Macular hole is an age-related disorder defined by a full-thickness defect of the foveal retina and a profound loss of central vision. First described in the mid-19th century, its study has now extended across more than 150 years. Breakthroughs in science and technology—especially the relentless refinement of retinal imaging platforms—have progressively refined our understanding of the disease. Optical coherence tomography(OCT)in particular has revolutionized characterization of the condition. At the same time, the widespread adoption of macular hole surgery has not only driven deeper investigations into pathogenesis and pre-operative assessment but also facilitated the global dissemination of surgical expertise and a marked rise in anatomical success. This review synthesizes the multimodal imaging hallmarks of macular holes and highlights the remaining clinical challenges in the application of OCT technology.

Kounis syndrome is an acute coronary syndrome triggered by an allergic reaction, which is clinically rare and frequently subject to misdiagnosis or missed diagnosis. This article presents a case report of a 70-year-old male patient who developed a rash, pruritus, and chest pain following colon polyp resection. Coronary angiography revealed occlusion of the left anterior descending artery, and blood flow was restored after stent implantation. However, the patient experienced recurrent symptoms accompanied by loss of consciousness. Drug skin tests confirmed positive reactions to chlorhexidine and fondaparinux sodium, leading to a diagnosis of type Ⅱ Kounis syndrome. By avoiding allergenic drugs and combining antihistamines with symptomatic treatment to correct myocardial ischemia, the patient′s clinical symptoms significantly improved, and he eventually recovered and was discharged from the hospital. This case underscores the importance of maintaining vigilance for this syndrome in patients with allergies accompanied by chest pain and promptly identifying and avoiding allergens.

Objective To investigate the changes in peripheral blood T-lymphocyte levels in patients with epithelial ovarian cancer(OC),and to analyze their relationship with patients'pathological parameters and their predictive value for patients'prognosis.Methods A total of 60 epithelial OC patients were selected as the case group,and 85 benign ovarian tumor patients were selected as the benign group.All patients in the case group received laparoscopic surgery and were followed up for 3 years.According to the prognosis,patients were divided into the good prognosis group(n=32)and the poor prognosis group(n=28).The peripheral blood levels of CD3+,CD4+and CD8+were detected,and the ratio of CD4+/CD8+was calculated.The peripheral blood levels of T lymphocytes in epithelial OC patients with different clinicopathological characteristics were compared.Receiver operating characteristic curve(ROC)was drawn to analyze the prognostic value of peripheral blood T lymphocytes in patients with epithelial OC.Results Compared with the benign group,the peripheral blood levels of CD3+,CD4+and CD4+/CD8+were decreased in the case group,and the CD8+level was increased(P＜0.05).Compared with epithelial OC patients with stage Ⅰ-Ⅱ,high differentiation,no peritoneal effusion and no lymph node metastasis,the peripheral blood CD3+and CD4+levels in epithelial OC patients with stage Ⅲ-Ⅳ,moderate and low differentiation,with peritoneal effusion and lymph node metastasis were lower,while CD8+was higher(P＜0.05).Compared with the good prognosis group,the peripheral blood levels of CD3+and CD4+were lower in the poor prognosis group,while the CD8+level was higher(P＜0.05).ROC analysis showed that the area under the curve(AUC)of combined detection of CD3+,CD4+,CD8+and CD4+/CD8+to predict the prognosis of epithelial OC patients was 0.952,which was higher than that of single detection of CD3+,CD4+,CD8+and CD4+/CD8+(P＜0.05).Conclusion Peripheral blood T-lymphocyte levels are correlated with clinicopathological characteristics and prognosis of patients with epithelial OC,and the combined testing of each index is more advantageous in predicting the prognosis of patients with epithelial OC.

