AIM: To investigate the influencing factors of stereoscopic function reconstruction after intermittent exotropia(IXT)surgery and the construction of a nomogram prediction model.METHODS:A total of 204 patients with IXT(all underwent strabismus correction surgery)admitted to our hospital from September 2021 to October 2023 were randomly divided into modeling group(143 cases)and validation group(61 cases). The patients in the modeling group were further divided into reconstructive group and non-reconstructive group according to whether they had stereoscopic function reconstruction after surgery; the general patient information was collected; Multivariate Logistic regression analysis was performed on the influencing factors of stereoscopic visual function reconstruction after IXT surgery. The nomogram model was constructed using R software. The ROC curve was drawn to evaluate the distinction of the nomogram model. The decision curve analysis(DCA)was used to evaluate the clinical application value of the model.RESULTS:Reconstruction occurred in 50.5%(103 cases)of the 204 patients, and reconstruction occurred in 50.3%(72 cases)of the 143 patients in the modeling group. There were differences in age of onset, course of disease and postoperative horizontal strabismus between the reconstructive group and the non-reconstructive group(all P<0.05). Multivariate Logistic regression analysis showed that age of onset and postoperative horizontal strabismus were risk factors for stereoscopic visual function reconstruction after IXT surgery(all P<0.05), and the course of disease was a protective factor(P<0.05). The AUC of the modeling group was 0.892, and the H-L test was χ2=6.654 and P=0.615. The AUC of the validation group was 0.935, and the H-L test was χ2=6.498 and P=0.642. The DCA curve showed that the clinical value of the nomogram model was higher when the probability was 0.09-0.95.CONCLUSION: The age of onset, course of disease and postoperative amount of horizontal strabismus are the influencing factors of stereoscopic visual function reconstruction after IXT surgery, and the nomogram model constructed by this can better predict postoperative stereoscopic function reconstruction.

ObjectiveTo provide a clinical reference for rational selection of the methods for common bile duct closure after laparoscopic common bile duct exploration （LCBDE） in patients with recurrent choledocholithiasis （RCL）. MethodsA retrospective analysis was performed for the clinical data of 121 patients with RCL who underwent LCBDE in the Department of Hepatopancreatobiliary Surgery， The Affiliated Hospital of North China University of Science and Technology， from February 2022 to December 2025， and according to the method for common bile duct closure， the patients were divided into primary duct closure group （PDC group with 58 patients） and T-tube drainage group （TTD group with 63 patients）. The two groups were compared in terms of time of operation， drainage volume on day 1 after surgery， total bilirubin level on day 3 after surgery， time to diet after surgery， time to drainage tube removal after surgery， common bile duct diameter at 1 week after surgery， length of postoperative hospital stay， total hospitalization costs， and complications， and the risk factors for postoperative complications were analyzed. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The multivariate Logistic regression analysis was used to identify influencing factors for postoperative complications. ResultsCompared with the TTD group， the PDC group had a significantly shorter time of operation ［48.50 （39.00 — 59.25） min vs 55.00 （46.00 — 69.00） min， Z=-2.726， P=0.006］， a significantly lower level of total bilirubin on day 3 after surgery ［17.25 （14.43 — 21.30） μmol/L vs 20.06 （16.40 — 29.30） μmol/L， Z=-2.950， P=0.003］， a significantly shorter time to diet after surgery ［1 （1 — 1） d vs 1 （1 — 2） d， Z=-4.506， P<0.001］， a significantly shorter time to drainage tube removal after surgery ［7 （7 — 7） d vs 8 （8 — 9） d， Z=-9.693， P<0.001］， a significantly shorter length of postoperative hospital stay ［8 （8 — 8） d vs 10 （9 — 11） d， Z=-8.960， P<0.001］， and significantly lower total hospitalization costs ［21 750 （20 369 — 23 310） yuan vs 24 889 （23 438 — 26 920） yuan， Z=-5.572， P<0.001］， and common bile duct diameter at 1 week after surgery in the PDC group was closer to the normal physiological anatomical structure of the biliary tract compared with that in the TTD group ［1.0 （0.9 — 1.1） cm vs 1.0 （1.0 — 1.1） cm， Z=-2.064， P=0.039］. Compared with the TTD group， the PDC group had significantly lower incidence rates of total complications （10.34% vs 26.98%， P=0.024） and electrolyte disturbance （1.72% vs 15.87%， P=0.006）. The multivariate logistic regression analysis showed that common bile duct diameter <1.3 cm before surgery and total bilirubin level ≥21.0 μmol/L before surgery were independent risk factors for postoperative complications， while primary duct closure was an independent protective factor against postoperative complications （P<0.05）. ConclusionUnder the premise of strict control of indications， PDC after LCBDE for RCL patients can accelerate recovery and reduce complications and hospitalization costs， thereby demonstrating greater advantages in clinical application.

