AIM: To evaluate the visual function and optical quality in adults aged 80y and older following the bilateral implantation of zonal refractive multifocal intraocular lens(IOL, LS-313 MF30).METHODS: A single-center, non-randomized, prospective clinical trial was conducted, involving cataract patients aged 80 y and older. Patients received bilateral implantation of the LS-313 MF30 or CT Asphina 409MP, based on personal preference. Postoperative assessments included uncorrected and corrected visual acuity at distance, intermediate, and near ranges, as well as defocus curve. Subjective evaluations were performed using the visual function(VF-14)questionnaire, spectacle independence rates, and patient satisfaction surveys. Photic phenomena such as glare, halos, and starbursts were also analyzed.RESULTS: The MF30 group(16 eyes from 8 participants, 85.38±2.56 y)exhibited superior uncorrected and corrected intermediate and near visual acuity compared to the 409MP group(26 eyes from 13 participants, 85.77±2.20 y), while distance visual acuity was comparable between groups. The defocus curve of the MF30 group revealed two peaks at 0.00 D and -3.00 D, indicating a broader depth of focus. Patients in the MF30 group reported higher rates of spectacle independence and greater satisfaction. While photic phenomena such as glare(28.6% vs 18.5%, P=0.584), starburst(9.5% vs 3.7%, P=0.567)and halos(23.8% vs 11.11%, P=0.438)were more prevalent in the MF30 group, they were generally mild and did not significantly impact daily activities.CONCLUSION: Zonal refractive multifocal IOLs provide elderly patients with improved distance and near vision, greater spectacle independence, and greater satisfaction. Although photic phenomena were slightly more frequent with MF30, they are generally reported as non-disruptive and do not affect their daily life compared to monofocal IOLs.

Numerous techniques for C2 screw fixation have been recently reported. However, concerns remain regarding the risk of spinal cord or vertebral artery injury and inadequate biomechanical stability. To our knowledge, the specific transforaminal “in-out-in” screw fixation technique has not been previously reported. This study aimed to investigate the feasibility and preliminary clinical outcomes of a transforaminal “in-out-in” multi-cortical purchase screw for posterior C2 screw fixation. Between October 2022 and March 2023, 10 patients underwent posterior atlantoaxial internal fixation. All patients had severe hypoplasia of the C2 pedicle on at least one side, precluding the use of standard C2 pedicle screws. A transforaminal “in-out-in” screw was used as an alternative. No spinal cord injury, vascular injury, or other major complications were observed. No implant failure was noted at the final follow-up. In conclusion, the transforaminal “in-out-in” screw may achieve rigid three-column fixation with multiple cortical purchases. It represents a safe and effective alternative for posterior C2 fixation in patients with severely narrow C2 pedicles where traditional pedicle screw placement is not feasible.

Objective To explore the efficacy of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in distinguishing the properties of abnormal lymph nodes and its role in assessing the prognosis of patients with related diseases, and to provide more precise evidence for clinical diagnosis and treatment regimen formulation. Methods The clinical data of 97 patients with malignant tumors diagnosed with abnormal lymph nodes at Wuxi People’s Hospital Affiliated to Nanjing Medical University between April 2024 and June 2025 were retrospectively analyzed. Patients were divided into a malignant lymph node group (n=47) and a benign lymph node group (n=50) based on pathological results. PET/CT metabolic parameters [maximum standardized uptake value (SUV_max), mean standardized uptake value (SUV_mean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were compared between the two groups of patients. Receiver operating characteristic curves were used to evaluate the diagnostic value of ¹⁸F-FDG PET/CT parameters for abnormal lymph nodes. Progression-free survival was compared among patients in the malignant lymph node group stratified by different levels of SUV_max, SUV_mean, MTV, and TLG. Results SUV_max, SUV_mean, MTV, and TLG were significantly higher in the malignant lymph node group than in the benign lymph node group (P < 0.05). The areas under the receiver operating characteristic curves for predicting malignant lymph nodes with SUV_max, SUV_mean, MTV, and TLG were 0.761, 0.855, 0.860, and 0.792, with sensitivities of 74.47%, 82.98%, 74.47%, and 70.21%, and specificities of 76.00%, 76.00%, 90.00%, and 82.00%, respectively (P < 0.05). Comparison of progression-free survival in patients with malignant lymph nodes with different ¹⁸F-FDG PET/CT parameter levels revealed that patients with lower levels of SUV_max, SUV_mean, MTV, and TLG had significantly longer progression-free survival than those with higher levels (Log-rank χ²=4.297, P=0.038; Log-rank χ²=6.569, P=0.010; Log-rank χ²=5.970, P=0.015; and Log-rank χ²=7.422, P=0.006, respectively). Conclusion ¹⁸F-FDG PET/CT metabolic parameters (SUV_max, SUV_mean, MTV, and TLG) demonstrate high efficacy in the differential diagnosis of benign and malignant abnormal lymph nodes and prognostic evaluation, providing significant guidance for clinical treatment decisions.