BACKGROUND: Telesurgery has the potential to overcome spatial limitations for surgeons, which depends on surgical robot and the quality of network communication. However, the influence of network latency and bandwidth on telesurgery is not well understood. METHODS: A telesurgery system capable of dynamically adjusting image compression ratios in response to bandwidth changes was established between Beijing and Sanya (Hainan province), covering a distance of 3000 km. In total, 108 animal operations, including 12 surgical procedures, were performed. Total latency ranging from 170 ms to 320 ms and bandwidth from 15-20 Mbps to less than 1 Mbps were explored using designed surgical tasks and hemostasis models for renal vein and internal iliac artery rupture bleeding. Network latency, jitter, frame loss, and bit rate code were systemically measured during these operations. National Aeronautics and Space Administration Task Load Index (NASA-TLX) and a self-designed scale measured the workload and subjective perception of surgeons. RESULTS: All 108 animal telesurgeries, conducted from January 2023 to June 2023, were performed effectively over a total duration of 3866 min. The operations were completed with latency up to 320 ms and bandwidths as low as 1-5 Mbps. Hemostasis for vein and artery rupture bleeding models was effectively achieved under these low bandwidth conditions. The NASA-TLX results indicated that latency significantly impacted surgical performance more than bandwidth and image clarity reductions. CONCLUSIONS This telesurgery system demonstrated safety and reliability. A total of 320 ms latency is acceptable for telesurgery operations. Reducing image clarity can effectively mitigate the potential latency increase caused by decreased bandwidth, offering a new method to reduce the impact of latency on telesurgery.
Animals ; Robotic Surgical Procedures/methods* ; Laparoscopy/methods*

Objective To investigate the changes in peripheral blood T-lymphocyte levels in patients with epithelial ovarian cancer(OC),and to analyze their relationship with patients'pathological parameters and their predictive value for patients'prognosis.Methods A total of 60 epithelial OC patients were selected as the case group,and 85 benign ovarian tumor patients were selected as the benign group.All patients in the case group received laparoscopic surgery and were followed up for 3 years.According to the prognosis,patients were divided into the good prognosis group(n=32)and the poor prognosis group(n=28).The peripheral blood levels of CD3+,CD4+and CD8+were detected,and the ratio of CD4+/CD8+was calculated.The peripheral blood levels of T lymphocytes in epithelial OC patients with different clinicopathological characteristics were compared.Receiver operating characteristic curve(ROC)was drawn to analyze the prognostic value of peripheral blood T lymphocytes in patients with epithelial OC.Results Compared with the benign group,the peripheral blood levels of CD3+,CD4+and CD4+/CD8+were decreased in the case group,and the CD8+level was increased(P＜0.05).Compared with epithelial OC patients with stage Ⅰ-Ⅱ,high differentiation,no peritoneal effusion and no lymph node metastasis,the peripheral blood CD3+and CD4+levels in epithelial OC patients with stage Ⅲ-Ⅳ,moderate and low differentiation,with peritoneal effusion and lymph node metastasis were lower,while CD8+was higher(P＜0.05).Compared with the good prognosis group,the peripheral blood levels of CD3+and CD4+were lower in the poor prognosis group,while the CD8+level was higher(P＜0.05).ROC analysis showed that the area under the curve(AUC)of combined detection of CD3+,CD4+,CD8+and CD4+/CD8+to predict the prognosis of epithelial OC patients was 0.952,which was higher than that of single detection of CD3+,CD4+,CD8+and CD4+/CD8+(P＜0.05).Conclusion Peripheral blood T-lymphocyte levels are correlated with clinicopathological characteristics and prognosis of patients with epithelial OC,and the combined testing of each index is more advantageous in predicting the prognosis of patients with epithelial OC.

Sarcomatoid carcinoma of the renal pelvis accounts for a very low percentage of malignant tumors in the renal pelvis and has a poor prognosis. This article reported a patient with sarcomatoid carcinoma of the renal pelvis. The patient presented with macroscopic hematuria as the first symptom, and CT suggested left renal occupancy, unilateral nephrectomy was performed, and pathology suggested sarcomatoid carcinoma of the renal pelvis. Three weeks after surgery, a follow-up CT showed tumor recurrence. Programmed death 1(PD-1)inhibitor was given once every 3 weeks. Repeated CT examination after 24 weeks of continuous treatment suggested that the recurrent tumor disappeared. The patients was followed-up for 42 months without tumor recurrence or metastasis.

