1.Progress in artificial intelligence for predicting therapeutic efficacy of intravitreal injection
Xiaofeng WU ; Jiayi ZHANG ; Chunyan XIAO ; Yanshuang GENG ; Yonggang LIU ; Boxuan SONG ; Jiawei WANG
International Eye Science 2026;26(4):687-693
Intravitreal anti-vascular endothelial growth factor(anti-VEGF)therapy has been widely used, but the variability in its therapeutic efficacy limits individualized treatment. In recent years, the application of artificial intelligence(AI)has opened up new avenues for personalized treatment response prediction, and its core branches include machine learning(ML)and deep learning(DL). This review systematically retrieved and analyzed 41 relevant studies published up to April 2025. Comprehensive analysis reveals that AI predictive models are evolving from forecasting single endpoints(such as visual acuity or central retinal thickness)to integrating multi-dimensional endpoints(encompassing anatomical, functional, and treatment demand parameters)and generating predictive imaging outputs. In terms of technical approaches, DL models(28 studies, accounting for 68.3%)dominate this field due to their robust image interpretation capabilities, while ML models(10 studies, 24.4%)retain significant value in the analysis of structured clinical data. Cross-disease comparisons indicate that research efforts are most concentrated on age-related macular degeneration(ARMD)and diabetic macular edema(DME), with shared conceptual frameworks for model construction, yet distinct anatomical and functional indicators are prioritized for each disease. Currently, the field confronts several key challenges, including insufficient prospective clinical validation, limited model interpretability(the “black box problem”), and a scarcity of high-quality multi-center datasets. Moving forward, it is imperative to advance real-world validation and develop explainable AI techniques to expedite the clinical translation of these predictive models.
2.Disease burden of influenza like illness among student populations in Shenzhen
PENG Weijun, ZHANG Wei, LUO Jingwei,CHEN Hongbiao, ZHOU Xiaofeng, LIN Sixiao, LIU Honglian
Chinese Journal of School Health 2026;47(4):589-592
Objective:
To understand the epidemiological characteristics and disease burden of influenza like illness (ILI) among student populations, so as to provide data support for policy formulation and optimal allocation of health resources.
Methods:
From January 2024 to February 2025, a questionnaire survey was conducted among parents of kindergarten, primary school, junior and senior high school students in 9 districts of Shenzhen, including Longhua, Futian, Bao an, Longgang, Luohu, Nanshan, Guangming, Pingshan and Yantian. Parents were asked to complete the questionnaire based on whether their children had fever, cough, vomiting, diarrhea, rash and other common symptoms in 2024. A total of 3 537 parents were investigated, and 444 ILI cases were included as study subjects. The epidemiological burden, including incidence rate of influenza, visitation rate, years lived with disability (YLDs) and economic burden (including direct economic burden, indirect economic burden and intangible burden) were analyzed.
Results:
The incidence rate of influenza among students in Shenzhen in 2024 was 12.55%. The ILI incidence rates in kindergarten, primary school, junior and senior high school were 14.01%, 11.69% and 5.23%, respectively, with a statistically significant difference ( χ 2= 45.20, P <0.01). The ILI consultation rate among students was 85.36%, and the consultation rates in kindergarten (87.36%) and primary school students (84.62%) were higher than those in junior and senior high school students ( 56.52 %) ( χ 2=16.47, P <0.01). A total of 78.88% of cases did not receive etiological detection.The median total economic burden per ILI case was 2 354.62 yuan, including direct medical costs of 300.00 yuan, direct non medical costs of 212.50 yuan, indirect costs of 1 000.00 yuan, and intangible burden of 500.00 yuan.
Conclusions
Schools are high risk environment for influenza, and younger students are a high risk group for ILI. The disease burden caused by student ILI remains substantial.
