Background There is currently limited research on the antibiotic resistance of Legionella pneumophila in China. Establishing analytical methods for antibiotic resistance phenotypes and resistance genes of Legionella pneumophila in artificial water environment is of great significance. Objective To investigate the antibiotic resistance characteristics of Legionella pneumophila isolated from artificial water environment in Zhongshan, and to provide a scientific basis for the prevention and control of Legionella infection. Methods A total of 295 strains of Legionella pneumophila isolated from central air conditioning systems and hot water systems in Zhongshan from 2012 to 2024 were collected. The minimum inhibitory concentrations (MIC) of antimicrobial agents against the strains were determined using the E-test method. Whole genome sequencing combined with bioinformatics techniques was used to analyze the antibiotic resistance genes of 16 strains of Legionella pneumophila. The phylogenetic evolutionary relationships between these strains and clonal strains from different sources worldwide were analyzed based on whole genome single nucleotide polymorphisms (wgSNPs). Results The antimicrobial susceptibility testing results showed that the highest resistance rate of Legionella pneumophila was to erythromycin (ERY) (56.9%), followed by azithromycin (AZM) (27.1%) and levofloxacin (LEV) (12.2%). The antibiotic resistance rates to rifampicin (RIF) and cefotaxime (CTX) were low, and the strains were fully susceptible to clarithromycin (CLA), ciprofloxacin (CIP), and doxycycline (DOX). Compared to the isolates from the hot water systems, those from the central air conditioning systems exhibited higher resistance rates to ERY (70.9% vs. 28.1%) and AZM (34.2% vs. 12.5%), and the differences were statistically significant (χ²=48.226, P<0.001; χ²=15.388, P<0.001). The MIC values of Lp1 isolates for four antibiotics (AZM, CLA, DOX, and CTX) were significantly higher than those of Lp2-14 isolates (Z=−3.490, P <0.001; Z=−3.035, P <0.05; Z=−2.662, P<0.05; Z=−2.973, P <0.05). The MIC values of Lp2−14 isolates for RIF were significantly higher than those of Lp1 isolates (Z=−3.190, P<0.05). The strains isolated from 2019–2024 exhibited higher MIC values for both CLA and DOX than those isolated from 2012–2018 (Z=−4.847, P <0.001; Z=−6.057, P <0.001). Whole genome sequencing analysis showed that the 16 strains of Legionella pneumophila carried antibiotic resistance genes for aminoglycosides, macrolides, cephalosporins, and penicillins. The phylogenetic analysis showed that Legionella pneumophila in this region exhibited high genetic diversity and was consistent with the epidemic trends of strains from other regions worldwide. Conclusion The isolates of Legionella pneumophila in this study are highly susceptible to most antimicrobial agents. However, the antibiotic resistance should not be ignored, and continuous monitoring of antibiotic resistance is necessary.

Objective:The purpose of this study was to analyze the epidemiological characteristics of hand, foot, and mouth disease (HFMD) among individuals aged 6 years and above in Guangzhou from 2010 to 2023, with the intention that a scientific basis be provided for effective prevention and control measures in older age groups.Methods:Data on HFMD incidence among individuals aged 6 years and above in Guangzhou from 2010 to 2023 were collected and analyzed. Descriptive epidemiological methods were used to analyze the distributions and pathogen components of HFMD cases in Guangzhou residents aged 6 years and above. Spatial autocorrelation analysis and Getis-Ord Gi* analysis were conducted to identify the spatial clustering patterns of HFMD at the street town level. Results:From 2010 to 2023, the gender ratio of HFMD cases in persons aged 6 and above was 1.49∶1 in Guangzhou. The average annual incidence rate of HFMD among individuals aged 6 years and above in Guangzhou was 25.75 per 100 000. Furthermore, the reported incidence rate indicated an increased tendency. The annual incidence showed a bimodal distribution, with the main peak occurring from May to July and the secondary peak from September to October. HFMD incidence rates vary by townships, with hotspots clustered in urban and urban-rural regions. The dominant pathogen shifts from year to year. Enterovirus 71 (EV71) was the prevalent strain in 2010, followed by other enteroviruses and Coxsackievirus (CV)-A16 from 2011 to 2016. Since 2017, CV-A6 has steadily become the major pathogen.Conclusions:The incidence of HFMD cases among individuals aged 6 years and above in Guangzhou increased generally from 2010 to 2023, with hotspots localized in urban and urban-rural areas. The pathogen composition altered dramatically, with the proportion of EV71 dropping overall, while CV-A6 eventually became the dominating strain. Therefore, it is imperative to focus on the prevention and control of HFMD in this age group, especially by strengthening measures in areas with high prevalence.

