1.Molecular Crosstalk Mechanisms of Shoutai Wan and Juyuan Jian on Maternal-fetal Interface Subcellular Clusters in CBA/J×DBA/2 Recurrent Pregnancy Loss Model
Jingxin GAO ; Qiuping CHEN ; Xiaoyan ZHENG ; Pengfei ZENG ; Rui ZHOU ; Yancai TANG ; Qian ZENG ; Wenli GUO ; Jinzhu HUANG ; Weijun DING ; Linwen DENG ; Hang ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):70-87
ObjectiveTo systematically compare the differential regulation of the maternal-fetal interface cell lineages and communication networks in the CBA/J×DBA/2 mouse model of recurrent pregnancy loss (RPL) by the two classic therapeutic methods-tonifying the kidney to stabilize the fetus and invigorating the spleen to stabilize the fetus (Shoutai Wan, Juyuan Jian)-of traditional Chinese medicine (TCM) at the single-cell resolution and clarify their modern scientific connotations. MethodsFemale non-pregnant CBA/J mice were caged with male BALB/c (blank group) and DBA/2 (modeling group) mice separately. Pregnant mice in the modeling group were randomly grouped as follows: high/low-dose Shoutai Wan, high/low-dose Juyuan Jian, model (RPL), and positive control (dydrogesterone), with 10 mice in each group. Starting from the day after the detection of the vaginal plug, mice were administrated with drugs or an equal volume of normal saline by gavage for 10 consecutive days. After the intervention, the following indicators were measured. ① Macroscopic evaluation: general conditions, uterine wet weight, embryo loss rate, four coagulation parameters [prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), and thrombin time (TT)], and peripheral blood estradiol (E2) and progesterone (Pg) levels. The decidua with embryos was stained with hematoxylin-eosin (HE) and evaluated by transmission electron microscopy (TEM). The expression of B-cell lymphoma-2 (Bcl-2), vascular endothelial growth factor (VEGF), angiotensin Ⅱ (AngⅡ), matrix metalloproteinase-2 (MMP-2), interleukin-6 (IL-6), leukemia inhibitory factor (LIF), CXC chemokine ligand 12 (CXCL12), and microtubule-associated protein 1 light chain 3 homolog (LC3)Ⅰ/Ⅱ was quantified by Western blot. ② Mechanism analysis at the single-cell level: The decidua with embryos from the blank, model, high-dose Shoutai Wan, and high-dose Juyuan Jian groups (6 mice per group, with 3 single-cell samples per group, totaling 24 mice) were analyzed by the BD Rhapsody™ platform, and the whole-cell atlas was drawn by uniform manifold approximation and projection (UMAP) dimensionality reduction clustering combined with the single-cell mouse cell atlas (scMCA). The differentially expressed genes (DEGs) and cell interaction networks were analyzed via Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and CellChat, and the protein-protein interaction (PPI) map of subtype cells was constructed. The CytoTRACE pseudo-temporal analysis was performed to explore the developmental trajectories of core immune cells (natural killer cells, NK cells) from maternal and fetal sources. Results① Pathological and Western blot results indicated that compared with the blank group, the RPL group showed an increase in the embryo loss rate (P<0.01), down-regulated expression of Bcl-2, LIF, MMP-2, and Vegf in the decidua with embryos (P<0.05), up-regulated protein levels of CXCL-12, AngⅡ, and IL-6 (P<0.05), blocked angiogenesis, apoptosis-inflammation imbalance, and coagulation dysfunction. Both prescriptions dose-dependently reduced the abortion rate and restored the