ObjectiveThrough multimodal research methods including medication rule mining， network pharmacology， molecular docking and dynamics simulation， and in vivo animal experiments， this study aims to speculate and verify the core composition （Ginseng Radix et Rhizoma Rubra-Salviae Miltiorrhizae Radix et Rhizoma-Notoginseng Radix et Rhizoma） and efficacy （Qi-invigorating and blood-activating） of the drug combination in Yitangkang Compound for improving diabetic cardiomyopathy （DCM）， investigate the interaction relationship and binding strength between core active ingredients of the drug combination and key signaling pathway targets， and further explore the mechanism by which the Qi-invigorating and blood-activating drug combination regulates the calcium signaling pathway to improve cardiac function in DCM rats. MethodsThe Ancient and Modern Medical Cases Cloud Platform was used to construct a DCM prescription database， and the "Analysis Method" module of the platform was applied to mine and summarize medication rules， thereby determining the core composition of the Qi-invigorating and blood-activating drug combination in Yitangkang. Drug-active ingredient-signaling pathway-core target-disease analysis and visualization were conducted by combining network pharmacology with the Traditional Chinese Medicine System Pharmacology Platform （TCMSP） database， SwissTargetPrediction platform， GeneCards database， MetaScape database， CytoScape software， etc. Then， molecular docking was performed via the CB-Dock2 platform， and molecular dynamics simulation of the high-binding-strength docking complexes was carried out by Gromacs software. Finally， in vivo animal experiments were carried out. Twenty-eight Sprague Dawley （SD） rats meeting the research criteria were divided into a normal group， a model group， a drug combination group （3.3 g·kg^-1）， and a Yitangkang group （20 g·kg^-1）. A type 2 diabetes mellitus （T2DM） rat model was established by high-fat diet feeding combined with intraperitoneal injection of streptozotocin （STZ）， followed by continuous feeding for eight weeks until the DCM model was successfully established. During this period， the traditional Chinese medicine （TCM） compound and drug combination were administered for prevention and treatment intervention. Meanwhile， changes in blood glucose， body weight， and heart index of each group were monitored. Cardiac function was assessed by echocardiography， and electrophysiological signals were detected by an electrocardiogram. The heart tissue was observed for pathological changes by hematoxylin-eosin （HE） and Masson staining， and the expression of L-type calcium channel （CACNA1C）， calmodulin （CALM1）， calcium/calmodulin-dependent protein kinase Ⅱδ （CAMK2D）， and neuronal nitric oxide synthase （NOS1） proteins in the calcium signaling pathway of myocardial tissue was detected by Western blot. ResultsIn 62 DCM prescriptions， Ginseng Radix et Rhizoma Rubra， Salviae Miltiorrhizae Radix et Rhizoma， and Notoginseng Radix et Rhizoma were used most frequently. Their meridian tropism mainly involved the spleen， heart， and lung， and their sweet and warm properties were prominent. The drugs for tonifying or blood-activating and stasis-resolving ranked top. In association rule analysis， （Ginseng Radix et Rhizoma Rubra， Salviae Miltiorrhizae Radix et Rhizoma）-Notoginseng Radix et Rhizoma had the highest lift. Network pharmacology obtained 75 active ingredients of the drug combination， 714 drug combination action targets， 2 702 disease targets， and 286 intersection targets. Protein-protein interaction （PPI） network predicted nine interaction component-targets （nine active ingredients and four calcium signaling pathway target genes）. Molecular docking showed the four complexes with the lowest binding energy were 2f3z-ginsenoside Re， 1cll-quercetin， 9blh-（6S）-6-（hydroxymethyl）-1，6-dimethyl-8，9-dihydro-7H-naphtho［8，7-g］benzofuran-10，11-dione， and 5vv0-miltionone Ⅱ. Dynamics simulation showed the CALM1-quercetin complex had the strongest binding affinity. The animal experiment results revealed that compared with the normal group， the model group showed significant changes in blood glucose， body weight， myocardial tissue morphology， heart index， cardiac function， electrophysiological indexes， and the expression levels of CACNA1C， CALM1， CAMK2D， and NOS1 proteins （P<0.05， P<0.01）. Compared with the model group， the Yitangkang group had a certain improvement effect on the above indexes （P<0.05， P<0.01）. Compared with the Yitangkang group， the drug combination group showed no significant difference in improving myocardial tissue morphology， heart index， cardiac function， electrophysiological indexes， and the expression of CACNA1C， CALM1， CAMK2D， and NOS1 proteins， except for blood glucose and body weight. ConclusionGinseng Radix et Rhizoma Rubra， Salviae Miltiorrhizae Radix et Rhizoma， and Notoginseng Radix et Rhizoma are the core Qi-invigorating and blood-activating drug combination in Yitangkang Compound. They have a good preventive and therapeutic effect on STZ-induced DCM in rats， and their mechanism of action may be related to the regulation of the calcium signaling pathway.