ObjectiveTo evaluate the larvicidal effect of ultrasonic waves against Aedes albopictus larvae at various exposure parameters (distance and time), and to preliminarily investigate the effects of different containers (water volume and depth) and ultrasonic devices on the larvicidal efficacy, so as to provide experimental evidence for the application of ultrasound-based mosquito control technology. MethodsUnder controlled laboratory conditions, two commercially available ultrasonic devices [40 kHz/300 W and (50±5) kHz/70 W] were used to systematically examine the effects of exposure distance (20, 40, 60, 80, and 100 cm), exposure duration (1, 3, 6, 15 and 60 min), larval instar(Ⅰ‒Ⅱ and Ⅲ‒Ⅳ）, and container type on the immediate mortality of Aedes albopictus larvae collected from urban areas of Shanghai. Statistical analysis of the mortality rates of larvae among different experimental groups was performed using the chi-square test. ResultsUltrasonic exposure exerted a detectable larvicidal effect against Aedes albopictus larvae of all instars. For early-instar larvae, exposure time significantly affected mortality at all tested distances (20, 40, 60, 80 and 100 cm), with χ² values ranging from 25.57 to 32.74 ( all P<0.001). No significant distance effect was observed in the first and second instar larvae after short-term exposure (1 and 3 min; P>0.05). However, a distance-dependent effect emerged from 6 min onward (P<0.05). During short-term exposure (1 min and 3 min) at close range (20 cm and 40 cm), the immediate mortality of the third and fourth instar larvae was higher than that of the first and second instar larvae. Conversely, during prolonged exposure (15 min and 60 min), the first and second instar larvae exhibited significantly higher mortality than that of the third and fourth instar larvae. These results indicated that larval mortality was jointly influenced by exposure duration and distance. Preliminary experiments indicated that larvicidal efficacy in shallow water was lower than that in deep water. No significant difference in larvicidal effect was observed between the two ultrasonic devices with different frequencies and power outputs. ConclusionUnder laboratory conditions, ultrasound can effectively kill Aedes albopictus larvae, and the larvicidal effect is jointly influenced by larval instar, exposure distance, and aquatic environment. Compact ultrasonic devices show potential for field application in biological mosquito control.