Objective To explore the improving effect of eicosapentaenoic acid(EPA)on the skeletal muscle insulin resistance in obese rats by regulating the p38 MAPK signaling pathway.Methods Fifty male Wistar rats were randomly divided into the control group,model group,inhibitor group,EPA group and inhibi-tor+EPA group,10 cases in each group.The intervention lasted for 6 weeks.The inhibitor group was given 1 mg/kg p38 MAPK inhibitor SB203580 by gavage.The EPA group was given 70 mg/kg EPA by gavage,the in-hibitor+EPA group was given SB203580+EPA by gavage,and the model group and control group were given equal volume of saline.The levels of fasting blood-glucose,fasting serum insulin,glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)and malondialdehyde(MDA)in the skeletal muscles were deter-mined.The rat insulin resistance degree was evaluated by using the intraperitoneal glucose tolerance test(IPGTT)and insulin tolerance test(ITT).The protein and mRNA expression levels of phosphorylation p38 in the rat skeletal muscle tissues were detected by Western blot and qRT-PCR.Results Compared with the control group,the body weight,epididymal fat wet weight,fasting blood-glucose and insulin levels,IPGTT and ITT blood glucose levels,and MDA content in the model group were significantly increased,the GSH-Px and SOD activities were significantly decreased,and the relative expression levels of p-p38 protein and p38 mRNA expression in skeletal muscle tissues were significantly increased(P＜0.05).Compared with the model group,the body weight and epididymal fat wet weight in the EPA group and inhibitor+EPA group were sig-nificantly decreased,while the fasting blood-glucose,fasting serum insulin,IPGTT and ITT blood glucose lev-els and MDA contents in the inhibitor group and EPA group were significantly decreased,the activities of GSH-Px and SOD were significantly increased,and the relative expression level of p-p38 protein in skeletal muscle tissues was significantly decreased(P＜0.05).However,the expression of p38 mRNA in skeletal muscle tissues had no significant change(P＞0.05).Conclusion EPA alleviates the oxidative stress possibly by inhibiting p38 MAPK signaling pathway,thus improves the skeletal muscle insulin resistance of obese rats.

Objective:To investigate the impact of group-based rehabilitation exercise on motor and non-movement symptoms of Parkinson's disease(PD).Methods:A total of 88 patients from out-patient and in-patient services at our hospital were randomly assigned to an early exercise group(E-EG), a late exercise group(L-EG), and a control group(CG)using a randomized delayed-start design.Patients in the E-EG carried out a rigorous, formal group exercise program, one hour per session, twice per week, for 18 months(May 2018-November 2019). Patients in the L-EG took part in the exercise program in the final 6-12 months of the study.We assessed outcomes using the Unified Parkinson's Disease Rating Scale(UPDRS), Parkinson's disease questionnaire-39(PDQ-39 Q), trail-making test part A & B, nine-hole peg test(9-HPT), 30 second sit to stand test(30s SST), 10 m walk test(10 m W), mini-balance evaluation systems test(Mini-BEST), Fullerton Advanced Balance(FAB)Scale and time up and go(TUG)test.Results:Compared with pre-exercise levels, patients with PD in the E-EG had lower performance in UPDRS(17.5±8.3 vs.20.0±8.6, t=-2.2, P=0.02)and lower performance in PDQ-39(27.2±2.1 vs.29.0±9.8, t=-2.6, P=0.001)after exercise.Moreover, compared with pre-exercise levels, patients with PD in the E-EG showed decreased post-exercise performance in trail-making test part B(114.2±25.5 vs.129.8±28.4, t=-2.3, P=0.02)and in 9-HPT(33.7±7.3 vs.39.6±9.3, t=-2.6, P=0.001). Conclusions:The practice of group-based rehabilitation exercise can improve movement abilities and quality of life in PD patients, especially if implemented early.Targeted rehabilitation exercise should be taken as part of the treatment strategy for PD patients as early as possible to deliver the best benefits.

Articular cartilage injury is common in orthopedics. Improper exercises and physical trauma can lead to the injury of cartilage. Since articular cartilage lacks blood supply, once damaged, it is difficult for the cartilage to repair itself. If not treated effectively, cartilage injuries will develop into severe osteoarthritis affecting the whole joint. Arthroscopic microfracture technique can achieve better therapeutic effects than regular joint debridement, with simple procedures, minimal invasion, and low cost. However, the microfracture technique is limited by the patients′ age (under 45 years old) and the size of the cartilage defect area (less than 4 cm 2) Additionally, postoperative patients need to conduct strict and long-term rehabilitation trainings. Generally speaking, the short-term prognosis of microfracture is satisfactory. However, the repair tissue is mainly composed of fibrocartilage, which is inferior to hyaline cartilage because of its poor mechanical properties and anti-wear abilities. Therefore, the long-term effect is controversial. To conclude, arthroscopic microfracture is a recommended method for young patients with small cartilage defect areas, but its exact long-term clinical effects still need to be verified by further research. This paper reviews the operation protocol, clinical efficacy, and the mechanism of arthroscopic microfracture surgery, and aims to provides theoretical basis for its application in clinical treatment.

This article reviews the influencing factors of intestinal lavage in patients with defecation disorder after spinal cord injury, and summarizes the intervention methods to improve the effect of intestinal lavage, so as to provide a reference for the correct implementation of intestinal lavage and improve the quality of life of patients.