BACKGROUND: Doxorubicin hydrochloride (DOX) is extensively used in the treatment of various tumors. However, its clinical application is limited due to dose-dependent cardiotoxicity. Currently, few effective strategies exist to mitigate or eliminate DOX-induced cardiomyopathy (DIC). Although ferroptosis is implicated in DIC and its inhibition partially alleviates the condition, the direct targets of DOX in the progression of cardiotoxicity remain unclear. This study aimed to discover the direct targets of DOX in ferroptosis-mediated DIC. METHODS: A DOX pulldown assay was performed to identify proteins specifically binding to DOX in murine hearts, followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify candidate proteins. A cardiac injury mouse model was established by DOX treatment. Based on this, multiple ferroptosis biomarkers were detected by flow cytometry, quantitative real-time polymerase chain reaction, western blotting, immunochemistry, etc. Besides, specific activator and inhibitor of signaling pathways were applied to illuminate molecular mechanisms. RESULTS: Glutathione S-transferase P1 (GSTP1) was identified as a DOX target. GSTP1 activity was inhibited in DOX-treated cardiomyocytes, while its overexpression significantly alleviated DIC. Moreover, GSTP1 overexpression inhibited acyl-CoA synthetase long-chain family member 4 (ACSL4)-dependent ferroptosis. Mechanistically, GSTP1 overexpression suppressed c-Jun N-terminal kinase (JNK) phosphorylation, thereby reducing reactive oxygen species (ROS) production and inhibiting ferroptosis in DIC. CONCLUSIONS This study identifies the DOX/GSTP1/JNK axis as a critical pathway mediating ACSL4-dependent ferroptosis in DIC. GSTP1 is highlighted as a potential key mediator of ferroptosis and a promising therapeutic target for DIC.

Objective:To examine the postoperative morphological changes in outer retinal wave-like changes (ORC) in eyes with rhegmatogenous retinal detachment (RRD).Methods:A retrospective clinical study. From March 2020 to March 2024, 64 eyes of 64 RRD patients diagnosed at The Second Affiliated Hospital of Zunyi Medical University were included. The cohort included 39 males (39 eyes) and 25 females (25 eyes), with a mean age of (45.3±15.7) years and a mean retinal detachment duration of (16.6±13.5) days. Macular involvement was observed in 51 eyes. Scleral buckling surgery (SB), pars plana vitrectomy (PPV), and SB+PPV were performed in 17, 44, and 3 eyes respectively. Best corrected visual acuity (BCVA) and spectral domain optical coherence tomography examinations were performed in all affected eyes. BCVA examination was performed using the standard logarithmic visual acuity chart, and the visual acuity was converted to logarithm of the minimum angle of resolution (logMAR) during statistics. Combined with the ORC situation before the operation, the morphological repositioning of outer retinal folds (ORF) after the operation was classified into types Ⅰ, Ⅱ and Ⅲ. One week and one and three months after the operation, relevant examinations were performed using the same equipment and methods as before the operation. The structural characteristics of ORC and the morphology of ORF after surgery were observed. The comparison between groups was conducted using the independent sample t test or the Mann-Whitney U test. Results:Among the 64 eyes, preoperative ORC was present in 46 eyes (71.9%, 46/64) and absent in 18 eyes (28.1%, 18/64). The 18 eyes without ORC had retinal detachment durations of either ≤4 days or ≥42 days. Postoperatively, ORF was observed in 51 eyes (79.7%, 51/64) and absent in 13 eyes (20.3%, 13/64). Among the 51 eyes with macular holes involved, 24 eyes (47.1%, 24/51) had ORF after the operation and 27 eyes (52.9%, 27/51) had no ORF. Among the 46 and 18 eyes