ObjectiveTo investigate the neuroprotective effect of glycosides of cistanches （GCs） in 1-methyl-4-phenyl-1，2，3，6-tetrahydropyridine （MPTP）-induced Parkinson’s disease （PD） model mice and its potential mechanism. MethodsForty mice were randomly divided into control group， PD group， GCs group and levodopa （L-DOPA） group， with 10 mice in each group. The control group received intraperitoneal injection of normal saline， while the other groups were intraperitoneally injected with MPTP （30 mg/kg） once daily for 5 consecutive days. After model establishment， the control group and PD group were intragastrically administered normal saline， and the GCs group and L-DOPA group received intragastric administration once daily for 28 consecutive days， at doses of 100 mg/kg and 50 mg/kg， respectively. The open field test and rotarod test were used to evaluate motor function. Immunohistochemistry was performed to detect the number of tyrosine hydroxylase （TH）-positive neurons in the substantia nigra of the midbrain. Transmission electron microscopy was adopted to observe the ultrastructure of mitochondria in the substantia nigra. Biochemical assays were used to determine the levels of glutathione （GSH）， malondialdehyde （MDA）， total superoxide dismutase （T-SOD） and reactive oxygen species （ROS） in substantia nigra tissues. Western blot was applied to detect the protein expression of TH， nuclear factor erythroid 2-related factor 2 （Nrf2）， Kelch-like ECH-associated protein 1 （Keap-1） and heme oxygenase-1 （HO-1） in substantia nigra tissues. ResultsCompared with the control group， mice in the PD group exhibited markedly impaired motor function， significantly decreased T-SOD activity， obvious reductions in the number of TH-positive neurons and GSH content， as well as elevated MDA and ROS levels in the substantia nigra （P<0.01）. Compared with the PD group， mice in the GCs group showed improved motor function， increased T-SOD activity， higher number of TH-positive neurons and elevated GSH content， accompanied by decreased MDA and ROS levels （P<0.05）. In the control group， mitochondria in the substantia nigra displayed normal morphology without obvious blurred membrane structures or vacuolar degeneration. The PD group presented mitochondrial swelling， disordered cristae and vacuolar changes， whereas these mitochondrial pathological alterations were alleviated in the GCs group. Compared with the control group， the protein levels of TH， Nrf2 and HO-1 were significantly downregulated， while Keap-1 protein expression was markedly upregulated in the PD group （P<0.01）. Compared with the PD group， the GCs group showed significant upregulation of TH， Nrf2 and HO-1 protein levels and a notable reduction in Keap-1 protein level （P<0.05）. ConclusionGCs ameliorate motor dysfunction and attenuate dopaminergic neuronal and mitochondrial damage in MPTP-induced PD model mice. These effects may be associated with modulation of Nrf2/HO-1 pathway-related protein expression， enhancement of antioxidant capacity， and alleviation of oxidative stress.

Objective To compare the efficacies of allogeneic hematopoietic stem cell transplantation(allo-HSCT)in the treatment of post-chronic aplastic anemia(CAA)myelodysplastic syndrome(MDS)and primary MDS.Methods A retrospective analysis was conducted on 32 patients who received allo-HSCT treatment in Department of Hematology,North China University of Science and Technology Affiliated Hospital between Feb.2012 and Feb.2022,including 12 patients with post-CAA MDS and 20 patients with primary MDS.The overall survival rate,cumulative incidence of relapse(CIR)rate,non-relapse mortality(NRM)rate,and event-free survival rate were compared between the 2 groups.Results The median follow-up time for CAA to progress to MDS was 120(72-180)months.All the patients were followed up for 36(3-79)months after allo-HSCT.The 3-year overall survival rate of the post-CAA MDS group was significantly higher than that of the primary MDS group(83.8%vs 45.0%,P=0.035).The 3-year CIR of the post-CAA MDS group was significantly lower than that of the primary MDS group(16.7%vs 55.0%,P=0.021).There was no significant difference in the event-free survival rates or NRM rates between the 2 groups(both P＞0.05).Conclusion The post-CAA MDS patients have better survival after allo-HSCT than the primary MDS patients.Early allo-HSCT treatment may improve the prognosis.

