AIM: To evaluate the application effectiveness of the 3D surgical video system and intraoperative optical coherence tomography(OCT)in idiopathic epiretinal membrane vitrectomy.METHODS: A retrospective analysis was conducted on 61 patients(61 eyes)with idiopathic epiretinal membrane at our hospital from January 2023 to October 2023. The patients were divided into two groups based on the surgical methods: with 31 patients(31 eyes)who underwent surgery using the 3D surgical video system and intraoperative OCT technology in 3D group, and 30 patients(30 eyes)underwent surgery using the Resight non-contact wide-angle lens system in traditional surgery group. Surgical time, membrane peeling time were recorded, followed-up for 6 mo, post-operative best-corrected visual acuity(BCVA), intraocular pressure(IOP), central macular thickness(CMT), and complications were analyzed for the two groups.RESULTS:All patients successfully underwent surgery without experiencing serious intraoperative complications such as major retinal hemorrhage, retinal tears, or retinal detachment. Additionally, no postoperative complications such as endophthalmitis or secondary glaucoma occurred. The surgical duration and membrane peeling time in the 3D group were significantly shorter than those in the traditional surgery group(20.13±1.59 vs 25.97±2.09 min; 3.74±0.89 vs 8.13±1.72 min, respectively; both P<0.001). There were no significant differences in BCVA and CMT between preoperative and 1-month postoperative values for both groups of patients(both P>0.008). However, both BCVA and CMT improved significantly at 3 and 6 mo postoperatively compared to preoperative levels(both P<0.008). At 6 mo postoperatively, the BCVA in the 3D group was significantly better than that in the traditional surgery group(P=0.007). There were no significant differences in CMT or IOP between the two groups at any postoperative time point(all P>0.05).CONCLUSION: Both the 3D surgical video system and the traditional surgical group can treat idiopathic epiretinal membrane, but the 3D surgical video system has advantages in shortening the surgical time, improving surgical efficiency, and enhancing the precision of surgical steps during surgery with the assistance of intraoperative OCT.

Objective To understand the epidemiological characteristics of HIV-positive patients in Wuhan from 2013 to 2022, and to further discover the high-risk groups, high-risk factors and high-risk links of AIDS in Wuhan. Methods The data of 21212 HIV antibody confirmed positive cases submitted for examination in Wuhan Comprehensive AIDS Management Platform from 2013 to 2022 were collected. A chi-square test was conducted on the data using SPSS software, and the results were analyzed. Results The number of confirmed tests showed an overall increasing trend from 2013 to 2022 (χ²=252.92, P＜0.001). Among the 12 448 confirmed positive cases, the male to female ratio was 7.44:1. The number of cases in 20-years age group was the highest (32.96%). The proportion of males in 60-years age group showed an increasing trend year by year (χ²=13.222, P＜0.005). Most of the cases were divorced/widowed/unmarried (5655 cases, 45.43%，χ²=296.166，P＜0.001). The majority were college students or above (3190 cases, 25.63%), and there was an increasing trend year by year (χ²=384.615，P＜0.001). The top three occupations were housework and unemployment, students, and business services (χ²=1225.833, P＜0.001). The patient detection and preoperative detection were the most among the sources (χ²=4941.911, P＜0.001). Medical institutions sent the most cases for testing, but the positive rate was low (49.37%, χ²=2571.462, P＜0.001). Conclusion The overall number of confirmatory tests shows an increasing trend. It is recommended to supplement other diagnostic criteria and methods to improve the accuracy of positive rates in medical institutions. Efforts should be intensified to intervene in the elderly population, strengthen AIDS prevention education in schools, and raise awareness of AIDS prevention among young people.

Objective To compare the efficacy of MRI-transrectal ultrasound(TRUS)software fusion-guided biopsy and cognitive fusion-guided biopsy for detecting prostate cancer(PC).Methods Data of 120 patients with suspected PC(127 lesions)who underwent transperineal prostate biopsy with 2-3 times of target biopsy(TB)and 10 times of system biopsy were retrospectively analyzed.According to TB guidance methods,73 cases(78 lesions)received MRI-TRUS software fusion-guided biopsy were classified into group A,and 47 cases(49 lesions)received cognitive fusion-guided biopsy were classified into group B.The positive rate of PC,clinic significant PC(csPC)and PC in different sized lesions by TB were compared between groups,and the positive rate of PC between 2 or 3 times TB was also compared within each group.Results The positive rate of PC and csPC detected by TB was 55.13%(43/78)and 39.74%(31/78)in group A,53.06%(26/49)and 34.69%(17/49)in group B,respectively,no significant difference was found(all P＞0.05).The positive rate of PC in lesions with the maximum diameter≤10 mm detected by TB in group A was higher than that in group B(P＜0.05),but no significant difference of lesions with the maximum diameter＞10 mm and＜15 mm nor≥15 mm was found between groups(all P＞0.05).No significant difference of positive rate of PC was found between 2 and 3 times TB in group A(P＞0.05),while positive rate of PC of 3 times TB was significantly higher than that of 2 times TB in group B(P＜0.05).Conclusion MRI-TRUS software fusion-guided biopsy had positive rate of PC and csPC similar to that of cognitive fusion-guided biopsy,but was helpful for reducing times of TB and increasing detecting rate for lesions with the maximum diameter≤10 mm.