with and without ORC, the ORF after surgery was 28 (60.9%, 28/46) and 1 (5.6%, 1/18) eyes, respectively. There was a statistically significant difference in the reduction rate of ORF after surgery between eyes with and without ORC ( χ2=15.974, P<0.001). Among the 46 eyes with ORC, the proportions of ORF to types Ⅰ, Ⅱ and Ⅲ after surgery were 24 (52.2%, 24/46), 20 (43.5%, 20/46), and 2 (4.3%, 2/46) eyes, respectively. There was no statistically significant difference in the incidence of ORF after different surgical methods in eyes with ORC ( P>0.05). One week and one month after the surgery, the logMAR BCVA of the affected eyes with and without ORF was 0.97±0.47, 0.69±0.34 and 0.85±0.32, 0.54±0.21, respectively. The BCVA of those without ORF was better than that of those with ORF, but the differences were not statistically significant ( t=0.237, 0.408; P>0.05). Conclusions:The occurrence of ORC in RRD eyes has a certain relationship with the time of retinal detachment. For RRD eyes with ORC before the operation, the repositioning morphology after the operation is more likely to show changes in ORF. The transformation from ORC to ORF after ORC surgery has no correlation with the surgical method.

Objective:To explore the related risk factors of diaphragmatic hernia after thoraco-laparoscopic minimally invasive Mckeown esophagectomy (MIME).Methods:This is a retrospective controlled study. A retrospective analysis was conducted on the clinical data of patients who underwent MIME at the Department of Thoracic Surgery, Fourth Hospital of Hebei Medical University, from January 2016 to December 2023. A total of 619 patients were included. There were 423 males and 196 females, aged (63.7±7.6) years (range: 37 to 87 years). The diagnosis of diaphragmatic hernia after MIME was made based on clinical symptoms and CT scans. Patients were divided into two groups: the diaphragmatic hernia group ( n=16) and the non-diaphragmatic hernia group ( n=603). Clinical data, including age, gender, body mass index (BMI), smoking history, tumor location (upper, middle, and lower thoracic esophagus), preoperative neoadjuvant therapy history, and tumor staging, were collected and analyzed. A BMI of 25 kg/m2 and age of 65 years were used as cutoff values. The χ2 test and Fisher′s exact test were used to compare the data between the two groups, and Logistic regression was employed for risk factor analysis. The diaphragmatic hernia group and non-diaphragmatic hernia group were matched in a 1∶3 ratio with a caliper value of 0.02 by propensity score matching. Kaplan-Meier method was used for survival analysis and compared using the log-rank test for between-group differences. Results:The proportion of patients with diaphragmatic hernia after MIME who underwent surgical treatment was 6/16. Statistically significant differences were observed between the diaphragmatic hernia group and the non-diaphragmatic hernia group in terms of age ( χ2=16.057, P<0.01), BMI ( χ2=16.057, P<0.01), and tumor location ( χ2=12.048, P=0.002). Multivariate logistic regression analysis revealed that age ≥65 years ( OR=1.236, P=0.023) and BMI<25 kg/m2 ( OR=0.810, P<0.01) were independent risk factors for the development of diaphragmatic hernia after MIME. Survival analysis showed no significant difference in long-term survival between patients with and without diaphragmatic hernia after MIME ( P=0.187), and whether patients with diaphragmatic hernia underwent surgery was not associated with long-term prognosis ( P=0.560). Conclusion:Patients with BMI<25 kg/m 2 and age ≥65 years are independent risk factors for diaphragmatic hernia after MIME. The occurrence of diaphragmatic hernia is not associated with prognosis, and whether patients with diaphragmatic hernia undergo surgery does not affect the prognosis.

