Rhegmatogenous retinal detachment(RRD)is a common blinding ophthalmic disease that has always received significant attention in clinical treatment. The foldable capsular buckle(FCB), as a new method for extraocular treatment of RRD, offers“Five Noes” advantages over traditional treatments such as scleral buckling(SB), pars plana vitrectomy(PPV), and pneumatic retinopexy(PR), including no retrobulbar anesthesia, no muscle traction, no scleral fluid release, no intraoperative positioning, and no cryotherapy. This effectively reduces postoperative complications in RRD patients and shortens the operation time. This review aims to investigate the development process and treatment principle of FCB, and focus on its therapeutic advantages, indication selection, efficacy and safety for RRD. It is expected to play a more important role in the treatment of a variety of retinal diseases through technological innovation and application field expansion.

OBJECTIVES: We propose a Contrastive Regional Attention and Prior Knowledge-Infused U-Transformer model (CRAKUT) to address the challenges of imbalanced text distribution, lack of contextual clinical knowledge, and cross-modal information transformation to enhance the quality of generated radiology reports. METHODS: The CRAKUT model comprises 3 key components, including an image encoder that utilizes common normal images from the dataset for extracting enhanced visual features, an external knowledge infuser that incorporates clinical prior knowledge, and a U-Transformer that facilitates cross-modal information conversion from vision to language. The contrastive regional attention in the image encoder was introduced to enhance the features of abnormal regions by emphasizing the difference between normal and abnormal semantic features. Additionally, the clinical prior knowledge infuser within the text encoder integrates clinical history and knowledge graphs generated by ChatGPT. Finally, the U-Transformer was utilized to connect the multi-modal encoder and the report decoder in a U-connection schema, and multiple types of information were used to fuse and obtain the final report. RESULTS: We evaluated the proposed CRAKUT model on two publicly available CXR datasets (IU-Xray and MIMIC-CXR). The experimental results showed that the CRAKUT model achieved a state-of-the-art performance on report generation with a BLEU-4 score of 0.159, a ROUGE-L score of 0.353, and a CIDEr score of 0.500 in MIMIC-CXR dataset; the model also had a METEOR score of 0.258 in IU-Xray dataset, outperforming all the comparison models. CONCLUSIONS The proposed method has great potential for application in clinical disease diagnoses and report generation.
Humans ; Radiology Information Systems ; Radiology

Objective:To evaluate the clinical efficacy of Huaiqi Huang Granules combined with conventional Western medicine therapy for the treatment of Kawasaki disease in children.Methods:A randomized controlled trial study was conducted. A total of 96 children with Kawasaki disease admitted to Hebei Children's Hospital from August 2022 to July 2024 were selected as the research objects and divided into the observation group and the control group by the random number table method, with 48 cases in each group. The control group received conventional Western medicine treatment on the basis of symptomatic treatment, while the observation group took Huaiqi Huang Granules on the basis of the control group. The treatment for both groups lasted 7 d. TCM symptoms scores of both groups were evaluated. ELISA was used to detect the levels of TNF-α, MCP-4, and IL-8, while fluorescence immunoassay was used to detect the levels of von Willebrand factor (vWF), endothelin-1 (ET-1), and nitric oxide (NO); flow cytometry was used to detect CD4 +, CD3 +, CD8 + levels and calculate CD4 +/CD8 +ratio; adverse reactions were recorded during treatment and clinical efficacy was evaluated. Results:The total effective rate was 93.75% (45/48) in the observation group and 77.08% (37/48) in the control group, with statistical significance ( χ2=5.35, P=0.021). After treatment, the scores of persistent high fever, skin macules, red throat and eyes, and fatigue in the observation group were lower than those in the control group ( t values were 5.66, 5.45, 5.03, and 5.42 respectively, P<0.01). After treatment, the levels of serum TNF-α, MCP-4 and IL-8 in the observation group were lower than those in the control group ( t values were 4.10, 5.97 and 3.82 respectively, P<0.01). After treatment, the levels of serum vWF [(19.43±3.85) μg/L vs. (23.02±4.13) μg/L, t=4.41] and ET-1 [(38.54±5.12) μg/L vs. (43.90±5.26) μg/L, t=5.06] in the observation group were lower than those in the control group ( P<0.01); the level of NO [(81.23±8.44) μg/L vs. (74.42±8.13) μg/L, t=4.03] was higher than that of the control group ( P<0.01); after treatment, the levels of serum CD4 + and CD3 + and the ratio of CD4 +/CD8 + in the observation group were higher than those in the control group ( t values were 4.91, 4.23, and 3.81 respectively, P<0.01); the CD8 + level was lower than that of the control group ( t=4.19, P<0.01). During the treatment period, the incidence of adverse reactions was 10.42% (5/48) in the observation group and 8.33% (4/48) in the control group, without statistical significance ( χ2=0.12, P=0.726). Conclusion:Huaiqi Huang Granules combined with conventional Western medicine therapy can effectively reduce the TCM syndrome score of children with Kawasaki disease, inhibit the levels of inflammatory factors, improve vascular endothelial function, enhance the body's immunity, and have good medication safety.