Objective:To explore the safety and efficacy of TBF conditioning regimen of thiotepa, fludarabine and busulfan in haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for recipients with hematological malignancies unsuitable for BUCY conditioning regimen (busulfan, cyclophosphamide & mBUCY).Method:A retrospective analysis was conducted for 20 recipients with malignant hematologic diseases receiving TBF conditioning regimen before haplo-HSCT at Soochow Hopes Hematologic Hospital from January 2020 to December 2023. The regimen-related toxicity of TBF was assessed by the Bearman scoring criteria. For comparing the safety and efficacy of TBF conditioning regimen with mBUCY regimen, propensity score matching was performed in a ratio of 1: 2 with disease type, patient age and gender as matching factors.Result:Mild oral mucositis and gastrointestinal reaction were major side-effects without severe cardiac events. Median time to neutrophil and platelet engraftments in TBF group was 11 and 18 days with comparable engraftment in mBUCY group. TBF regimen had a significantly lower incidence of grade Ⅱ-Ⅳ acute graft-versus-host disease (aGVHD) than mBUCY at Day 100 (5% vs 35%, P=0.01). No significant inter-group difference existed in overall survival (68% vs 62%, P=0.98) while 1-year incidence of graft-versus-host disease-free, relapse-free survival (GRFS) improved (63% vs 37%, P=0.06) in TBF group. Conclusion:TBF is a promising conditioning regimen with low toxicity and decent safety for haplo-HSCT. TBF patients tend to have a lower incidence of grade Ⅱ-ⅣaGVHD and better GRFS than mBUCY.

Objective:To investigate the efficacy and safety of protein A immunoadsorption (PAIA) combined with rituximab (RTX) in highly sensitized patients who underwent haplo-hematopoietic stem cell transplantation (haplo-HSCT) .Methods:The clinical data of 56 highly sensitized patients treated with PAIA and RTX before haplo-HSCT at the First Affiliated Hospital of Soochow University and Soochow Hopes Hematonosis Hospital between March 2021 and June 2023 were retrospectively analyzed. The number of human leukocyte antigen (HLA) antibody types and the mean fluorescence intensity (MFI), humoral immunity, adverse reactions during adsorption, and survival within 100 days before and after adsorption were measured.Results:After receiving the PAIA treatment, the median MFI of patients containing only HLA Ⅰ antibodies decreased from 7 859 (3 209-12 444) to 3 719 (0-8 275) ( P<0.001), and the median MFI of HLA Ⅰ+Ⅱ antibodies decreased from 5 476 (1 977-12 382) to 3 714 (0-11 074) ( P=0.035). The median MFI of patients with positive anti-donor-specific antibodies decreased from 8 779 (2 697-18 659) to 4 524 (0–15 989) ( P<0.001). The number of HLA-A, B, C, DR, and DQ antibodies in all patients decreased after the PAIA treatment, and the differences were statistically significant (A, B, C, DR: P<0.001, DQ: P<0.01). The humoral immune monitoring before and after the PAIA treatment showed a significant decrease in the number of IgG and complement C3 ( P<0.001 and P=0.002, respectively). Forty-four patients underwent HLA antibody monitoring after transplantation, and the overall MFI and number of antibody types decreased. However, five patients developed new antibodies with low MFI, and nine patients continued to have high MFI. The overall survival, disease-free survival, non-recurrent mortality, and cumulative recurrence rates at 100 days post-transplantation were 83.8%, 80.2%, 16.1%, and 4.5%, respectively. Conclusions:The combination of PAIA and RTX has a certain therapeutic effect and good safety in the desensitization treatment of highly sensitive patients before haplo-HSCT.

