Primary angiitis of the central nervous system （PACNS） is a rare immune-inflammatory disease confined to the small and medium blood vessels of the central nervous system， with unclear etiology and pathogenesis. The incidence of PACNS in the general population has not been accurately defined， and its clinical management is challenged by diagnostic difficulty， a high recurrence rate，and limited evidence supporting therapeutic interventions. The disease predominantly occurs in people aged 40‒60 years，with headache， cognitive impairment， and neurological deficits as the main clinical manifestations， which are non-specific.There are no characteristic indicators in laboratory tests， and cerebrospinal fluid examination can only rule out infection.Imaging findings include multiple infarctions and segmental vascular stenosis. Brain tissue biopsy is the gold standard for diagnosis. Clinically， the Calabrese and Mallek diagnostic criteria are often used， combined with supplementary criteria for stratified diagnosis. Treatment is based on glucocorticoids， with stratified induction， maintenance， and intensive therapy according to the type of involved blood vessels and disease severity， combined with immunosuppressants such as cyclophosphamide and mycophenolate mofetil. Biologics may be considered for refractory or recurrent cases.Long-term immunosuppressive therapy may reduce the risk of recurrence. Antiplatelet drugs， thrombolysis， and endovascular therapy can be used as needed. Currently， the diagnosis and treatment of PACNS still rely on diagnosis of exclusion and expert consensus，lacking high-level evidence.Future efforts should focus on exploring specific diagnostic markers and precise treatment regimens to promote standardized diagnosis and treatment.

AIM: To assess the consistency of the new anterior segment analyzer, MS-39, the Sirius and Pentacam in measuring corneal white-to-white(WTW)and central anterior chamber depth(ACD), and to compare their differences in guiding implantable collamer lens(ICL)size selection.METHODS: Retrospective case study. A total of 210 consecutive patients(420 eyes)who treated at the Ophthalmology Refractive Surgery Center of the First Affiliated Hospital of Xi'an Jiaotong University between September 2019 and September 2020 were enrolled. Three anterior segment analysis systems, MS-39, Sirius, and Pentacam, were utilized to assess the WTW and ACD, with comparative analysis of the results. The sizing of the ICL V4c was simulated using the method recommended by the STAAR company. Data correlation and consistency were evaluated.RESULTS: The WTW measurement results obtained from MS-39, Sirius, and Pentacam were 11.39±0.35, 11.42±0.36, and 11.46±0.35 mm, respectively. Notably, the WTW measurement value from MS-39 was significantly lower than that from Pentacam(P=0.002), while no statistically significant differences were observed between MS-39 and Sirius, or between Sirius and Pentacam(all P>0.05). The WTW measurements from the three devices exhibited a strong positive correlation, with correlation coefficients(r)of 0.942 between MS-39 and Sirius, 0.925 between MS-39 and Pentacam, and 0.882 between Sirius and Pentacam(all P<0.0001). The ACD measurements values from the MS-39, Sirius and Pentacam were 3.28±0.22, 3.28±0.24, and 3.21±0.23 mm, respectively. While, no statistically significant difference was found between MS-39 and Sirius(P>0.05), both measurements were significantly higher than that of Pentacam(both P<0.0001). The ACD measurements also demonstrated a strong positive correlation, with r values of 0.959 between MS-39 and Sirius, 0.947 between MS-39 and Pentacam, and 0.932 between Sirius and Pentacam(all P<0.0001). In terms of ICL size selection based on the measurements from the three devices, the 12.6 mm size was the most frequently selected, while the 13.7 mm size was the least common, the distribution of size selections across the devices was similar.CONCLUSION: MS-39 demonstrated strong positive correlation with both Sirius and Pentacam for WTW and ACD measurements, indicating that the results can be considered clinically interchangeable. Furthermore, the outcomes derived from MS-39 for ICL size selection were closely aligned with those from Sirius and Pentacam, suggesting its clinical feasibility.