Objective To explore the risk factors of hospitalization within 24 h after birth and respiratory support in late preterm and term neonates.Methods A case-control study was conducted on 1 468 neonates with gestational ages≥34 weeks and<42 completed weeks delivered at the University-Town Hospital of Chongqing Medical University from January 2023 to March 2024.Maternal health parameters and neonatal outcomes were systematically obtained through standardized case report forms during the study period.The neonates were stratified into the hospitalization group and the non-hospitalization group based on neonatal ward admission within 24 h.For those hospitalized with infectious diseases,subgroup analysis was conducted with further categorization into respiratory support and the non-respiratory support subgroups according to ventilatory assistance requirements.The perinatal risk factors were compared between groups and subgroups,and the independent risk factors for hospitalization and the need for respiratory support within 24 h in neonates were identified.The indicators with P<0.1 in the univariate analysis were included in the multivariate logistic regression analysis,and the stepwise regression analysis was used to fit the multivariate logistic regression model.Results There were 213 cases(14.5%)in the hospitalization group and 1 255 cases(85.5%)in the non-hospitalization group.A total of 150 neonates were hospitalized due to infectious diseases,including 48 cases(32.0%)in the respiratory support subgroup and 102 cases(68.0%)in the non-respiratory support subgroup.The multivariate logistic regression analysis showed that non-regular maternal prenatal examination(OR=2.687,95%CI:1.175～6.141,P=0.019),intrauterine growth retardation(OR=2.711,95%CI:1.106～6.646,P=0.029),premature rupture of membranes(OR=1.667,95%CI:1.139～2.438,P=0.008),chorioamnionitis(OR=4.852,95%CI:2.114～11.135,P<0.001),infectious diseases in the first week before delivery(OR=1.531,95%CI:1.015～2.310,P=0.042),turbidity of amniotic fluid(OR=3.170,95%CI:2.099～4.787,P<0.001),abnormal placenta(OR=2.335,95%CI:1.202～4.534,P=0.012),complications during pregnancy(OR=2.367,95%CI:1.360～4.118,P=0.002),and the use of glucocorticoids before delivery(OR=2.744,95%CI:1.219～5.528,P=0.009)were positively correlated with hospitalization within 24 h postnatally in late preterm and term neonates.Gestational age(OR=0.693,95%CI:0.602～0.797,P<0.001),5-minute Apgar score(OR=0.026,95%CI:0.003～0.212,P=0.001),umbilical cord blood pH(OR=0.044,95%CI:0.002～0.793,P=0.034),and umbilical cord blood BE(OR=0.885,95%CI:0.823～0.823,P=0.001)were negatively correlated with it.Premature rupture of membranes(OR=0.207,95%CI:0.070～0.618,P=0.005),infectious diseases in the first week before delivery(OR=0.245,95%CI:0.070～0.854,P=0.027),5-minute Apgar score(OR=0.063,95%CI:0.008～0.526,P=0.011),and abnormal C-reactive protein of newborns(OR=0.145,95%CI:0.046～0.460,P=0.001)were negatively correlated with the need for respiratory support in neonates hospitalized due to infectious diseases.Conclusion Risk factors for neonatal hospitalization within 24 h postnatal late preterm and term are identified as irregular antenatal care,fetal growth restriction and premature rupture of membranes in late preterm and term neonates.premature rupture of membranes,antenatal maternal infections within 1 week prior to delivery and 5-minute Apgar score≥7 emerge as significant protective factors against respiratory support requirement in neonates hospitalized with infectious diseases.

Objective:To evaluate the effect and causality of serum metabolites on the pathogenesis of ulcerative colitis (UC), so as to provide reference for nutritional programs for patients with UC.Methods:Two-sample Mendelian randomization (MR) analysis was performed to estimate the causal relationship between serum metabolites and UC. Genome-wide association studies (GWAS) of 1 400 metabolites were performed, with the metabolites as exposure and UC as outcome. Inverse-variance weighted (IVW) was used to calculate causal estimates. Four other MR methods with different modeling assumptions including MR-Egger, weighted median, weighted mode, and simple mode were used as additional analyses to improve the stability of the results. The results were validated through heterogeneity and pleiotropy tests. Finally, the possible causal metabolites were analyzed by metabolic pathway analysis.Results:MR analysis revealed that 85 metabolites had a possible causal relationship with UC. Among them, phosphatidylglycerol 1,2-dipalmitoyl-gpc (DPPC) ( P=2.75×10 -6) and isovaleryl carnitine (C5) ( P=1.84×10 -5) were significant risk factors for UC. Metabolic pathway analysis identified 5 metabolic pathways that might be affected by these metabolites (all P<0.05), among which the porphyrin ( P=0.004) and pyrimidine metabolic pathways ( P=0.008) had higher confidence in impacting UC. Conclusions:There are causal relationships between some serum metabolites (in particular 1,2-dipalmitoyl-GPC and isovalerylcarnitine) and the risk of UC. The porphyrin and pyrimidine metabolic pathways may impact the pathogenesis of UC.