Objective:To explore the cardioprotective effects of icariin (ICA) against radiation-induced cardiac disease (RICD) in C57BL/6 mice.Methods:A total of 48 female C57BL/6J mice aged 6-8 weeks were randomly divided into three groups: the control group (CON), the irradiation group (IR), and the irradiation combined with icariin group (IR+ ICA), with 16 mice in each group. The IR and IR+ ICA groups received a single cardiac irradiation at a dose of 30 Gy, while the CON group received no radiation treatment. The IR+ ICA group was treated with ICA (70 mg·kg -1·d -1) two weeks before irradiation until the end of the experiment through intragastric administration. In contrast, the CON and IR groups were treated with an equal volume of vehicle solution (0.5% sodium carboxymethyl cellulose, NaCMC) via intragastric administration. The mice′s mental status, food intake, body weight, and survival rates were monitored during the experiment. At two weeks post-irradiation, the venous blood of the mice was collected and serum was separated for the enzyme-linked immunosorbent assays (ELISA) of creatine kinase MB isoenzyme (CK-MB) and cardiac troponin T (cTnT/TNNT2). At 12 weeks post-irradiation, the cardiac function of the mice was assessed using echocardiography. After the mice were euthanized under anesthesia, the histopathological changes and fibrosis degree of their myocardial tissues were assessed using hematoxylin and eosin (HE) and Masson′s trichrome staining, followed by the calculation of collagen volume fraction (CVF). The differential gene expression of brain natriuretic peptide (BNP), transforming growth factor-β (TGF-β), and interleukin-6 (IL-6) in the cardiac tissues of the mice was detected using real-time reverse transcription-polymerase chain reaction (RT-PCR). Apoptosis-related proteins and proteins associated with the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) pathway were determined using Western blotting. The survival curves of the mice were plotted using Kaplan-Meier, and the survival differences of the mice among various groups were compared using the log-rank test. Results:After irradiation, the mice in the IR group showed lethargy, as well as decreased food intake and activity, while these symptoms in the IR+ ICA group were significantly alleviated. At two weeks post-irradiation, the CK-MB and cTnT levels of the IR group were significantly elevated compared with the CON group ( t = 5.28, 8.89, P < 0.01). At 12 weeks post-irradiation, the mice in the IR group exhibited significantly decreased body weight ( t = 2.47, P < 0.05) and decreased survival rates ( HR = 8.25, 95% CI: 1.157-58.770, P < 0.05) compared with the CON group. Echocardiography revealed that the IR group featured decreased left ventricular ejection fraction (EF), decreased fractional shortening (FS), and increased left ventricular end-diastolic diameter (LVDD) compared with the CON group ( t = 7.02, 4.45, P < 0.05). Histopathological examination revealed that the IR group suffered from cardiomyocyte edema, disordered arrangement, and increased fibrosis, with an elevated CVF. The IR group exhibited significantly upregulated gene expression of BNP, TGF-β, and IL-6 in cardiac tissues compared with the CON group ( t = 4.23, 6.39, 4.61, P < 0.05). After-irradiation, the IR group exhibited upregulated apoptosis-related proteins Cleaved Caspase-3 and Bax ( t = 6.29, 9.54, P < 0.05), decreased Bcl-2 expression ( t = 8.20, P < 0.001), and decreased phosphorylation levels of PI3K and Akt ( t = 6.47, 3.42, P < 0.001). The symptoms of the mice were partially ameliorated after treatment with ICA. Specifically, the mice in the IR+ ICA group exhibited higher body weight ( t = 5.13, P < 0.001) and significantly higher survival rates ( HR = 0.121, 95% CI: 0.017-0.864, P < 0.05) than the IR group. Compared to the IR group, the IR+ ICA group showed elevated cardiac function indicators EF and FS( t = 3.23, 3.05, P < 0.05), and reduced LVDD ( t = 3.02, P < 0.05). The histopathological analysis revealed mitigated edema and disordered arrangement of cardiomyocytes in the IR+ ICA group. Furthermore, the IR+ ICA group exhibited significantly lower BNP, TGF-β, and IL-6 expression levels than the IR group ( t = 2.83, 4.15, 2.96, P < 0.05). The expression of apoptosis-related proteins Cleaved Caspase-3 and Bax was lower ( t = 3.23, 3.24, P < 0.05), Bcl-2 expression was higher ( t = 5.92, P < 0.001), and restored phosphorylation levels of PI3K and Akt ( t = 2.89, 8.35, P < 0.001). Conclusions:Icariin has protective effects against the RICD. It alleviates cardiomyocyte apoptosis possibly by upregulating the phosphorylation levels of PI3K and Akt.

