB1)and tumor necrosis factor α-induced protein-3(TNFAIP3)involved in cell proliferation in lupus nephritis(LN)patients and human mesangial cells(HMC).Methods Immunofluorescence and immunohistochemistry technique were employed to detect HMGB1,TNFAIP3 and IκBα expression levels in glomerular cells of type Ⅳ LN patients.BrdU incorporation technology was used to detect cell proliferation level in HMC after stimulated by recombinant HMGB1.TNFAIP3 and IκBα expression levels in HMC were detected after HMGB1 stimulation by Western blot.Results The expression levels of HMGB1 and TNFAIP3 were increased in LN patients,while IκBα was decreased.HMC proliferation levels increased significantly after HMGB1 stimulation.At the same time,30 minutes after HMGB1 stimulation,the expression level of TNFAIP3 was significantly increased(P<0.05),while IκBα decreased(P<0.05)and then p65 increased significantly(P<0.05),compared with control group.Conclusion HMGB1 and TNFAIP3 are probably involved in mesangial cell proliferation by activating of NF-κB signaling pathways in LN pathogenesis.