AIM: To observe the clinical outcomes of Phorcides analytic engine-assisted topography-guided personalized laser assisted in situ keratomileusis(LASIK)for the treatment of myopia and astigmatism in virgin eyes with the refractive astigmatism significantly deviating from corneal topography.METHODS: Retrospective clinical study. A total of 32 cases(42 eyes)with myopia and astigmatism that received corneal topography-guided personalized LASIK in the Ophthalmology Refractive Surgery Center of the First Affiliated Hospital of Xi'an Jiaotong University from December 2019 to March 2021 were selected. The uncorrected distance visual acuity(UDVA), best corrected distance visual acuity(CDVA), refractive state and aberrations before and at 6 mo after surgery were recorded.RESULTS: There were 15 males and 17 females, with an age of 23.00(18.00, 29.25)years old; preoperative sphere was -5.75(-6.25, -4.00)D, and cylinder was -0.75(-1.38, -0.25)D. At 6 mo postoperatively, the UDVA exceeded the preoperative CDVA in 19 eyes(45%). The spherical equivalent(SEQ)of all eyes(100%)was -0.50 to +0.50 D at 6 mo postoperatively, and the postoperative SEQ of 23 eyes(55%)was -0.13 to +0.13 D. There were 33 eyes(79%)had a postoperative astigmatism ≤ 0.25 D, the target-induced astigmatism(TIA)was 0.94±0.96 D, and the surgically induced astigmatism(SIA)was 0.94±0.86 D, with no statistical significance between TIA and SIA(P>0.05). The astigmatism axial deviation ranged from -5° to +5° in 33 eyes(79%)at 6 mo postoperatively. Compared to pre-operation, the total higher-order aberrations and spherical aberrations within the central 6 mm diameter of the anterior corneal surface increased at 6 mo postoperatively(Z=-3.778, P<0.001; Z=-4.929, P<0.001); the postoperative coma aberrations had no change(Z=-1.763, P=0.078); the postoperative trefoil aberrations decreased(Z=-2.490, P=0.013). Compared to pre-operation, the Strehl ratio of the anterior corneal surface increased significantly at 6 mo after surgeries(t=-5.401, P=0.013).CONCLUSION: Using the Phorcides analytic engine to assist topography-guided personalized LASIK for the treatment of myopia and astigmatism in virgin eyes with the refractive astigmatism significantly deviating from topography-measured astigmatism can achieve good therapeutic effects. Postoperative UDVA exceeded preoperative CDVA in nearly half of the eyes, and the quality of postoperative corneal imaging was improved.

BACKGROUND:The stiffness of muscle fibers and tendons within skeletal muscles is regulated by the neuromuscular system and remains variable.However,observing the mechanical properties of muscle fibers and tendons during complex multi-joint movements is challenging,and the real-time variation patterns of their stiffness are not yet clear.OBJECTIVE:Taking the open-access simulation data of triceps surae at different running speeds and gait phases as an example,to explore the real-time stiffness change rules of muscle fiber stiffness and tendon stiffness.METHODS:OpenSim simulation results of muscle fiber activation,length,velocity parameters,and tendon length parameters of the triceps surae in five long-distance runners at different running speeds were collected from the Website of Stanford University.The instantaneous slope of the force-length relationship curve of muscle fibers and tendons in the Hill-Zajac muscle model used in the simulation was extracted as the real-time stiffness of the triceps surae muscle fibers and tendons.The temporal changes of stiffness indicators of muscle fibers and tendons during gait were analyzed.RESULTS AND CONCLUSION:The regulation of muscle fiber activation-length-velocity status and tendon strain resulted in the stiffness of muscle fibers and tendons changing in the same trend as the applied force.Compared with lower running speeds,the stiffness of the gastrocnemius muscle fibers was higher in the early support phase at higher running speeds(P ≤ 0.01),and the tendon stiffness of the medial head of the gastrocnemius was higher in the early support phase(P≤ 0.02).The stiffness of the gastrocnemius muscle fibers and tendons was lower from the mid-support to the mid-swing phase(P≤ 0.03),and the stiffness of the soleus muscle fibers was higher during the support phase(P ≤ 0.02).Under all running speeds,the stiffness of the triceps surae muscle fibers and tendons showed a trend of being higher during the support phase than during the pre-swing phase(P ≤ 0.03),and the stiffness of the gastrocnemius muscle fibers and tendons increased again in the late swing phase(P ≤ 0.05).These findings indicate that increasing running speed can increase the stiffness of triceps surae muscle fibers and tendons during the stance phase;when running speed and gait phase change,gastrocnemius and soleus muscles have different patterns of muscle fiber and tendon stiffness changes,whereas gastrocnemius can increase its muscle fiber stiffness and tendon stiffness in the late swing phase through pre-activation phenomenon.

