AIM: To explore the factors affecting the whole-eye astigmatism after pterygium excision combined with autologous limbal stem cell transplantation.METHODS: A retrospective analysis was conducted on the medical records of 42 patients(42 eyes)with primary pterygium admitted in the ophthalmology department of Xijing Hospital from January 2023 to October 2023. They underwent pterygium excision combined with autologous limbal stem cell transplantation. The maximum invasion depth of pterygium into the cornea was measured with anterior segment optical coherence tomography(AS-OCT)before operation, the length of the pterygium invading cornea, the width of the limbus and the area of the invading cornea were measured during the operation, and three-dimensional values of corneal astigmatism of anterior segment, index of surface variance(ISV), index of vertical asymmetry(IVA), best corrected visual acuity(BCVA)and whole-eye astigmatism were collected before and at 1 mo after surgery. Patients with astigmatism ≤0.50 D or >0.50 D of the whole eye at 1 mo after surgery were assigned to group A and B, respectively. The differences of clinical data before and at 1 mo after surgery between the two groups, and the correlation between pre-operative clinical indicators and whole-eye astigmatism were analyzed. The decision tree algorithm was performed to explore the influencing factors of whole-eye astigmatism at 1 mo postoperatively.RESULTS: The maximum invasion depth of pterygium in the group A was significantly less than that in the group B [80.00(40.00, 180.00)μm vs 175.00(123.00, 190.00)μm, P=0.002]. Preoperative BCVA(LogMAR), whole-eye astigmatism, cornea astigmatism, ISV, IVA and maximum invasion depth of pterygium were positively correlated with whole-eye astigmatism at 1 mo after surgery(rs=0.317, P=0.041; rs=0.545, P<0.001; rs=0.448, P=0.003; rs=0.389, P=0.011; rs=0.382, P=0.013; rs=0.391, P=0.010). The decision tree algorithm screened out two influential factors: the maximum invasion depth of pterygium into the cornea and preoperative whole-eye astigmatism. The risk of whole-eye astigmatism >0.50 D at 1 mo after operation was higher with maximum invasion depth of pterygium into the cornea >95 μm than that with ≤95 μm. Among the patients with whole-eye astigmatism >2.63 D before operation, the probability of residual whole-eye astigmatism >0.50 D was 88.9%, and the predictive model AUC was 0.804.CONCLUSION: The whole-eye astigmatism after pterygium resection is mainly affected by the maximum invasion depth of pterygium into the cornea and preoperative whole-eye astigmatism. When the maximum invasion depth of pterygium into the corneal is >95 μm and the whole-eye stigmatism is >2.63 D before surgery, the patient should receive surgical treatment as soon as possible in order to obtain good clinical benefits.

Aim To investigate the effect of adenovirus(ADV)-mediated Profurin(PF)expression on the plaque stability of ApoE-/-mice.Methods ApoE-/-mice were fed with high-fat diet for 8 weeks,and then treated with ADV-mediated PF intervention,followed by high-fat diet for 4 weeks.Aortic roots were isolated for atherosclerotic plaque area analysis and immunohistochemical analysis.Plasma phospholipid transfer protein(PLTP)activity was detec-ted by fluorescence donor essay,plasma total cholesterol(TC)and triglyceride(TG)were measured by enzyme assay kits,and fast protein liquid chromatography was used for lipoprotein profile analysis.Results Compared with the con-trol group,the plasma TC and TG levels,PLTP activity and circulating tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in ADV-PF group were significantly decreased(P＜0.01).In the ADV-PF group,there was no significant change in atherosclerotic lesions on the inner surface of the full-length aorta,but the plaque area and lipid area in the aortic root were reduced(P＜0.01),the content of macrophages was significantly decreased(P＜0.01),and the smooth muscle cells and collagen area were not significantly different.The content of matrix metalloproteinase-9 in plaque was signifi-cantly decreased(P＜0.05).Conclusion Overexpression of PF can alleviate atherosclerosis and reduce the levels of circulating inflammatory factors to a certain extent,and effectively improve the plaque stability of ApoE-/-mice.