angiogenesis-inflammation balance, and Shoutai pill showed superior performance in restoring the E2 level to the Pg level (P<0.05). ② Single-cell transcriptome analysis indicated that compared with the blank group, the RPL group showed differences in multiple key cell populations such as decidual cells, trophoblast cells, endothelial cells, erythroblasts, NK cells, and macrophages at the maternal-fetal interface. Immunity and angiogenesis were the key links in RPL. Compared with the RPL group, high-dose Shoutai Wan reversed the changes of NK cells in the embryonic layer (upregulating the mRNA levels of 17 genes and downregulating the mRNA levels of 29 genes) and macrophages (upregulating the mRNA levels of 117 genes and downregulating the mRNA levels of 53 genes) through the regulation of gene expression. High-dose Shoutai pill regulated the immune cells to affect unfolded proteins, cell adhesion, and programmed cell death, thereby promoting decidualization and angiogenesis and modulating embryo-membrane development. High-dose Juyuan Jian regulated the key subgroups of NK cells (up-regulating the mRNA levels of 9 genes and down-regulating the mRNA levels of 17 genes) and macrophages (up-regulating the mRNA levels of 110 genes and down-regulating the mRNA levels of 81 genes), which affected decidual inflammation and apoptosis and intervened in glycolysis. ③ The pseudo-temporal analysis and communication network indicated that the communication frequency of the RPL group decreased. High-dose Shoutai Wan restored maternal-fetal tolerance through pathways such as NKG2D, CDH5, GDF, and FASLG. High-dose Juyuan Jian enhanced the IL-6/LIFR/JAK/signal transducer and activator of transcription 3 (STAT3) and desmosome/SEMA6/tumor necrosis factor-like weak inducer of apoptosis (TWEAK) signaling to improve endometrial receptivity. The RPL group showed an increased proportion of toxic dNK7, a decreased proportion of reparative dNK4, and blocked embryo fNK1. High-dose Shoutai Wan down-regulated dNK7 and up-regulated dNK4. High-dose Juyuan Jian inhibited the terminal differentiation of dNK7 and up-regulated LILRB1, thus restoring the balance of cytotoxicity and repair. ConclusionBoth the kidney-tonifying and spleen-invigorating methods are effective in treating RPL. NK and macrophages are the key immune cells in the interaction between the embryo and the membrane. The kidney-tonifying method (Shoutai Wan) has an advantage in regulating the phenotypes of unfolded protein, cell adhesion, and programmed cell death, and shows expression characteristics closer to the physiological state in the regulation of NKG2D and CDH5 signals. The spleen-invigorating method (Juyuan Jian) has an advantage in regulating epithelial-mesenchymal transition (EMT), angiogenesis, and glycolysis and shows higher communication intensity in the IL-6 and LIFR pathways.
2.Hei Xiaoyaosan Ameliorates Cognitive Impairment in Rat Model of Alzheimer's Disease by Clearing Peripheral Aβ via AMPK/SREBP2/PCSK9/LRP-1 Signaling Pathway
Zifan NIE ; Yingchuan MA ; Wenli PEI ; Yumei HAN ; Jiao YANG ; Ruixue JIN ; Qian WANG ; Huping WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):61-73
