AIM: To evaluate the safety and efficacy of low-dose transscleral cyclophotocoagulation(TSCP)in the management of persistent ocular hypertension after an acute attack of angle-closure glaucoma(AACG).METHODS:This retrospective study enrolled patients diagnosed with persistent ocular hypertension after an acute AACG attack at the No.988 Hospital of the Joint Logistics Support Force of the Chinese PLA between September 2023 and September 2024. All patients underwent low-dose TSCP using a semiconductor diode laser. Subsequent cataract surgery combined with goniosynechialysis was performed once intraocular pressure(IOP)was stabilized. Changes in anterior chamber depth(ACD), best-corrected visual acuity(VA), and IOP were compared before and after TSCP, as well as before and after phacoemulsification. Post-TSCP complications were also documented.RESULTS: A total of 21 patients(21 eyes)were enrolled, including 8 males and 13 females, with a mean age of 67.95±7.25 y. Compared with pre-cyclophotocoagulation values, ACD increased significantly at 3 d post-TSCP(1.49±0.18 vs 1.22±0.21 mm; P<0.001). BCVA and IOP decreased significantly at 1 d post-TSCP, pre-phacoemulsification, 1 wk post-phacoemulsification, and 1 mo post-phacoemulsification compared with pre-TSCP IOP(all P<0.01). Regarding postoperative complications, 2 eyes experienced pain on the day of the procedure, 5 eyes developed mild corneal endothelial folds, 2 eyes exhibited moderate anterior chamber inflammatory reaction, and 12 eyes showed shallow ciliary body detachment. No serious complications occurred during the 1-month follow-up period.CONCLUSION:Low-dose TSCP appears to be an effective bridging therapy for patients with persistent ocular hypertension following an AACG attack. It facilitates rapid IOP reduction, alleviates symptoms, and helps preserve visual function with a favorable safety profile, thereby reducing the risks associated with subsequent intraocular surgery.

Traditional Chinese medicine （TCM） therapy has unique clinical advantages in the treatment of atrial fibrillation， mainly reflected in five aspects， improving quality of life， enabling early diagnosis and treatment， promoting cardiac rehabilitation， making up for the limitations of Western medicine， and improving the success rate of catheter ablation. However， there is insufficient evidence in current clinical research. Based on the current status of TCM research in the treatment of atrial fibrillation， it is suggested that future studies should focus on standardized research on syndrome differentiation and classification. This can be achieved through clinical epidemiological surveys， expert consensus， and other methods to establish a unified syndrome differentiation and classification standard for atrial fibrillation. Clinical efficacy evaluation indicators should be standardized， and core outcome measures for clinical research on TCM treatment of atrial fibrillation should be developed through systematic reviews， patient interviews， and other methods. Additionally， clinical research design， implementation， and data management should be improved. By leveraging modern information technologies such as artificial intelligence， the scientific and standardized nature of TCM intervention research on atrial fibrillation can be enhanced， ultimately improving the quality of research.

[Objective] To explore the predictive value of HALP score for prognosis in patients with multiple myeloma (MM). [Methods] A retrospective analysis was conducted on laboratory indicators and related clinical data of newly diagnosed multiple myeloma (NDMM) patients, treated at the Affiliated Hospital of North Sichuan Medical College from January 2016 to October 2023, prior to their first treatment. The HALP score was calculated, and the optimal cutoff value for HALP was determined using X-tile software. Survival analysis was performed using Kaplan-Meier curves for high HALP and low HALP groups. Univariate and multivariate analyses were conducted using the Cox regression model, and a forest plot was generated using Graphpad Prism to illustrate factors that may impact patient prognosis. The predictive ability of HALP score combined with β2-microglobulin and ECOG score for prognosis in MM patients was evaluated using receiver operating characteristic curve (ROC) analysis. [Results] A total of 203 MM patients were included, with the optimal cutoff value for HALP score being 29.15 (P<0.05). Among them, 101 patients were in the low HALP score group, and 102 patients were in the high HALP score group. The results of univariate and multivariate analysis using the Cox regression model showed that a HALP score <29.15 was an independent risk factor for progression-free survival (PFS) and overall survival (OS) (P<0.05). ROC curve analysis indicated that the combination of HALP score with β2-microglobulin and ECOG score had a higher predictive value for prognosis in MM patients compared to using HALP score alone. [Conclusion] The HALP score is closely related to the prognosis of patients with NDMM. A low HALP score indicates a poorer prognosis, while the combination of HALP score with β2-microglobulin and ECOG score provides a higher predictive value when assessed together.

