AIM: To investigate the influence of pterygium thickness and area on corneal refractive status.METHODS: Prospective longitudinal study. A total of 60 cases(60 eyes)of pterygium patients admitted to our hospital from January 2024 to September 2024 were randomly selected. All patients underwent pterygium excision combined with pedicle conjunctival flap transplantation for treatment. Optical coherence tomography(OCT)was used to measure the preoperative thickness of patient's pterygium, and a digital slit lamp microscope was used to measure the area of pterygium. The corneal refractive status(degree of corneal astigmatism and average curvature)and changes in uncorrected visual acuity of patients before surgery, 1 d, 1, and 3 mo after surgery were compared. The relationship between preoperative thickness and area of pterygium in patients and corneal refractive status indicators at different postoperative time points were analyzed, and Logistic regression was used to analyze the impact of pterygium thickness and area on postoperative visual improvement in patients.RESULTS: All patients completed follow-up after surgery for 3 mo. At 3 mo after surgery, visual acuity improved in 21 eyes(35%). The results of bivariate Pearson correlation analysis showed that the thickness and area of pterygium positively correlated with the degree of corneal astigmatism and uncorrected visual acuity before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05), and negatively correlated with the average corneal curvature before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05). Logistic regression analysis showed that the thickness and area of pterygium before surgery, high degree of corneal astigmatism, and low uncorrected visual acuity(large LogMAR value)were all risk factors for poor postoperative visual improvement in patients(OR>1, P<0.05). The large average corneal curvature before surgery was a protective factor for poor postoperative visual improvement in patients(OR<1, P<0.05).CONCLUSION: The increase in thickness and area of pterygium can, to some extent, improve corneal astigmatism, reduce the average curvature of the cornea, and affect postoperative visual recovery.

Objective To investigate the risk factors for postoperative recurrence and metastasis in patients with T1 stageⅢ/Ⅳ clear cell renal cell carcinoma(ccRCC), and to analyze the influence of surgical methods on prognosis, so as to provide prognostic evaluation and treatment guidance for clinical practice. Methods A retrospective analysis was conducted on 398 patients diagnosed with T1 stage Ⅲ/Ⅳ ccRCC who underwent either partial nephrectomy(PN)or radical nephrectomy(RN)at Jiangsu Province Hospital during Jan. 2008 and Sep. 2022. The patients were divided into recurrence group(n=49)and non-recurrence group(n=349)according to whether the tumor recurred during the follow-up period. The general, clinical data and prognosis were compared between the two groups. Univariate and multivariate Cox regression analyses were used to explore the factors influencing disease-free survival(DFS)and overall survival(OS)after surgery. Subgroup analysis using Kaplan-Meier curves was performed for T1a and T1b patients. Results During the median follow-up of 67(42, 98)months, the recurrence group was characterized by older age, larger tumor diameter, higher proportion of T1b stage, and more complex tumor anatomy. Univariate and multivariate Cox regression analyses showed that age ≥55 years and R.E.N.A.L. score ≥7 were independent risk factors for poorer DFS and OS(P＜0.05). Subgroup analysis revealed that PN or RN did not significantly affect DFS or OS in T1a patients and OS in T1b patients, while RN significantly improved DFS in T1b patients(P＜0.05). Conclusion Age ≥55 years and R.E.N.A.L. score ≥7 are independent risk factors for poor DFS and OS in highgrade T1 ccRCC patients. For T1b patients, RN may improve DFS.

Objective To analyze the clinical, imaging, pathological characteristics and prognosis of renal mucinous tubular and spindle cell carcinoma (MTSCC), so as to provide preference for the differential diagnosis and clinical management of this disease.Methods A retrospective analysis was conducted on the clinical and follow-up data of 14 patients diagnosed with renal MTSCC at the Eastern Theater Command General Hospital during June 2021 and Aug.2025.Relevant literature was reviewed.Results Of the 14 patients, 10 were female (71.4%) and 4 were male (28.6%), with a mean age of 56.9 years. Pathological staging included pT1a in 6 cases, pT1b in 7 cases, and pT2b in 1 case.The median tumor diameter was 4.5 (range 2.0-11.0) cm.Twelve cases (85.7%) were asymptomatic and detected incidentally.On ultrasonography, most tumors exhibited well-defined margins and regular morphology (9/10, 90%) and appeared as homogeneous hypoechoic masses (7/10, 70%).All lesions demonstrated hypovascular features on imaging studies.Ten patients (71.4%) underwent laparoscopic radical nephrectomy, and 4(28.6%) received partial nephrectomy.Histologically, a distinctive architecture composed of tubular structures, spindle-shaped cells, and mucinous stroma was exhibited.Immunohistochemically, the positive rates of PAX-8, VIMENTIN and CK7 in tumor cells were 100% (13/13), 91.7% (11/12) and 84.6% (11/13), respectively.The Ki-67 proliferation index ranged from 2.0% to 40.0%.During a median follow-up of 25.0 (range4.9-0.0) months, no local recurrence or distant metastasis was observed.Conclusion Renal MTSCC is a rare subtype of renal cell carcinoma, typically lacking specific clinical symptoms and characterized by hypovascular imaging features.The tumor generally follows an indolent course with a favorable prognosis.For localized tumors, partial nephrectomy should be the primary consideration.For cases with high-risk pathological features such as sarcomatoid changes, due attention should be paid to the potential invasiveness and follow-up should be closely conducted.