ObjectiveTo investigate the mechanism of Hei Xiaoyaosan (HXS) in ameliorating cognitive impairment in the rat model of Alzheimer's disease (AD) by regulating the adenosine 5'-monophosphate-activated protein kinase (AMPK)/sterol regulatory element-binding protein 2 (SREBP2)/proprotein convertase subtilisin/kexin type 9 (PCSK9)/low-density lipoprotein receptor-related protein 1 (LRP-1) signaling pathway to clear amyloid-β (Aβ) from the peripheral circulation. MethodsNinety 8-week-old specific pathogen-free (SPF)-grade male Sprague-Dawley (SD) rats were acclimatized for 1 week. After acclimatization, 10 rats were randomly selected as the blank control group, and the remaining 80 rats were prepared for surgical modeling. Among the 80 rats for modeling, 70 were anesthetized and injected with 1 μL of amyloid-β1-42 (Aβ1-42) solution into the bilateral hippocampal CA1 region for the modeling of AD, and the remaining 10 were assigned to the sham operation group, which received an injection of 1 μL normal saline at the same anatomical site. The successfully modeled rats were randomly assigned into 6 groups (n=10 per group): a model group, a donepezil hydrochloride group, an acadesine (AICAR, an AMPK agonist) group, and high-, medium-, and low-dose HXS groups. After 42 consecutive days of administration intervention, the Morris water maze test and T-maze test were performed to evaluate the learning and memory abilities of rats. Fluoro-Jade B (FJB) staining was conducted to observe pathological changes of neurons in the rat hippocampus, and thioflavin S staining to quantify the area of Aβ deposition in the hippocampal region. Immunofluorescence double staining (IF-DS) was performed to detect the expression of LRP-1 and Aβ signals in the liver tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of Aβ1-42 and soluble LRP-1 (sLRP-1) in the serum. Western blot was performed to determine the protein levels of AMPK, phosphorylated AMPK (p-AMPK), SREBP2, PCSK9, and LRP-1 in the liver tissue. Real time polymerase chain reaction(Real-time PCR) was adopted to assess the mRNA levels of AMPK, SREBP2, PCSK9, and LRP-1 in the liver tissue. ResultsCompared with the blank control group, the model group showed increased total swimming distance on day 6 and path length in the target quadrant on day 7 (P<0.01), a decreased correct alternation rate in the T-maze test (P<0.01), disarrangement of hippocampal neurons, increased FJB-positive cells (P<0.01), enlarged area of Aβ deposition (P<0.01). reduced LRP-1 fluorescence signals and enhanced Aβ fluorescence signals in the liver tissue (P<0.01), elevated serum level of Aβ1-42, declined serum level of sLRP-1 (P<0.01), downregulated protein levels of p-AMPK and LRP-1 as well as mRNA levels of AMPK and LRP-1, and upregulated protein and mRNA levels of SREBP2 and PCSK9 in the liver tissue (P<0.01). Compared with the model group, the high-dose HXS group, donepezil hydrochloride group, and AICAR group exhibited reduced total swimming distance and target quadrant path length (P<0.05, P<0.01), an increased correct alternation rate in the T-maze test (P<0.05), decreased FJB-positive cells (P<0.01), reduced Aβ deposition (P<0.01) in the hippocampal tissue, enhanced LRP-1 signals and weakened Aβ signals in the liver tissue (P<0.01), a declined serum level of Aβ1-42 and an elevated serum level of sLRP-1 (P<0.01), upregulated protein levels of p-AMPK and LRP-1 as well as mRNA levels of AMPK and LRP-1, and downregulated protein and mRNA levels of SREBP2 and PCSK9 in the liver tissue (P<0.01). ConclusionHei Xiaoyaosan can regulate the AMPK/SREBP2/PCSK9/LRP-1 signaling pathway to enhance the clearance of peripheral Aβ by the liver tissue and reduce Aβ deposition in the brain, thereby improving the learning and memory abilities of AD rats.
