Objective:To investigate the effects of vitreomacular traction (VMT) on the efficacy of internal limiting membrane (ILM) removal combined with air tamponade in the treatment of macular holes.Methods:The clinical data of 44 patients with macular holes who underwent ILM removal combined with air tamponade at the Affiliated Hospital of Shaoxing University from January 2019 to December 2022 were collected and analyzed retrospectively. The patients were divided into two groups based on the presence of VMT prior to surgery: the VMT group and the non-VMT group, with 22 cases in each group. The best corrected visual acuity, closure of the macular hole, continuity of the external limiting membrane, and ellipsoid zone integrity were compared between the two groups during the postoperative follow-up.Results:There was no significant difference in the best corrected visual acuity, the rate of visual acuity improvement, or the rate of macular hole closure between the two groups (all P > 0.05). However, the continuity rate of the external limiting membrane [54.5% (12/22)] and the rate of ellipsoid band integrity [36.4% (8/22)] in the VTM group were significantly higher than those in the non-VTM group [9.1% (2/22), 0; χ2 = 10.47, 7.49, both P < 0.05]. Conclusions:Macular holes caused by VMT show better outcomes after vitrectomy to relieve the vitreous traction. However, for macular holes without remarkable VMT, vitrectomy alone may not yield ideal results. In such cases, it may be necessary to expand the area of ILM removal to adequately relieve the tangential traction.

Objective To analyze the characteristics of facial and tongue chromaticity parameters in patients with gastrointestinal tumors by setting the inspection image characteristics of patients with gastrointestinal tumors as the main research content;To establish an auxiliary diagnostic model for gastrointestinal tumors.Methods One-way ANOVA,t-test,Mann-whitney U test,canonical correlation analysis and Spearman statistical methods were used to analyze the characteristics of inspection image indexes and correlation of tumor markers of the 391 cases in the control group and 359 patients with gastrointestinal tumors.Machine learning methods such as SVM,Random Forest,KNN,Naive Bayes,XG Boost and Ada Boost were used to establish an auxiliary diagnostic model for gastrointestinal tumors.Results In terms of facial indicators,there were differences in F-R,F-G and F-B indicators among the control group,early-stage gastrointestinal cancer patients,and mid-to late-stage gastrointestinal cancer patients,in the comparison of tongue features among,TC-L,TB-L and TB-a of the control group,patients with early gastrointestinal tumors,and patients with intermediate and advanced gastrointestinal tumors showed a gradual downward trend;the AUC of the auxiliary diagnosis model of gastrointestinal tumor disease based on the chromaticity parameters of face tongue image constructed by Ada Boost algorithm was 0.930.Conclusion The auxiliary diagnostic model of gastrointestinal diseases constructed by facial and tongue images has good diagnostic effect,which can provide objective data support for in-depth exploration of the complex relationship between diagnosis and disease.

Aim To explore the underlying molecular mechanism of Alisol A 24-acetate(24A)in improving oxygen-glucose deprivation/reoxygenation(OGD/R)injury in brain microvascular endothelial cells(BMECs)and its correlation with miR-98-5p/transi-ent receptor potential melastatin-2(TRPM2).Meth-ods The ischemia-reperfusion injury in brain micro-vascular endothelial cells(BMECs)was established u-sing bEnd.3 cells subjected to 8 h of oxygen-glucose deprivation followed by 16 h of re-oxygenation.The cells were intervened by miR-98-5p mimics and/or 18.77 μmol·L-1 24A for 24 h and divided into the control group,OGD/R group,OGD/R+24A group,OGD/R+24A+miR-98-5p mimics group and OGD/R+miR-98-5p mimics group.The mRNA levels of miR-98-5p and TRPM2 were detected by qPCR.IL-1 β and TNF-α levels were detected by ELISA.The expression levels of TRPM2,p-AKT,p-GSK3 β,AKT,GSK3 β,Bcl-2,Bax,ZO-1,Occludin,Claudin-5 were detected by Western blot.Apoptosis and reactive oxygen species(ROS)levels were detected by flow cytometry.The targeting relationship between miR-98-5p and TRPM2 was verified using dual luciferase assay.Results Compared with the control group,the apoptosis of OGD/R group was obvious,Bcl-2/Bax decreased,ZO-1,Occludin,Claudin-5 decreased,IL-1 β,TNF-α and ROS increased,miR-98-5p,p-AKT/AKT,p-GSK3β/GSK3β decreased but TRPM2 increased.But com-pared with the OGD/R group,except the control group,the other three groups showed the opposite trend in the above aspects;compared with the OGD/R+24A group,OGD/R+24A+miR-98-5p mimics group showed decreased apoptosis,decreased degradation of ZO-1,Occludin and Claudin-5,and decreased inflam-mation and ROS.miR-98-5p,p-AKT/AKT,p-GSK3β/GSK3β increased and TRPM2 decreased.However,compared with the OGD/R+24A+miR-98-5p mimics group,the OGD/R+miR-98-5p mimics group reversed this trend.Dual luciferase confirmed that miR-98-5p targeted regulation of TRPM2.Conclusion 24A in-hibits the expression of TRPM2 in BMECs through miR-98-5p,regulates AKT/GSK3β signal pathway,re-duces OGD/R inflammation and oxidative stress-medi-ated apoptosis,prevents the degradation of ZO-1,Oc-cludin and Claudin-5,and improves BBB permeability.