Gallstones are highly prevalent worldwide, with a complex pathogenesis. Symptomatic patients often undergo cholecystectomy, and effective preventive measures are lacking. In recent years, with the deepening of research on digestive tract microbiota, growing evidence has shown that gallstone patients exhibit an imbalance in the digestive tract microbiota, which is involved in bile acid and cholesterol metabolism as well as stone formation through multiple mechanisms. Certain probiotic strains have demonstrated potential in preventing and treating cholesterol gallstones. This article focuses on the current research status of digestive tract microbiota in gallstone disease, including their microbiota composition, potential microbial mechanisms, microecological interventions, and future research directions.

AIM:To investigate the effect of plasmin on epithelial sodium channel γ-subunit(γ-ENaC)acti-vation in mouse M-1 cells and the role of nuclear factor-κB(NF-κB).METHODS:Mouse M-1 cells were divided into three experimental parts.In the first part,the cells were divided into a control group,a plasmin group,and a plasmin+BAY 11-7082(NF-κB inhibitor)group to explore the effects of plasmin on inflammatory factors and γ-ENaC.In the sec-ond part,the cells were divided into a control group,a BAY 11-7082 group and a BAY 11-7082+plasmin group.M-1 cells were pretreated with BAY 11-7082 to explore the role of NF-κB in the regulation of γ-ENaC expression by plasmin.In the third part,the cells were divided into a control group,a plasmin group and an interleukin-6(IL-6)group.M-1 cells were treated with plasmin or IL-6 to explore the regulatory effect of IL-6 downstream of NF-κB on γ-ENaC.After drug interven-tion,the levels of IL-6,tumor necrosis factor-α(TNF-α),monocyte chemoattractant protein-1(MCP-1)and IL-1β in cell culture supernatants were detected by ELISA.The protein levels of phosphorylated inhibitor of nuclear factor-κB α(p-IκBα)/IκBα,p-NF-κB p65/NF-κB p65,and γ-ENaC was detected by Western blot.The distribution of γ-ENaC on the membrane was detected by immunofluorescence staining.RESULTS:Compared with control group,the levels of IL-6,TNF-α,MCP-1 and IL-1β in the supernatants of cells treated with 10 mg/L plasmin for 24 h were increased(n=3,P<0.01),the protein levels of p-IκBα/IκBα,p-NF-κB p65/NF-κB p65 and γ-ENaC were increased(n=5,P<0.01),and the distribution of γ-ENaC on the membrane was increased.Compared with plasmin group,the levels of IL-6,TNF-α,MCP-1,IL-1β,p-IκBα/IκBα,p-NF-κB p65/NF-κB p65 and γ-ENaC,and the γ-ENaC distribution on the membrane were lowered in plasmin and BAY 11-7082 coculture group(n=3,P<0.05 or P<0.01).Compared with control group,the ratio of p-NF-κB p65/NF-κB p65 decreased in BAY 11-7082 group(n=5,P<0.05),whereas there was no significant change in γ-ENaC.After stimulation with plasmin,the levels of p-IκBα/IκBα,p-NF-κB p65/NF-κB p65 and γ-ENaC in-creased(n=5,P<0.05 or P<0.01),and the γ-ENaC distribution on the membrane increased.Treatment with IL-6,downstream of NF-κB,increased the protein expression of γ-ENaC(n=5,P<0.05)and the distribution of γ-ENaC on the membrane after 24 h of intervention.CONCLUSION:The regulation of γ-ENaC expression by plasmin in mouse M-1 cells is related to the abnormal increase in inflammatory factors after NF-κB activation.

Objective:To explore the spatiotemporal evolution and convergence trend of the level of health resource supply in the Yangtze River Delta Region,and to provide quantitative support for the formulation of health resource supply policies.Methods:Using Dagum Gini coefficient,kernel density estimation,Markov chain,and spatial β convergence model to analyze the regional differences,dynamic evolution,and convergence of health resource supply levels in the Yangtze River Delta.Results:From 2010 to 2022,the level of health resource supply in the Yangtze River Delta maintained an increasing trend,with overall differences,intra regional and inter regional differences all showing a narrowing trend.Inter regional differences contributed the most,and Anhui Province's development was relatively balanced.There is a weak polarization phenomenon in the Yangtze River Delta as a whole,and the balance in Zhejiang has improved in the later stage.The spatial factors significantly affect the dynamic evolution process of the supply level of health resources in the Yangtze River Delta,with obvious positive spillover effects,and the supply level has β convergence characteristics.Conclusion:It is needed to promote the comprehensive development of regional economy,accelerate the improvement of the supply level of health resources in underdeveloped areas,and narrow the gap.At the same time,it needs to enhance spatial interaction between regions and pay attention to the positive spillover effects in areas with higher supply levels.