3.Hei Xiaoyaosan Ameliorates Cognitive Impairment in Rat Model of Alzheimer's Disease by Activating Autophagy Through Regulating AMPK/ULK1 Signaling Pathway
Wenli PEI ; Yumei HAN ; Zifan NIE ; Yingchuan MA ; Ruixue JIN ; Qian WANG ; Jiao YANG ; Huping WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):91-101
ObjectiveTo investigate the effect and mechanism of Hei Xiaoyaosan in preventing and treating Alzheimer's disease (AD) by activating autophagy through regulating the adenosine monophosphate-activated protein kinase (AMPK)/UNC-51 like autophagy activating kinase 1 (ULK1) signaling pathway. MethodsNinety 8-week-old male SPF-grade SD rats were selected and randomized into two groups: a blank control group (n=10) and a modeling group (n=80). From the modeling group, 10 rats were randomly assigned as a sham group (bilateral hippocampal injection of 1 μL normal saline), while the remaining 70 rats were injected with 1 μL Aβ1-42 solution bilaterally into the hippocampus to replicate the AD model. The Morris water maze test was conducted to screen the successfully modeled rats, which were then randomly allocated to the model, donepezil hydrochloride, 5-aminoimidazole-4-carboxamide 1-β-D-ribofuranoside (AICAR, an AMPK agonist), and high-, medium-, and low-dose Hei Xiaoyaosan groups, with 10 rats per group. After 42 days of drug intervention, the Morris water maze and open field tests were conducted to assess learning and memory abilities and motor function. Pathological changes in the hippocampal tissue were observed by Nissl staining, and autophagy-related pathological damage was examined via transmission electron microscopy (TEM). The expression of LC3 in the hippocampus was observed by immunofluorescence staining. The protein levels of AMPK, phosphorylate (p)-AMPK, ULK1, p-ULK1, p62, and autophagy related 7 (Atg7) were determined by Western blot, while the mRNA levels of AMPK and ULK1 were measured by Real-time polymerase chain reaction (Real-time PCR). ResultsCompared with the blank control group, the model group showed increased escape latency (P<0.01) and decreased platform crossings (P<0.01) on day 6 in the water maze test, reduced total distance traveled and average speed in the open field test (P<0.01), disarranged neurons with Nissl body loss and evident autophagic damage, weakened LC3 fluorescence signal (P<0.01), downregulated protein levels of p-AMPK, p-ULK1, and Atg7 and mRNA levels of AMPK and ULK1 in the hippocampus (P<0.01), and upregulated protein level of p62 (P<0.01). Compared with the model group, the positive drug group, high-dose Hei Xiaoyaosan group, and AICAR group showed decreased escape latency (P<0.05, P<0.01) and increased platform crossings (P<0.01) on day 6, and increased total distance traveled and average speed in the open field test (P<0.05). The positive drug group, high- and medium-dose Hei Xiaoyaosan groups, and the AICAR group showed alleviated cellular structural damage, regular neuronal arrangement, increased Nissl bodies, and orderly distribution of autophagosomes. Furthermore, the LC3 fluorescence intensity was enhanced in the positive drug group, high- and medium-dose Hei Xiaoyaosan groups, and the AICAR group (P<0.01). The positive drug group, high-dose Hei Xiaoyaosan group, and the AICAR group exhibited upregulated protein and mRNA levels of p-AMPK and p-ULK1 (P<0.05, P<0.01), upregulated protein level of Atg7 (P<0.05, P<0.01), and downregulated protein level of p62 (P<0.01). ConclusionHei Xiaoyaosan can improve learning and memory abilities and alleviate pathological status in the rat model of AD by regulating the AMPK/ULK1 signaling pathway, enhancing cellular autophagy, and repairing damaged nerve cells.
