With the advent of the refractive era of cataract surgery, postoperative residual refractive error has become a key factor affecting visual quality. The accuracy of intraocular lens(IOL)power calculation is affected by multiple factors, including ocular biological parameters, calculation formulas, and lens constants. Currently, the lens constants widely used in clinical practice are mostly based on Western populations, which have a mismatch with the ocular characteristics of the Chinese population, such as shorter axial length and steeper cornea. Therefore, the personalized optimization of the constant has become a research hotspot. This review primarily summarizes the research progress on lens constant optimization in improving the accuracy of IOL power calculation. Currently, there is no consensus on lens constant optimization methods. Single-constant formulas can be optimized through iterative methods, while multi-constant formulas require the combination of linear or nonlinear strategies. Simplified gradient descent and data-driven techniques offer new optimization pathways, but cross-validation is needed to evaluate their performance. Segmented optimization based on axial length, corneal curvature, and anterior chamber depth has shown significant effectiveness in patients with special anatomical structures, effectively reducing postoperative refractive errors in different patient groups, but limitations remain in some extreme cases. The interaction of multiple parameters significantly impacts the predictive accuracy of complex cases. While new-generation formulas integrating multiple parameters or incorporating AI algorithms have improved accuracy, constant optimization still holds value. Currently, the complex relationships between multiple parameters and intraoperative dynamic changes require further in-depth research. Future research, including targeted population optimization studies, the development of real-time monitoring technologies, and innovative IOL designs, may make achieving zero postoperative refractive error a possibility.

Objective To investigate the predictive value of Mayo adhesion probability(MAP)score for intraoperative bleeding during microchannel percutaneous nephrolithotomy(PCNL), so as to provide reference for optimizing surgical decisions.Methods A retrospective analysis was conducted on the clinical data of 86 patients who underwent microchannel PCNL at our hospital during Jan.2018 and Jul. 2025.Patients were divided into two groups based on preoperative CT-derived MAP scores:MAP score＜3 group(n=45)and MAP score≥3 group(n=41).Baseline characteristics, surgical parameters and outcome measures were compared between the two groups.Univariate and multivariate logistic regression analyses were performed to identify risk factors for intraoperative bleeding(defined as a postoperative hemoglobin decrease of ≥20 g/L). Results The incidence of intraoperative bleeding was significantly higher in the MAP score≥3 group than in the MAP score＜3 group(43.9% vs.20.0%, P=0.017).Multivariate analysis identified MAP score ≥3(OR=3.045, 95%CI:1.125-9.547, P=0.019), use of anticoagulant medication(OR=3.016, 95%CI:1.251-9.257, P=0.020), establishment of multiple tracts(OR=5.445, 95%CI:1.798-17.578, P=0.003), and operation time ≥90 minutes(OR=5.697, 95%CI:1.890-13.632, P=0.001)as risk factors for intraoperative bleeding.The area under the curve for the MAP score in predicting intraoperative bleeding was 0.704.Conclusion The MAP score is an independent risk factor for intraoperative bleeding during microchannel PCNL.Preoperative assessment can help identify high-risk patients and provide a basis for optimizing surgical decision-making.

Objective To explore the application value of computed tomography (CT) three-dimensional reconstruction in total knee arthroplasty (TKA). Methods A total of 102 patients who underwent TKA in our hospital between April 2022 and April 2025 were enrolled and divided using a random number table into a traditional group (51 cases, routine preoperative evaluation) and a study group (51 cases, CT three-dimensional reconstruction-assisted surgery). The therapeutic efficacy at 3 months postoperatively and perioperative indicators were compared between the two groups. The hip-knee-ankle (HKA) angle was measured preoperatively and at 3 months postoperatively. The Hospital for Special Surgery (HSS) knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were recorded preoperatively and at 3 and 6 months postoperatively. Complications were documented. Results The excellent/good rate in the study group (92.16%) was higher than that in the traditional group (74.51%) (P<0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were (69.52 ± 7.11) min, (102.69 ± 8.54) mL, (167.33 ± 12.35) mL, and (10.93 ± 2.37) days, respectively, which were shorter than those in the traditional group [(78.45 ± 5.98) min, (108.36 ± 10.02) mL, (175.96 ± 14.93) mL, and (12.04 ± 1.95) days] (P<0.05). At 3 months postoperatively, the HKA angle was 178.02° ± 1.05° in the study group and 177.45° ± 1.34° in the traditional group, both were significantly improved compared with those before operation, with the study group showing better improvement (P<0.05). The HSS knee and WOMAC scores in both groups at 3 and 6 months postoperatively were improved compared with preoperative scores (P<0.05). At 3 and 6 months postoperatively, the study group showed higher HSS knee score and lower WOMAC score than the traditional group (P<0.05). The incidence of complications in the study group (3.92%) was lower than that in the traditional group (17.65%) (P<0.05). Conclusion TKA guided by CT three-dimensional reconstruction improved the excellent/good rate, optimized HKA angle and knee function, shortened operation time and hospital stay, reduced intraoperative blood loss and postoperative drainage volume, and decreased the incidence of complications.