Objective: To analyze the serotypes and VP1 coding region genetic characteristics of poliovirus (PV) isolated from Acute Flaccid Paralysis (AFP) Surveillance System and environmental sewage surveillance samples in Anhui Province. Methods: PV was isolated from fecal samples of polio cases and their close contacts in the AFP Surveillance System and environmental sewage surveillance samples in Anhui Province in 2023. Intratype identification was performed by rRT-PCR method. The nucleotide sequence variation sites and variation numbers in the VP1 coding region were amplified and determined. The mutation hotspots, neurovirulence determinants, and antigenic determinant site changes were analyzed. A PV phylogenetic tree was constructed based on the VP1 coding region gene, and the genetic association between PV in Anhui Province and other foreign vaccine-derived PV (VDPV) was analyzed. Results: A total of 35 PV strains were isolated in Anhui Province in 2023, including 10 strains from AFP Surveillance System samples and 25 strains from environmental sewage surveillance samples. By intratype identification, there were 14 type Ⅰ PV strains and 21 type Ⅲ PV strains. By VDPV screening, there were 2 type Ⅰ VDPV strains, with VP1 coding region nucleotide sequence variation numbers of 10-<150; all others were vaccine-like strains. The mutation rates of nt2747 and nt2795 sites in type Ⅰ PV were higher, which were 78.57% and 21.43%, respectively. Three strains had revertant mutations at the attenuated site nt2795. Twelve strains had mutations at antigenic determinant site 1. The mutation rates of nt3353, nt3346, and nt3357 sites in type Ⅲ PV were higher, which were 42.86%, 28.57%, and 28.57%, respectively. No revertant mutations were found at attenuated sites. Four strains had mutations at antigenic determinant site 2, and 6 strains had mutations at antigenic determinant site 3. Phylogenetic tree analysis showed that the isolated 2 type Ⅰ VDPV strains were on the same independent main branch, which was different from other isolated type Ⅰ PV strains, and had a distant genetic relationship with other VDPV monitored abroad. Conclusions In 2023, the VP1 coding regions of type Ⅰ and type Ⅲ PV isolated in Anhui Province had mutation hotspots, and revertant mutations occurred at attenuated sites. Type Ⅰ VDPV had no genetic association with previously discovered VDPV. It is recommended to strengthen PV surveillance and sequence analysis capabilities to reduce the risk of circulating VDPV.

Objective:To analyze the genetic characteristics of varicella-zoster virus（VZV）in Anhui province from 2022 to 2023.Methods:Vesicle fluid and throat swab samples were collected from suspected varicella patients in Anhui province during 2022—2023. Fresh vesicle fluid samples were selected for VZV isolation，and real-time PCR was used for VZV nucleic acid detection. For positive samples，the region containing five single nucleotide polymorphism（SNP）sites in the open reading frame 22（ORF22）fragment was amplified，and PCR products were sequenced to identify viral genotypes. Reference sequences of VZV genotypes were downloaded from GenBank，sequence alignment and phylogenetic tree analysis were performed using Sequencher and MEGA5.0 software. Additionally，four SNP sites in ORF38 and ORF62 fragments were detected to distinguish vaccine strains from wild strains.Results:Among 96 samples from suspected varicella cases，55 of 61 vesicle fluid samples and 21 of 35 throat swab samples were positive for VZV nucleic acid. The virus isolation rate for vesicle fluid samples was 14.75%. Genetic sequencing was successful for 51 strains，all of which were wild strains belonging to the clade 2 genetic branch. Compared with the reference strain of clade 2，the nucleotide and amino acid homologies of the ORF22 fragment were 99.46%~100% and 98.39%~100%，respectively. One strain（2023VZVCZ45）exhibited an A→G mutation at site 37916.Conclusion:The prevalent VZV strains detected in Anhui province during 2022—2023 were all wild strains of clade 2，with no vaccine-associated cases identified.

