AIM: To analyze the influencing factors of capsular constriction syndrome(CCS)in cataract patients after phacoemulsification(Phaco)combined with intraocular lens(IOL)implantation.METHODS: Retrospective study. The data of 2 900 cataract patients(2 900 eyes)in our hospital's information system from January 2021 to January 2024 were collected. All patients were treated with Phaco combined with IOL implantation, and the incidence of CCS within 30 wk after surgery was recorded. Patients were categorized into CCS(116 cases, 116 eyes)and N-CCS group(2 784 cases, 2 784 eyes)based on the occurrence of CCS. The basic data of the two groups were compared, and the influencing factors of CCS within 30 wk after Phaco combined with IOL implantation in cataract patients were analyzed by multivariate Logistic regression.RESULTS: Among 2 900 patients(2 900 eyes)included, 116 cataract patients(116 eyes)developed CCS within 30 wk after Phaco combined with IOL implantation, with an incidence rate of 4.00%. The single factor and multi-factor Logistic regression analysis showed that the complicated diabetes, high myopia, complicated glaucoma, and axial length(AL)>30 mm were the risk factors for the occurrence of CCS after Phaco IOL implantation in cataract patients(all P<0.05).CONCLUSION: Attention should be paid to cataract patients with diabetes, high myopia, glaucoma and AL>30 mm, which will increase the risk of CCS within 30 wk after Phaco combined with IOL implantation in cataract patients.

Objective To evaluate and compare the success rate and short-term clinical prognosis of transfemoral transcatheter aortic valve replacement(TF-TAVR)for patients with pure aortic regurgitation(PAR)of different annulus sizes.Methods This study is a single center retrospective study,selecting symptomatic PAR patients who received TF-TAVR treatment at Zhongshan Hospital Fudan University from September 2019 to September 2023.Based on preoperative CT results,all patients were divided into three groups:Group A(aortic annulus circumference＜80 mm),Group B(80 mm≤aortic annulus circumference＜85 mm),and Group C(aortic annulus circumference≥ 85 mm).The primary endpoint was success rate and 30d all-cause mortality,while the secondary endpoint was TAVR related complications.Results A total of 61 PAR patients were included in this study,including 27 in Group A,21 in Group B,and 13 in Group C.The overall success rate is 82.0％,and the 30 d all-cause mortality rate is 3.3％.The success rate of Group C patients was significantly lower(P=0.012),with higher rates of conversion to surgery and valve-in-valve implantation(P=0.022 and P=0.040).In terms of secondary endpoint events,there were no significant differences among the three groups in major bleeding events,major vascular complications,stroke,myocardial infarction,newly developed atrial fibrillation,implantation of new pacemakers,coronary artery occlusion,and postoperative moderate to severe perivalvular leakage(all P＞0.05).Conclusions The circumference of the aortic valve annulus is a key factor affecting the success rate of TF-TAVR in PAR,and PAR patients with an aortic valve annulus circumference less than 85mm may be more suitable for TF-TAVR.

Objective:To explore the role of bone marrow mesenchymal stem cells(BMSC),an essential element of the bone marrow microenvironment,in multidrug resistance(MDR)of K562 cells,as well as the reversal effect of tetrandrine(TET)on BMSC-mediated MDR and its potential mechanism.Methods:A mixed co-culture system and a transwell co-culture system for BMSC and K562 cells were established,and the cells were divided into different groups and treated with daunorubicin(DNR)alone or combined with TET and DNR.The CCK-8 assay was used to detect the proliferation of K562 cells in each group,and the cell inhibition rate was calculated.Cytometric bead array(CBA)was used to detect the expression levels of IFN,IL-2,IL-6 and IL-10 in the supernatant of different groups.RT-qPCR and Western blot were used to detected the expression of STAT3 at mRNA and protein levels,respectively.Results:Compared with K562+DNR group,the inhibition rate of DNR on K562 cell proliferation in K562+BMSC+DNR group was significantly decreased(P＜0.05),while the levels of IL-6 in the culture supernatant and phosphorylated STAT3 in K562 cells were significantly increased(P＜0.05).Compared with K562+BMSC+DNR group,the inhibition rate of DNR on K562 cell proliferation in K562+BMSC+DNR+TET group was significantly increased(P＜0.05),while the level of IL-6 and phosphorylated STAT3 was significantly decreased(P＜0.05).Conclusion:BMSC can promote the drug resistance of leukemia cells,and TET may reverse the BMSC-mediated drug resistance via inhibiting IL-6/STAT3 signaling pathway.