4.Research on the equity of maternal health service utilization in Changning District, Shanghai
Ying HUANG ; Wenli FANG ; Fang BU ; Ye SHEN ; Ning QIAN ; Xuelin BAI ; Shuo YU ; Ji LIANG
Journal of Public Health and Preventive Medicine 2025;36(6):137-141
Objective To understand the equity and influencing factors of maternal health service utilization in Changning District, Shanghai. Methods A convenience sampling method was used to conduct a questionnaire survey among mothers of children aged 1 to 1.5 years old who received health services from the child health care clinics and EPI clinics of 10 community health service centers in Changning District, Shanghai from March to April 2022. Count data was expressed by frequency and percentage. Chi-square analysis, binomial logistic regression analysis, and multivariate logistic regression analysis were used to analyze fairness-related factors. Rate difference, rate ratio and concentration index were used to represent fairness. Results A total of 696 subjects were investigated, with an average age of (33.35±4.76) years. There were statistically significant differences in service utilization among women with different household registrations only in early pregnancy registration (χ2=11.026, P=0.001) and postpartum visits (χ2=4.989, P=0.026). Women with a career showed differently in folic acid supplement (χ2=6.247, P=0.012), early pregnancy registration (χ2=12.989, P=0.002), physical examination in 42 days postpartum (χ2=4.446, P=0.035) and postpartum contraception (χ2=4.061, P=0.044), and the differences were statistically significant. Women with different monthly family income had a statistically significant difference in pre-pregnancy examination (χ2=8.977, P=0.030) and postpartum visit (χ2=16.114, P=0.001). There was a statistically significant difference between women with maternity insurance or not in the early pregnancy registration (χ2=10.576, P=0.001) and physical examination in 42 days postpartum (χ2=8.166, P=0.004). The results of the multivariate analysis showed that occupation (OR=2.616, 95% CI: 1.142-5.990) and maternity insurance (OR=4.490, 95% CI: 1.992~10.120) affected the utilization of service in early pregnancy registration. The monthly household income (OR=0.278, 95% CI: 0.124-0.625) affected the utilization of services in postpartum visit. At the same time, the monthly household income (10,000-19,999: OR=0.286, 95% CI: 0.090-0.907; ≥30,000: OR=0.180, 95% CI: 0.041-0.801) also affected the utilization of service in physical examination in 42 days postpartum. Conclusion The equity of maternal health care service utilization overall is good in central area in Shanghai, but there is still room for improvement. It is necessary to strengthen community mobilization, propagandize maternal health services, and expand the coverage of maternity insurance to improve the equity of maternal health service utilization and provide equal access to maternity health services.
5.Digital and intelligent medicine empowering precision abdominal surgery:today and the future
Qian DONG ; Jingmiao WANG ; Wenli XIU
Chinese Journal of Surgery 2025;63(10):878-882
The complex anatomical structure of abdominal organs demands high precision in surgical procedures, which also increases postoperative complication risks. Advancements in digital medicine have created new opportunities for precision surgery. This article summarizes the current applications of digital intelligence in precision abdominal surgery. The processing and real-time monitoring technologies of medical imaging provide powerful tools for accurate diagnosis and treatment. Meanwhile, big data analysis and precise classification capabilities of artificial intelligence further enhance diagnostic efficiency and safety. Additionally, the paper analyzes the advantages and limitations of digital intelligence in empowering precision abdominal surgery, while exploring future development directions.
6.HMGB1 induces proliferation of lung cancer cells and suppresses immune cell function via NF-κB pathway
Yaohui WANG ; Yu MENG ; Yike QIAN ; Wenli CHEN ; Rongyu LI ; Bohan DONG
Chinese Journal of Immunology 2025;41(3):628-633
Objective:To investigate the molecular mechanisms by which HMGB1 in lung cancer cells affects the function of lung cancer cells themselves and immune cells through the NF-κB pathway.Methods:Western blot detected HMGB1 expressions in Lewis lung cancer(LLC)cells,Raw264.7 cells,and mouse spleen cells,while tumor cell lysates(TCL)with low HMGB1 was pre-pared by inhibiting HMGB1 expression in lung cancer cells with glycyrrhetinic acid(GA);the effects of endogenous HMGB1 inhibi-tion or TCL with low HMGB1 on apoptosis and proliferation of lung cancer cells were detected by flow cytometry and CCK-8;TCL with normal HMGB1 or TCL with low HMGB1 was prepared by freeze-thawing;Raw264.7 cells and mouse splenocytes were treated with them for 48 h.Apoptosis and CD69 expression were detected by flow cytometry,and secretion of cytokines IL-2,IL-4,IL-6,TNF-α and TNF-β were detected by ELISA;Western blot detected lung cancer cells or immune cells.Western blot was performed to detect the protein expression of key signaling molecules of the NF-κB signaling pathway in lung cancer cells or immune cells.Results:HMGB1 was expressed in LLC cells,Raw264.7 cells,and mouse spleen cells,among which LLC cells had the highest expression of HMGB1,and 30 μg/ml GA had the best inhibitory effect on HMGB1 expression in LLC cells.Endogenous HMGB1 in LLC cells could promote cell proliferation.Exogenous HMGB1 in TCL induced apoptosis in lung cancer cells and inhibited immune cell activation and prolifera-tion.Inhibition of endogenous HMGB1 in lung cancer cells leaded to activation of the apoptosis-inducing factor CASP9 in the NF-κB signaling pathway,which was inhibited in lung cancer cells or immune cells after the action of TCL with low HMGB1.Conclusion:Tumor cell HMGB1 has a dual role in lung carcinogenesis,promoting the proliferation of lung cancer cells while suppressing the func-tion of immune cells,which in turn causes lung carcinogenesis,a process associated with the activation of the NF-κB signaling path-way in different cells.