Objective To investigate the prognosis and its influencing factors in patients with hypertension complicated with heart failure (HF). Methods A total of 381 patients with hypertension and HF who were treated in our hospital from March 2022 to April 2025 were chosen. The patients were followed up for the prognosis within 6 months and split into good prognosis group (n=266) and poor prognosis group (n=115). The clinical data of the two groups were compared and analyzed. Multivariate Logistic regression analysis was used to determine the influencing factors of poor prognosis. Results The group with poor prognosis had higher proportions of atrial fibrillation and New York Heart Association (NYHA) Class III-IV, as well as increased left ventricular end-diastolic diameter (LVED), left ventricular end-systolic diameter (LVES), interventricular septum thickness (IVS), and left ventricular posterior wall thickness (LVPW) compared to the group with good prognosis (P<0.05). Additionally, levels of systolic blood pressure (SBP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), total cholesterol (TC), low-density lipoprotein (LDL), creatinine (Cr) were elevated (P<0.05), while left ventricular ejection fraction (LVEF) was decreased (P<0.05). NYHA classification, LVEF, LVED, LVPW, NT-proBNP were independent influencing factors of poor prognosis in patients with hypertension complicated with HF (P<0.05). Conclusion NYHA classification, LVEF, LVED, LVPW and NT-proBNP are closely related to the poor prognosis of patients with hypertension and HF.

Objective To explore the efficacy of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in distinguishing the properties of abnormal lymph nodes and its role in assessing the prognosis of patients with related diseases, and to provide more precise evidence for clinical diagnosis and treatment regimen formulation. Methods The clinical data of 97 patients with malignant tumors diagnosed with abnormal lymph nodes at Wuxi People’s Hospital Affiliated to Nanjing Medical University between April 2024 and June 2025 were retrospectively analyzed. Patients were divided into a malignant lymph node group (n=47) and a benign lymph node group (n=50) based on pathological results. PET/CT metabolic parameters [maximum standardized uptake value (SUV_max), mean standardized uptake value (SUV_mean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were compared between the two groups of patients. Receiver operating characteristic curves were used to evaluate the diagnostic value of ¹⁸F-FDG PET/CT parameters for abnormal lymph nodes. Progression-free survival was compared among patients in the malignant lymph node group stratified by different levels of SUV_max, SUV_mean, MTV, and TLG. Results SUV_max, SUV_mean, MTV, and TLG were significantly higher in the malignant lymph node group than in the benign lymph node group (P < 0.05). The areas under the receiver operating characteristic curves for predicting malignant lymph nodes with SUV_max, SUV_mean, MTV, and TLG were 0.761, 0.855, 0.860, and 0.792, with sensitivities of 74.47%, 82.98%, 74.47%, and 70.21%, and specificities of 76.00%, 76.00%, 90.00%, and 82.00%, respectively (P < 0.05). Comparison of progression-free survival in patients with malignant lymph nodes with different ¹⁸F-FDG PET/CT parameter levels revealed that patients with lower levels of SUV_max, SUV_mean, MTV, and TLG had significantly longer progression-free survival than those with higher levels (Log-rank χ²=4.297, P=0.038; Log-rank χ²=6.569, P=0.010; Log-rank χ²=5.970, P=0.015; and Log-rank χ²=7.422, P=0.006, respectively). Conclusion ¹⁸F-FDG PET/CT metabolic parameters (SUV_max, SUV_mean, MTV, and TLG) demonstrate high efficacy in the differential diagnosis of benign and malignant abnormal lymph nodes and prognostic evaluation, providing significant guidance for clinical treatment decisions.