Objective:To observe the effects of estradiol on expression of plasma membrane Ca 2+-ATPase isoform 2 in inner ear of rats. Methods:Twenty-five Three-months-old female Sprague-Dawley rats were randomly and equally divided into five groups by random number table mathod,with five rats in each group. Animals in Sham group were sham-operated while others were bilateral ovariactmized. One month after modeling, the OVX groups were supplemented with estradiol (E2 group), progesterone (P group), estradiol and progesterone (E2+P group)and vehicle sesame oil (Veh group), while the Sham operation group (Sham group) was supplemented with vehicle sesame oil.All rats were sacrificed and otocysts were obtained immediately. Enzyme-linked immunosorbent assay was used to detect the changes in serum estradiol and progesterone levels of each group of rats before operation, before treatment and before sacrifice. Western blot and quantitative real-time polymerase chain reaction were used to detect the expression of total PMCA2 protein and mRNA in the inner ear of each group.Results:There was no significant difference in serum estradiol and progesterone levels among the five groups before operated( P>0.05). Before treatment, the serum estradiol and progesterone levels of rats in each group were significantly lower than those in Sham group ( P<0.05). The serum estradiol level in E2 group and E2+P group was not significantly different from that in Sham group ( P>0.05), while the serum estradiol level in P group and Veh group was significantly different from that in Sham group ( P<0.05). The level of progesterone in P group and E2+P group was higher than that in Sham group ( P<0.05), while the level of progesterone in Veh group and E2 group was lower than that in Sham group ( P<0.05). Protein and mRNA expression of PMCA2 in P and Veh groups were significantly decreased compared with that of Sham group ( P<0.05) while the expression levels underwent no significantly change in E2 and E2+P groups ( P<0.05). Conclusion:The decrease of serum estradiol level can reduce the expression of otolith regulatory protein PMCA2 in rats, and then affect otolith metabolism, which may be an important link of estrogen affecting otolith metabolism.

Objective To investigate the diagnostic value of ultrasound ADNEX model in ovarian tumors.Methods 226 patients with pathological-confirmed ovarian tumor from Jun.2014 to Jun.2018 were selected,and the preoperative ultrasound imaging,clinical and pathological data were analyzed.The ultrasound imaging was recorded,and ovarian tumor was diagnosed through ADNEX model.The diagnostic efficiency of ADNEX model for ovarian benign and malignant tumors was analyzed with pathological findings as the gold standard.Results The differences of onset age,CA125 level,tumor solid components maximum diameter and ratio,＞10 locules and ascites were all statistically significant between each ovarian tumor group (P＜0.05).The overall accuracy rate of ADNEX model in diagnosing different ovarian tumors was 83.2％,which has a good consistency with histopathological findings (Kappa=0.782,P＜0.05).The sensitivity and specificity of the prediction model in predicting benign,borderline,stage Ⅰ,stage Ⅱ-ⅣV and metastatic ovarian tumor were respectively 85.5％ and 95.7％,69.2％ and 96.0％,81.6％ and 93.8％,89.1％ and 94.4％,80.0％ and 98.5％.Conclusion Ultrasound ADNEX model is helpful in differential diagnosis of benign and malignant ovarian tumor,and it has important significance for clinical treatment and prognosis evaluation.