7.Development and clinical application of a machine learning-driven model for metabolite-based diagnosis of small cell lung cancer
Xin HUANG ; Jiahui LIU ; Jingwen YE ; Wenli QIAN ; Wanxing XU ; Lin WANG
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(8):1009-1016
Objective·To develop an early diagnostic model for small cell lung cancer(SCLC)based on differences in serum metabolite expression profiles between patients with SCLC and those with benign pulmonary diseases,using machine learning algorithms.Methods·Serum samples were collected from 29 SCLC patients and 67 patients with benign lung diseases at Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,as the training cohort.An independent external validation cohort included 20 SCLC patients and 40 patients with benign lung diseases from Gansu Provincial Cancer Hospital.A total of 69 serum metabolites were quantitatively analyzed using liquid chromatography-tandem mass spectrometry(LC-MS/MS).The XGBoost Classifier was employed to rank metabolite importance,and a forward feature selection strategy based on XGBoost was used to identify a subset of key metabolites.Diagnostic models were constructed using AdaBoost,random forest(RF),and light gradient boosting machine(LGBM)algorithms.Model performance was assessed using receiver operating characteristic(ROC)curves and the area under the curve(AUC),and validated on the external test cohort.Results·Principal component analysis(PCA)and orthogonal projections to latent structures-discriminant analysis(OPLS-DA)of the training cohort revealed distinct metabolic profiles between SCLC and benign lung disease patients.Based on feature importance rankings,six key metabolites were selected to construct the MTB-6 diagnostic model.Among the models,AdaBoost achieved the best performance,with an AUC of 0.943,sensitivity of 75.0%,and specificity of 90.9%in the training cohort.In the external test cohort,the model demonstrated robust performance with an AUC of 0.921,sensitivity of 80.0%,and specificity of 87.5%.Conclusion·The MTB-6 model,based on six serum metabolites and the AdaBoost algorithm,exhibits excellent diagnostic performance and holds potential for the differential diagnosis of SCLC and benign pulmonary diseases.