Objective To explore limb coordination patterns and energy flow strategies during the sit-to-stand(STS)transition in individuals with patellofemoral pain(PFP),so as to provide a theoretical evidence for the pathogenesis of PFP and subsequent formulation of treatment and rehabilitation strategies for PFP patients.Methods A totoal of 36 participants was recruited for the STS test.They were divided into the unilateral PFP group(unilateral group),bilateral PFP group(bilateral group),and control group,based on the number of limbs affected by PFP.An infrared motion capture system and a three-dimensioanl force plate were used for motion capture.Visual 3D and Matlab software were used to calculate the trunk and pelvis angles,angular velocities,linear velocities,and proximal and distal joint forces.Additionally,the angles,torques,and joint forces of the hip,knee,and ankle joints,along with the angular and linear velocities of the thigh and shank,were computed.Coupling angles was used to represent coordination patterns via vector coding;the segmental net energy integration method was used to calculate energy flow within segments at each stage.Results For the coordination pattern at frontal plane,the proximal coordination mode frequency of the pelvis-hip coordination in the flexion momentum phase(FMP)was higher in unilateral group than that in bilateral group(P=0.024).In the momentum transfer phase(MTP),the frequency of in-phase coordination in the trunk-pelvis coordination was higher in unilateral group than that in bilateral group(P=0.023),while the frequency of distal coordination was higher in control group than in that in unilateral group(P=0.032).For the knee-ankle coordination pattern,the frequency of distal coordination in control group was lower than that in unilateral and bilateral groups(P=0.025,P=0.005).In segmental energy flow,during the FMP,the energy output from the pelvis during extension phase(MP)was higher in bilateral group than that in control group(P=0.021).Conclusions PFP affects energy flow patterns and coordination patterns at frontal plane during the STS transition.Individuals in unilateral group may engage in lateral pelvic and ankle movements as a dynamic compensation for patellofemoral joint pressure,whereas individuals in bilateral group appear to increase pelvic region energy output and employ a more complex whole-body coordination pattern to compensate for functional deficits in the knee caused by PFP.