OBJECTIVE To acquire the real-world incidence of ceftazidime-avibactam sodium(CAZ)-related ad-verse reactions of blood system among a large sample of drug medication patients based on the active monitoring system so as to provide reference for safe clinical use of drugs.METHOD With the help of'Adverse Drug Event Active Surveillance and Assessment System-Ⅱ'(ADE-ASAS-Ⅱ),the use of CAZ of the patients who were hospi-talized in Chinese PLA General Hospital from Jan.1,2020 to Dec.31,2023 were retrospectively and automatical-ly monitored,the patients who were alarmed by system were evaluated by two persons,the incidence rates of CAZ-related thrombocytopenia,hemoglobin decreased and leucopenia were calculated,and the related influencing factors were analyzed.RESULTS Among the 278 case-times(191 cases)of patients who were treated with drugs and were enrolled in the study,there were 3(1.08％)case-times of thrombocytopenia,8(2.88％)case-times of hemoglobin decreased and 19(6.83％)case-times of leucopenia;the total incidence of adverse reactions of blood system was 10.79％.Logistic regression analysis showed that age and duration of drug administration were the in-fluencing factors for the CAZ-related adverse reactions of blood system.CONCLUSIONS It is common for the CAZ-related adverse reactions of blood system.The middle-aged and elderly patients who take drug therapy for a long time period are more likely to have the blood system-related adverse reactions.It is necessary to focus on the monitoring of renal function of the patients and adjust the dosage of administration in a timely manner so as to re-duce the incidence of adverse reactions of the blood system.

Gallstones are highly prevalent worldwide, with a complex pathogenesis. Symptomatic patients often undergo cholecystectomy, and effective preventive measures are lacking. In recent years, with the deepening of research on digestive tract microbiota, growing evidence has shown that gallstone patients exhibit an imbalance in the digestive tract microbiota, which is involved in bile acid and cholesterol metabolism as well as stone formation through multiple mechanisms. Certain probiotic strains have demonstrated potential in preventing and treating cholesterol gallstones. This article focuses on the current research status of digestive tract microbiota in gallstone disease, including their microbiota composition, potential microbial mechanisms, microecological interventions, and future research directions.