Objective:To evaluate the efficacy and safety of immunotherapy combined with chemotherapy as conversion therapy for initially unresectable locally advanced esophageal squamous cell carcinoma.Methods:This retrospective case series study analyzed clinical and pathological data of 32 patients with initially unresectable locally advanced esophageal squamous cell carcinoma who received immunotherapy combined with chemotherapy at the Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, from June 2020 to December 2024. The cohort included 27 males and 5 females, with an age ( M(IQR)) of 61(9)years (range:46 to 73 years). Five patients were diagnosed with stage Ⅲ, 27 with stage ⅣA. All patients received PD-1 inhibitor sintilimab combined with nedaplatin and albumin-bound paclitaxel. Radiological evaluations were performed every two cycles, the multidisciplinary team evaluation was conducted to determine conversion to resectable status, and patients with successful conversion underwent radical esophagectomy. Follow-up was conducted via telephone or outpatient visits every 3 to 6 months after the last treatment. The primary endpoint was R0 resection rate, secondary endpoints included objective response rate (ORR), pathological complete response (pCR) rate, major pathological response (MPR) rate, event-free survival (EFS), disease-free survival (DFS) in patients with R0 resection, overall survival (OS) and safety. Kaplan-Meier method was used to plot survival curves and estimate median EFS, DFS, OS rates and their 95% CI. The 95% CI for ORR, pCR rate, MPR rate, and downstaging rate were calculated using the Clopper-Pearson method. Results:The median treatment cycle of 2(1) (range:2 to 8). As of June 2025, the median follow-up was 32.5(13.5)months (range:6.4 to 59.1 months). Among the 32 patients, 9 experienced progression or recurrence, including 2 with liver and lymph node metastases, 2 with lung metastases, 2 with thoracic vertebral metastases, and 3 with mediastinal lymph node metastases. After conversion therapy, 29 patients underwent surgery, achieving an R0 resection rate of 84.4% (95% CI:67.2% to 94.7%), a pCR rate of 27.6% (95% CI:12.7% to 47.2%), and an MPR rate of 55.2% (95% CI:35.7% to 73.6%). Grade 3 or higher surgical complications occurred in 6.9%(2/29) of patients, and grade 3 or higher treatment-related adverse events were observed in 15.6%(5/29). Among the 32 patients, the ORR was 56.3% (95% CI:37.7% to 73.6%),the 3-year EFS rate and OS rate was 59.4% (95% CI:40.8% to 86.4%) and 59.7% (95% CI:40.0% to 89.0%) respectively. Conclusion:Immunotherapy combined with chemotherapy demonstrates high conversion rates and favorable safety in the conversion therapy of initially unresectable locally advanced esophageal squamous cell carcinoma, representing a promising treatment strategy.

Purpose To evaluate the long-term efficacy of radiofrequency ablation(RFA)for T1N0M0 papillary thyroid carcinoma(PTC)with rich blood supply and poor blood supply.Materials and Methods Clinical data,ultrasound and contrast-enhanced ultrasound(CEUS)images,RFA parameters,and postoperative follow-up indicators of 375 T1N0M0 PTC patients who received RFA from June 2014 to December 2018 were retrospectively collected.The propensity score matching method was used to match the baseline data of the two groups in a 1:1 ratio,finally a total of 212 patients were included in the study.The RFA parameters,volume,tumor disappearance,and local tumor progression(LTP)were compared between the groups.Besides,the correlation between rich blood supply and LTP was analyzed using multivariate COX regression.Results According to the peak intensity displayed by preoperative CEUS,all lesions were divided into a group with rich blood supply(n=129)and another with poor blood supply(n=246).After a mean follow-up time of(84.48±14.44)months,the tumor disappearance in the rich blood supply group was 87.74%,while in the poor blood supply group it was 88.68%,and there was no statistically significant difference(Z=0.05,P=0.831).There were 10 cases of LTP in the rich blood supply group(6 cases of residual cancer and 4 cases of new cancer),and 6 cases of LTP in the poor blood supply group(2 cases of residual cancer and 4 cases of new cancer).The LTP rates of the two groups were 9.43%and 5.67%,with no statistically significant difference(x2=1.08,P=0.298).The Kaplan-Meier survival curve showed no statistically significant difference in progression free survival between both groups(P=0.265).The adjusted multivariate COX proportional risk model analysis showed that rich blood supply was no association with LTP(HR=1.54,P=0.409).Conclusion RFA for T1N0M0 PTC with rich blood supply can achieve effective ablation,and its long-term efficacy is similar to that of poor blood supply.RFA can serve as an effective alternative treatment for T1N0M0 PTC patients with different blood supply.