3.Expert recommendations on vision friendly built environments for myopia prevention and control in children and adolescents
Chinese Journal of School Health 2026;47(1):1-5
Abstract
The prevention and control of myopia in Chinese children and adolescents has become a major public health issue. While maintaining increased outdoor activity as a cornerstone intervention, there is an urgent need to explore new complementary approaches that can be effectively implemented in both indoor and outdoor settings. In recent years, environmental spatial frequency has gained increasing attention as one of the key environmental factors influencing the development and progression of myopia. Both animal studies and human research have confirmed that indoor environments lacking mid to high spatial frequency components, often characterized as "visually impoverished", can promote axial elongation and myopia through mechanisms such as disruption of retinal neural signaling, impaired accommodative function, and altered expression of related molecules. Based on the scientific consensus, it is recommended that "enriching of environmental spatial frequency" should be integrated into the myopia prevention and control framework. Following the principles of schoolled organization, family cooperation, community involvement, and student participation, specific measures are put forward in three areas:optimizing school visual settings, improving home spatial environments, and promoting healthy visual behavior. The aim is to create "visually friendly" indoor environments as an important supplement to outdoor activity, thereby providing a novel perspective and strategy for comprehensively advancing myopia prevention and control among children and adolescents.
4.Effect of LncRNA SNHG16 targeting miR-141-3p/HMGB1 axis on angiogenesis of endometrial stromal cells in ectopic adenomyosis
Ting LIU ; Mingyang WANG ; Xiaofeng ZOU
Acta Universitatis Medicinalis Anhui 2026;61(3):533-539
ObjectiveTo investigate the effect of interfering with long noncoding RNA (LncRNA) small nucleolar RNA host gene16 (SNHG16) on improving angiogenesis of ectopic endometrial stromal cells (EScs) in adenomyosis (AM) by targeting upregulation of miRNA (miR)-141-3p and inhibition of high mobility group box-1 protein (HMGB1). MethodsThe expression levels of SNHG16, miR-141-3p and HMGB1 mRNA in endometrial tissues of 52 patients with adenomyosis (AM group) and 52 patients who needed hysterectomy due to cervical cancer or ovarian cancer (control group) were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Y14 cells were divided into small hairpin RNA (shRNA) NC group, shRNA SNHG16 group, shRNA SNHG16+miR-141-3p inhibitor (inhibitor) group, shRNA SNHG16+inhibitor NC group and blank group. The targeting relationship between miR-141-3p and SNHG16 as well as HMGB1 was verified. The expression levels of SNHG16, miR-141-3p and HMGB1 mRNA in Y14 cells were detected by qRT-PCR. CCK-8 and Transwell assay were used to detect cell proliferation, invasion and migration. Microvascular density (MVD) was determined by immunofluorescence. The expressions of hypoxia-inducing factor α (HIF-1α), cyclooxygenase-2 (Cox-2), vascular endothelial growth factor (VEGF) and HMGB1 were detected by Western blot. ResultsThe expression of SNHG16 and HMGB1 mRNA in AM group was higher than that in control group, but the expression of miR-141-3p was lower than that in control group (P0.05). The expression of SNHG16, HMGB1 mRNA, proliferation rate, migration, invasion number, MVD, expression of VEGF, HIF-1 α, Cox-2, and HMGB1 proteins in the shRNA SNHG16 group were lower than those in the blank group and shRNA NC group, while the expression of miR-141-3p was higher than that in the blank group and shRNA NC group (P0.05). Inhibition of miR-141-3p reversed the improvement of EScs angiogenesis by interfering with SNHG16. ConclusionInterference with LncRNA SNHG16 improves EScs angiogenesis and inhibits proliferation, migration, and invasion of EScs by targeting upregulation of miR-141-3p and inhibition of HMGB1.
5.Timing of endoscopic treatment for acute esophagogastric variceal bleeding in liver cirrhosis: Controversies and challenges
Xinhui LI ; Xingshun QI ; Xiaofeng LIU ; Daiming FAN ; Jing WANG
Journal of Clinical Hepatology 2026;42(5):1178-1184
Acute esophagogastric variceal bleeding (AEGVB) is one of the life-threatening complications of decompensated cirrhosis. Endoscopy is the main method for the diagnosis and treatment of AEGVB, and endoscopic treatment can effectively control acute bleeding and alleviate or eliminate varices. However, there is still a lack of consistent recommendations for the timing of endoscopic examination and intervention for AEGVB in related guidelines in China and globally. Existing studies in China and globally have low quality of evidence, with significant variations in the definition of “early endoscopy” and inconsistent conclusions. This article reviews the research advances in the timing of endoscopic treatment for AEGVB in liver cirrhosis, points out the controversies over the optimal timing of treatment, and discusses future research directions in this field.