Aim To explore the underlying molecular mechanism of Alisol A 24-acetate(24A)in improving oxygen-glucose deprivation/reoxygenation(OGD/R)injury in brain microvascular endothelial cells(BMECs)and its correlation with miR-98-5p/transi-ent receptor potential melastatin-2(TRPM2).Meth-ods The ischemia-reperfusion injury in brain micro-vascular endothelial cells(BMECs)was established u-sing bEnd.3 cells subjected to 8 h of oxygen-glucose deprivation followed by 16 h of re-oxygenation.The cells were intervened by miR-98-5p mimics and/or 18.77 μmol·L-1 24A for 24 h and divided into the control group,OGD/R group,OGD/R+24A group,OGD/R+24A+miR-98-5p mimics group and OGD/R+miR-98-5p mimics group.The mRNA levels of miR-98-5p and TRPM2 were detected by qPCR.IL-1 β and TNF-α levels were detected by ELISA.The expression levels of TRPM2,p-AKT,p-GSK3 β,AKT,GSK3 β,Bcl-2,Bax,ZO-1,Occludin,Claudin-5 were detected by Western blot.Apoptosis and reactive oxygen species(ROS)levels were detected by flow cytometry.The targeting relationship between miR-98-5p and TRPM2 was verified using dual luciferase assay.Results Compared with the control group,the apoptosis of OGD/R group was obvious,Bcl-2/Bax decreased,ZO-1,Occludin,Claudin-5 decreased,IL-1 β,TNF-α and ROS increased,miR-98-5p,p-AKT/AKT,p-GSK3β/GSK3β decreased but TRPM2 increased.But com-pared with the OGD/R group,except the control group,the other three groups showed the opposite trend in the above aspects;compared with the OGD/R+24A group,OGD/R+24A+miR-98-5p mimics group showed decreased apoptosis,decreased degradation of ZO-1,Occludin and Claudin-5,and decreased inflam-mation and ROS.miR-98-5p,p-AKT/AKT,p-GSK3β/GSK3β increased and TRPM2 decreased.However,compared with the OGD/R+24A+miR-98-5p mimics group,the OGD/R+miR-98-5p mimics group reversed this trend.Dual luciferase confirmed that miR-98-5p targeted regulation of TRPM2.Conclusion 24A in-hibits the expression of TRPM2 in BMECs through miR-98-5p,regulates AKT/GSK3β signal pathway,re-duces OGD/R inflammation and oxidative stress-medi-ated apoptosis,prevents the degradation of ZO-1,Oc-cludin and Claudin-5,and improves BBB permeability.