Objective:To observe the changes of subfoveal choroidal thickness (SFCT) under the macular center recess after trabeculectomy in eyes with open-angle glaucoma (POAG), and to preliminarily analyze its relationship with visual function.Methods:A retrospective case-control study. 117 patients with POAG who were diagnosed by ophthalmologic examination and treated with trabeculectomy in Department of Ophthalmology of Shangluo Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were included in the study. Among them, 63 cases were male; 54 cases were female. All of them underwent naked-eye visual acuity, best-corrected visual acuity (BCVA), refraction, optical coherence tomography (OCT) examination, and axial length measurement. SFCT was measured using enhanced deep imaging with an OCT instrument. Based on the visual function reduction at 1 month after surgery, the patients were categorized into a visual function unreduced group and a visual function reduced group of 67 and 50 cases, respectively. Visual function included binocular adjustment amplitude and sensitivity; visual quality included objective scattering index (OSI) and modulation transfer function (MTF). Changes in SFCT and visual function-related indexes were analyzed by repeated-measures analysis of variance; the risk associated with changes in SFCT and visual function-related indexes was evaluated by a binary logistic regression model; and the relationship between SFCT and post-surgical visual function loss was analyzed by a Joint model; the SFCT and post-surgical visual function reduction was analyzed by a Joint model; the dose-response relationship between SFCT and post-surgical visual function decompensation was analyzed by applying the restricted cubic spline (RCS). Decision curve (DCA) was used to predict visual hypoplasia.Results:Comparison of the percentage of patients with different ages, anterior chamber hemorrhage, and post-surgical anterior chamber inflammatory response in the unreduced visual function group and the reduced visual function group showed statistically significant differences ( P<0.05). The results of the main effect test showed that the differences between SFCT and visual function adjustment amplitude, sensitivity time effect, between-group effect, and interaction effect were statistically significant in both groups ( P<0.05). The results of the separate effects test showed that compared with the preoperative period, the SFCT, accommodation amplitude, and sensitivity of the affected eyes of the two groups were significantly increased at different times after surgery, and the differences were statistically significant ( P<0.05). The results of multivariate ANOVA showed that SFCT, accommodation amplitude, and sensitivity at different times before and after surgery were significantly lower in the group with reduced visual function than in the group without reduced visual function, and the differences were statistically significant ( P<0.05). The △naked-eye visual acuity, △BCVA, △OSI, and △MTF of the patients in the group with reduced visual function were significantly lower than those in the group without reduced visual function, and the differences were all statistically significant ( P<0.05). Correlation analysis showed that SFCT was positively correlated with △adjustment amplitude, △sensitivity, △naked-eye visual acuity, △BCVA, △OSI, and △MTF ( r=0.426, 0.419, 0.311, 0.315, 0.325, 0.285; P<0.05). Multiple linear regression analysis showed that △SFCT was positively correlated with △adjustment amplitude, △sensitivity, △naked-eye visual acuity, △BCVA, △OSI, and △MTF before and after adjusting for confounders ( P<0.05). The results of Joint modeling analysis showed that the risk of visual function decompensation was increased by 5% for every 1 μm increase in SFCT. The results of RCS analysis showed a nonlinear correlation between SFCT and surgical The RCS analysis showed that there was a nonlinear relationship between SFCT and post-surgical visual impairment for nonlinear test ( P<0.001); the threshold effect analysis showed that the fold point at which SFCT affected post-surgical visual impairment was 243.25 μm.The DCA analysis showed that SFCT predicted a significant increase in the net clinical benefit rate of post-surgical visual impairment for risk thresholds ranging from 0.00 to 0.84. Conclusions:After POAG trabeculectomy, SFCT of those with or without reduced visual function are significantly thickened compared to pre-surgery; the magnitude of visual function adjustment and sensitivity tended to increase significantly after surgery. Naked eye visual acuity, BCVA, OSI, and MTF all have a significant effect on postoperative visual function.