Objective:To investigate the effectiveness and safety of domestic upper gastrointestinal endoscopic ultrasound (EUS).Methods:A total of 160 patients undergoing EUS at Shengjing Hospital of China Medical University (Center1) and Shenzhen People's Hospital (Center 2) from March to July 2021 were randomly selected by stratified blocked randomization, and were treated with SonoScape EG-UG5T (the test group) or Fujifilm EG-580UT (the control group). The primary outcome was the ultrasound image quality excellence rate, and the comparison was verified by non-inferiority. The secondary outcomes were the endoscopic image quality excellence rate, the operational performance excellence rate, and the system stability evaluation. The safety evaluation was based on the occurrence of intraoperative and postoperative adverse events in the subjects.Results:In the intention-to-treat analysis set (ITT), the excellence rate of ultrasound image quality in the test group and the control group was 100.0% (78/78) and 100.0% (77/77), respectively. The rate difference between the two groups was 0.0% (95% CI: -4.7%-4.8%). In the per protocol analysis set (PPS), the excellence rate of ultrasound image quality in the test group and the control group was 100.0% (78/78) and 100.0% (75/75), respectively. The rate difference between the two groups was 0.0% (95% CI: -4.7%-4.9%). The lower limit of the confidence interval of ultrasound image quality excellence rate of both data sets was greater than the non-inferiority threshold value of -8%, which inferred that the non-inferiority hypothesis of the test machine non-inferior to the control machine was valid. The endoscopic image quality excellence rate and the operational performance excellence rate of the test group and the control group was 100.0% in both the ITT and PPS analyses, and there was no statistically significant difference between the two groups ( P=1.000). The system instability event rate was 0.0% (0/78) in the test group and 3.9% (3/77) in the control group ( P=0.120). No adverse event occurred in either group. Conclusion:The domestic upper gastrointestinal endoscopic ultrasound is standard-compliant for clinical application under normal conditions in terms of effectiveness, safety, and stability.

Objective:To explore and analyze the predictive value of EuroSCORE Ⅱ and SYNTAX Ⅱ scores for clinical outcomes in patients undergoing coronary artery bypass grafting (CABG) surgery.Methods:A total of 500 coronary artery disease (CAD) patients who underwent CABG in Shanxi Cardiovascular Hospital from April 2014 to July 2023 were selected as the study subjects, all patients were given EuroSCORE Ⅱand SYNTAX Ⅱ scores to evaluate the predictive value of EuroSCOREⅡfor perioperative mortality and SYNTAX Ⅱ for 4-year mortality. Univariate and multivariate Logistic analysis were employed to analyze the independent risk factors for perioperative and 4-year mortality.Results:There were 3 deaths during the perioperative period, with a mortality rate of 0.60%, the predicted mortality rate of EuroSCOREⅡwas 1.71%; there were 21 deaths at 4 years after surgery, with a mortality rate of 4.23% and the predicted mortality rate of SYNTAX Ⅱwas 9.02%. Logistic regression analysis showed that left ventricular ejection fraction (LVEF) was the only independent protective factor for perioperative mortality, and advanced age was the only independent risk factor for 4-year postoperative mortality in patients ( P<0.05). The analysis of the working characteristic curve of the subjects found that the area under the receiver operating characteristic curve ( ROC) of EuroSCORE Ⅱ for perioperative mortality was 0.782, and the area under ROC curve of SYNTAX Ⅱfor postoperative 4-year mortality was 0.743. Conclusion:Both EuroSCORE Ⅱand SYNTAX Ⅱhave certain predictive value for perioperative mortality and postoperative 4-year mortality in patients undergoing CABG, respectively, but the predicted mortality rate is relatively higher.