6.Treatment of 149 cases of large-volume benign prostatic hyperplasia with blue laser vaporization
Haifeng CHENG ; Chao WANG ; Quan DU ; Guoxiong LIU ; Zhenwei FAN ; Xiaoliang FU ; Nan LI ; Wanglong YUN ; Xiaofeng XU
Journal of Modern Urology 2026;31(5):443-445
Objective To explore the efficacy and safety of blue laser vaporization in the treatment of large-volume (>80 mL) benign prostatic hyperplasia (BPH). Methods A retrospective analysis was conducted on the clinical data of 149 BPH patients with prostate volume>80 mL who underwent blue laser vaporization at our hospital during Aug. 2023 and Aug. 2025. The 1-month postoperative maximum urinary flow rate (Qmax) and international prostate symptom score (IPSS), operation time, postoperative hemoglobin drop, bladder irrigation volume, catheter indwelling time, and incidence of postoperative complications were recorded and analyzed. Results All operations were successfully completed, without conversion to other approaches. The operation time was (41.47±11.05) minutes, postoperative hemoglobin drop (2.78±1.19) g/L, bladder irrigation volume (9.97±1.49) bags, and catheter indwelling time (3.30±1.85) days. One month after surgery, the Qmax was significantly higher than the preoperative value [(20.19±3.39) mL/s vs. (2.39±2.17) mL/s], while the IPSS was significantly lower [(4.46±0.87) vs. (27.69±2.06)], with statistically significant differences (P<0.001). Postoperative complications included 1 case of incontinence (0.67%), 2 cases of urethral stricture/bladder neck contracture (1.34%), and 1 case of secondary bleeding (0.67%), all of which improved with symptomatic treatment. Conclusion Blue laser vaporization is effective for treating large-volume BPH, with advantages such as minimal bleeding risk, short operation time, fast recovery and safety.
7.Construction of a prognostic model of future asthma exacerbation risk in adults combined with novel biomarkers
Li ZHANG ; Liang LI ; Mei ZHOU ; Qianyun ZHOU ; Qin LIU ; Mei LIANG ; Jihong TANG ; Xiaofeng FU
International Journal of Laboratory Medicine 2025;46(4):435-442
Objective To construct a prognostic model of future asthma exacerbation risk in adults by com-bining novel biomarkers of serum chitinase-3-like protein 1(YKL-40),dipeptidyl peptidase-4(DPP4)and conventional predictors.Methods Patients with asthma in the non-acute exacerbation phase were recruited from the People's Hospital of Yubei District of Chongqing,from March 2022 to May 2023.Baseline clinical da-ta collected included medical history,forced expiratory volume in the first second(FEV1)/forced vital capacity(FVC),percentage of predicted forced expiratory volume in the first second(FEV1%pred),blood eosinophil count(EOS),blood neutrophil count(NEU),fractional exhaled nitric oxide(FeNO),serum YKL-40,and ser-um DPP4,etc.The patients were followed for one year to gather data on asthma acute exacerbations and their timings as defined in this study.A COX proportional hazards regression model was used to construct a prog-nostic model for future asthma exacerbations,with internal validation and results presentation.Results A to-tal of 224 patients with asthma completed the study.During the one-year follow-up period,102 patients experi-enced acute exacerbations as defined in this study.Based on univariate COX regression,stepwise regression for variable selection,clinical significance,and model simplicity,asthma control test(ACT)score group,number of asthma exacerbations in the past year group,log10(YKL-40),log10(FeNO),log10(EOS),and FEV1%pred were the following predictors were included in the final model.The overall C-statistic of the model was 0.795(95%CI:0.754-0.836),the area under the curve at the 52-week follow-up was 0.879(95%CI:0.834-0.924),and the Brier score at the 52-week follow-up was 0.142(95%CI:0.117-0.168).The calibration curve was close to a slope of 1,and bootstrap validation suggested good stability of the prediction model.The model was presented using a Nomogram and a dynamic scoring table in a web APP,which can be used to predict the risk of asthma exacerbations within 52 weeks for individual patients.Conclusion The prediction model based on serum YKL-40,EOS,FeNO,the number of asthma exacerbation in the past year group,FEV1%pred and ACT scores group can accurately predict the probability of acute attacks in 52 weeks of asthma patients.