Objective:To examine the interaction between gender and the visceral adiposity index (VAI) in relation to the risk of type 2 diabetes mellitus (T2DM).Methods:This retrospective cohort study utilized data from the public Dryad database derived from the NAGALA (NAFLD in the Gifu Area, Longitudinal Analysis) project (1994-2016). Participants were stratified into quartiles based on VAI levels. A multivariate Cox proportional hazards regression model was employed to evaluate whether VAI independently predicts T2DM risk. Kaplan-Meier survival curves and receiver operating characteristic (ROC) curves were constructed for each VAI quartile. Subgroup analyses were conducted to examine associations across age and body mass index categories. Both multiplicative and additive interaction effects between gender and VAI were assessed. Additionally, gender-specific Cox models were fitted to further explore these associations.Results:A total of 15 453 participants [8 419 males and 7 034 females; mean age, (43.7±8.9) years] were included, with a median follow-up duration of 5.39 years. During follow-up, 373 participants (2.4%) developed T2DM. After adjustment for potential confounders, higher VAI levels were independently associated with increased T2DM risk ( HR=1.16; 95% CI 1.11-1.21), consistent with the results across VAI quartiles. Kaplan-Meier analysis revealed a significant trend of increasing T2DM incidence across VAI quartiles ( P<0.001). The area under the ROC curve for VAI in predicting T2DM at 3, 5, and 10 years was 0.755, 0.735, and 0.696, respectively. Sensitivity analyses showed that elevated VAI was associated with increased T2DM risk across all age and body mass index subgroups (all P<0.05). Regarding interaction analysis, the HR (95% CI) for the multiplicative interaction between VAI and gender was 1.22 (1.19-1.26). The relative excess risk of interaction was -1.08 (95% CI -2.96 to -0.06), the attributable proportion of interaction was -0.54 (95% CI -1.35 to -0.01), and the synergy index was 0.48 (95% CI 0.26-0.91), indicating a negative additive interaction. Using low-VAI women as the reference group, the risk of T2DM in high-VAI women was higher ( HR=2.53, 95% CI 1.59-4.02) compared to high-VAI men ( HR=2.01, 95% CI 1.49-2.72). In gender-specific analyses, increasing VAI remained significantly associated with elevated T2DM risk after adjustment in both females ( HR=1.43, 95% CI 1.21-1.68) and males ( HR=1.16; 95% CI 1.11-1.22), with consistent findings across VAI quartiles. Conclusions:VAI and gender demonstrated multiplicative and additive interaction in relation to T2DM risk. The association between increasing VAI and T2DM risk was more pronounced in women than in men.

Objective The aim of this study is to discuss the causal relationship between periodontal disease(PD)and prostate cancer(PCa).Methods A two-sample bidirectional Mendelian randomization(MR)analysis based on publicly statistical data from genome-wide association studies(GWAS)was conducted.MR Egger,weighted medium,simple mode and weighted mode were supplemented,while inverse variance weighted analysis(IVW)was the main method of analysis.Heterogeneity testing,pleiotropy testing and leave-one-out testing were used to assess the sensitivity and stabili-ty.Results The results of MR analysis showed that PD had no significant impact on the occurrence of PCa:East Asian(IVW,PD:OR=1.07,P=0.48);European(IVW,PD:OR=1.00,P=0.37,periodontitis:OR=1.03,P=0.14,chronic gingivitis:OR=0.99,P=0.37,chronic periodontitis:OR=1.03,P=0.22).The reverse MR analysis also did not show a causal relationship between PCa and PD:East Asian(IVW,PD:OR=0.97,P=0.22);European(IVW,PD:OR=0.84,P=0.44,periodontitis:OR=1.01,P=0.75,chronic gingivitis:OR=0.93,P=0.23,chronic periodontitis:OR=0.99,P=0.80).The results of other analysis were consistent with those of IVW analysis.Conclusions The results of our two-sample bidirectional MR analysis do not support a causal relationship between PD and PCa.