Objective To evaluate the effect of clemastine fumarate on Toll-like receptor 4/phosphatidylinositol-3-kinase/serine-threonine kinase (TLR4/PI3K/Akt) signaling pathway during hypoxia-reoxygenation (H/R) in rat cardiomyocytes.Methods H9C2 cells of rats cultured in vitro were seeded in culture wells or dishes at a density of 1×105 cells/ml and divided into 3 groups (n=11 each) by using a random number table method:control group (group C),H/R group and clemastine fumarate group (CF group).Cardiomyocytes were exposed to 5％ CO2-95％ N2in a low-glucose DMEM medium at 37℃ for 4 h followed by 4 h reoxygenation.At 4 h of reoxygenation,the cell viability was detected by CCK-8 assay,the ultrastructure was observed with a transmission electron microscope,the expression of TLR4,PI3K,phosphorylated Akt (p-Akt) and caspase-3 was detected by Western blot,and the expression of TLR4,PI3K and caspase-3 was detected by immunofluorescence.Results Compared with group C,the cell viability was significantly decreased,the expression of TLR4 and caspase-3 was up-regulated,and the expression of PI3K and p-Akt was down-regulated in group H/R (P＜0.05).Compared with group H/R,the cell viability was significantly increased,the expression of TLR4 and caspase-3 was down-regulated,the expression of PI3K and p-Akt was up-regulated (P＜0.05),and the mitochondrial damage was significantly attenuated in group CF.Conclusion The mechanism by which clemastine fumarate alleviates H/R injury to rat cardiomyocytes may be related to inhibiting TLR4 expression and activating PI3K/Akt signaling pathway.

Objective To assess the efficacy and safety of methimazole combined with selenium therapy in the treatment of hyperthyroidism .Methods 130 cases with hyperthyroidism were selected , and according to the digital table they were randomly divided into methimazole plus selenium treatment group ( ATD +Se group ) and methimazole treatment group(ATD group),65 cases in each group.The patients were followed up for 3 months.The thyroid function index and thyroid antibody index were observed before and after treatment .The adverse reactions were observed,too.Results After treatment,the serum levels of FT3,FT4,TSH in the ATD +Se group were (3.32 ± 0.53)pg/mL,(1.02 ±0.17)ng/dL,(2.72 ±0.32)mIU/L,respectively,which in the ATD group were (4.82 ± 0.75)pg/mL,(2.41 ±0.32)ng/dL,(2.72 ±0.32)mIU/L,respectively.The change ranges of the ATD +Se group were better than those of the ATD group ,the differences were statistically significant (t=4.591,3.814,3.567,all P<0.05).The TPOAb,TGAb,TRAb in the ATD+Se group were (120.3 ±23.1) IU/mL,(123.3 ±26.5) IU/mL, (1.72 ±0.89)IU/mL,respectively,which in the ATD group were (132.8 ±21.1)IU/mL,(134.8 ±21.3)IU/mL, (3.68 ±1.06)IU/mL,respectively.The changes of the ATD+Se group were more significant than those of the ATD group,the differences were statistically significant (t=4.291,3.514,3.767,all P<0.05 ).The total effective rate of the ATD+Se group was higher than that of the ATD group (90.77％vs.76.92％χ2 =13.147,P<0.05 ).The incidence rate of adverse reactions in the ATD +Se group was lower than that in the ATD group (12.31％vs.27.69％χ2 =18.685,P<0.05 ).Conclusion The results suggest that methimazole combined with selenium treatment is effective and safe for hyperthyroidism .