Objective:To design a set of new type of surgery instrument for pectus excavatum(PE),so as to improve safety and effectiveness of minimally invasive operation in surgery for PE.Methods:The design of the new type of surgical instrument for PE adopted multifunctional orthopedic board that combined both penetrating and supporting functions.The T type handle,special sealing screw for single hole,setscrew and stator,which were convenient for operation,were equipped for the orthopedic board.The new type of surgical instrument was applied in clinical PE surgery since November,2010,and a total of 1398 PE surgeries were conducted in the 10 years,which included 1078 surgeries with single hole,and 320 surgeries with multi holes.The success rate of PE surgery with single hole mode was assessed.Results:In 1398 PE surgeries,the number of PE patients,whose ages were less or equal to 12 years old,and who all adopted single hole mode,was 887 cases,and the success rate of surgery with single hole was 100%.In addition,the number of PE patients,whose age was larger than 12 years old,was 511 cases,and the surgery with single hole was successfully applied in 191 cases of them,and the success rate of surgery with single hole was 37.4%.Conclusion:The the new type of surgical instrument for PE by surgery with single hole and multi holes has mature technique,and it is safety and effectiveness,which has higher clinical application value.

Objective:To compare the efficacy of body posture combined with pharmacotherapy and pharmacotherapy alone in the treatment of chronic subdural hematoma(CSDH).Methods:Firstly, retrospective case series study was conducted. Thirty cases of CSDH that had received body posture combined with pharmacotherapy at Department of Neurosurgery, Huashan Hospital Affiliated to Fudan University from December 2016 to October 2020 were studied retrospectively. Twenty-seven patients were male, and 3 patients were female. The age of patients ( M(IQR)) was 66(16) years (range:28 to 84). Nineteen patients had unilateral hematoma, and 11 patients had bilateral hematoma. All patients received pharmacotherapy and body posture therapy that was to raise their lower limbs 20 to 30 cm with leg lift pad and get abdominal compressed with customized abdominal belt in supine position. Patients were required to maintain the body posture as much as possible, with the maximum to 16 to 18 hours per day. Patients with unilateral hematoma should tilt the head to the affected side and avoid tilting it to the opposite side. For patients with bilateral hematoma, there was no need for head lateralization. Patient were treated with oral dexamethasone and atorvastatin simultaneously. The preliminary efficacy of body posture combined with pharmacotherapy was determined by hematoma improvement rate which was analyzed by Clopper-Pearson method. Then, the multi-center, prospective, randomized controlled trial had carried out in 9 medical centers from August 2020 to November 2021. The stratified block randomization method was adopted. Patients were randomized in a ratio of 1∶1 to either receive pharmacotherapy alone(the control group) or body posture combined with pharmacotherapy(the experiment group) for 3 months and followed up for 6 months. Effective treatment was defined as complete absorption of hematoma, or the hematoma volume decreased by more than 10 ml and Markwalder grading scale score had improved by more than 1 point compared to the baseline. The efficacy rate and surgery conversion rate at 3 months and recurrence at 6 months were observed. Comparison between groups was performed with paired sample t test, Mann-Whitney U test, χ2 