Objective:To investigate the difference of condylar bone density,volume and surface area in adult female patients with different vertical skeletal features of skeletal Class Ⅱ.Methods:This study was a retrospective case-control study.150 female patients aged 18-30 years were included as the subjects.Lateral cephalic radiographs were measured and the cases with high angle,average an-gle and low angle of skeletal Class Ⅱ were included and respectively grouped(n=50),the CBCT images were collected,the condyles were reconstructed by Mimics Reseach 20.0 software,the bone density,volume and surface area of the condyles were measured.Univa-riate analysis of variance(ANOVA)was used to compare the difference of condyle measurements among the 3 groups.Results:The overall difference of condylar bone density,volume and surface area among the 3 groups were statistically significant(P＜0.05).Pair-wise comparison showed that the condyle bone mineral density in high angle group was lower than that in average angle group(P＜0.05),in average angle group was lower than that in low angle group(P＜0.05),in high angle group was lower than that in low angle group(P＜0.001).Condyle volume and surface area in high angle group were lower than those in low angle group(P＜0.05),in aver-age angle group was lower than those in low angle group(P＜0.001),in high angle group was lower than those in average angle group(P＞0.05).Conclusion:The condyle bone density,volume and surface area of the different vertical skeletal features of skeletal class Ⅱ in adult female patients are different.

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Objective:To explore the value of amide proton transfer-weighted (APTw) imaging and intravoxel incoherent motion (IVIM) imaging for diagnosing and evaluating the pathological differentiation of cervix squamous cell carcinoma (CSCC).Methods:This study was a diagnostic trial. Totally 56 patients pathologically diagnosed with CSCC at the First Hospital of Lanzhou University from October 2021 to October 2022 were retrospectively collected, as the CSCC group. And 36 female healthy volunteers who underwent physical examinations at the First Hospital of Lanzhou University from October 2021 to October 2023 were recruited as the control group. CSCC patients were divided into well-moderately differentiated ( n=34) and poorly differentiated groups ( n=22). The region of interest was placed in the lesions of CSCC group and normal cervical stroma of control group, and the quantitative parameters for asymmetric magnetization transfer ratio (MTR asym) of APTw imaging and pure diffusion coefficient (D), false diffusion coefficient (D *) and perfusion fraction (f) for IVIM were obtained. The independent sample t test was used to compare the differences in quantitative parameters between the two groups, the logistic regression model was used to establish combined parameters for the quantitative parameters with statistical significance between the two groups. The receiver operator characteristic curve was used to evaluate the diagnostic efficacy of single quantitative parameters and combined parameters to distinguish the CSCC group from the control group, and the well-moderately differentiated group from the poorly differentiated group in CSCC patients. The area under the curve (AUC) was compared using the DeLong test. Results:There were significant differences in MTR asym, D and f between CSCC group and control group ( t=-9.79, 10.09, 11.35, P<0.001). Also, significant differences were found for MTR asym and D between the well-moderately differentiated and poorly differentiated group ( t=4.11, -3.76, P<0.001). There was no significant difference in other quantitative parameters ( P>0.05). When comparing the CSCC group and control group, the AUC (95% CI) of MTR asym, D, f and combined parameter (MTR asym+D+f) were 0.887 (0.804-0.944), 0.940 (0.871-0.979), 0.968 (0.909-0.993), 0.995 (0.950-1.000). The AUC of the combined parameter was higher than those of MTR asym and D, with statistical significance ( Z=3.07, 2.06, P=0.002, 0.040). When comparing the well-moderately differentiated and poorly differentiated group, the AUC (95% CI) of MTR asym, D, and combined parameter (MTR asym+D) were 0.789 (0.660-0.887), 0.775 (0.644-0.876), 0.852 (0.731-0.932). There was no significant difference between each two AUCs ( P>0.05). Conclusion:The quantitative parameters of APTw and IVIM imaging can be used to diagnose and preliminarily evaluate the pathological differentiation of CSCC. Joint parameters can improve the diagnostic efficiency of CSCC.

In addition to providing energy for cells, mitochondria also participate in calcium homeostasis, cell information transfer, cell apoptosis, cell growth and differentiation. Therefore, maintaining mitochondrial homeostasis is very crucial for the body to carry out normal life activities. Ubiquitination, a post-translational modification of proteins, is involved in various physiological and pathological processes of cells by regulating mitochondrial homeostasis. However, the mechanism by which ubiquitination regulates mitochondrial homeostasis has not been summarized, especially the effect of Parkin protein on cardiovascular diseases. In this paper, the specific mechanism of mitochondrial homeostasis regulated by ubiquitination of Parkin protein is discussed, and the influence of mitochondrial homeostasis imbalance on cardiovascular diseases is reviewed, with a view to providing potential therapeutic strategies for the clinical treatment of cardiovascular diseases.