AIM: To explore the factors affecting the whole-eye astigmatism after pterygium excision combined with autologous limbal stem cell transplantation.METHODS: A retrospective analysis was conducted on the medical records of 42 patients(42 eyes)with primary pterygium admitted in the ophthalmology department of Xijing Hospital from January 2023 to October 2023. They underwent pterygium excision combined with autologous limbal stem cell transplantation. The maximum invasion depth of pterygium into the cornea was measured with anterior segment optical coherence tomography(AS-OCT)before operation, the length of the pterygium invading cornea, the width of the limbus and the area of the invading cornea were measured during the operation, and three-dimensional values of corneal astigmatism of anterior segment, index of surface variance(ISV), index of vertical asymmetry(IVA), best corrected visual acuity(BCVA)and whole-eye astigmatism were collected before and at 1 mo after surgery. Patients with astigmatism ≤0.50 D or >0.50 D of the whole eye at 1 mo after surgery were assigned to group A and B, respectively. The differences of clinical data before and at 1 mo after surgery between the two groups, and the correlation between pre-operative clinical indicators and whole-eye astigmatism were analyzed. The decision tree algorithm was performed to explore the influencing factors of whole-eye astigmatism at 1 mo postoperatively.RESULTS: The maximum invasion depth of pterygium in the group A was significantly less than that in the group B [80.00(40.00, 180.00)μm vs 175.00(123.00, 190.00)μm, P=0.002]. Preoperative BCVA(LogMAR), whole-eye astigmatism, cornea astigmatism, ISV, IVA and maximum invasion depth of pterygium were positively correlated with whole-eye astigmatism at 1 mo after surgery(rs=0.317, P=0.041; rs=0.545, P<0.001; rs=0.448, P=0.003; rs=0.389, P=0.011; rs=0.382, P=0.013; rs=0.391, P=0.010). The decision tree algorithm screened out two influential factors: the maximum invasion depth of pterygium into the cornea and preoperative whole-eye astigmatism. The risk of whole-eye astigmatism >0.50 D at 1 mo after operation was higher with maximum invasion depth of pterygium into the cornea >95 μm than that with ≤95 μm. Among the patients with whole-eye astigmatism >2.63 D before operation, the probability of residual whole-eye astigmatism >0.50 D was 88.9%, and the predictive model AUC was 0.804.CONCLUSION: The whole-eye astigmatism after pterygium resection is mainly affected by the maximum invasion depth of pterygium into the cornea and preoperative whole-eye astigmatism. When the maximum invasion depth of pterygium into the corneal is >95 μm and the whole-eye stigmatism is >2.63 D before surgery, the patient should receive surgical treatment as soon as possible in order to obtain good clinical benefits.

Neuropathic pain, often featuring allodynia, imposes significant physical and psychological burdens on patients, with limited treatments due to unclear central mechanisms. Addressing this challenge remains a crucial unsolved issue in pain medicine. Our previous study, using protein kinase C gamma (PKCγ)-tdTomato mice, highlights the spinal feedforward inhibitory circuit involving PKCγ neurons in gating neuropathic allodynia. However, the regulatory mechanisms governing this circuit necessitate further elucidation. We used diverse transgenic mice and advanced techniques to uncover the regulatory role of the descending serotonin (5-HT) facilitation system on spinal PKCγ neurons. Our findings revealed that 5-HT neurons from the rostral ventromedial medulla hyperpolarize spinal inhibitory interneurons via 5-HT_2C receptors, disinhibiting the feedforward inhibitory circuit involving PKCγ neurons and exacerbating allodynia. Inhibiting spinal 5-HT_2C receptors restored the feedforward inhibitory circuit, effectively preventing neuropathic allodynia. These insights offer promising therapeutic targets for neuropathic allodynia management, emphasizing the potential of spinal 5-HT_2C receptors as a novel avenue for intervention.
Animals ; Neuralgia/physiopathology* ; Protein Kinase C/metabolism* ; Receptor, Serotonin, 5-HT2C/metabolism* ; Hyperalgesia/physiopathology* ; Mice, Transgenic ; Mice ; Spinal Cord/metabolism* ; Serotonin/metabolism* ; Male ; Neurons/metabolism* ; Mice, Inbred C57BL

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

Neutrophil extracellular traps(NETs)are net-like complexes released by neutrophils and play a crucial role in antimicrobial defense. In addition, NETs can exacerbate inflammatory responses associated with various diseases, including diabetes, cardiovascular diseases, and autoimmune diseases. Currently, the role of NETs in ocular diseases has received extensive attention. This article systematically summarizes the formation mechanism of NETs and their role in maintaining intraocular homeostasis under physiological conditions. At the same time, it focuses on elaborating the pathogenic role of NETs in the field of ophthalmic diseases, such as dry eye, keratitis, uveitis, diabetic retinopathy, retinal vein occlusion, and age-related macular degeneration, emphasizing the importance of NETs as therapeutic targets for ocular diseases and the potential application value as new markers for ocular diseases. Future in-depth research on the mechanism of NETs in ocular diseases will provide a stronger theoretical basis for the treatment of related eye diseases.