Objective To explore limb coordination patterns and energy flow strategies during the sit-to-stand(STS)transition in individuals with patellofemoral pain(PFP),so as to provide a theoretical evidence for the pathogenesis of PFP and subsequent formulation of treatment and rehabilitation strategies for PFP patients.Methods A totoal of 36 participants was recruited for the STS test.They were divided into the unilateral PFP group(unilateral group),bilateral PFP group(bilateral group),and control group,based on the number of limbs affected by PFP.An infrared motion capture system and a three-dimensioanl force plate were used for motion capture.Visual 3D and Matlab software were used to calculate the trunk and pelvis angles,angular velocities,linear velocities,and proximal and distal joint forces.Additionally,the angles,torques,and joint forces of the hip,knee,and ankle joints,along with the angular and linear velocities of the thigh and shank,were computed.Coupling angles was used to represent coordination patterns via vector coding;the segmental net energy integration method was used to calculate energy flow within segments at each stage.Results For the coordination pattern at frontal plane,the proximal coordination mode frequency of the pelvis-hip coordination in the flexion momentum phase(FMP)was higher in unilateral group than that in bilateral group(P=0.024).In the momentum transfer phase(MTP),the frequency of in-phase coordination in the trunk-pelvis coordination was higher in unilateral group than that in bilateral group(P=0.023),while the frequency of distal coordination was higher in control group than in that in unilateral group(P=0.032).For the knee-ankle coordination pattern,the frequency of distal coordination in control group was lower than that in unilateral and bilateral groups(P=0.025,P=0.005).In segmental energy flow,during the FMP,the energy output from the pelvis during extension phase(MP)was higher in bilateral group than that in control group(P=0.021).Conclusions PFP affects energy flow patterns and coordination patterns at frontal plane during the STS transition.Individuals in unilateral group may engage in lateral pelvic and ankle movements as a dynamic compensation for patellofemoral joint pressure,whereas individuals in bilateral group appear to increase pelvic region energy output and employ a more complex whole-body coordination pattern to compensate for functional deficits in the knee caused by PFP.

BACKGROUND:The stiffness of muscle fibers and tendons within skeletal muscles is regulated by the neuromuscular system and remains variable.However,observing the mechanical properties of muscle fibers and tendons during complex multi-joint movements is challenging,and the real-time variation patterns of their stiffness are not yet clear.OBJECTIVE:Taking the open-access simulation data of triceps surae at different running speeds and gait phases as an example,to explore the real-time stiffness change rules of muscle fiber stiffness and tendon stiffness.METHODS:OpenSim simulation results of muscle fiber activation,length,velocity parameters,and tendon length parameters of the triceps surae in five long-distance runners at different running speeds were collected from the Website of Stanford University.The instantaneous slope of the force-length relationship curve of muscle fibers and tendons in the Hill-Zajac muscle model used in the simulation was extracted as the real-time stiffness of the triceps surae muscle fibers and tendons.The temporal changes of stiffness indicators of muscle fibers and tendons during gait were analyzed.RESULTS AND CONCLUSION:The regulation of muscle fiber activation-length-velocity status and tendon strain resulted in the stiffness of muscle fibers and tendons changing in the same trend as the applied force.Compared with lower running speeds,the stiffness of the gastrocnemius muscle fibers was higher in the early support phase at higher running speeds(P ≤ 0.01),and the tendon stiffness of the medial head of the gastrocnemius was higher in the early support phase(P≤ 0.02).The stiffness of the gastrocnemius muscle fibers and tendons was lower from the mid-support to the mid-swing phase(P≤ 0.03),and the stiffness of the soleus muscle fibers was higher during the support phase(P ≤ 0.02).Under all running speeds,the stiffness of the triceps surae muscle fibers and tendons showed a trend of being higher during the support phase than during the pre-swing phase(P ≤ 0.03),and the stiffness of the gastrocnemius muscle fibers and tendons increased again in the late swing phase(P ≤ 0.05).These findings indicate that increasing running speed can increase the stiffness of triceps surae muscle fibers and tendons during the stance phase;when running speed and gait phase change,gastrocnemius and soleus muscles have different patterns of muscle fiber and tendon stiffness changes,whereas gastrocnemius can increase its muscle fiber stiffness and tendon stiffness in the late swing phase through pre-activation phenomenon.