BACKGROUND: Asthma is a common chronic inflammatory airway disease and intermittent hypoxia is increasingly recognized as a factor that may impact disease progression. The present study investigated whether intermittent hypoxia (IH) could aggravate asthma by promoting hypoxia-inducible factor-1α (HIF-1α)/nucleotide-binding oligomerization domain (NOD)-like receptor pyrin domain-containing protein 3 (NLRP3)/interleukin (IL)-1β-dependent pyroptosis and the inflammatory response and further elucidated the underlying molecular mechanisms involved. METHODS: A total of 49 patients diagnosed with severe bronchial asthma and diagnosed by polysomnography were enrolled at Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, between January 2022 and December 2022, and their general data and induced sputum were collected. BEAS-2B cells were treated with IL-13 and subjected to IH. An ovalbumin (OVA)-treated mouse model was also used to assess the effects of chronic intermittent hypoxia (CIH) on asthma. Pyroptosis, the inflammatory response, and related signalling pathways were assessed in vivo and in vitro . RESULTS: In this study, as the apnoea and hypopnea index (AHI) increased, the proportion of patients with uncontrolled asthma increased. The proportions of neutrophils and the levels of IL-6, IL-8, HIF-1α and NLRP3 in induced sputum were related to the AHI. NLRP3-mediated pyroptosis, which could be mediated by the HIF-1α signalling pathway, was activated in IL-13 plus IH-treated BEAS-2B cells and in the lungs of OVA/CIH mice. HIF-1α downregulation significantly reduced lung pyroptosis and ameliorated neutrophil inflammation by modulating the NLRP3/IL-1β pathway both in vitro and in vivo . Similarly, pretreatment with LW6, an inhibitor of HIF-1α, effectively blocked the generation of inflammatory cytokines in neutrophils. In addition, administration of the NLRP3 activator nigericin obviously increased lung neutrophil inflammation. CONCLUSIONS Obstructive sleep apnoea-hypopnea syndrome (OSAHS) is a risk factor for asthma exacerbation. IH aggravates neutrophil inflammation in asthma via NLRP3/IL-1β-dependent pyroptosis mediated by the HIF-1α signalling pathway, which should be considered a potential therapeutic target for the treatment of asthma with OSAHS.
NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Humans ; Asthma/metabolism* ; Animals ; Pyroptosis/physiology* ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism* ; Mice ; Signal Transduction/physiology* ; Male ; Hypoxia/metabolism* ; Female ; Interleukin-1beta/metabolism* ; Adult ; Inflammation/metabolism* ; Middle Aged ; Mice, Inbred C57BL

Objective:To review and analyze the results of cervical cancer screening for women aged 30-65 years in Tianjin from 2018—2023, and to explore the choice of cervical cancer screening strategies.Methods:The results of free cervical cancer screening in Tianjin from January 2018 to December 2023 were collected and divided into two periods: group A [2018—2020; screening programs included cervical cytology, Thinprep cytologic test (TCT), and human papillomavirus (HPV) DNA+TCT combined screening] and group B (2021—2023; the screening scheme of HPV E6/E7 mRNA primary screening and TCT diversion, referred to as “HPV E6/E7 mRNA primary screening”) according to the policy changes, and according to the primary screening method of cervical cancer, it was divided into four methods: cervical smear primary screening, TCT primary screening, HPV DNA+TCT combined primary screening and HPV E6/E7 mRNA primary screening. Cervical cancer and precancerous lesion detection rate, cervical cancer early diagnosis rate were analyzed.Results:(1) A total of 1 634 155 women of eligible age were screened, and the detection rate of cervical cancer and precancerous lesion was 216.3/100 000 (3 535/1 634 155), among which the detection rate of precancerous lesion was 200.3/100 000 (3 274/1 634 155) and cervical cancer was 16.0/100 000 (261/1 634 155). (2) The cervical cancer and precancerous lesion detection rate and cancer early diagnosis rate in group B were significantly higher than those in group A [480.3/100 000 (2 132/443 924) vs 117.9/100 000 (1 403/1 190 231), 97.56% (2 080/2 132) vs 92.37% (1 296/1 403); both P<0.001]. (3) The detection rates of cervical cancer and precancerous lesions in women who underwent initial screening with cervical cytology, TCT, HPV DNA+TCT combined screening, and HPV E6/E7 mRNA screening were 106.8/100 000 (10 980/1 028 227), 167.7/100 000 (190/113 319), 236.2/100 000(115/48 685) and 480.3/100 000 (2 132/443 924), respectively. HPV E6/E7 mRNA primary screening had the highest cervical cancer and precancerous lesion detection rate among the four screening methods ( χ2=2 017.59, P<0.001). Conclusion:After 2021, the cervical cancer screening method of HPV E6/E7 mRNA primary screening and TCT triage adopted in Tianjin is suitable for general screening of large populations and is an effective method for initial screening of cervical cancer.