AIM:To investigate the effect of plasmin on epithelial sodium channel γ-subunit(γ-ENaC)acti-vation in mouse M-1 cells and the role of nuclear factor-κB(NF-κB).METHODS:Mouse M-1 cells were divided into three experimental parts.In the first part,the cells were divided into a control group,a plasmin group,and a plasmin+BAY 11-7082(NF-κB inhibitor)group to explore the effects of plasmin on inflammatory factors and γ-ENaC.In the sec-ond part,the cells were divided into a control group,a BAY 11-7082 group and a BAY 11-7082+plasmin group.M-1 cells were pretreated with BAY 11-7082 to explore the role of NF-κB in the regulation of γ-ENaC expression by plasmin.In the third part,the cells were divided into a control group,a plasmin group and an interleukin-6(IL-6)group.M-1 cells were treated with plasmin or IL-6 to explore the regulatory effect of IL-6 downstream of NF-κB on γ-ENaC.After drug interven-tion,the levels of IL-6,tumor necrosis factor-α(TNF-α),monocyte chemoattractant protein-1(MCP-1)and IL-1β in cell culture supernatants were detected by ELISA.The protein levels of phosphorylated inhibitor of nuclear factor-κB α(p-IκBα)/IκBα,p-NF-κB p65/NF-κB p65,and γ-ENaC was detected by Western blot.The distribution of γ-ENaC on the membrane was detected by immunofluorescence staining.RESULTS:Compared with control group,the levels of IL-6,TNF-α,MCP-1 and IL-1β in the supernatants of cells treated with 10 mg/L plasmin for 24 h were increased(n=3,P<0.01),the protein levels of p-IκBα/IκBα,p-NF-κB p65/NF-κB p65 and γ-ENaC were increased(n=5,P<0.01),and the distribution of γ-ENaC on the membrane was increased.Compared with plasmin group,the levels of IL-6,TNF-α,MCP-1,IL-1β,p-IκBα/IκBα,p-NF-κB p65/NF-κB p65 and γ-ENaC,and the γ-ENaC distribution on the membrane were lowered in plasmin and BAY 11-7082 coculture group(n=3,P<0.05 or P<0.01).Compared with control group,the ratio of p-NF-κB p65/NF-κB p65 decreased in BAY 11-7082 group(n=5,P<0.05),whereas there was no significant change in γ-ENaC.After stimulation with plasmin,the levels of p-IκBα/IκBα,p-NF-κB p65/NF-κB p65 and γ-ENaC in-creased(n=5,P<0.05 or P<0.01),and the γ-ENaC distribution on the membrane increased.Treatment with IL-6,downstream of NF-κB,increased the protein expression of γ-ENaC(n=5,P<0.05)and the distribution of γ-ENaC on the membrane after 24 h of intervention.CONCLUSION:The regulation of γ-ENaC expression by plasmin in mouse M-1 cells is related to the abnormal increase in inflammatory factors after NF-κB activation.

Objective:To explore the spatiotemporal evolution and convergence trend of the level of health resource supply in the Yangtze River Delta Region,and to provide quantitative support for the formulation of health resource supply policies.Methods:Using Dagum Gini coefficient,kernel density estimation,Markov chain,and spatial β convergence model to analyze the regional differences,dynamic evolution,and convergence of health resource supply levels in the Yangtze River Delta.Results:From 2010 to 2022,the level of health resource supply in the Yangtze River Delta maintained an increasing trend,with overall differences,intra regional and inter regional differences all showing a narrowing trend.Inter regional differences contributed the most,and Anhui Province's development was relatively balanced.There is a weak polarization phenomenon in the Yangtze River Delta as a whole,and the balance in Zhejiang has improved in the later stage.The spatial factors significantly affect the dynamic evolution process of the supply level of health resources in the Yangtze River Delta,with obvious positive spillover effects,and the supply level has β convergence characteristics.Conclusion:It is needed to promote the comprehensive development of regional economy,accelerate the improvement of the supply level of health resources in underdeveloped areas,and narrow the gap.At the same time,it needs to enhance spatial interaction between regions and pay attention to the positive spillover effects in areas with higher supply levels.

Aim To investigate the effect of adenovirus(ADV)-mediated Profurin(PF)expression on the plaque stability of ApoE-/-mice.Methods ApoE-/-mice were fed with high-fat diet for 8 weeks,and then treated with ADV-mediated PF intervention,followed by high-fat diet for 4 weeks.Aortic roots were isolated for atherosclerotic plaque area analysis and immunohistochemical analysis.Plasma phospholipid transfer protein(PLTP)activity was detec-ted by fluorescence donor essay,plasma total cholesterol(TC)and triglyceride(TG)were measured by enzyme assay kits,and fast protein liquid chromatography was used for lipoprotein profile analysis.Results Compared with the con-trol group,the plasma TC and TG levels,PLTP activity and circulating tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in ADV-PF group were significantly decreased(P＜0.01).In the ADV-PF group,there was no significant change in atherosclerotic lesions on the inner surface of the full-length aorta,but the plaque area and lipid area in the aortic root were reduced(P＜0.01),the content of macrophages was significantly decreased(P＜0.01),and the smooth muscle cells and collagen area were not significantly different.The content of matrix metalloproteinase-9 in plaque was signifi-cantly decreased(P＜0.05).Conclusion Overexpression of PF can alleviate atherosclerosis and reduce the levels of circulating inflammatory factors to a certain extent,and effectively improve the plaque stability of ApoE-/-mice.