AIM:To observe the changes of Th17 related cytokines in tears of conjunctivochalasis(CCH)patients with liver-kidney yin deficiency treated with traditional Chinese medicine Qi Jing Mingmu decoction combined with artificial tears.METHODS:A total of 56 CCH patients(56 eyes)with liver-kidney yin deficiency of grade Ⅱ to Ⅲ were collected and randomly divided into treatment group(treated with Qi Jing Mingmu decoction combined with artificial tears)of 26 cases(26 eyes)and control group(treated with pure artificial tears)of 30 cases(30 eyes). The treatment course was 1 mo, and international ocular surface disease index(OSDI), tear film break-up time(BUT), tear meniscus height(TMH)and conjunctival congestion index of the patients were observed before and after treatment. The patients' tears were collected before and after treatment, and Th17 related cytokines in tears were detected using flow cytometry immunofluorescence luminescence method.RESULTS:After treatment, the OSDI, BUT and conjunctival congestion index of CCH patients in the treatment group and control group were significantly improved(all P<0.01). After treatment, the TMH of CCH patients in the treatment group was significantly reduced(P<0.01), while there was no statistically significant difference in TMH of the control group before and after treatment(P=0.41). After treatment, the levels of Th17 related cytokines IL-17A, IL-22, IFN-γ, IL-17F, and IL-1β in tears of CCH patients in the treatment group were significantly reduced after treatment(all P<0.01), and the changes in the treatment group were more significant(all P<0.05). There was no significant difference in the control group before and after treatment(all P>0.05). After treatment, the levels of IL-6 and TNF-α in the tears of both groups of CCH patients decreased compared to those before treatment(both P<0.05), but the changes in the treatment group were more significant(both P<0.01).CONCLUSION:Qi Jing Mingmu decoction combined with artificial tears can effectively improve the ocular surface microenvironment, enhance tear film stability, and inhibit ocular surface inflammation in CCH patients with liver-kidney yin deficiency. This may be related to its reduction in the secretion of Th17 related cytokines in tears.

Objective:To investigate the potential diagnostic value of peripheral blood soluble programmed cell death protein 1 (sPD-1) and soluble programmed cell death protein ligand 1 (sPD-L1) in acute rejection (AR) following liver transplantation using a rat model.Methods:A rat liver transplantation AR model was established, with the AR group (Lewis→BN) set as the experimental group (n=6) and the non-AR group (BN→BN) as the control group (n=6). Peripheral blood sPD-1 and sPD-L1 concentrations were measured using enzyme-linked immunosorbent assay (ELISA) at 1 day before transplantation and at 1, 3, and 7 days postoperatively. On postoperative day 7, the expression levels of PD-1 and PD-L1 in liver tissues were detected by immunohistochemistry (IHC). Independent samples t-test and repeated measures ANOVA were used to compare the results between the two groups. Pearson correlation analysis was conducted to evaluate the relationship between sPD-1, sPD-L1, the sPD-1/sPD-L1 ratio, and the rejection activity index.Results:On postoperative day 7, the experimental group exhibited significantly higher peripheral sPD-1 levels (218.59±36.88 vs. 164.95±15.82 ng/L) and a higher sPD-1/sPD-L1 ratio (0.44±0.12 vs. 0.36±0.07), but lower sPD-L1 levels (379.56±73.41 vs. 423.64±96.55 ng/L) compared to the control group (all P<0.05). Correlation analysis revealed a significant positive correlation between sPD-1 levels and the rejection activity index ( r=0.680, P<0.05), as well as between the sPD-1/sPD-L1 ratio and the rejection activity index ( r=0.795, P<0.01), while no correlation was observed between sPD-L1 levels and the rejection activity index. IHC demonstrated positive PD-1 and PD-L1 expression in the liver tissues of the experimental group, whereas the control group showed negative expression. Conclusion:Peripheral blood sPD-1 levels and the sPD-1/sPD-L1 ratio are significantly associated with AR after liver transplantation in rats, suggesting their potential as biomarkers for diagnosing AR in liver transplant recipients.

Objective:A bidirectional Mendelian randomization approach was applied to dissect the causal association between dairy product consumption and osteoarthritis (OA), so to offering novel insights for the prevention, treatment, and prognosis assessment of knee osteoarthritis (KOA).Methods:A two-sample Mendelian randomization (MR) analysis was conducted using public available genome-wide association studies. The primary analysis was performed using the inverse variance weighted (IVW) method. To assess the stability and reliability of the results, we compared IVW and MR-Egger regression using Cochran′s Q test to evaluate SNP heterogeneity. MR-Egger regression was employed to assess pleiotropy, while a leave-one-out approach was used for sensitivity analysis. Results:Based on 207 instrumental variables (IVs), two-sample MR analysis revealed that for each standard deviation increase in genetically predicted cheese intake, the risk of OA was significantly negatively associated [ OR(95% CI)=0.98(0.98, 0.99), P<0.001], so did the risk of KOA [ OR(95% CI)=0.73(0.63, 0.85), P<0.001]. However, no significant association was found between OA risk and the intake of full-fat milk (30 IVs), semi-skimmed milk (15 IVs), skimmed milk (32 IVs), soy milk (25 IVs), or other types of milk (13 IVs), yogurt (11 IVs), or butter (3 IVs). Conclusion:The two-sample MR analysis revealed causally inverse associations between cheese intake and OA as well as KOA.