BACKGROUND:Studies have shown that immune cells are involved in all processes of ischemic stroke,in which cuproptosis also plays a key role.OBJECTIVE:To screen diagnostic biomarkers related to the progression of ischemic stroke through bioinformatics,and analyze and validate cuproptosis-related genes closely related to the occurrence and development of ischemic stroke.METHODS:The GSE16561 microarray was obtained from the GEO database,containing data from 39 cases of ischemic stroke(ischemic stroke group)and 24 controls(control group).Differentially expressed genes from the ischemic stroke microarray data were analyzed.Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed.By using LASSO and Random Forest methods,key genes affecting the occurrence and development of ischemic stroke were screened,and a diagnostic model was established and validated.Differential gene analysis was performed through immune cell infiltration and weighted gene co expression network.The differentially expressed immune-related genes were intersected with cuproptosis genes to obtain the hub genes related to cuproptosis immunity.In vitro cell experiments were conducted to divide rat hippocampal neurons into a normal group and an ischemic stroke group,and qPCR experiments were performed to verify the results.RESULTS AND CONCLUSION:(1)573 differentially expressed genes were obtained by differential analysis.Differentially expressed genes were mainly enriched in biological processes,such as positive regulation of immune response,and signaling pathways such as lipid and atherosclerosis.(2)Machine learning methods were used to screen diagnostic genes such as MFN2,PKM2,CREG1,and FOXO3A,which may have some diagnostic value for ischemic stroke.(3)Immune infiltration analysis revealed resting plasma cells,NK cells,macrophages,etc.,indicating that immune cells play a certain role in the pathogenesis of ischemic stroke.(4)Weighted gene co-expression network analysis combined with immune infiltration analysis obtained 118 key module genes,which were intersected with cuproptosis genes to obtain 2 cuproptosis and immune characteristic genes.The correlation analysis between four diagnostic genes and Hub genes showed that the expression of FOXO3A and MFN2,PKM2 and BCL2L1,MTF1 and MFN2,ATP7B and BCL2L1 were correlated.(5)The qPCR results showed significant differences in the genes MTF1 and ATP7B between the ischemic stroke group and the blank group.To conclude,ATP7B and MTF1 can serve as characteristic genes for cuproptosis in ischemic stroke.It is possible to improve ischemic stroke by intervening in ATP7B and MTF1 to regulate cuproptosis.

This study systematically analyzed the clinical applications of photobiomodulation(PBM)therapy in Parkinson disease(PD)patients using a scoping review methodology,with the aim of summarizing treatment protocols,outcome measures,and therapeutic effects to provide references for subsequent clinical research and treatment.A comprehensive search was conducted across Web of Science,PubMed,Embase,Cochrane Library,CNKI,and Wanfang,ultimately including 13 studies.The results indicate that PBM therapy can effectively improve motor symptoms,non-motor symptoms,and brain structure in PD patients,serving as a beneficial supplement to conventional treatments.However,there remains a scarcity of large-sample randomized controlled trials(RCTs),along with significant variations in the selected treatment parameters.Therefore,further investigations with larger sample sizes and extended durations are required to validate its therapeutic efficacy.

Objective We aimed to investigate the effects of different non-surgical embryo transfer devices,number of transferred embryos,embryo stage,and embryos obtained from different mouse strains on the efficiency of non-surgical embryo transfer in mice,and to compare the efficiencies of surgical and non-surgical embryo transfer,in order to establish a stable non-surgical embryo transfer technology system.Methods Mouse embryo transfer was carried out using non-surgical method.Results The pregnancy rates using two different non-surgical transfer devices were(75.00±0.00)％and(66.67±14.43)％,and the birth rates were(46.11±6.31)％and(18.89±0.96)％,respectively.Transfer of 10,15,and 20 embryos resulted in pregnancy rates of(66.67±11.55)％,(80.00±0.00)％,and(66.67±23.09)％,and birth rates of(29.33±4.16)％,(38.67±4.81)％,and(17.00±3.46)％,respectively.When blastocysts and morulae were transferred non-surgically,the resulting pregnancy rates were(80.00±0.00)％and(46.67±11.55)％and the birth rates were(38.67±4.81)％and(10.22±2.77)％,respectively.Four strains(C57BL/6J,ICR,genetically modified mice A,genetically modified mice B)were used as donors for non-surgical embryo transfer,with resulting pregnancy rates of(66.67±11.55)％,(80.00±0.00)％,(73.33±11.55)％,and(80.00±0.00)％,and birthrates of(26.67±2.67)％,(38.67±4.81)％,(32.00±3.53)％,and(29.34±2.31)％,respectively.Fifteen pseudo-pregnant mice were transplanted surgically and 15 were transplanted non-surgically,with pregnancy rates of(80.00±0.00)％and(86.67±11.55)％,and birth rates of(38.67±4.81)％and(36.00±5.82)％,respectively.Conclusions Transfer device A resulted in a higher birth rate in this study.The embryo transfer efficiency was higher when 15 embryos were transferred into unilateral uterine horns of pseudo-pregnant 2.5-day recipients.Blastocyst-stage embryo transfer was more efficient than morula-stage transfer.There was no significant difference in efficiency between surgical and non-surgical embryo transfer procedures.