Objective:To evaluate the efficacy of curative esophagectomy versus definitive chemoradiotherapy (dCRT) in patients with clinical T1bN0M0 thoracic esophageal cancer.Methods:The propensity score matching (PSM) and retrospective cohort study was conducted. The clinico-pathological data of 163 patients with clinical T1bN0M0 thoracic esophageal cancer who were admitted to Henan Provincial People′s Hospital from January 2014 to December 2020 were collected. There were 125 males and 38 females, aged (58.9±7.0)years. Of 163 patients, 124 cases undergoing curative transthoracic esophagectomy were allocated into the radical resection group, 39 cases undergoing dCRT were allocated into the dCRT group. Observation indicators:(1) PSM and compari-son of clinicopathological characteristics of patients between the two groups after matching; (2) complications in the radical resection group and treatment status in the dCRT group; (3) survival analysis; (4) analysis of factors influencing patients′ prognosis. Comparison of measurement data with normal distribution between groups was conducted using the Welch t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the Mann-Whitney U test. The Cox proportional hazard model was used for univariate and multivariate analyses. The Kaplan-Meier method was used to calculate survival rate and plot survival curve, and Log-rank test was used for survival analysis. PSM was performed using the 2∶1 nearest neighbor matching method. The caliper value was set as 0.05. Results:(1) PSM and comparison of clinicopathological charac-teristics of patients between the two groups after matching. Of the 163 patients, 117 cases were successfully matched, with 78 cases in the radical resection group and 39 cases in the dCRT group. After PSM, the elimination of tumor differentiation degree confounding bias ensured comparability. (2) Complications in the radical resection group and treatment status in the dCRT group.Among the 78 patients in the curative esophagectomy group, 22 cases developed complications within 30 days after surgery. There was no death within 30 days after surgery. Among the 39 patients in the dCRT group, 25 cases received concurrent chemoradiotherapy alone, 8 cases received induction chemo-therapy followed by concurrent chemoradiotherapy, 3 cases received sequential chemoradiotherapy, and 3 cases received radiotherapy alone. Among the 33 patients who received concurrent chemo-radiotherapy, 29 cases were treated with the XP regimen, and 4 cases with the FP regimen. Efficacy evaluation showed that 37 patients achieved complete remission, and 2 patients had residual lesions. Twenty-two patients developed treatment-related adverse reactions. (3) Survival analysis. After PSM, the follow-up duration was 58(range, 13-125)months in the radical resection group and 56(range, 10-129)months in the dCRT group. The postoperative 5-year overall survival rates were 95.7% and 97.1% in the radical resection group and dCRT group, respectively, showing no significant difference between the two groups ( χ2=0.001, P>0.05). The postoperative 5-year disease-free progression survival rates were 88.2% and 94.2% in the radical resection group and dCRT group, respectively, showing no significant difference between the two groups ( χ2=0.652, P>0.05). (4) Analysis of factors influencing patients prognosis. Age and pathological TNM stage were indepen-dent influencing factors for overall survival time in patients with clinical T1bN0M0 thoracic esophageal cancer ( hazard ratio=1.312, 2.945, 95% confidence interval as 1.042-1.711, 2.204-5.517, P<0.05). Age and pathological TNM stage were independent influencing factors for disease-free survival time in patients with clinical T1bN0M0 thoracic esophageal cancer ( hazard ratio=1.215, 3.301, 95% confidence interval as 1.012-1.699, 2.012-6.321, P<0.05). Conclusions:There is no significant difference in overall survival and disease-free survival between patients with clinical T1bN0M0 thoracic esophageal cancer undergoing curative esophagectomy and dCRT. The treatment modality is not an independent prognostic factor.