Objective To explore the application value of computed tomography (CT) three-dimensional reconstruction in total knee arthroplasty (TKA). Methods A total of 102 patients who underwent TKA in our hospital between April 2022 and April 2025 were enrolled and divided using a random number table into a traditional group (51 cases, routine preoperative evaluation) and a study group (51 cases, CT three-dimensional reconstruction-assisted surgery). The therapeutic efficacy at 3 months postoperatively and perioperative indicators were compared between the two groups. The hip-knee-ankle (HKA) angle was measured preoperatively and at 3 months postoperatively. The Hospital for Special Surgery (HSS) knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were recorded preoperatively and at 3 and 6 months postoperatively. Complications were documented. Results The excellent/good rate in the study group (92.16%) was higher than that in the traditional group (74.51%) (P<0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were (69.52 ± 7.11) min, (102.69 ± 8.54) mL, (167.33 ± 12.35) mL, and (10.93 ± 2.37) days, respectively, which were shorter than those in the traditional group [(78.45 ± 5.98) min, (108.36 ± 10.02) mL, (175.96 ± 14.93) mL, and (12.04 ± 1.95) days] (P<0.05). At 3 months postoperatively, the HKA angle was 178.02° ± 1.05° in the study group and 177.45° ± 1.34° in the traditional group, both were significantly improved compared with those before operation, with the study group showing better improvement (P<0.05). The HSS knee and WOMAC scores in both groups at 3 and 6 months postoperatively were improved compared with preoperative scores (P<0.05). At 3 and 6 months postoperatively, the study group showed higher HSS knee score and lower WOMAC score than the traditional group (P<0.05). The incidence of complications in the study group (3.92%) was lower than that in the traditional group (17.65%) (P<0.05). Conclusion TKA guided by CT three-dimensional reconstruction improved the excellent/good rate, optimized HKA angle and knee function, shortened operation time and hospital stay, reduced intraoperative blood loss and postoperative drainage volume, and decreased the incidence of complications.

Objective To explore the application value of computed tomography (CT) three-dimensional reconstruction in total knee arthroplasty (TKA). Methods A total of 102 patients who underwent TKA in our hospital between April 2022 and April 2025 were enrolled and divided using a random number table into a traditional group (51 cases, routine preoperative evaluation) and a study group (51 cases, CT three-dimensional reconstruction-assisted surgery). The therapeutic efficacy at 3 months postoperatively and perioperative indicators were compared between the two groups. The hip-knee-ankle (HKA) angle was measured preoperatively and at 3 months postoperatively. The Hospital for Special Surgery (HSS) knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were recorded preoperatively and at 3 and 6 months postoperatively. Complications were documented. Results The excellent/good rate in the study group (92.16%) was higher than that in the traditional group (74.51%) (P<0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were (69.52 ± 7.11) min, (102.69 ± 8.54) mL, (167.33 ± 12.35) mL, and (10.93 ± 2.37) days, respectively, which were shorter than those in the traditional group [(78.45 ± 5.98) min, (108.36 ± 10.02) mL, (175.96 ± 14.93) mL, and (12.04 ± 1.95) days] (P<0.05). At 3 months postoperatively, the HKA angle was 178.02° ± 1.05° in the study group and 177.45° ± 1.34° in the traditional group, both were significantly improved compared with those before operation, with the study group showing better improvement (P<0.05). The HSS knee and WOMAC scores in both groups at 3 and 6 months postoperatively were improved compared with preoperative scores (P<0.05). At 3 and 6 months postoperatively, the study group showed higher HSS knee score and lower WOMAC score than the traditional group (P<0.05). The incidence of complications in the study group (3.92%) was lower than that in the traditional group (17.65%) (P<0.05). Conclusion TKA guided by CT three-dimensional reconstruction improved the excellent/good rate, optimized HKA angle and knee function, shortened operation time and hospital stay, reduced intraoperative blood loss and postoperative drainage volume, and decreased the incidence of complications.

