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.

BACKGROUND: Immune checkpoint inhibitors (ICIs) have been included in various neoadjuvant therapy (NAT) regimens for non-small cell lung cancer (NSCLC). However, due to the relatively short period for the use of ICIs in NAT, patients' clinical outcomes with different regimens are uncertain. Our study aims to examine the efficacy of neoadjuvant immunotherapy (NAIT) for NSCLC patients and compare the overall survival (OS) and event-free survival (EFS) of patients receiving different NAT regimens. METHODS: This study retrospectively included 308 NSCLC patients treated with different NAT regimens and subsequent surgery in National Cancer Center between August 1, 2016 and July 31, 2022. Kaplan-Meier survival analysis and Cox proportional hazards regression analysis were conducted to evaluate the prognosis of patients. RESULTS: With a median follow-up of 27.5 months, the 1-year OS rates were 98.8% and 96.2%, and the 2-year OS rates were 96.6% and 85.8% in patients of the NAIT and neoadjuvant chemotherapy (NACT) group, respectively (hazard ratio [HR], 0.339; 95% confidence interval [CI], 0.160-0.720; P = 0.003). The 1-year EFS rates were 96.0% and 88.0%, and the 2-year EFS rates were 92.0% and 77.7% for patients in the NAIT and NACT groups, respectively (HR, 0.438; 95% CI, 0.276-0.846; P = 0.010). For patients who did not achieve pathological complete response (pCR), significantly longer OS ( P = 0.012) and EFS ( P = 0.019) were observed in patients receiving NAIT than those receiving NACT. Different NAT regimens had little effect on surgery and the postoperative length of stay (6 [4, 7] days vs . 6 [4, 7] days, Z = -0.227, P = 0.820). CONCLUSIONS NAIT exhibited superior efficacy to NACT for NSCLC, resulting in longer OS and EFS. The OS and EFS benefits were also observed among patients in the NAIT group who did not achieve pCR.
Humans ; Carcinoma, Non-Small-Cell Lung/mortality* ; Male ; Female ; Lung Neoplasms/mortality* ; Middle Aged ; Immune Checkpoint Inhibitors/therapeutic use* ; Neoadjuvant Therapy/methods* ; Retrospective Studies ; Aged ; Adult ; Kaplan-Meier Estimate ; Treatment Outcome ; Immunotherapy/methods*

Traditional Chinese medicine of Polygonum cuspidatum has been utilized in China for thousands of years. Its primary active compound, polydatin, exhibits a variety of pharmacological effects including the regulation of glucose and lipid metabolism, suppression of cough and asthma, as well as antibacterial and anti-inflammatory properties. However, conventional methods for polydatin production are inadequate to satisfy the market demand. This study aims to explore the green and efficient preparation of polydatin. With resveratrol as the substrate, we efficiently synthesized polydatin by using the triple mutant IGW (Y14I/I62G/M315W) of the glycosyltransferase UGT_BS based on a strategy of two-enzyme coupled with one-pot and realized the recycling of uridine diphosphate-glucose (UDPG). The conditions of the two-enzyme reaction were optimized. Under the conditions of 35 ℃, pH 8.0, IGW: AtSuSy1 activity ratio of 3:4, dimethyl sulfoxide (DMSO) volume fraction of 5%, uridine diphosphate (UDP) concentration of 0.10 mmol/L, and sucrose concentration of 0.6 mol/L, the conversion of 2 mmol/L resveratrol reached 80.6% within 1 h, and the proportion of polydatin was over 90%. This study achieved the recycling of UDPG via a two-enzyme coupling system and shortened the reaction time. At the same time, the fed-batch strategy was adopted, and the yield of polydatin reached 6.28 g/L after 24 h in the one-pot coupling reaction, which provided a new strategy for green and efficient preparation of polydatin.
Stilbenes/chemistry* ; Glucosides/biosynthesis* ; Resveratrol ; Fallopia japonica/chemistry* ; Glycosyltransferases/genetics*