Objective:To investigate the clinical efficacy of botulinum toxin type A（BTX-A）bladder injection in the treatment of neurogenic detrusor overactivity（NDO）with autonomic dysreflexia（AD）.Methods:The patients with spinal cord injury at or above T6，who were treated at Guangdong Provincial Work Injury Rehabilitation Hospital from January 2018 to December 2022，were included in this study prospectively. Inclusion criteria：①chronic spinal cord injury patients over 18 years old（with no progression of neurological symptoms within 3 months）；② presence of NDO and AD；③ inadequate response or intolerance to oral antimuscarinic agent（M-receptor antagonists or β 3-receptor agonists）④ perform clean intermittent catheterization to empty the bladder. Exclusion criteria：① primary disease in the acute or progressive phase；② previous surgeries that would affect lower urinary tract function，such as transurethral sphincterotomy，bladder neck resection，prostatectomy，or bladder surgery；③ allergy to BTX-A or its adjuvants，or those with allergic predisposition ④ patients who were pregnant，breastfeeding，or planning for pregnancy in the near future；⑤ patients did not accept or were unable to perform intermittent catheterization. Before treatment，all patients were required to maintain 3-5 day urine diary，along with urodynamic studies（UDS），incontinence specific quality of life instrument（I-QOL）and AD symptom severity assessment，and blood pressure monitored. Key UDS parameters recorded included maximum bladder capacity，maximum detrusor pressure during filling phase，changes in maximum systolic blood pressure（SBP）relative to baseline（ΔSBP）during UDS examination，and the frequency of 24-hour blood pressure exceeding baseline by 20 mmHg. After general anesthesia or epidural anesthesia，BTX-A（200 U）was injected into the bladder at 30 points（including the triangle）under the cystoscope using a special injection needle，6.7 U per injection，and then the catheter was kept for 3-5 days after treatment. Three months later，relevant indicators were collected and compared with pre-treatment data. Results:A total of 43 patients were included in this study，including 34 males and 9 females. The age was（39.23±13.17）years old and the disease course was（2.69±3.27）years old. There were 33 cervical and 10 thoracic cases. The American Spinal Injury Association Injury Scale score distribution was as follows：26（60%）A，4（9%）B，9（21%）C，and 4（9%）D. The presence of AD was confirmed in all patients during urodynamic examination（UDS），that was the systolic blood pressure（SBP）suddenly increased and exceeded 20 mmHg（1 mmHg = 0.133 kPa）. Before treatment，The AD symptoms severity score（consist of headache，sweating，goose bumps，anxiety and palpitation）were（14.53±2.51），Bladder-related AD frequency was 10.67 episodes/day. Baseline SBP was（103.51±9.64）mmHg，the maximum SBP was（150.40±22.75）mmHg，and the change in SBP（ΔSBP）from maximum to baseline SBP during UDS examination was（43.83±21.01）mmHg. The UDS indicated that the maximum detrusor pressure during storage phase was（54.95±24.68）cmH 2O，and the bladder capacity was（131.70±75.29）ml. Bladder diary showed the volume of catheterization each time from was（181.16±49.86）ml，and The I-QOL score was（44.07±8.60）. Three months after treatment，the AD symptoms severity score（consist of headache，sweating，goose bumps，anxiety and palpitation）were（11.37±2.39）. The frequency of bladder-related AD episodes was（7.51±2.37）episodes/day，showing statistically significant differences compared to pre-treatment（ P<0.05）.The SBP before UDS examination was（102.12±10.28）mmHg，with no statistically significant difference from baseline（ P = 0.518）. The maximum SBP in perfusion phase and the ΔSBP were（132.84±16.30）mmHg and（28.72 ± 14.02）mmHg，respectively，both demonstrating statistically significant differences（ P < 0.05）. The UDS examination revealed that the maximum detrusor pressure during the storage phase was（29.77±13.72）cmH 2O，showed a significant decrease，and the bladder capacity was（272.63±79.75）ml，which were both statistically different before and after surgery. Bladder diary showed the volume of catheterization each time was（326.74±63.71）ml；I-QOL score was（71.86±11.45），both were significant different after treatment（ P < 0.01）. Conclusion:BTX-A intravesical injection in the treatment of NDO can also alleviate the severity and frequency of bladder related AD.