Objective The reference range for perfusion index(PI)in healthy newborns was established,and the prognostic value of PI at multiple time points(6 h,18 h,24 h,48 h,and 72 h)in critically ill newborns was evaluated.Methods A total of 100 healthy neonates born at the Hainan Women and Children's Medical Center between July 2022 and September 2024,along with 142 critically ill neonates admitted to the neonatal intensive care unit,were enrolled as study participants.The healthy neonates constituted the control group,while the critically ill neonates were categorized into low-risk(n=44),medium-risk(n=61),and high-risk(n=37)groups according to disease severity.The clinical outcomes of the critically ill neonates were recorded and classified into poor prognosis(n=38)and good prognosis(n=104)groups.PI values were monitored in all neonates from 6 to 72 hours after birth.Spearman correlation analysis was performed to assess the association between illness severity and PI values during this period,while logistic regression analysis was employed to examine the relationship between PI values and prognosis in critically ill neonates.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the predictive value of PI for poor prognosis,and the optimal cutoff threshold for prognosis prediction was determined.Results The PI values of healthy neonates between 6 and 72 hours after birth ranged from 2.61 to 3.31.Critically ill neonates exhibited consistently lower PI values than their healthy counterparts during the same period,with statistically significant differences observed across neonates of varying illness severity(P<0.05).PI values in all groups gradually increased within the first 72 hours post-birth(P<0.05).Neonatal illness severity was negatively correlated with PI values measured at 6,18,24,48,and 72 hours after birth(P<0.05).Furthermore,neonates in the poor prognosis group had significantly lower PI values between 6 and 72 hours compared to those in the good prognosis group(P<0.05).Reduced PI values were significantly associated with an increased risk of poor prognosis in critically ill neonates(P<0.05).The predictive performance of PI values for poor prognosis,as assessed by the area under the curve(AUC),yielded values of 0.760,0.779,0.768,0.797,and 0.808 at 6,18,24,48,and 72 hours,respectively,with corresponding cut-off values of 0.88,1.12,1.25,1.65,and 1.82.Conclusion The PI values measured between 6 and 72 hours after birth are closely associated with disease severity in neonates,with lower PI values indicating a poorer prognosis.These early postnatal PI measurements demonstrate auxiliary predictive value for the outcomes of critically ill neonates.

Objective:To review and analyze the results of cervical cancer screening for women aged 30-65 years in Tianjin from 2018—2023, and to explore the choice of cervical cancer screening strategies.Methods:The results of free cervical cancer screening in Tianjin from January 2018 to December 2023 were collected and divided into two periods: group A [2018—2020; screening programs included cervical cytology, Thinprep cytologic test (TCT), and human papillomavirus (HPV) DNA+TCT combined screening] and group B (2021—2023; the screening scheme of HPV E6/E7 mRNA primary screening and TCT diversion, referred to as “HPV E6/E7 mRNA primary screening”) according to the policy changes, and according to the primary screening method of cervical cancer, it was divided into four methods: cervical smear primary screening, TCT primary screening, HPV DNA+TCT combined primary screening and HPV E6/E7 mRNA primary screening. Cervical cancer and precancerous lesion detection rate, cervical cancer early diagnosis rate were analyzed.Results:(1) A total of 1 634 155 women of eligible age were screened, and the detection rate of cervical cancer and precancerous lesion was 216.3/100 000 (3 535/1 634 155), among which the detection rate of precancerous lesion was 200.3/100 000 (3 274/1 634 155) and cervical cancer was 16.0/100 000 (261/1 634 155). (2) The cervical cancer and precancerous lesion detection rate and cancer early diagnosis rate in group B were significantly higher than those in group A [480.3/100 000 (2 132/443 924) vs 117.9/100 000 (1 403/1 190 231), 97.56% (2 080/2 132) vs 92.37% (1 296/1 403); both P<0.001]. (3) The detection rates of cervical cancer and precancerous lesions in women who underwent initial screening with cervical cytology, TCT, HPV DNA+TCT combined screening, and HPV E6/E7 mRNA screening were 106.8/100 000 (10 980/1 028 227), 167.7/100 000 (190/113 319), 236.2/100 000(115/48 685) and 480.3/100 000 (2 132/443 924), respectively. HPV E6/E7 mRNA primary screening had the highest cervical cancer and precancerous lesion detection rate among the four screening methods ( χ2=2 017.59, P<0.001). Conclusion:After 2021, the cervical cancer screening method of HPV E6/E7 mRNA primary screening and TCT triage adopted in Tianjin is suitable for general screening of large populations and is an effective method for initial screening of cervical cancer.