BACKGROUND:With the continuous development of medical technology,the treatment of distal radius fractures is facing the need for more precise and personalized treatment.The traditional splint fixation method has some limitations in clinical application,which often has defects such as unstable fixation and easy to occur pressure sores.The validation of the improved 3D printed splint with rapid grid-free simulation is expected to lead to more accurate and effective treatment options for distal radius fractures.OBJECTIVE:To explore the design method of 3D printed splint for distal radius fracture based on clinical defect improvement and verify its clinical efficacy by rapid grid-free analysis.METHODS:Clinical defects of splint fixation of extended distal radius fracture were retrospectively analyzed,and 3D printed small splint was designed with specific improvement.The digital models of traditional splint and improved new 3D printed splint were made by Computer Aided Design drawing.Total,bone,soft tissue,and splint displacement and stress distribution were calculated through simulation analysis using rapid grid-free analysis tools.RESULTS AND CONCLUSION:(1)Compared with the traditional splint,the improved new 3D printing splint exerteded more balanced pressure on the skin without obvious stress concentration,and had better body surface adhesion.The displacement was smaller and the movement range was more reasonable.(2)An 3D printed splint based on clinical defect improvement can be designed.Rapid grid-free analysis verifies the advantages of the improved 3D splint,providing a basis for clinical application.

Objective:To develop and validate a risk prediction model for in-stent restenosis (ISR) after percutaneous coronary intervention (PCI).Methods:This prospective study included 126 patients with acute myocardial infarction (AMI) who underwent PCI at Lishui Central Hospital from May 2021 to April 2023. The patients were divided into two groups based on whether they experienced ISR after PCI: ISR group ( n = 33) and non-ISR group ( n = 93). Clinical data were compared between the two groups. Binary logistic regression was used to identify independent risk factors for ISR in patients with AMI after PCI. A risk prediction model was then developed, and the predictive value of the model was assessed using receiver operating characteristic curve analysis. Results:After surgery, significant differences were observed between the ISR and non-ISR groups regarding postoperative smoking [21(63.64%) vs. 27(29.03%)], elevated uric acid level [19 (57.58%) vs. 28(30.11%)], serum amyloid A (SAA) ≥ 10 mg/L [20(60.61%) vs. 26(27.96%)], and lipoprotein(a) [Lp(a)] ≥ 300 mg/L [21(63.64%) vs. 32(34.41%)] [ χ2 = 12.36, 7.85, 11.20, 8.53, all P < 0.05]. Postoperative smoking, elevated uric acid levels, SAA ≥ 10 mg/L, and Lp(a) ≥ 300 mg/L were identified as independent risk factors for ISR in patients with AMI after PCI ( OR = 0.234, 0.317, 0.252, 0.300, all P < 0.05). A risk prediction model for ISR after PCI was developed based on postoperative smoking, elevated uric acid levels, SAA levels, and Lp(a) levels ≥ 300 mg/L. Receiver operating characteristic curve analysis revealed the areas under the curve were 0.673 [95% CI(0.564, 0.782)], 0.637 [95% CI(0.525, 0.750)], 0.663 [95% CI(0.552, 0.774)], 0.646 [95% CI(0.536, 0.757)], and 0.889 [95% CI(0.821, 0.958)] for ostoperative smoking, elevated uric acid levels, SAA levels, Lp(a) levels ≥ 300 mg/L, and the risk prediction model, respectively. At the critical threshold values, the sensitivities for these variables were 0.636, 0.576, 0.606, 0.636, and 0.909, respectively, while the specificities were 0.710, 0.699, 0.720, 0.656, and 0.763, respectively. The bootstrap method (B = 1000) was used for the internal validation of the risk prediction model. After bias correction, the predicted curve approached the ideal curve, yielding a consistency index of 0.778, which indicates a high predictive value for the model. Moreover, the risk prediction model demonstrated a net benefit greater than 0 within a threshold probability range of 0.02 to 0.93, exceeding two ineffective thresholds. Conclusions:Postoperative smoking, elevated uric acid levels, SAA, and Lp(a) are independent risk factors for ISR in patients with AMI after PCI. The risk prediction model developed based on these four factors demonstrates a high predictive value, which can aid in assessing the risk of ISR in AMI patients with AMI after PCI and in formulating appropriate intervention measures.