BACKGROUND:The development of artificial intelligence in the medical field is rapidly advancing,with increasing research on its applications in the field of bone trauma.Through bibliometric analysis,this paper analyzed the research hotspots of artificial intelligence in the field of bone trauma in recent years,and predicted the future research trend. OBJECTIVE:To summarize the development history,research status,hot spots,and future development trends of artificial intelligence technology in the field of bone trauma to provide new insights for future research. METHODS:This study selected relevant literature from the Web of Science core database,covering the period from the inception to August 2023,and retrieved 420 articles related to the application of artificial intelligence,machine learning,and deep learning in the field of bone trauma.After manual screening,202 articles related to this article were exported,and Citespace software was used for visual analysis of cooperation of countries,institutions,cited journals,citation analysis,keyword co-occurrence,and other aspects. RESULTS AND CONCLUSION:(1)The overall number of publications from the 202 selected articles showed an upward trend,indicating significant research potential for future studies.The country with the highest centrality and the highest publication volume was the United States.The University of California(USA)was the most prolific research institution.(2)The top five most commonly used keywords in bone trauma research using artificial intelligence were deep learning,artificial intelligence,bone density,machine learning,and diagnosis.The keyword with the highest centrality was bone density,and the keyword with the highest frequency was deep learning.(3)The top 10 most cited reference papers provided comprehensive insights into the feasibility of applying artificial intelligence techniques to the diagnosis of bone trauma from various perspectives.Among them,eight papers focused on bone and joint injuries and deep convolutional neural networks.One paper discussed the use of deep learning in detecting osteoporosis in CT scans to prevent fragility fractures,while another paper explored the correlation between the application of artificial intelligence in identifying changes in skin texture and the recognition of bone characteristics.(4)In the future,the research hotspots of artificial intelligence will mainly focus on the specific study of fractures caused by bone and joint trauma and osteoporosis.The research trend mainly focuses on improving the performance of artificial intelligence algorithms,using new artificial intelligence technologies to accurately classify and quickly and efficiently diagnose bone injuries,especially for the diagnosis of complex and hidden fractures.By establishing finite element analysis models,more standardized evaluations of bone injuries can be achieved.

Ankylosing spondylitis (AS) is linked to an increased prevalence of myocardial infarction (MI). However, research dedicated to elucidating the pathogenesis of AS-MI is lacking. In this study, we explored the biomarkers for enhancing the diagnostic and therapeutic efficiency of AS-MI. Datasets were obtained from the Gene Expression Omnibus database. We employed weighted gene co-expression network analysis and machine learning models to screen hub genes. A receiver operating characteristic curve and a nomogram were designed to assess diagnostic accuracy. Gene set enrichment analysis was conducted to reveal the potential function of hub genes. Immune infiltration analysis indicated the correlation between hub genes and the immune landscape. Subsequently, we performed single-cell analysis to identify the expression and subcellular localization of hub genes. We further constructed a transcription factor (TF)-microRNA (miRNA) regulatory network. Finally, drug prediction and molecular docking were performed. S100A12 and MCEMP1 were identified as hub genes, which were correlated with immune-related biological processes. They exhibited high diagnostic value and were predominantly expressed in myeloid cells. Furthermore, 24 TFs and 9 miRNA were associated with these hub genes. Enzastaurin, meglitinide, and nifedipine were predicted as potential therapeutic agents. Our study indicates that S100A12 and MCEMP1 exhibit significant potential as biomarkers and therapeutic targets for AS-MI, offering novel insights into the underlying etiology of this condition.
Humans ; Spondylitis, Ankylosing/complications* ; Systems Biology/methods* ; Myocardial Infarction/diagnosis* ; Biomarkers/metabolism* ; MicroRNAs/genetics* ; Gene Regulatory Networks ; Gene Expression Profiling ; Machine Learning

Objective:To investigate the impact of early invasive arterial blood pressure (IBP) monitoring on survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR).Methods:This retrospective cohort study analyzed 44 OHCA patients receiving ECPR between January 2021 and January 2023. Patients were divided into: Early intervention group : IBP established within 3 min of ECMO initiation; Late intervention group : IBP established after ICU admission. Baseline characteristics, ECMO parameters, and clinical outcomes were compared. Multivariable logistic regression (adjusted for age, initial rhythm, etc.) and Spearman's correlation were used.Results:This study included a total of 44 patients treated with OHCA and ECPR, divided into an early intervention group of 23 cases and a late intervention group of 21 cases. The early intervention group showed significantly higher: Survival to discharge (43.5% vs. 9.5%, P<0.05), Good neurological recovery (CPC 1-2: 34.8% vs. 9.5%, P<0.05).Early intervention independently predicted survival (adjusted OR=18.84, 95% CI:1.97-179.98, P=0.01). Stratified analysis by pH (cutoff 7.0) demonstrated consistent benefits in both pH>7.0 ( aOR=0.392, 95% CI:0.106-0.678) and pH≤7.0 subgroups ( aOR=0.385, 95% CI: 0.075-0.695; interaction P=0.183). Early IBP positively correlated with CPC scores ( ρ=0.40, P=0.007). Conclusions:Early IBP monitoring significantly improves survival and neurological outcomes in OHCA-ECPR patients, supporting its integration into standardized protocols.