Serine protease inhibitor Kazal-type (SPINK) is a skin keratinizing protease inhibitor, which was initially found in animal serum and is widely present in plants, animals, bacteria, and viruses, and they act as key regulators of skin keratinizing proteases and are involved in the regulation of keratinocyte proliferation and inflammation, primarily through the inhibition of deregulated tissue kinin-releasing enzymes (KLKs) in skin response. This process plays a crucial role in alleviating various skin problems caused by hyperkeratinization and inflammation, and can greatly improve the overall condition of the skin. Specifically, the different members of the SPINK family, such as SPINK5, SPINK6, SPINK7, and SPINK9, each have unique biological functions and mechanisms of action. The existence of these members demonstrates the diversity and complexity of skin health and disease. First, SPINK5 mutations are closely associated with the development of various skin diseases, such as Netherton’s syndrome and atopic dermatitis, and SPINK5 is able to inhibit the activation of the STAT3 signaling pathway, thereby effectively preventing the metastasis of melanoma cells, which is important in preventing the invasion and migration of malignant tumors. Secondly, SPINK6 is mainly distributed in the epidermis and contains lysine and glutamate residues, which can act as a substrate for epidermal transglutaminase to maintain the normal structure and function of the skin. In addition, SPINK6 can activate the intracellular ERK1/2 and AKT signaling pathways through the activation of epidermal growth factor receptor and protease receptor-2 (EphA2), which can promote the migration of melanoma cells, and SPINK6 further deepens its role in stimulating the migration of malignant tumor cells by inhibiting the activation of STAT3 signaling pathway. This process further deepens its potential impact in stimulating tumor invasive migration. Furthermore, SPINK7 plays a role in the pathology of some inflammatory skin diseases, and is likely to be an important factor contributing to the exacerbation of skin diseases by promoting aberrant proliferation of keratinocytes and local inflammatory responses. Finally, SPINK9 can induce cell migration and promote skin wound healing by activating purinergic receptor 2 (P2R) to induce phosphorylation of epidermal growth factor and further activating the downstream ERK1/2 signaling pathway. In addition, SPINK9 also plays an antimicrobial role, preventing the interference of some pathogenic microorganisms. Taken as a whole, some members of the SPINK family may be potential targets for the treatment of dermatological disorders by regulating multiple biological processes such as keratinization metabolism and immuno-inflammatory processes in the skin. The development of drugs such as small molecule inhibitors and monoclonal antibodies has great potential for the treatment of dermatologic diseases, and future research on SPINK will help to gain a deeper understanding of the physiopathologic processes of the skin. Through its functions and regulatory mechanisms, the formation and maintenance of the skin barrier and the occurrence and development of inflammatory responses can be better understood, which will provide novel ideas and methods for the prevention and treatment of skin diseases.

ObjectiveTo observe the clinical efficacy and safety of Tangning Tongluo tablets in the treatment of nonproliferative diabetic retinopathy （DR）. MethodsFourteen research centers participated in this study， which spanned a time interval from September 2021 to May 2023. A total of 240 patients with nonproliferative DR were included and randomly assigned into an observation group （120 cases） and a control group （120 cases）. The observation group was treated with Tangning Tongluo tablets， and the control group with calcium dobesilate capsules. Both groups were treated for 24 consecutive weeks. The vision， DR progression rate， retinal microhemangioma， hemorrhage area， exudation area， glycosylated hemoglobin （HbA1c） level， and TCM syndrome score were assessed before and after treatment， and the safety was observed. ResultsThe vision changed in both groups after treatment （P<0.05）， and the observation group showed higher best corrected visual acuity （BCVA） than the control group （P<0.05）. The DR progression was slow with similar rates in the two groups. The fundus hemorrhage area and exudation area did not change significantly after treatment in both groups， while the observation group outperformed the control group in reducing the fundus hemorrhage area and exudation area. There was no significant difference in the number of microhemangiomas between the two groups before treatment. After treatment， the number of microhemangiomas decreased in both the observation group （Z=-1.437， P<0.05） and the control group （Z=-2.238， P<0.05）， and it showed no significant difference between the two groups. As the treatment time prolonged， the number of microhemangiomas gradually decreased in both groups. There was no significant difference in the HbA1c level between the two groups before treatment. After treatment， the decline in the HbA1c level showed no significant difference between the two groups. The TCM syndrome score did not have a statistically significant difference between the two groups before treatment. After treatment， neither the TCM syndrome score nor the response rate had significant difference between the two groups. With the extension of the treatment time， both groups showed amelioration of TCM syndrome compared with the baseline. ConclusionTangning Tongluo tablets are safe and effective in the treatment of nonproliferative DR， being capable of improving vision and reducing hemorrhage and exudation in the fundus.