BACKGROUND:With the continuous development of medical technology,the treatment of distal radius fractures is facing the need for more precise and personalized treatment.The traditional splint fixation method has some limitations in clinical application,which often has defects such as unstable fixation and easy to occur pressure sores.The validation of the improved 3D printed splint with rapid grid-free simulation is expected to lead to more accurate and effective treatment options for distal radius fractures.OBJECTIVE:To explore the design method of 3D printed splint for distal radius fracture based on clinical defect improvement and verify its clinical efficacy by rapid grid-free analysis.METHODS:Clinical defects of splint fixation of extended distal radius fracture were retrospectively analyzed,and 3D printed small splint was designed with specific improvement.The digital models of traditional splint and improved new 3D printed splint were made by Computer Aided Design drawing.Total,bone,soft tissue,and splint displacement and stress distribution were calculated through simulation analysis using rapid grid-free analysis tools.RESULTS AND CONCLUSION:(1)Compared with the traditional splint,the improved new 3D printing splint exerteded more balanced pressure on the skin without obvious stress concentration,and had better body surface adhesion.The displacement was smaller and the movement range was more reasonable.(2)An 3D printed splint based on clinical defect improvement can be designed.Rapid grid-free analysis verifies the advantages of the improved 3D splint,providing a basis for clinical application.

Objective:To develop and validate a risk prediction model for in-stent restenosis (ISR) after percutaneous coronary intervention (PCI).Methods:This prospective study included 126 patients with acute myocardial infarction (AMI) who underwent PCI at Lishui Central Hospital from May 2021 to April 2023. The patients were divided into two groups based on whether they experienced ISR after PCI: ISR group ( n = 33) and non-ISR group ( n = 93). Clinical data were compared between the two groups. Binary logistic regression was used to identify independent risk factors for ISR in patients with AMI after PCI. A risk prediction model was then developed, and the predictive value of the model was assessed using receiver operating characteristic curve analysis. Results:After surgery, significant differences were observed between the ISR and non-ISR groups regarding postoperative smoking [21(63.64%) vs. 27(29.03%)], elevated uric acid level [19 (57.58%) vs. 28(30.11%)], serum amyloid A (SAA) ≥ 10 mg/L [20(60.61%) vs. 26(27.96%)], and lipoprotein(a) [Lp(a)] ≥ 300 mg/L [21(63.64%) vs. 32(34.41%)] [ χ2 = 12.36, 7.85, 11.20, 8.53, all P < 0.05]. Postoperative smoking, elevated uric acid levels, SAA ≥ 10 mg/L, and Lp(a) ≥ 300 mg/L were identified as independent risk factors for ISR in patients with AMI after PCI ( OR = 0.234, 0.317, 0.252, 0.300, all P < 0.05). A risk prediction model for ISR after PCI was developed based on postoperative smoking, elevated uric acid levels, SAA levels, and Lp(a) levels ≥ 300 mg/L. Receiver operating characteristic curve analysis revealed the areas under the curve were 0.673 [95% CI(0.564, 0.782)], 0.637 [95% CI(0.525, 0.750)], 0.663 [95% CI(0.552, 0.774)], 0.646 [95% CI(0.536, 0.757)], and 0.889 [95% CI(0.821, 0.958)] for ostoperative smoking, elevated uric acid levels, SAA levels, Lp(a) levels ≥ 300 mg/L, and the risk prediction model, respectively. At the critical threshold values, the sensitivities for these variables were 0.636, 0.576, 0.606, 0.636, and 0.909, respectively, while the specificities were 0.710, 0.699, 0.720, 0.656, and 0.763, respectively. The bootstrap method (B = 1000) was used for the internal validation of the risk prediction model. After bias correction, the predicted curve approached the ideal curve, yielding a consistency index of 0.778, which indicates a high predictive value for the model. Moreover, the risk prediction model demonstrated a net benefit greater than 0 within a threshold probability range of 0.02 to 0.93, exceeding two ineffective thresholds. Conclusions:Postoperative smoking, elevated uric acid levels, SAA, and Lp(a) are independent risk factors for ISR in patients with AMI after PCI. The risk prediction model developed based on these four factors demonstrates a high predictive value, which can aid in assessing the risk of ISR in AMI patients with AMI after PCI and in formulating appropriate intervention measures.