OBJECTIVE: To identify the key features of facial and tongue images associated with anemia in female populations, establish anemia risk-screening models, and evaluate their performance. METHODS: A total of 533 female participants (anemic and healthy) were recruited from Shuguang Hospital. Facial and tongue images were collected using the TFDA-1 tongue and face diagnosis instrument. Color and texture features from various parts of facial and tongue images were extracted using Face Diagnosis Analysis System (FDAS) and Tongue Diagnosis Analysis System version 2.0 (TDAS v2.0). Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for feature selection. Ten machine learning models and one deep learning model (ResNet50V2 + Conv1D) were developed and evaluated. RESULTS: Anemic women showed lower a-values, higher L- and b-values across all age groups. Texture features analysis showed that women aged 30-39 with anemia had higher angular second moment (ASM)and lower entropy (ENT) values in facial images, while those aged 40-49 had lower contrast (CON), ENT, and MEAN values in tongue images but higher ASM. Anemic women exhibited age-related trends similar to healthy women, with decreasing L-values and increasing a-, b-, and ASM-values. LASSO identified 19 key features from 62. Among classifiers, the Artificial Neural Network (ANN) model achieved the best performance [area under the curve (AUC): 0.849, accuracy: 0.781]. The ResNet50V2 model achieved comparable results [AUC: 0.846, accuracy: 0.818]. CONCLUSION Differences in facial and tongue images suggest that color and texture features can serve as potential TCM phenotype and auxiliary diagnostic indicators for female anemia.
Humans ; Female ; Tongue/diagnostic imaging* ; Adult ; Anemia/diagnosis* ; Middle Aged ; Face/diagnostic imaging* ; Young Adult ; Machine Learning

Objective To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application.Methods and Results Recommendations were formulated based on literature review and expert group discussion,and consensus was reached following expert consultation.The consensus recommendations are comprehensive,covering the entire treatment procedures from preoperative assessment and preparation,surgical operation process,postoperative management and traditional Chinese medicine treatment to individualized treatment planning.The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain,reduced the use of opioid drugs,and significantly improved the quality of life and enhanced immune function of the patients.Postoperative follow-up suggested good treatment tolerance among the patients without serious complications.Conclusion The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy.The combined treatment has a high clinical value with a good safety profile for management of cancer pain.

Objective:This study aims to investigate the differences in hemostatic efficacy and patient comfort between an innovative domestically produced biodegradable nasal packing sponge and a traditional absorbent sponge following endoscopic nasal surgery. Methods:A prospective, randomized controlled trial design was utilized, including 30 patients who were divided into two groups according to random allocation, each receiving one of the two types of nasal packing. The study assessed the hemostatic efficacy, comfort, and safety of the materials by comparing the rates of no bleeding within 24 hours after packing, re-bleeding rates after 48 hours, pain ratings in the head and nasal areas, scores on a visual analog scale for nasal ocular symptoms, and safety indicators between the two groups. Results:The rates of no bleeding within 24 hours post-packing were 73.33% for both the experimental and control groups, with a no-bleeding rate of 100% after 48 hours in both groups. The pain rating in the head and nasal areas at various times post-packing was Grade Ⅰ（100%） in both groups, with no statistically significant difference（P=1.000）. The experimental groups sneezing score on the day of packing was（0.73±1.03）, lower than the control groups（2.27±1.67）, （P=0.007）; after 48 hours, the experimental groups sneezing score was（0.67±0.98）, also lower than the control groups（1.67±1.18）, （P=0.019）. There was no significant difference between the two groups in the Lund-Kennedy scoring during endoscopic examinations at the screening period, 7 days, 1 month, and 3 months post-packing（P>0.05）. Laboratory tests for other examination indicators were normal in both groups. Conclusion:The innovative domestically produced biodegradable nasal packing sponge not only provides hemostatic efficacy comparable to imported materials but also significantly improves patient comfort after surgery. It represents an economical and effective choice for nasal packing materials.
Humans ; Prospective Studies ; Surgical Sponges ; Endoscopy/methods* ; Male ; Female ; Epistaxis/prevention & control* ; Middle Aged ; Nasal Surgical Procedures/methods* ; Adult