Objective:To evaluate the efficacy of curative esophagectomy versus definitive chemoradiotherapy (dCRT) in patients with clinical T1bN0M0 thoracic esophageal cancer.Methods:The propensity score matching (PSM) and retrospective cohort study was conducted. The clinico-pathological data of 163 patients with clinical T1bN0M0 thoracic esophageal cancer who were admitted to Henan Provincial People′s Hospital from January 2014 to December 2020 were collected. There were 125 males and 38 females, aged (58.9±7.0)years. Of 163 patients, 124 cases undergoing curative transthoracic esophagectomy were allocated into the radical resection group, 39 cases undergoing dCRT were allocated into the dCRT group. Observation indicators:(1) PSM and compari-son of clinicopathological characteristics of patients between the two groups after matching; (2) complications in the radical resection group and treatment status in the dCRT group; (3) survival analysis; (4) analysis of factors influencing patients′ prognosis. Comparison of measurement data with normal distribution between groups was conducted using the Welch t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the Mann-Whitney U test. The Cox proportional hazard model was used for univariate and multivariate analyses. The Kaplan-Meier method was used to calculate survival rate and plot survival curve, and Log-rank test was used for survival analysis. PSM was performed using the 2∶1 nearest neighbor matching method. The caliper value was set as 0.05. Results:(1) PSM and comparison of clinicopathological charac-teristics of patients between the two groups after matching. Of the 163 patients, 117 cases were successfully matched, with 78 cases in the radical resection group and 39 cases in the dCRT group. After PSM, the elimination of tumor differentiation degree confounding bias ensured comparability. (2) Complications in the radical resection group and treatment status in the dCRT group.Among the 78 patients in the curative esophagectomy group, 22 cases developed complications within 30 days after surgery. There was no death within 30 days after surgery. Among the 39 patients in the dCRT group, 25 cases received concurrent chemoradiotherapy alone, 8 cases received induction chemo-therapy followed by concurrent chemoradiotherapy, 3 cases received sequential chemoradiotherapy, and 3 cases received radiotherapy alone. Among the 33 patients who received concurrent chemo-radiotherapy, 29 cases were treated with the XP regimen, and 4 cases with the FP regimen. Efficacy evaluation showed that 37 patients achieved complete remission, and 2 patients had residual lesions. Twenty-two patients developed treatment-related adverse reactions. (3) Survival analysis. After PSM, the follow-up duration was 58(range, 13-125)months in the radical resection group and 56(range, 10-129)months in the dCRT group. The postoperative 5-year overall survival rates were 95.7% and 97.1% in the radical resection group and dCRT group, respectively, showing no significant difference between the two groups ( χ2=0.001, P>0.05). The postoperative 5-year disease-free progression survival rates were 88.2% and 94.2% in the radical resection group and dCRT group, respectively, showing no significant difference between the two groups ( χ2=0.652, P>0.05). (4) Analysis of factors influencing patients prognosis. Age and pathological TNM stage were indepen-dent influencing factors for overall survival time in patients with clinical T1bN0M0 thoracic esophageal cancer ( hazard ratio=1.312, 2.945, 95% confidence interval as 1.042-1.711, 2.204-5.517, P<0.05). Age and pathological TNM stage were independent influencing factors for disease-free survival time in patients with clinical T1bN0M0 thoracic esophageal cancer ( hazard ratio=1.215, 3.301, 95% confidence interval as 1.012-1.699, 2.012-6.321, P<0.05). Conclusions:There is no significant difference in overall survival and disease-free survival between patients with clinical T1bN0M0 thoracic esophageal cancer undergoing curative esophagectomy and dCRT. The treatment modality is not an independent prognostic factor.