Objective To explore the efficacy of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in distinguishing the properties of abnormal lymph nodes and its role in assessing the prognosis of patients with related diseases, and to provide more precise evidence for clinical diagnosis and treatment regimen formulation. Methods The clinical data of 97 patients with malignant tumors diagnosed with abnormal lymph nodes at Wuxi People’s Hospital Affiliated to Nanjing Medical University between April 2024 and June 2025 were retrospectively analyzed. Patients were divided into a malignant lymph node group (n=47) and a benign lymph node group (n=50) based on pathological results. PET/CT metabolic parameters [maximum standardized uptake value (SUV_max), mean standardized uptake value (SUV_mean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were compared between the two groups of patients. Receiver operating characteristic curves were used to evaluate the diagnostic value of ¹⁸F-FDG PET/CT parameters for abnormal lymph nodes. Progression-free survival was compared among patients in the malignant lymph node group stratified by different levels of SUV_max, SUV_mean, MTV, and TLG. Results SUV_max, SUV_mean, MTV, and TLG were significantly higher in the malignant lymph node group than in the benign lymph node group (P < 0.05). The areas under the receiver operating characteristic curves for predicting malignant lymph nodes with SUV_max, SUV_mean, MTV, and TLG were 0.761, 0.855, 0.860, and 0.792, with sensitivities of 74.47%, 82.98%, 74.47%, and 70.21%, and specificities of 76.00%, 76.00%, 90.00%, and 82.00%, respectively (P < 0.05). Comparison of progression-free survival in patients with malignant lymph nodes with different ¹⁸F-FDG PET/CT parameter levels revealed that patients with lower levels of SUV_max, SUV_mean, MTV, and TLG had significantly longer progression-free survival than those with higher levels (Log-rank χ²=4.297, P=0.038; Log-rank χ²=6.569, P=0.010; Log-rank χ²=5.970, P=0.015; and Log-rank χ²=7.422, P=0.006, respectively). Conclusion ¹⁸F-FDG PET/CT metabolic parameters (SUV_max, SUV_mean, MTV, and TLG) demonstrate high efficacy in the differential diagnosis of benign and malignant abnormal lymph nodes and prognostic evaluation, providing significant guidance for clinical treatment decisions.

OBJECTIVE: To explore the effectiveness and feasibility of two osteotomy guides in medial open wedge high tibial osteotomy (MOWHTO). METHODS: Clinical data of 103 patients who underwent routine MOWHTO surgery between January 2020 and December 2022 were collected for retrospective analysis. The patients were divided into two groups based on the method of osteotomy guide plate. The control group of 51 patients received traditional osteotomy guide plate technique, including 17 males and 34 females, aged from 48 to 68 years old with an average of(57.93±4.82) years old, with a disease duration ranged from 1 to 8 years with an average of (4.89±1.49) years. The observation group of 52 patients received personalized osteotomy guide plate technique, including 23 males and 29 females, aged from 48 to 69 with an average of (58.22±5.10) years, with a disease duration ranged from 1 to 9 years with an average of(5.10±1.55) years. The perioperative indicators, complications, and knee joint recovery rate were statistically analyzed for both groups, as well as the preoperative and postoperative coagulation function, fibrinogen (FIB), D-dimer (D-D), gait parameters (step frequency, step length, step speed), biomechanical indicators, weight bearing line (WBL), medial proximal tibial angle (MPTA), joint line conergence angle (JLCA), and anterior cruciate ligament (ACL) function (body width, tibial anterior displacement). RESULTS: All patients were followed up for 6 months. The intraoperative blood loss, operation time, and number of fluoroscopic views in the observation group were (358.58±93.76) ml, (84.42±8.17) min, and (2.00±0.44) times, respectively, which were all less than those in the control group (465.55±105.38) ml, (96.53±10.51) min, and (6.31±0.58) times (P<0.05). Three days after surgery, the FIB and D-D levels in the observation group were (4.21±0.48) g·L^-1 and (204.47±35.59) μg·L^-1, respectively, which were both lower than those in the control group (5.56±0.57) g·L^-1 and (311.12±42.23) μg·L^-1 (P<0.05). Three months after surgery, the step frequency, step length, and step speed in the observation group were (1.89±0.23) steps·s^-1, (0.57±0.15) m, and (0.99±0.11) m·s^-1, respectively, which were all higher than those in the control group (1.80±0.18) steps·s^-1, (0.50±0.14) m, and (0.95±0.09) m·s^-1 (P<0.05). Three months after surgery, the WBL and MPTA in the observation group were (45.53±4.41)% and (87.03±8.15)°, respectively, which were both higher than those in the control group (38.38±4.36)% and (83.68±8.50)°, and the JLCA was (2.36±0.24)°, which was lower than that in the control group (2.61±0.33)° (P<0.05). The ACL body width during internal fixation removal was (5.60±0.51) mm, which was greater than that in the control group (5.08±0.56) mm, and the tibial migration was (5.70±0.42) mm, which was less than that in the control group (6.33±0.48) mm (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Six months after surgery, there was no significant difference in the recovery rate of knee joint between the two groups (P>0.05). CONCLUSION The application of personalized osteotomy guide technique in MOWHTO can help improve knee biomechanics and ACL function, and has less effect on coagulation function and no increase in complications.
Humans ; Male ; Female ; Osteotomy/methods* ; Middle Aged ; Tibia/physiopathology* ; Aged ; Biomechanical Phenomena ; Retrospective Studies ; Osteoarthritis, Knee/physiopathology*