test, corrected χ2 test, or Fisher exact probability method. Logistic regression was used to compare the effective rate and operation rate between the two groups. Results:In the respective study, 30 patients completed follow-up 13 to 353 days after treatment. At the last follow-up, the incidence of almost complete absorption or significantly absorption of hematoma (hematoma volume was significantly reduced accompanied by symptom improvement) was 93.3%. The 95% CI for the incidence that analyzed by the Clopper-Pearson method was 77.9% to 99.2%. One hundred and six patients were enrolled in the multicenter study. Fifty-five patients underwent body posture combined with pharmacotherapy. The age was 74(17) years (range:26 to 92). Thirty-nine patients were males and 16 were females. Fifty-one patients underwent pharmacotherapy alone. The age was 69(12) years (range:48 to 84). Thirty-seven patients were males and 14 were females. The length of body posture recorded in diary card was (15.7±2.3) hours(range:7.6 to 19.3 hours). The efficacy rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 83.6% (46/55) and 56.9% (29/51), respectively at 3 months. The result of the logistic regression analysis showed that the efficacy of body posture combined with pharmacotherapy group was better than that of pharmacotherapy alone group ( OR=3.88,95% CI:1.57 to 9.58, P=0.003). Surgery rate in the body posture combined with pharmacotherapy group and pharmacotherapy alone group were 5.5% (3/55) and 21.6% (11/51) respectively. The result of Logistic regression showed that the pharmacotherapy alone group was more likely to be converted to surgery ( OR=0.21,95% CI:0.05 to 0.80, P=0.023). At the 6 months, no recurrence of cases was found in the body posture combined with pharmacotherapy group. However, the recurrence rate of pharmacotherapy alone group was 6.3% (3/48), there was no significant difference between the two groups ( P>0.05). Conclusion:The effect of body posture combined with pharmacotherapy for chronic subdural hematoma is better than that of pharmacotherapy alone.

Objective To construct a model that can predict the risk of diagnosing ABO-blood group sys-tem hemolytic disease of the newborn(ABO-HDN)and to verify its effectiveness.Methods A total of 446 children with neonatal hyperbilirubinemia who met the inclusion criteria and were first diagnosed in this hos-pital from January 2022 to March 2023 were selected as the modeling group,and were divided into the develo-ping group(200 cases)and the non-developing group(246 cases)according to whether ABO-HDN was diag-nosed.Totally 17 potential influencing factors were included for univariate analysis and multi-factor analysis,and independent risk factors were included in R software to establish a Nomogram model to predict the risk of ABO-HDN.Another 105 cases of neonatal hyperbilirubinemia in the hospital from April to September 2023 were selected as the verification group.Results In the modeling group,Logistic regression analysis showed that maternal pregnancy number,prenatal serum titer,hemoglobin level,white blood cell count,creatine ki-nase level and neonatal Apgar 1 min score were all independent risk factors for ABO-HDN(P＜0.05).Multi-variate Logistic regression analysis showed that the area under receiver operating characteristic(ROC)curve of the modeling group was 0.819(95％CI:0.779-0.859),sensitivity was 0.655,specificity was 0.878.In the verification group,the area under ROC curve was 0.867(95％CI:0.800-0.933),the sensitivity was 0.803,and the specificity was 0.773.Conclusion The established predictive model scoring system can effec-tively predict the risk of ABO-HDN.