Purpose To evaluate the long-term efficacy of radiofrequency ablation(RFA)for T1N0M0 papillary thyroid carcinoma(PTC)with rich blood supply and poor blood supply.Materials and Methods Clinical data,ultrasound and contrast-enhanced ultrasound(CEUS)images,RFA parameters,and postoperative follow-up indicators of 375 T1N0M0 PTC patients who received RFA from June 2014 to December 2018 were retrospectively collected.The propensity score matching method was used to match the baseline data of the two groups in a 1:1 ratio,finally a total of 212 patients were included in the study.The RFA parameters,volume,tumor disappearance,and local tumor progression(LTP)were compared between the groups.Besides,the correlation between rich blood supply and LTP was analyzed using multivariate COX regression.Results According to the peak intensity displayed by preoperative CEUS,all lesions were divided into a group with rich blood supply(n=129)and another with poor blood supply(n=246).After a mean follow-up time of(84.48±14.44)months,the tumor disappearance in the rich blood supply group was 87.74%,while in the poor blood supply group it was 88.68%,and there was no statistically significant difference(Z=0.05,P=0.831).There were 10 cases of LTP in the rich blood supply group(6 cases of residual cancer and 4 cases of new cancer),and 6 cases of LTP in the poor blood supply group(2 cases of residual cancer and 4 cases of new cancer).The LTP rates of the two groups were 9.43%and 5.67%,with no statistically significant difference(x2=1.08,P=0.298).The Kaplan-Meier survival curve showed no statistically significant difference in progression free survival between both groups(P=0.265).The adjusted multivariate COX proportional risk model analysis showed that rich blood supply was no association with LTP(HR=1.54,P=0.409).Conclusion RFA for T1N0M0 PTC with rich blood supply can achieve effective ablation,and its long-term efficacy is similar to that of poor blood supply.RFA can serve as an effective alternative treatment for T1N0M0 PTC patients with different blood supply.

Objective:To examine the postoperative morphological changes in outer retinal wave-like changes (ORC) in eyes with rhegmatogenous retinal detachment (RRD).Methods:A retrospective clinical study. From March 2020 to March 2024, 64 eyes of 64 RRD patients diagnosed at The Second Affiliated Hospital of Zunyi Medical University were included. The cohort included 39 males (39 eyes) and 25 females (25 eyes), with a mean age of (45.3±15.7) years and a mean retinal detachment duration of (16.6±13.5) days. Macular involvement was observed in 51 eyes. Scleral buckling surgery (SB), pars plana vitrectomy (PPV), and SB+PPV were performed in 17, 44, and 3 eyes respectively. Best corrected visual acuity (BCVA) and spectral domain optical coherence tomography examinations were performed in all affected eyes. BCVA examination was performed using the standard logarithmic visual acuity chart, and the visual acuity was converted to logarithm of the minimum angle of resolution (logMAR) during statistics. Combined with the ORC situation before the operation, the morphological repositioning of outer retinal folds (ORF) after the operation was classified into types Ⅰ, Ⅱ and Ⅲ. One week and one and three months after the operation, relevant examinations were performed using the same equipment and methods as before the operation. The structural characteristics of ORC and the morphology of ORF after surgery were observed. The comparison between groups was conducted using the independent sample t test or the Mann-Whitney U test. Results:Among the 64 eyes, preoperative ORC was present in 46 eyes (71.9%, 46/64) and absent in 18 eyes (28.1%, 18/64). The 18 eyes without ORC had retinal detachment durations of either ≤4 days or ≥42 days. Postoperatively, ORF was observed in 51 eyes (79.7%, 51/64) and absent in 13 eyes (20.3%, 13/64). Among the 51 eyes with macular holes involved, 24 eyes (47.1%, 24/51) had ORF after the operation and 27 eyes (52.9%, 27/51) had no ORF. Among the 46 and 18 eyes with and without ORC, the ORF after surgery was 28 (60.9%, 28/46) and 1 (5.6%, 1/18) eyes, respectively. There was a statistically significant difference in the reduction rate of ORF after surgery between eyes with and without ORC ( χ2=15.974, P<0.001). Among the 46 eyes with ORC, the proportions of ORF to types Ⅰ, Ⅱ and Ⅲ after surgery were 24 (52.2%, 24/46), 20 (43.5%, 20/46), and 2 (4.3%, 2/46) eyes, respectively. There was no statistically significant difference in the incidence of ORF after different surgical methods in eyes with ORC ( P>0.05). One week and one month after the surgery, the logMAR BCVA of the affected eyes with and without ORF was 0.97±0.47, 0.69±0.34 and 0.85±0.32, 0.54±0.21, respectively. The BCVA of those without ORF was better than that of those with ORF, but the differences were not statistically significant ( t=0.237, 0.408; P>0.05). Conclusions:The occurrence of ORC in RRD eyes has a certain relationship with the time of retinal detachment. For RRD eyes with ORC before the operation, the repositioning morphology after the operation is more likely to show changes in ORF. The transformation from ORC to ORF after ORC surgery has no correlation with the surgical method.