8.Analysis of anterior chamber and lens characteristics in age-related cataract patients with zonular weakness based on CASIA2
Lin SHEN ; Wenli YANG ; Dongjun LI ; Ziyang WANG ; Wei CHEN ; Qi ZHAO ; Yifeng LI ; Rui CUI ; Qian LIU ; Chuanchuan WEI ; Rongyao ZHOU ; Yifan LI
Chinese Journal of Experimental Ophthalmology 2025;43(3):227-232
Objective:To analyze the biological parameters of the anterior segment of age-related cataracts patients with or without zonular weakness with the new generation of sweep-source anterior optical coherence tomography (OCT) device CASIA2 to provide a basis for the diagnosis of zonular weakness.Methods:A case-control study was conducted.A total of 158 cases (186 eyes) of patients with age-related cataracts having zonular weakness as a zonular weakness group, and 80 cases (80 eyes) of cataract with age-related cataracts without zonular weakness as a normal zonule group were enroll from June 2022 to June 2023 at Beijing Tongren Hospital.All patients underwent routine preoperative ophthalmological examination including slit lamp microsopy, IOLMaster 700, ocular B-ultrasound and OCT.The anterior chamber depth (ACD), anterior chamber volume (ACV), lens thickness (LT), lens vault (LV), anterior chamber angle opening distance at 750 μm (AOD750), lens decentration and tilt, radius of curvature of the anterior lens surface (RAL), and radius of curvature of the posterior lens surface (RPL) of patients were measured with CASIA2 and compared between the two groups.The relationship between zonular weakness and anterior chamber parameters and lens parameters was evaluated by logistic regression analysis.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital (No.TRECKY2018-049), and all enrolled patients signed the informed consent form.Results:In the zonular weakness group, ACD, ACV, RAL, and AOD750 were (2.34±0.56)mm, (85.05±40.19)mm 3, 7.52 (7.13, 8.08)mm, and 0.27 (0.07, 0.30)mm, respectively, which were smaller than (3.13±0.38)mm, (127.75±38.15)mm 3, 9.28(8.51, 9.76)mm, and 0.52 (0.31, 0.65)mm in the normal zonule group, with statistically significant differences (all P<0.05).LT and LV in the zonular weakness group were (5.14±0.45)mm and (1.22±0.53)mm, respectively, which were larger than (4.27±0.52)mm and (0.32±0.30)mm in the normal zonule group, and the differences were statistically significant (both P<0.05).Magnitude of lens decentration and tilt in the zonular weakness were 0.34 (0.13, 0.45)mm and 6.44 (3.67, 7.32)°, respectively, which were significantly larger than 0.19 (0.12, 0.25)mm and 4.88 (3.85, 5.65)° in the normal zonule group (both P<0.05).No obvious pattern was found in the direction of decentration and tilt.Logistic regression analysis showed that LV and lens decentration were risk factors of zonular weakness (odds ratios [ OR]=706.170, 335.339; both P<0.05), and RAL was a protective factor of zonular weakness ( OR=0.239, P<0.05). Conclusions:Age-related cataract patients with zonular weakness often present with a decrease in ACV due to increased anterior convexity of the lens.Decreased RAL, increased lens decentration and elevated LV are risk factors for zonular weakness.
9.Ultrasound imaging manifestations of idiopathic uveal effusion syndrome
Lin SHEN ; Zhijun SHEN ; Wenli YANG ; Hong WANG ; Dongjun LI ; Ziyang WANG ; Wei CHEN ; Qi ZHAO ; Yifeng LI ; Rui CUI ; Qian LIU
Chinese Journal of Ocular Fundus Diseases 2025;41(5):381-385
Objective:To observe the ultrasonographic features of idiopathic uveal effusion syndrome (IUES).Methods:A retrospective controlled study. From January 2012 to December 2023, 13 patients with IUES (26 eyes) diagnosed by ophthalmology examination in Department of Ophthalmonogy of Beijing Tongren Hospital (IUES group) and 22 healthy people with 30 eyes (control group) were included in the study. Both eyes of all participants were examined by color Doppler ultrasound (CDU) and ultrasonic biomicroscopy (UBM). The thickness of the ocular wall at 300 μm on the temporal side of the optic disc was measured by CDU. UBM was used to measure the thickness of the nasal and temporal scleral processes. Corneal thickness (CT), anterior chamber depth (AD), lens thickness (LT) and axial length (AL) were measured by A-mode ultrasound. There were