AIM:To compare the effect of AT TORBI 709M and Tecnis ZMT intraocular lenses on astigmatism correction in patients with corneal astigmatism at 3 mo after operation based on the standard astigmatism vector analysis.METHODS: This was a retrospective case-control study. The clinical data of 69 patients(69 eyes)with corneal astigmatism who underwent phacoemulsification and implantation of toric intraocular lens(IOL)from June 2021 to December 2021 in Day Surgery Center of Xi'an No.1 Hospital was analyzed. The patients were divided into two groups. In group one, 38 cases(38 eyes)were implanted with AT TORBI 709M, and 31 patients(31 eyes)with Tecnis ZMT in group two. The axial length, preoperative astigmatism and axis, and the degree of intraocular lens were recorded. The uncorrected distance visual acuity(UCDVA), best corrected distance visual acuity(BCDVA), diopter, residual astigmatism and axis were recorded preoperatively and at 1 wk, 1 and 3 mo postoperatively. The postoperative surgical indicators, including spherical equivalent(SE), target induced astigmatism vector(TIA), surgically induced astigmatism vector(SIA), magnitude of error(ME), absolute value of angle of error(|AE|), absolute value of difference vector(|DV|), correction index(CI), and index of success(IOS)were evaluated by the standard astigmatism vector analysis.RESULTS:Postoperative UCDVA and BCDVA were significantly improved(all P<0.001), and there were statistically significant differences compared to preoperative UCDVA and BCDVA(all P<0.001). While, there was no significant difference in UCDVA and BCDVA between the two groups(P=0.275, 0.124). The standard astigmatism vector analysis showed that a good astigmatism correction was achieved in both AT TORBI 709M group and Tecnis ZMT group, and both |DV| and IOS were close to 0(P=0.329, 0.288). The CI of the AT TORBI 709M group was closer to 1, indicating a better astigmatism correction, while the CI of the Tecnis ZMT group was higher than 1, suggesting an overcorrection of astigmatism. However, the difference between the two groups was not statistically significant(P=0.193). The mean residual astigmatism at 3 mo postoperatively was -0.11±0.91 D in the AT TORBI 709M group and -0.46±0.76 D in the Tecnis ZMT group, respectively, showing no statistically significance difference(t=1.732, P=0.088).CONCLUSION:Both the flat loop AT TORBI 709M and the double C-loop Tecnis ZMT intraocular lenses can effectively improve postoperative visual acuity in patients with regular corneal astigmatism, showing good rotational stability and comparable correction abilities for both astigmatism with the rule and against-the-rule astigmatism.