Objective To investigate the effects of canagliflozin combined with amiloride and benzamir on doxorubicin-induced ne-phrotic syndrome(NS)model rats.Methods A total of 49male SD rats were randomly divided into 7groups:normal control group(NG group),model group(MG group),canagliflozin group(KG group),benzamil group(BH group),amiloride group(AL group),cana-gliflozin+benzamil group(KB group)and canagliflozin+amiloride group(KA group),with 7 rats in each group.The NS model was established by injection of doxorubicin in the tail vein.The 24h-UTP of each group was detected one day before treatment to verify the successful preparation of the model.Each group was given intragastric administration according to the body weight of rats regularly every day,NG group and MG group were given equal amount of normal saline,the course of treatment was 6 weeks.After 6 weeks of treatment,the 24h-UTP,UNa,UK,UCl levels in urine and the albumin(ALB),triglyceride(TG),total cholesterol(TC),low density lipopro-tein(LDL),Urea,Crea,CysC,SNa,SK,SCl levels in serum were measured,respectively.The expression of serum transforming growth factor-β1(TGF-β1)and soluble thrombomodulin(sTM)were detected by enzyme-linked immunosorbent assay(ELISA).The expression of TGF-β1 gene was detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).The renal pathology of rats in each group were tested by the hematoxylin-eosin(HE)staining and Masson staining.Results After successful modeling,the levels of 24h-UTP,TG,TC,LDL in the MG group were increased,while the levels of ALB was decreased(P＜0.05).After 6 weeks of drug intervention,compared with MG group,the levels of 24h-UTP,TC,TG,LDL were decreased,and the level of ALB was increased in all drug groups(P＜0.05),and the level of TGF-β1 was decreased in the KG group(P＜0.05),and the levels of CysC,UNa,TGF-β1,sTM was increased in the KA group(P＜0.05).The results of HE staining and Masson staining showed that typical characteristics of focal segmental glomerulosclerosis appeared in the renal tissue of rats in MG group,all drug groups were observed in varying degrees of improvement.Conclusion Canagliflozin,benzamil,amiloride alone and canagliflozin combined with benzatrimil and amiloride could improve the macroproteinuria,hypoproteinemia and hyperlipidemia of doxorubicin-induced NS model rats.Canagli-flozin alone can effectively reduce TGF-β1 expression and thereby reduce kidney inflammation,but the combination of canagliflozin and amiloride may cause renal insufficiency and endothelial injury.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

[Objective]To evaluate the efficacy and safety of total oral regimens containing pomalidomide as a second-line treatment strategy in multiple myeloma.[Methods]A total of 22 patients with multiple myeloma placed on total oral regimens containing pomalidomide as a second-line therapy from March 2020 to December 2023 were retrospectively analyzed to evaluate the treatment response,survival and safety.[Results]The median age of the 22 patients was 71.5 years old. The total oral treatment regimens containing pomalidomide included IPD (7 cases),PCD (11 cases),XPD (2 cases),and PD (2 cases). The median number of treatment cycles was 14. Among the 13 patients with prior lenalidomide exposure,ORR was 53.85％,of which 23.08％ was ≥VGPR. In 9 patients without prior lenalidomide exposure,the ORR was 77.78％,and of which 55.56％ was ≥VGPR. There was no significant difference in ORR between these two groups (P=0.38). In 12 patients with high genetic risk,the ORR was 50％,and ≥VGPR was 16.67％. The median follow-up time was 10.6 months. Disease progressed in 10 patients and death occurred in 6 patients of them. The median progression free survival (PFS) was not reached (not reached and 10.6 months in non-lenalidomide-exposure patients or lenalidomide-exposure patients,respectively).The high grade treatment-related adverse events (AEs)(≥3 ) were reported in 18.18％ patients,including granulocytopenia,thrombocytopenia,and pulmonary infection. There was no treatment-related death.[Conclusion]Total oral regimens containing pomalidomide as a second-line therapy is generally effective and safe for multiple myeloma patients.