8.Efficacy of R0 surgery combined with PARP inhibitors in the treatment of advanced epithelial ovarian cancer in 52 patients
Xiaohong ZHENG ; Xiaofeng WU ; Dandan LIU ; Hong HU
Chinese Journal of Primary Medicine and Pharmacy 2025;32(7):1019-1023
Objective:To investigate the efficacy and safety of R0 surgery combined with PARP inhibitors in the treatment of advanced epithelial ovarian cancer in 52 patients.Methods:A retrospective analysis was performed on 104 patients with International Federation of Gynecology and Obstetrics Ⅲ-Ⅳ epithelial ovarian cancer who received treatment at the Department of Gynecology and Obstetrics, Xinhua Hospital, Huainan Xinhua Medical Group from January 2021 to December 2023. The patients were divided into a control group and an observation group ( n = 52/group). Patients in the control group underwent non-R0 surgery followed by six cycles of chemotherapy with platinum and paclitaxel, along with maintenance therapy using olaparib or niraparib. Patients in the observation group underwent R0 surgery followed by the same chemotherapy and maintenance therapy as those in the control group. Comparisons were made between the two groups regarding general data, perioperative conditions, and postoperative levels of cancer antigen 125, human epididymis protein 4, vascular endothelial growth factor, interleukin-15, gamma interferon, and recurrence rates measured within 1 year after chemotherapy. Results:There was no statistically significant difference in age, underlying diseases, or pathological types according to International Federation of Gynecology and Obstetrics staging between the two groups (all P > 0.05). However, compared with the control group, the observation group had a longer surgical time [(290.17 ± 36.72) minutes vs. (206.58 ± 22.57) minutes, t = 171.20, P < 0.001]. The intraoperative blood loss in the observation group was significantly greater than that in the control group [(800.44 ± 134.22) mL vs. (743.16 ± 87.85) mL, t = 1 094.00, P = 0.003]. The interval between surgery and the start of chemotherapy in the observation group was longer than that in the control group [(13.00 ± 0.94) days vs.(12.04 ± 0.92) days, t = 3.07, P < 0.001]. There was no statistically significant difference in postoperative complications ( P > 0.05). Compared with the control group, the observation group had lower levels of cancer antigen 125 [(14.27 ± 2.16) IU/mL vs. (188.57 ± 30.74) IU/mL, t = 40.794, P < 0.001], human epididymis protein 4 [(25.29 ± 2.49) pmol/L vs. (74.21 ± 0.52) pmol/L, t = 138.68, P < 0.001], vascular endothelial growth factor [(23.70 ± 3.01) ng/mL vs. (51.66 ± 4.67) ng/mL, t = 36.28, P < 0.001], and recurrence rate [17.30% (9/52) vs. 88.46% (46/52), χ2 = 52.83, P < 0.001]. Compared with the control group, the observation group showed higher levels of interleukin-15 [(57.36 ± 9.48) pg/mL vs. (24.24 ± 4.04) pg/mL, t = -23.17, P < 0.001] and gamma interferon [(50.16 ± 4.43) pg/mK vs. (12.99 ± 1.30) pg/mL, t = -763.17, P < 0.001]. Conclusions:R0 surgery is effective and safe. R0 surgery followed by maintenance therapy with PARP inhibitors can significantly improve chemotherapy outcomes and delay tumor recurrence in patients with advanced epithelial ovarian cancer non-R0 surgery combined with chemotherapy plus maintenance therapy with PARP inhibitors.