Retinitis pigmentosa(RP)is an inherited retinal degenerative disease characterized by progressive photoreceptor cell degeneration, in which cataract—a common complication—significantly affects visual prognosis. Currently, phacoemulsification with intraocular lens implantation has become the main treatment for RP complicated with cataract. However, postoperative complications such as posterior capsular opacification, capsular contraction syndrome, intraocular lens dislocation, and macular edema occur at considerably higher rates in these patients, severely compromising the long-term outcomes of cataract surgery. Based on the latest clinical evidence, this review systematically elaborates on the clinical characteristics of RP with cataract, key perioperative surgical considerations, and recent advances in the prevention and management of complications, aiming to optimize the surgical approach, improve postoperative visual quality, and enhance long-term efficacy for RP patients, thereby providing an evidence-based medical reference.

OBJECTIVE: To investigate the clinical effect of minimally invasive technique in the treatment of moderate and severe gluteal muscle contracture. METHODS: A retrospective study was conducted on 85 patients (170 sides) with bilateral gluteal muscle contracture admitted from January 2016 to December 2019. All patients were treated with minimally invasive release of tendon knife. There were 32 males and 53 females, ranging in age from 15 to 37 years old, with an average age of (22.3±6.3) years old. Operation time, intraoperative blood loss, incision length, first postoperative ambulation time, complication rate, recurrence rate, and Harris hip score (HHS) were analyzed and evaluated. RESULTS: The average follow-up time was (16.2±4.6) months, ranging from 12 to 30 months. The operation time ranged from 7 to 15 min, with an average of (10.2±3.1) min. Intraoperative blood loss ranged from 2 to 20 ml, with an average of (8.4±2.2) ml. The incision length ranged from 0.6 to 2.0 cm, with an average of (0.8±0.3) cm. The time to postoperative ambulation ranged from 12 to 28 h, with an average of (20.0±3.2) h. All patients achieved primary wound healing without sciatic nerve injury or recurrence. HHS hip function scores ranged from 90 to 98, with an average score of (96.2±1.4). Complications included intraoperative tendon blade tip fracture in two cases (removed under fluoroscopic guidance) and subcutaneous hematoma in three cases-two resolved with compression and one with open evacuation.. Twenty-nine patients exhibited transient swaying gait postoperatively, of which 24 patients returned to normal after 4 weeks and 5 patients returned to normal after 6 weeks. CONCLUSION Minimally invasive tendon blade release is a safe and effective technique for treating gluteal muscle contracture, offering minimal trauma, rapid recovery, and excellent cosmetic and functional outcomes. However, it exhibits a low risk of blade tip fracture and sciatic nerve injury, warranting experienced surgical handling.
Humans ; Male ; Female ; Adult ; Minimally Invasive Surgical Procedures/methods* ; Adolescent ; Retrospective Studies ; Buttocks/surgery* ; Young Adult ; Contracture/surgery* ; Tendons/surgery* ; Muscle, Skeletal/surgery*

[Objective] To evaluate the value of X-ray combined with MRI in the diagnosis of rotator cuff injury. [Methods] A retrospective study was conducted on the patients who underwent X-ray and MRI examinations at the First Affiliated Hospital of Air Force Medical University from January 2021 to March 2022. A total of 158 patients were recruited, among whom 146 had rotator cuff injury, 10 had rheumatoid arthritis, and 2 had shoulder joint space occupation. We compared the specificity, sensitivity, consistency, detection rate, missed diagnosis rate and misdiagnosis rate of various examinations, and compared the X-ray and MRI examination results. [Results] The sensitivity and specificity of X-ray for rotator cuff injury were 65.8% and 41.7%, those of MRI for rotator cuff injury were 78.1% and 66.7%, and those of the combined diagnosis were 93.8% and 83.3%, respectively. The Kappa value of the combined diagnosis of rotator cuff injury and surgical results was higher than that of X-ray and MRI diagnosis (P<0.05). The detection rate and missed diagnosis rate of the three groups differed significantly (χ²=6.095, 13.113, P<0.05). The detection rate of rotator cuff injury by the combined diagnosis was higher than that of X-ray and MRI diagnosis, and the missed diagnosis rate was lower than that of the latter (P>0.05). [Conclusion] The detection rate of rotator cuff injury of shoulder joint by the combined examination is higher than that of X-ray and MRI, and the rate of missed diagnosis and misdiagnosis is lower. The combined examination can provide detailed evaluation for preoperative diagnosis.