no significant differences in age ( t=0.842), sex component ratio ( χ2=0.540), eye difference ( χ2=0.108) and AL ( t=0.831) between IUES group and control group ( P>0.05). The CDU and UBM imaging features and biometrics of IUES affected eyes were observed. Independent sample t test was used for comparison between groups. Results:CDU examination results showed that in 26 eyes of IUES group, choroidal detachment occurred in 20 eyes (76.9%, 20/26), which showed arc-shaped band echo connected with peripheral and equatorial eye wall echo, with uniform low echo area below, and blood flow signal could be seen on the band echo. The echo thickened and decreased in 4 eyes (15.3%, 4/26). Nine eyes (33.3%, 9/26) were accompanied by retinal detachment, which showed that the posterior pole vitreous echo was connected to the optic disc echo, and the blood flow signal was seen on the ribbon echo. UBM results showed ciliary detachment in 22 eyes (84.7%, 22/26), showing a spongy thickening of the ciliary body with interlamellar echo separation and an echoless area between the sclera. Ciliary body echo thickened and decreased in 2 eyes (7.7%, 2/26). Shallow space between ciliary body and sclera was observed in 2 eyes (7.7%, 2/26). Compared with the control group, CT ( Z=2.054), LT ( Z=1.867), scleral thickness ( Z=2.536) and ocular wall thickness ( Z=2.094) were thickened in IUES group, and AD ( Z=1.888) were decreased, with statistical significance ( P<0.05). Conclusions:The CDU of IUES is characterized by a thickened echo of the ocular wall and a uniform low echo area under the detached choroid. UBM is characterized by a spongy thickening of the ciliary body echo with interlaminar echo separation.
10.Analysis of color Doppler flow imaging characteristics of vitreoretinal lymphoma
Ziyang WANG ; Wenli YANG ; Dongjun LI ; Wei CHEN ; Lin SHEN ; Yifeng LI ; Rui CUI ; Qian LIU ; Wenbin WEI
Chinese Journal of Ocular Fundus Diseases 2025;41(9):679-683
Objective:To observe the color Doppler flow imaging (CDFI) features of vitreoretinal lymphoma (VRL).Methods:Retrospective case series. From January 2022 to December 2024, 71 eyes of 42 patients diagnosed with VRL at the Eye Center of Beijing Tongren Hospital were enrolled. Among them, 17 were male and 25 female; 29 had bilateral and 13 unilateral involvement. Age ranged 17-78 years (median 59 years). Eleven cases had histopathologic confirmation and 31 were clinically diagnosed. All patients underwent CDFI and optical coherence tomography (OCT). CDFI findings were analyzed, noting the presence or absence of vitreous opacities (centrifugal distribution), posterior vitreous detachment (PVD), retinal detachment, and retinal elevated lesions. With Doppler overlay, blood flow within retinal lesions was assessed. The χ 2 test was used to compare the detection rates of retinal lesions by CDFI and OCT, while Cohen’s Kappa assessed agreement in identifying the depth of lymphoma cell infiltration. Results:Among 71 eyes, vitreous opacity occurred in 66 eyes (93.0%, 66/71), of which 40 eyes (60.6%, 40/66) showed centrifugal opacity. 58 eyes (81.7%, 58/71) had posterior vitreous detachment. Retinal detachment occurred in 7 eyes (9.9%, 7/71). Retinal occupying lesions occurred in 23 eyes (32.4%, 23/61), of which 15 eyes (65.2%, 15/23) showed blood flow signals on the surface of the lesions but no blood flow signals inside the lesions by CDFI, and OCT showed that tumor cells gathered under the retinal pigment epithelium. CDFI showed blood flow signals inside the lesions in 8 eyes (34.8%, 8/23), and OCT showed that tumor cells gathered between retinal neuroepithelial layers. The lesion detection rate of OCT (69.6%, 16/23) was significantly lower than that of CDFI (100.0%, 23/23) ( χ 2= 6.066, P=0.014). OCT and CDFI showed perfect agreement in determining the depth of tumor cell infiltration (Kappa=1.0). Conclusions:The ultrasonographic manifestations of VRL include vitreous opacity, PVD, and some retinal occupying lesions. Vitreous opacity often presents a characteristic centrifugal distribution. By observing whether there is blood flow signal in retinopathy using Doppler, the level of lymphoma cell infiltration can be suggested.


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