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 investigate the iodine nutritional status of pregnant women in Hangzhou City and analyze its influencing factors, in order to provide a basis for guiding pregnant women in Hangzhou City to supplement iodine scientifically.Methods:A stratified random sampling method was used to conduct a questionnaire survey on 1 400 pregnant women in Hangzhou City from March to October 2018. Random urine samples and household salt samples from pregnant women were collected, and the levels of urine iodine and salt iodine were measured using arsenic cerium catalytic spectrophotometry and direct titration, respectively. The iodine nutritional status of pregnant women with different basic characteristics and dietary levels were analyzed and compared (Kruskal-Wallis test), and the main influencing factors affecting the urinary iodine concentration level of pregnant women were identified (the ordinal multiple classification logistic regression analysis).Results:The median urinary iodine of pregnant women was 135.00 μg/L, and the qualified iodized salt consumption rate of pregnant women was 83.36% (1 167/1 400). In terms of basic characteristics, there were statistically significant differences in the distribution level of urine iodine among pregnant women with different pregnancy frequency, delivery frequency, and natural abortion frequency ( P < 0.05). In terms of diet, the frequency of consuming milk, yogurt, meat, and whether pregnant women consumed cabbage and cauliflower showed statistically significant differences in urinary iodine distribution levels ( P < 0.05). Ordinal multiple classification logistic regression analysis showed that the urine iodine levels of pregnant women who were pregnant twice were higher than those who were pregnant ≥3 times ( OR = 1.64, P = 0.003). Pregnant women who never or occasionally consumed yogurt had lower urine iodine levels than or equal to those who consumed 2 bottles of yogurt per day ( OR = 0.53, P = 0.044). Pregnant women who never or occasionally consumed meat and those who consumed meat once a week had higher urinary iodine levels than that who consumed meat ≥2 times per week ( OR = 1.40, 1.47, P < 0.05). Conclusions:The overall iodine nutrition of pregnant women in Hangzhou City is at an deficiency level. Pregnancy experience and dietary level are influencing factors on iodine nutrition of pregnant women. It is necessary to carry out in-depth health education for pregnant women, improve the dietary structure during pregnancy, and improve the abnormal iodine nutrition of pregnant women.

OBJECTIVE: To compare effectiveness of injecting platelet-rich plasma (PRP) with different concentrations of leukocytes under ultrasound in treatment of supraspinatus tendon injury. METHODS: A clinical data of 30 patients with supraspinatus tendon injury, who met the selection criteria and were admitted between December 2022 and December 2023, was retrospectively analyzed. Thirty patients were treated with 4 injections of leukocyte-poor PRP (LP-PRP, n=10), leukocyte-rich PRP (LR-PRP, n=11), and triamcinolone ( n=9), with an interval of 7-10 days between each injection. There was no significant difference between groups ( P>0.05) in the age, gender, disease duration, affected shoulder side, Ellman classification, preoperative visual analogue scale (VAS) score, Constant score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and American Shoulder and Elbow Surgeons (ASES) score. At 1, 3, and 6 months after injection, the shoulder pain and function were evaluated by using the VAS score, Constant score, DASH score, and ASES score. MRI was conducted to observe supraspinatus tendon healing. RESULTS: No severe adverse reactions was observed in all groups. All patients were followed up 6-7 months, with an average of 6.5 months. After injection, the ASES score and Constant score gradually increased in the LR-PRP group and LP-PRP group, while the VAS score and DASH score decreased, with significant differences compared to before injection ( P<0.05). Except for no significant difference between 3 and 6 months after injection in LR-PRP group ( P>0.05), the above scores showed significant differences between different time points ( P<0.05). At 1 month after injection, the Constant score in triamcinolone group significantly increased compared to before injection, while the VAS score significantly decreased ( P<0.05). There was no significant difference in all scores between other time points in the triamcinolone group ( P>0.05). Except for 1 month after injection, there was no significant difference in Constant score and VAS score between groups ( P>0.05). At all other time points, the LR-PRP group and LP-PRP group had better scores than the triamcinolone group ( P<0.05). There was no significant difference between the LR-PRP group and the LP-PRP group ( P>0.05). MRI showed that only 4 patients in the LP-PRP group had signs of repair at the supraspinatus tendon injury site at 6 months after injection, while no significant tendon repair sign was observed in the other patients. CONCLUSION Compared with triamcinolone treatment, multiple injections of LP-PRP and LR-PRP under ultrasound can promote the recovery of shoulder joint function and significantly relieve pain in patients with supraspinatus tendon injury, and imaging improvement can be seen after LP-PRP treatment.
Humans ; Platelet-Rich Plasma ; Rotator Cuff Injuries/therapy* ; Female ; Male ; Treatment Outcome ; Pain Measurement ; Leukocytes ; Tendon Injuries/therapy* ; Middle Aged ; Ultrasonography ; Ultrasonography, Interventional ; Range of Motion, Articular ; Adult