ObjectiveTo investigate the influence of histone deacetylase 3 (HDAC3) on the occurrence, development of psoriasis-like inflammation in mice, and the relative immune mechanisms. MethodsHealthy C57BL/6 mice aged 6-8 weeks were selected and randomly divided into 3 groups: control group (Control), psoriasis model group (IMQ), and HDAC3 inhibitor RGFP966-treated psoriasis model group (IMQ+RGFP966). One day prior to the experiment, the back hair of the mice was shaved. After a one-day stabilization period, the mice in Control group was treated with an equal amount of vaseline, while the mice in IMQ group was treated with imiquimod (62.5 mg/d) applied topically on the back to establish a psoriasis-like inflammation model. The mice in IMQ+RGFP966 group received intervention with a high dose of the HDAC3-selective inhibitor RGFP966 (30 mg/kg) based on the psoriasis-like model. All groups were treated continuously for 5 d, during which psoriasis-like inflammation symptoms (scaling, erythema, skin thickness), body weight, and mental status were observed and recorded, with photographs taken for documentation. After euthanasia, hematoxylin-eosin (HE) staining was used to assess the effect of RGFP966 on the skin tissue structure of the mice, and skin thickness was measured. The mRNA and protein expression levels of HDAC3 in skin tissues were detected using reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot (WB), respectively. Flow cytometry was employed to analyze neutrophils in peripheral blood and lymph nodes, CD4⁺ T lymphocytes, CD8⁺ T lymphocytes in peripheral blood, and IL-17A secretion by peripheral blood CD4⁺ T lymphocytes. Additionally, spleen CD4⁺ T lymphocyte expression of HDAC3, CCR6, CCR8, and IL-17A secretion levels were analyzed. Immunohistochemistry was used to detect the localization and expression levels of HDAC3, IL-17A, and IL-10 in skin tissues. ResultsCompared with the Control group, the IMQ group exhibited significant psoriasis-like inflammation, characterized by erythema, scaling, and skin wrinkling. Compared with the IMQ group, RGFP966 exacerbated psoriasis-like inflammatory symptoms, leading to increased hyperkeratosis. The psoriasis area and severity index (PASI) skin symptom scores were higher in the IMQ group than those in the Control group, and the scores were further elevated in the IMQ+RGFP966 group compared to the IMQ group. Skin thickness measurements showed a trend of IMQ+RGFP966>IMQ>Control. The numbers of neutrophils in the blood and lymph nodes increased sequentially in the Control, IMQ, and IMQ+RGFP966 groups, with a similar trend observed for CD4⁺ and CD8⁺ T lymphocytes in the blood. In skin tissues, compared with the Control group, the mRNA and protein levels of HDAC3 decreased in the IMQ group, but RGFP966 did not further reduce these expressions. HDAC3 was primarily located in the nucleus. Compared with the Control group, the nuclear HDAC3 content decreased in the skin tissues of the IMQ group, and RGFP966 further reduced nuclear HDAC3. Compared with the Control and IMQ groups, RGFP966 treatment decreased HDAC3 expression in splenic CD4⁺ and CD8⁺ T cells. RGFP966 treatment increased the expression of CCR6 and CCR8 in splenic CD4⁺ T cells and enhanced IL-17A secretion by peripheral blood and splenic CD4⁺ T lymphocytes. Additionally, compared with the IMQ group, RGFP966 reduced IL-10 protein levels and upregulated IL-17A expression in skin tissues. ConclusionRGFP966 exacerbates psoriatic-like inflammatory responses by inhibiting HDAC3, increasing the secretion of the cytokine IL-17A, and upregulating the expression of chemokines CCR8 and CCR6.

[Objective] To investigate the differences in metabolomics between apheresis platelets stored at 4℃ and at 22℃ with agitation, aiming to provide a theoretical basis for the cold storage of apheresis platelets. [Methods] Samples were collected at four time points (d1, d5, d10, d15) for platelets stored at 4℃ (experimental group) and two time points (d1, d5) for platelets stored at 22℃ with agitation (control group). Liquid chromatography-tandem mass spectrometry (LC-MS/MS) technology was used to detect changes in platelet metabolome levels under different storage conditions. Platelet functional activity was assessed by thromboelastography (TEG) for maximum amplitude (MA) values and flow cytometry for CD62P activation rates. [Results] Metabolites in the glycolytic pathway, key metabolites in the tricarboxylic acid cycle (citrate, α-ketoglutarate), metabolites in the purine metabolism pathway (adenine, inosine monophosphate, guanine, etc.) and amino acid metabolites significantly decreased by d5 in the control group, whereas they remained stable in the experimental group. The content of fatty acid metabolites, such as prostaglandin G2, 13(S)-HOTrE, and linoleic acid, significantly increased in the control group. Statistically significant differences in MA values were observed between the two groups at d1 and d5 (P<0.05). However, in the experimental group, as the storage time extended, the MA values at d10 and d15 showed no significant difference compared to the control group at d5 (P>0.05). The CD62P activation rate between the two groups was statistically significant (P<0.05). Additionally, the CD62P activation rate of platelets in the 22℃ group increased rapidly from d1, while it rose gradually in the 4 ℃ group. [Conclusion] Platelets stored at 4 ℃ exhibit more stable metabolic activity and slower functional deterioration, which is beneficial for extending the effective storage period of platelets.