9.Core symptoms of prostate cancer patients with androgen deprivation therapy and nursing implications: a contemporaneous network analysis
Hanxue LIU ; Zhenqi LU ; Xiaofeng GU ; Xiaodan ZHU
Chinese Journal of Practical Nursing 2025;41(32):2508-2515
Objective:To identify the core symptoms of prostate cancer patients with endocrine therapy by constructed the symptom network, and provide a basis for precise intervention of symptoms management.Methods:In a cross-sectional study, we conveniently sampled patients receiving endocrine therapy for prostate cancer at Fudan University Shanghai Cancer Center between March and August 2018. The Expanded Prostate cancer Index Composite 26-item version (EPIC-26) and the Hospital Anxiety and Depression Scale (HADS) were used to assess symptoms.Symptom networks were constructed, and network indexes and the accuracy and stability of core symptoms were computed based on various packages of R4.3.1. Subgroup network comparison tests were conducted by Prostate-specific antigen (PSA) level, stratifying patients into PSA>0.2 ng/ml and PSA≤0.2 ng/ml groups.Results:A total of 270 questionnaires were distributed, and 261 valid questionnaires were returned, yielding a valid response rate of 96.7%. The included patients were aged 43 - 87(67.81 ± 8.14) years. Symptom network analysis revealed that the core symptom in patients undergoing endocrine therapy for prostate cancer was endocrine disorder ( rs = 1.86, rc = 0.048). However, in the population with PSA ≤ 0.2 ng/ml, depression ( rs = 1.80, rc = 0.028) occupied a more central position. There was no statistically significant difference in the network structure among patients with different PSA levels ( M = 0.294, P = 0.100). But the difference in network strength was statistically significant ( S = 1.15, P<0.05). The strongest associations were observed between depression and anxiety, as well as between endocrine disorder anddepression.The network demonstrated good stability and accuracy,indicating a reliable network model. Conclusions:Endocrine disorder is the core symptom in patients undergoing endocrine therapy for prostate cancer, serving as a critical target for intervention. Special attention should be given to the interconnected effects between endocrine disorder and depression. For the population with PSA ≤ 0.2 ng/ml, negative emotions such as depression still require ongoing focus. In the future, comprehensive interventions centered on psychological support and endocrine symptom management should be implemented for prostate cancer patients receiving endocrine therapy.
10.Analysis of risk factors of bleeding caused by thrombus head shedding in patients with esophageal varices during endoscopic diagnosis and treatment and construction of nomogram prediction model
Minghui WANG ; Xiaofeng LIU ; Qun LI ; Jing WANG ; Wenbo LI
China Journal of Endoscopy 2025;31(7):25-30
Objective To investigate the risk factors of thrombus head shedding and bleeding during endoscopic treatment of patients with esophageal varices veins,and build a risk prediction model.Methods 209 cases of esophageal varices with thrombus head found by endoscopy from February 2009 to July 2024 were retrospectively analyzed,and divided into non-shedding group(n=186)and shedding group(n=23)according to whether thrombus head shedding bleeding occurred during endoscopic treatment.Clinical and endoscopic data of the two groups were compared.Statistically significant factors were included in multivariate Logistic regression analysis and their independent risk factors were explored.A nomogram risk prediction model was constructed by R software,and its prediction efficiency was evaluated.Results Multivariate Logistic regression analysis showed that red thrombus head((O^R)=6.231,95%CI:1.748~22.208),thrombus head diameter≥3 mm((O^R)=4.355,95%CI:1.341~14.144),conical thrombus head((O^R)=8.555,95%CI:2.427~30.154),and the presence of hematoma in the stomach((O^R)=7.079,95%CI:1.665~30.103)were risk factors for bleeding after thrombus head shedding during endoscopic diagnosis and treatment.A nomogram prediction model was constructed with a sensitivity of 0.870(95%CI:0.732~1.000)and a specificity of 0.887(95%CI:0.842~0.933).Conclusion The thrombus head being red,conical in shape,with a diameter of≥3 mm and the presence of hematoma in the stomach are independent risk factors for thrombus head shedding and bleeding during endoscopic diagnosis and treatment.Timely intervention should be made for the above factors to benefit patients.


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