Objective To compare pregnancy outcomes among pregnant women undergoing cervical polypectomy during different gestational periods.Methods A total of 125 pregnant women were diagnosed with cervical polyps and underwent surgical removal.These participants were divided into the natural pregnancy group(n=71)and the in vitro fertilization and embryo transfer group(IVF-ET group,n=54).Retrospective analysis was conducted on various clinical parameters including age,gestational times,delivery times,abortion times,history of adverse preg-nancy outcomes,history of endometrial polyps,pre-polyp removal vaginal bleeding episodes,gestational age at the time of polyp removal procedure,number of polyps detected during surgery,postoperative pathology results as well as pregnancy outcomes.Results Vaginal bleeding was the most common symptom of pregnancy combined with cer-vical polyps,accounting for 111 cases(88.8％)(62 cases in the natural pregnancy group(87.32％)and 49 ca-ses in the IVF-ET group(90.74％)).Some patients had increased vaginal discharge or were found during a gyne-cological exam,accounting for 11.2％of the patients.All patients underwent cervical polypectomy during pregnan-cy,except for 9 cases of continued pregnancy(4 cases in the natural pregnancy group and 5 cases in the IVF-ET group),of which 13 had miscarriage,10 had preterm birth(6 in the natural pregnancy group and 4 in the IVF group)and 93(54 cases in natural pregnancy group,39 cases in IVF group)(74.4％)delivered at full term.Postoperative pathology was mostly inflammatory polyps(105 cases,84％),deciduous polyps(20 cases,8％)(10 cases in the natural pregnancy group and 10 cases in the IVF-ET group,14.09％and 18.52％,respective-ly).The incidence of preoperative vaginal bleeding,decidual polyp,postoperative abortion,and postoperative pre-term birth in the IVF-ET group exhibited higher rates compared to those observed in the natural pregnancy group;however,these differences did not reach statistical significance.Conclusion The cervical polypectomy procedure was performed during pregnancy for both the natural conception group and the IVF-ET group,with no significant disparity observed in pregnancy outcomes between these two cohorts.

Digital intraoral scanning is a hot topic in the field of oral digital technology.In recent years,digital intra-oral scanning has gradually become the mainstream technology in orthodontics,prosthodontics,and implant dentistry.The precision of digital intraoral scanning and the accuracy and stitching of data collection are the keys to the success of the impression.However,the operators are less familiar with the intraoral scanning characteristics,imaging process-ing,operator scanning method,oral tissue specificity of the scanned object,and restoration design.Thus far,no unified standard and consensus on digital intraoral scanning technology has been achieved at home or abroad.To deal with the problems encountered in oral scanning and improve the quality of digital scanning,we collected common expert opin-ions and sought to expound the causes of scanning errors and countermeasures by summarizing the existing evidence.We also describe the scanning strategies under different oral impression requirements.The expert consensus is that due to various factors affecting the accuracy of digital intraoral scanning and the reproducibility of scanned images,adopting the correct scanning trajectory can shorten clinical operation time and improve scanning accuracy.The scanning trajec-tories mainly include the E-shaped,segmented,and S-shaped methods.When performing fixed denture restoration,it is recommended to first scan the abutment and adjacent teeth.When performing fixed denture restoration,it is recommend-ed to scan the abutment and adjacent teeth first.Then the cavity in the abutment area is excavated.Lastly,the cavity gap was scanned after completing the abutment preparation.This method not only meets clinical needs but also achieves the most reliable accuracy.When performing full denture restoration in edentulous jaws,setting markers on the mucosal tissue at the bottom of the alveolar ridge,simultaneously capturing images of the vestibular area,using different types of scanning paths such as Z-shaped,S-shaped,buccal-palatal and palatal-buccal pathways,segmented scanning of dental arches,and other strategies can reduce scanning errors and improve image stitching and overlap.For implant restora-tion,when a single crown restoration is supported by implants and a small span upper structure restoration,it is recom-mended to first pre-scan the required dental arch.Then the cavity in the abutment area is excavated.Lastly,scanning the cavity gap after installing the implant scanning rod.When repairing a bone level implant crown,an improved indi-rect scanning method can be used.The scanning process includes three steps:First,the temporary restoration,adjacent teeth,and gingival tissue in the mouth are scanned;second,the entire dental arch is scanned after installing a standard scanning rod on the implant;and third,the temporary restoration outside the mouth is scanned to obtain the three-di-mensional shape of the gingival contour of the implant neck,thereby increasing the stability of soft tissue scanning around the implant and improving scanning restoration.For dental implant fixed bridge repair with missing teeth,the mobility of the mucosa increases the difficulty of scanning,making it difficult for scanners to distinguish scanning rods of the same shape and size,which can easily cause image stacking errors.Higher accuracy of digital implant impres-sions can be achieved by changing the geometric shape of the scanning rods to change the optical curvature radius.The consensus confirms that as the range of scanned dental arches and the number of data concatenations increases,the scanning accuracy decreases accordingly,especially when performing full mouth implant restoration impressions.The difficulty of image stitching processing can easily be increased by the presence of unstable and uneven mucosal mor-phology inside the mouth and the lack of relatively obvious and fixed reference objects,which results in insufficient ac-curacy.When designing restorations of this type,it is advisable to carefully choose digital intraoral scanning methods to obtain model data.It is not recommended to use digital impressions when there are more than five missing teeth.