Objective To analyze the differential expression of non-coding RNAs (ncRNAs) from liver tissues adjacent to hepatic cystic echinococcosis (CE) lesions and distant normal liver tissues using whole transcriptome sequencing, and perform functional annotations of differentially expressed ncRNAs, so as to explore the potential role of ncRNAs in the pathogenesis of CE. Methods Intraoperative liver tissue specimens adjacent to hepatic CE lesions and distant normal liver tissue specimen were sampled from patients with hepatic CE, and the expression profiles of microRNAs (miRNAs), circular RNAs (circRNAs), and long non-coding RNAs (lncRNAs) were detected using whole transcriptome sequencing. Differentially expressed genes were identified, and functional annotations were performed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. In addition, a circRNA/lncRNA-miRNA-messenger RNA (mRNA) competing endogenous RNA (ceRNA) network was constructed using the Cytoscape software, and the expression of hub miRNAs in the network was validated using real-time quantitative reverse transcription PCR (RT-qPCR) assay. Results A total of 41 differentially expressed miRNAs were identified between the adjacent and distal tissues of hepatic CE lesions, including 8 up-regulated and 33 down-regulated miR-NAs, which were significantly enriched in biological processes of Ras signaling and neutrophil activation. Five differentially expressed circRNAs were detected, including 3 up-regulated and 2 down-regulated circRNAs, which were significantly enriched in molecular functions of hormone signaling pathways and RNA transcription regulation. A total of 447 differentially expressed lncRNAs were identified, including 200 up-regulated and 247 down-regulated lncRNAs, which were involved in cell proliferation, immune regulation, and extracellular matrix remodeling pathways. MiRNA target analysis predicted hsa-miR-27a-5p, hsa-miR-21-3p, and hsa-miR-181b-2-3p as hub nodes in the ceRNA network. RT-qPCR assay detected that the relative expression levels of ENSG00000253736, HAS2-AS1, PCSK6, hsa-miR-21-3p, hsa-miR-27a-5p, MIR23AHG, VIPR1-AS1, LINC02910, and hsa-miR-181b-2-3p were 3.00 ± 0.25, 2.75 ± 0.33, 1.01 ± 0.51, 2.65 ± 0.41, 1.01 ± 0.29, 1.10 ± 0.31, 1.05 ± 0.27, 0.25 ± 0.49, and 2.56 ± 0.35 in adjacent tissues of hepatic CE lesions, normalized to that in distant tissues from hepatic CE lesions, respectively (t = 6.21, 5.83, 7.51, 7.46, 6.12, 6.65, 7.13, 1.87 and 7.81, all P values < 0.01), which was consistent with whole transcriptome sequencing results. Conclusions Differentially expressed ncRNAs from adjacent and distal liver tissues of hepatic CE lesions may contribute to the pathological mechanisms of CE through mediating cell proliferation, immune evasion, and inflammatory responses, in which hsa-miR-27a-5p and hsa-miR-21-3p may serve as hub miRNAs.

Objective: To compare the clinical efficacy of visual dilated sheath combined with needle nephroscope percutaneous nephrolithotomy (PCNL) with traditional PCNL for renal calculi，so as to enhance the intraoperative safety and puncture accuracy. Methods: A retrospective analysis was conducted on 100 patients with renal calculi treated on hospital during Sep.2022 to Sep.2023.Based on the surgical approaches，patients were divided into the needle nephroscope group (PCNL with visual dilator sheath and needle nephroscope，n=52) and traditional group (traditional PCNL，n=48).Clinical characteristics，surgical parameters，and outcomes were compared between the two groups. Results: There were no significant differences between the two groups in baseline data，total operation time and hospital stay (P>0.05).The needle nephroscope group had a longer channel establishment time compared to the traditional group [20.0(17.0-22.0) min vs.16.0 (15.0-21.0) min，P=0.002]，but significantly shorter puncture time [2.0 (1.0-2.6) min vs. 2.8(2.0-3.5) min，P<0.001]，and fewer adjustments of the puncture needle (9.6% vs. 64.6%，P<0.001).The channel was successfully established on the first attempt in all patients in the needle nephroscope group，while only 41 of patients in the traditional group achieved success on the first attempt，6 cases needed 2 attempts，and 1 case needed 3 attempts.Postoperative complications were absent in the needle nephroscope group，whereas postoperative bleeding requiring interventional treatment occurred in 1 case in the traditional group.There was no significant difference in the first-stage stone-clearance rate between the two groups (88.4%vs. 85.4%，P=0.872). Conclusion: PCNL using a visual dilator sheath combined with a needle nephroscope achieves a comparable first-stage stone-clearance rate to traditional PCNL.However，it offers significant advantages in terms of shorter puncture time，fewer adjustments of the puncture needle，and lower postoperative complication rate.These findings suggest superior safety and precision，making it a valuable technique for clinical application.