Investigating the correlation between micronucleus formation and male infertility has the potential to improve clinical diagnosis and deepen our understanding of pathological progression. Our study enrolled 2252 male patients whose semen was analyzed from March 2023 to July 2023. Their clinical data, including semen parameters and age, were also collected. Genetic analysis was used to determine whether the sex chromosome involved in male infertility was abnormal (including the increase, deletion, and translocation of the X and Y chromosomes), and subsequent semen analysis was conducted for clinical grouping purposes. The participants were categorized into five groups: normozoospermia, asthenozoospermia, oligozoospermia, oligoasthenozoospermia, and azoospermia. Patients were randomly selected for further study; 41 patients with normozoospermia were included in the control group and 117 patients with non-normozoospermia were included in the study group according to the proportions of all enrolled patients. Cytokinesis-block micronucleus (CBMN) screening was conducted through peripheral blood. Statistical analysis was used to determine the differences in micronuclei (MNi) among the groups and the relationships between MNi and clinical data. There was a significant increase in MNi in infertile men, including those with azoospermia, compared with normozoospermic patients, but there was no significant difference between the genetic and nongenetic groups in azoospermic men. The presence of MNi was associated with sperm concentration, progressive sperm motility, immotile spermatozoa, malformed spermatozoa, total sperm count, and total sperm motility. This study underscores the potential utility of MNi as a diagnostic tool and highlights the need for further research to elucidate the underlying mechanisms of male infertility.
Humans ; Male ; Infertility, Male/genetics* ; Adult ; Micronucleus Tests ; Semen Analysis ; Oligospermia/genetics* ; Azoospermia/genetics* ; Chromosome Aberrations ; Sperm Count ; Micronuclei, Chromosome-Defective ; Middle Aged

OBJECTIVE: To investigate the clinical features, treatment and prognosis of extranodal NK/T-cell lymphoma, nasal type (ENKTL) with skin lesions as initial symptom. METHODS: The clinical data of 11 ENKTL patients with skin lesions as initial symptom were retrospectively analyzed from August 2016 to January 2023 in Wuhan First Hospital and Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. RESULTS: Among the 11 patients, there were 6 males and 5 females, with a median age of 50(32-80) years. All patients had different forms of skin lesions as initial clinical symptom, including rash, ulcerative mass, painful skin nodules, infiltrating macula, etc. Most of the skin lesions were involved in the limbs and trunk but also appeared in the lower limbs alone. Five patients had hemophagocytic lymphohistiocytosis (HLH) at initial diagnosis, and 8 patients had B symptoms. All patients were diagnosed with advanced clinical staging (Lugano staging IV), and classified as high risk (PINK-E score ≥3). Immunohistochemical examination revealed that the positive rates of CD56 and EBER were both 100%, and the median Ki-67 index was 75%(50%-80%). Plasma EBV-DNA tests were all positive (≥5×10² copies/ml). Most of the induction chemotherapy regimens were combination chemotherapy (MESA, p-Gemox, SMILE) containing pegaspargase or L-asparaginase, or combined with PD-1 monoclonal immunotherapy, or HLH regimens (HLH-04 regimen, L-DEP). The median follow-up time and overall survival (OS) time were both 4.5(0.5-27) months. During the follow-up period, all 8 patients who did not receive autologous hematopoietic stem cell transplantation (ASCT) died, most of whom died of rapid disease progression. Three patients received ASCT, one died of central nervous system recurrence after transplantation, and two survived. The OS of three patients who underwent ASCT was 21, 27, and 19 months, and PFS was 11, 20, and 13 months, respectively. The plasma EBV-DNA copy number was monitored irregularly after transplantation, and the load of EBV was consistent with the changes of the disease. CONCLUSIONS Early clinical symptoms of ENKTL patients with skin lesions as initial symptom are more atypical, and early diagnosis is particularly difficult. The disease progresses rapidly and the prognosis is poor. There is still no uniform standard for the best treatment strategy. The survival of patients can be significantly prolonged by applying ASCT as soon as possible after complete remission obtained by high-dose induction chemotherapy.
Humans ; Male ; Female ; Lymphoma, Extranodal NK-T-Cell/diagnosis* ; Middle Aged ; Adult ; Retrospective Studies ; Aged ; Prognosis ; Aged, 80 and over