Objective To investigate the correlation between the blood flow characteristics of contrastenhanced ultrasound (CEUS) and malignancy of patients with ovarian tumor.Methods 60 cases with ovarian tumors treated by surgery and confirmed by pathology were selected,including 28 cases of ovarian cancer and 32 cases of benign ovarian tumor.The time of arrival (AT),peak time (TTP) and intensity of enhancement (EI) were determined by CEUS,and microvessel density (MVD) of tumor tissue was detected by immunohistochemistry.The correlation of the above parameters with MVD and tumor staging was analyzed.Results AT,TTP of the malignant tumor group (10.8±2.1,25.3±10.5) was significantly lower than those of the benign tumor group (15.4±2.7,59.4±11.2).EI of the malignant tumor group (28.6±2.9) was significantly higher than that of the benign tumor group (14.9±2.6),with statistical significance (P＜0.05).MVD of the malignant tumor group (62.8± 13.6) was significantly higher than that of the benign tumor group (21.5±11.4),with significant difference (P＜0.05).AT and TTP were negatively correlated with MVD and FIGO staging (r=-0.562,r=-0.504,r=-0.636,r=-0.623),while EI was positively correlated with MVD and FIGO staging (r=0.839 and r=0.785),with statistical difference (P＜0.05).Conclusions Blood flow characteristics of CEUS are closely related to the malignancy of ovarian tumors.CEUS can accurately evaluate angiogenesis,blood perfusion and malignancy of ovarian tumors.

Objective To evaluate the role of chemokine CXC-ligand 16 (CXCL16) in renal fibrosis following renal ischemia-reperfusion (I/R) injury in mice.Methods Twenty-four healthy male C57BL/6 mice,aged 8-10 weeks,weighing 20-30 g,were divided into 4 groups (n =6 each) using a random number table method:sham operation group (group S),sham operation plus anti-CXCL16 antibody group (group S+A),group I/R,and I/R plus anti-CXCL16 antibody group (group I/R+A).Renal ischemia was induced by occlusion of the left renal artery for 30 min followed by 72-h reperfusion,and the fight kidney was removed on 5th day in anesthetized mice.CXCL16 antibody 5 mg/kg and the equal volume of normal saline were intraperitoneally injected at 72 h after reperfusion twice a week for 2 consecutive weeks in I/R+A and I/R groups,respectively.Sham operation was performed,and the equal volume of CXCL16 antibody 5 mg/kg and normal saline were intraperitoneally injected at 72 h after reperfusion twice a week for 2 consecutive weeks in S+A and S groups,respectively.Orbital venous blood samples were collected at day 14 after reperfusion for determination of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.Animals were then sacrificed and the left kidney was removed for measurement of the renal fibrosis size (using Sirius red staining),expression of t-smooth muscle actin (α-SMA),fibronectin (FN) and type Ⅰ collagen (Col-Ⅰ) in renal tissues by Western blot.Results Compared with group S,the serum BUN and Cr concentrations and renal fibrosis size were significantly increased,and the expression of α-SMA,FN and Col-Ⅰ was up-regulated in group I/R (P＜0.05).Compared with group I/R,the serum BUN and Cr concentrations and renal fibrosis size were significantly decreased,and the expression of α-SMA,FN and Col-Ⅰ was down-regulated in group I/R+A (P＜0.05).Conclusion CXCL16 is involved in the process of renal fibrosis following renal I/R injury in mice.

Objectives To provide reference for the improve of health care system and healthcare insurance con-trolling method, through researching on the value-based healthcare paying system in South Korea. Methods The basic characteristics of the Korean health care system was researched, Specifically, its reform experiences of value-based health insurance review and assessment paying system,which government took. Results South Korea’s health care pay-ing system had achieved both good social and policy effects. Conclusions Value-based health care paying system is the main reason for the reducing of health care expenditures and making of scientific health policy.