BACKGROUND: Cutaneous wound healing represents a common fundamental phenomenon requiring the participation of cells of distinct types and a major concern for the public. Evidence has confirmed that photobiomodulation (PBM) using near-infrared (NIR) can promote wound healing, but the cells involved and the precise molecular mechanisms remain elusive. METHODS: Full-thickness skin defects with a diameter of 1.0 cm were made on the back of rats and randomly divided into the control group, 10 J, 15 J, and 30 J groups. The wound healing rate at days 4, 8, and 12 postoperatively was measured. HE and Masson staining was conducted to reveal the histological characteristics. Immunofluorescence staining was performed to label the epidermal stem cells (ESCs) and hair follicle stem cells (HFSCs). Western blot was performed to detect the expressions of proteins associated with ESCs and HFSCs. Cutaneous wound tissues were collected for RNA sequencing. Gene ontology and the Kyoto Encyclopedia of Genes and Genomes analysis was performed, and the hub genes were identified using CytoHubba and validated by qRT-PCR. RESULTS: PBM can promote reepithelialization, extracellular matrix deposition, and wound healing, increase the number of KRT14+/PCNA+ ESCs and KRT15+/PCNA+ HFSCs, and upregulate the protein expression of P63, Krt14, and PCNA. Three hundred and sixty-six differentially expressed genes (DEGs) and 7 hub genes including Sox9, Krt5, Epcam, Cdh1, Cdh3, Dsp, and Pkp3 were identified. These DEGs are enriched in skin development, cell junction, and cadherin binding involved in cell–cell adhesion etc., while these hub genes are related to skin derived stem cells and cell adhesion. CONCLUSION PBM accelerates wound healing by enhancing reepithelialization through promoting ESCs and HFSCs proliferation and elevating the expression of genes associated with stem cells and cell adhesion. This may provide a valuable alternative strategy to promote wound healing and reepithelialization by modulating the proliferation of skin derived stem cells and regulating genes related to cell adhesion.

Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

AIM: To evaluate the neutrophil-to-lymphocyte ratio(NLR)in patients with retinitis pigmentosa(RP)complicated with cataract, and to explore its correlation with the clinical characteristics of RP patients complicated with cataract.METHODS: The retrospective study included 79 RP patients(125 eyes)complicated with cataract who received cataract surgery at our hospital from January 2008 to December 2018, among which 63 cases(63 eyes)were finally enrolled in the RP complicated with cataract group after the exclusion of patients with early age of onset. Another 63 age- and sex-matched patients(63 eyes)with age-related cataract(ARC)who had cataract surgery during the same period in our hospital were enrolled in the ARC group. The clinical data and NLR were collected, and the correlation of clinical manifestations with NLR in RP patients complicated with cataract was analyzed.RESULTS: The NLR in RP patients complicated with cataract was significantly higher than that in the ARC group [1.79(1.32, 2.27)vs 1.58(1.32, 1.98), P=0.032]. NLR was associated with the severity of posterior subcapsular cataract(PSC), zonular deficiency, and preoperative best-corrected visual acuity(>1 LogMAR). Receiver operating curve showed that NLR ≥1.36 could predict higher degrees(>P1)of RP complicated PSC(AUC=0.803, 95%CI 0.672-0.934, P=0.002), NLR ≥2.12 could predict zonular weakness in RP patients complicated with cataract(AUC=0.796, 95%CI 0.665-0.928, P=0.002), while NLR ≥1.51 could predict RP patients with worse preoperative BCVA(AUC=0.667, 95%CI 0.540-0.793, P=0.015).CONCLUSION: NLR in RP patients complicated with cataract is significantly higher than that in ARC patients, and it is correlated with the clinical manifestations of RP patients with cataract. NLR can be used as a potential predictor to evaluate the severity of clinical manifestations of RP complicated with cataract.