AIM: To analysis the correlation between extraocular muscle thickness measured by quantitative CT analysis of orbital structures and clinical activity score(CAS)of thyroid-associated ophthalmopathy(TAO).METHODS:This was a retrospective analysis, selecting clinical data of TAO patients admitted to the hospital from October 2020 to February 2025. Healthy individuals were chosen from hospital's physical examination as the control group. All participants underwent CT examination, the superior rectus muscle, inferior rectus muscle, medial rectus muscle, lateral rectus muscle, orbital area, protrusion degree, and total cross-sectional area of extraocular muscles/total orbital area ratio(OM/TOA)from the two groups of participants were compared. CAS was used to evaluate TAO patients, and the correlation between CAS score and quantitative analysis indicators of CT orbital structure was analyzed. Quantitative analysis indicators for CT orbital structure in TAO patients at different stages of activity were compared, and the predictive value of these indicators for TAO patients at different activity stages was investigated.RESULTS:A total of 77 TAO patients were enrolled in this study, including 38 males and 39 females, with ages ranging from 28 to 70 y(mean age 49.5±6.9 y). There were 77 cases in the control group, including 40 males and 37 females, with ages ranging from 26 to 70 y(mean age 49.0±7.3 y). There was no significant difference in gender and age between the two groups(both P>0.05). The quantitative analysis of left eye, right eye, and binocular CT orbital structure in TAO group patients showed significantly higher indicators than the control group(all P<0.001), and the CAS score of TAO group was 3.94±1.51 points. The CAS score was positively correlated with various indicators of CT orbital structure quantitative analysis(all P<0.05). According to the CAS score results, 14 cases(28 eyes)of TAO patients with a CAS score<3 were classified as inactive phase, including 8 males and 6 females, with an average age of 43.79±9.58 y. A total of 63 cases(126 eyes)with a CAS score of ≥3 was classified as active phase, including 30 males and 33 females, with an average age of 50.78±5.47 y. There was no significant difference in gender among TAO patients with different active phases(P=0.519), but there was a significant difference in age(P<0.001). The quantitative indicators of CT orbital structure in inactive patients were significantly lower than those in active patients(P<0.05). Finally, the superior rectus muscle, age, and degree of protrusion were selected to be included in the Logistic regression model. The analysis results showed that there was a correlation between the superior rectus muscle index, degree of protrusion and TAO activity phase(P<0.05), while age, and TAO activity phase showed no significant correlation(P>0.05). The ROC curve analysis results showed that the area under the curve(AUC)was 0.863, the standard error was 0.063, P<0.001, and the 95% confidence interval(95% CI)of AUC was 0.740-0.985. The sensitivity of the model prediction was 73.0%, the specificity was 92.9%, and the Youden index was 0.659. The prediction accuracy was 97.9%, the recall rate was 73.0%, and the F1 value was 0.836. The predicted optimal critical value was 0.857. The predicted probability was 0.74.CONCLUSION:Quantitative CT analysis of orbital structures can be used to assess disease severity in TAO patients.

Objective:To explore the effects of early wet compress with traditional Chinese medicine Ru-Yi-Jin-Huang-San on drug extravasation skin injury.Methods:Totally 21 patients with skin injuries caused by extravasation of different drugs from the First People's Hospital of Lianyungang and General Hospital of Eastern Theater Command between January 2017 and December 2019 were selected by convenient sampling. They received local wet compress with Ru-Yi-Jin-Huang-San according to the redness and swelling area, which was replaced once a day until the pain and swelling were ameliorated and the wound healed. Patients with irreversible tissue necrosis underwent debridement, anti-infection, negative pressure wound treatment or wet therapy according to the principles of wound care until the wound healed. The pain score, redness area, healing time and healing outcome were compared before and after wet compress, between upper and lower limbs, between wet compress within 24 hours and wet compress after 24 hours, and between patients with and without drug extravasation.Results:After wet compress with Ru-Yi-Jin-Huang-San for 2-13 days, the skin injury of 18 patients who received wet compress within 2-24 hours after extravasation healed completely, and the healing time was (6.44±2.99) d; 3 cases formed wounds, which healed after local debridement, anti-infection, wet therapy and negative pressure therapy, with a healing time of 67 (28, 154) d. There were statistically significant difference between the pain score before wet compress and those from day 1 to day 7 after wet compress ( P<0.05) ; there were statistically significant differences between the redness and swelling area before wet compress and those from day 1 to day 5 after wet compress ( P<0.05) ; there was no statistically significant difference in the redness and swelling area between day 6 and day 7 ( P>0.05) . There were no statistically significant differences in the pain score and the redness and swelling area between the upper and lower extremities before wet compress ( P>0.05) . 3 days after wet compress, the pain score of the upper extremities was lower than that of the lower extremities, and the difference was statistically significant ( P<0.05) , but there was no statistically significant difference in the redness and swelling area between the lower extremities and the upper extremities ( P>0.05) . Before wet compress, there was no statistically significant difference in the pain score and the redness and swelling area between the groups with different time of wet compress ( P>0.05) . 3 days after wet compress, the pain score of patients who received wet compress within 24 hours was lower than that of patients who received wet compress after 24 hours ( P>0.05) . The healing time of patients who received wet compress within 24 hours was shorter than that of patients who received wet compress after 24 hours, and the difference between the two groups was statistically significant ( P<0.05) . Before wet compress, there were no significant differences in pain score and the redness and swelling area between the groups with extravasation of different drugs ( P>0.05) . 3 days after wet compress, there were no statistically significant differences in the pain score and the redness and swelling area within the antibiotic extravasation group ( P>0.05) . Conclusions:Early wet compress with Ru-Yi-Jin-Huang-San is safe and effective for drug extravasation skin injury. The sooner the wet compress, the better the effect is.