Objective:To evaluate the effect and causality of serum metabolites on the pathogenesis of ulcerative colitis (UC), so as to provide reference for nutritional programs for patients with UC.Methods:Two-sample Mendelian randomization (MR) analysis was performed to estimate the causal relationship between serum metabolites and UC. Genome-wide association studies (GWAS) of 1 400 metabolites were performed, with the metabolites as exposure and UC as outcome. Inverse-variance weighted (IVW) was used to calculate causal estimates. Four other MR methods with different modeling assumptions including MR-Egger, weighted median, weighted mode, and simple mode were used as additional analyses to improve the stability of the results. The results were validated through heterogeneity and pleiotropy tests. Finally, the possible causal metabolites were analyzed by metabolic pathway analysis.Results:MR analysis revealed that 85 metabolites had a possible causal relationship with UC. Among them, phosphatidylglycerol 1,2-dipalmitoyl-gpc (DPPC) ( P=2.75×10 -6) and isovaleryl carnitine (C5) ( P=1.84×10 -5) were significant risk factors for UC. Metabolic pathway analysis identified 5 metabolic pathways that might be affected by these metabolites (all P<0.05), among which the porphyrin ( P=0.004) and pyrimidine metabolic pathways ( P=0.008) had higher confidence in impacting UC. Conclusions:There are causal relationships between some serum metabolites (in particular 1,2-dipalmitoyl-GPC and isovalerylcarnitine) and the risk of UC. The porphyrin and pyrimidine metabolic pathways may impact the pathogenesis of UC.

Intelligent acupuncture-moxibustion medical equipment is an important force in promoting the inheritance, innovation, and modernization of acupuncture-moxibustion. This paper reviews the development status of intelligent acupuncture-moxibustion medical equipment and related new technologies, as well as the challenges faced. It is found that, with the advancement of technologies such as big data and artificial intelligence, acupuncture-moxibustion medical equipment has shown characteristics of greater precision, miniaturization, intelligence, and portability. However, deficiencies remain in areas such as standardization and regulation, including relatively low rates of effective transformation and a lack of innovation in research outcomes. Therefore, there is an urgent need to formulate corresponding strategies: improving the development of relevant standards for intelligent acupuncture-moxibustion medical equipment, encouraging the integration of medicine and engineering, cultivating interdisciplinary talents, and strengthening the protection of invention patents. It is necessary to establish a demand-oriented pathway connecting "equipment development, equipment evaluation, product formation" through multiple stages such as talent training and research project initiation, thereby promoting the modernization and standardization of intelligent acupuncture-moxibustion medical equipment and supporting the revitalization of traditional medicine.
Moxibustion/instrumentation* ; Humans ; Acupuncture Therapy/trends* ; Artificial Intelligence