Objective:To observe the changes of subfoveal choroidal thickness (SFCT) under the macular center recess after trabeculectomy in eyes with open-angle glaucoma (POAG), and to preliminarily analyze its relationship with visual function.Methods:A retrospective case-control study. 117 patients with POAG who were diagnosed by ophthalmologic examination and treated with trabeculectomy in Department of Ophthalmology of Shangluo Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were included in the study. Among them, 63 cases were male; 54 cases were female. All of them underwent naked-eye visual acuity, best-corrected visual acuity (BCVA), refraction, optical coherence tomography (OCT) examination, and axial length measurement. SFCT was measured using enhanced deep imaging with an OCT instrument. Based on the visual function reduction at 1 month after surgery, the patients were categorized into a visual function unreduced group and a visual function reduced group of 67 and 50 cases, respectively. Visual function included binocular adjustment amplitude and sensitivity; visual quality included objective scattering index (OSI) and modulation transfer function (MTF). Changes in SFCT and visual function-related indexes were analyzed by repeated-measures analysis of variance; the risk associated with changes in SFCT and visual function-related indexes was evaluated by a binary logistic regression model; and the relationship between SFCT and post-surgical visual function loss was analyzed by a Joint model; the SFCT and post-surgical visual function reduction was analyzed by a Joint model; the dose-response relationship between SFCT and post-surgical visual function decompensation was analyzed by applying the restricted cubic spline (RCS). Decision curve (DCA) was used to predict visual hypoplasia.Results:Comparison of the percentage of patients with different ages, anterior chamber hemorrhage, and post-surgical anterior chamber inflammatory response in the unreduced visual function group and the reduced visual function group showed statistically significant differences ( P<0.05). The results of the main effect test showed that the differences between SFCT and visual function adjustment amplitude, sensitivity time effect, between-group effect, and interaction effect were statistically significant in both groups ( P<0.05). The results of the separate effects test showed that compared with the preoperative period, the SFCT, accommodation amplitude, and sensitivity of the affected eyes of the two groups were significantly increased at different times after surgery, and the differences were statistically significant ( P<0.05). The results of multivariate ANOVA showed that SFCT, accommodation amplitude, and sensitivity at different times before and after surgery were significantly lower in the group with reduced visual function than in the group without reduced visual function, and the differences were statistically significant ( P<0.05). The △naked-eye visual acuity, △BCVA, △OSI, and △MTF of the patients in the group with reduced visual function were significantly lower than those in the group without reduced visual function, and the differences were all statistically significant ( P<0.05). Correlation analysis showed that SFCT was positively correlated with △adjustment amplitude, △sensitivity, △naked-eye visual acuity, △BCVA, △OSI, and △MTF ( r=0.426, 0.419, 0.311, 0.315, 0.325, 0.285; P<0.05). Multiple linear regression analysis showed that △SFCT was positively correlated with △adjustment amplitude, △sensitivity, △naked-eye visual acuity, △BCVA, △OSI, and △MTF before and after adjusting for confounders ( P<0.05). The results of Joint modeling analysis showed that the risk of visual function decompensation was increased by 5% for every 1 μm increase in SFCT. The results of RCS analysis showed a nonlinear correlation between SFCT and surgical The RCS analysis showed that there was a nonlinear relationship between SFCT and post-surgical visual impairment for nonlinear test ( P<0.001); the threshold effect analysis showed that the fold point at which SFCT affected post-surgical visual impairment was 243.25 μm.The DCA analysis showed that SFCT predicted a significant increase in the net clinical benefit rate of post-surgical visual impairment for risk thresholds ranging from 0.00 to 0.84. Conclusions:After POAG trabeculectomy, SFCT of those with or without reduced visual function are significantly thickened compared to pre-surgery; the magnitude of visual function adjustment and sensitivity tended to increase significantly after surgery. Naked eye visual acuity, BCVA, OSI, and MTF all have a significant effect on postoperative visual function.