Objective:To understand the health status,influencing factors and spatial distribution of the Chinese floating population and to evaluate the health equity of the floating population.Methods:All the data were collected from the 2017 Migrant Population Dynamic Monitoring Survey in China,binary Logistic regression was used to analyze the factors that might affect the health of the floating population,and the concentration index method was used to evaluate the health equity of the floating population.Spa-tial autocorrelation analyses the spatial aggregation of health status and health equity.Results:The un-healthy rate of the floating population in China was 2.71％.Age and gender show a statistically signifi-cant impact on self-rated health;that is,as age increases,the self-rated health of the migrant population gradually deteriorates,and women are more likely to think that they are unhealthy.Fairness analysis shows that the concentration index of the floating population is 0.021 7,the urban household registration floating population is 0.021 6,and the rural household registration floating population is 0.021 9.It is shown that the fairness of the health status of the floating population is biased towards the high-income class,and the rural household registration floating population's health unfairness is greater than that of the urban household registration migration population.Moreover,Moran's i=0.211 for self-rated health and Moran's i=0.291 for the unhealthy rate indicate that self-rated health has a spatial aggregation trend.Moran's i=0.136 showed the characteristics of spatial clustering,and the two-week prevalence fairness of the floating population was mainly in the northern and southeastern coastal areas.Conclusion:In general,the health status of the floating population in China is relatively good.The main influencing factors of health included gender and age.The central tendency of health inequity is reflected in the south-east coastal and northern regions,which are characterized by poverty.Attention to spatial aggregation is not only helpful to analyze the reasons of floating population,but also to study the health differences between different regions and health-related factors,to improve the overall health level of the whole population.

Objective:To explore the short-term clinical efficacy, safety and patients' prognostic influencing factors of CyberKnife for the treatment of brain metastases in non-small cell lung cancer (NSCLC).Methods:A retrospective case series study was conducted. The clinical data of 58 NSCLC patients who received CyberKnife treatment for brain metastases at Jilin Cancer Hospital from July 2020 to January 2022 were retrospectively analyzed. At 3 months after CyberKnife treatment for brain metastases, and the efficacy of radiotherapy was evaluated on the basis of changes of brain metastases detected by contrast-enhanced magnetic resonance imaging (MRI) of the head. Overall survival (OS) and local recurrence-free survival (LRRFS) were analyzed in 58 patients by using the Kaplan-Meier method; the efficacy of cumulative brain metastasis volume for determining the survival of CyberKnife-treated NSCLC patients with brain metastases was analyzed by using the receiver operating characteristic (ROC) curve with the survival status of patients during the follow-up period as the gold standard, and the optimal cut-off value of cumulative brain metastasis volume was obtained; the clinical factors affecting OS and LRRFS of CyberKnife-treated NSCLC patients with brain metastases were analyzed by univariate and multivariate Cox proportional hazards models, and the adverse reactions associated with CyberKnife treatment were evaluated.Results:Among the 58 patients, 26 (44.8%) were male and 32 (55.2%) were female, with a median age [ M ( Q1, Q3)] of 64 years old (56 years old, 70 years old); there were 1-7 brain metastatic lesions in each patient, and there were 98 brain metastatic lesions in the 58 patients. There were 2 deaths (3.4%) within 3 months after CyberKnife treatment. At 3 months after treatment, there were 3 cases (5.4%) in complete remission, 36 cases (64.3%) in partial remission, 13 cases (23.2%) in stable disease, and 4 cases (7.1%) in disease progression in the remaining 56 patients. ROC curve analysis showed that the area under the curve for determining the survival of CyberKnife-treated NSCLC patients with brain metastases based on the cumulative brain metastasis volume was 0.593 (95% CI: 0.423-0.763), and the optimal cut-off value of cumulative brain metastasis volume was 15 cm 3. Median follow-up time was 12.6 months (7.5 months, 17.9 months). The 6- and 12-month OS rates were 91.3% and 79.5%, respectively, and the 6- and 12-month LRRFS rates were 93.0% and 89.2%, respectively. Multivariate Cox regression analysis showed that the Karnofsky functional status score (>70 points vs. ≤70 points, HR= 0.103, 95% CI: 0.019-0.545, P = 0.007), control of extracranial tumor (controlled vs. uncontrolled, HR = 0.145, 95% CI: 0.049-0.429, P < 0.001), cumulative brain metastasis volume (≤15 cm 3vs. >15 cm 3, HR = 0.105, 95% CI: 0.028-0.399, P = 0.001) were independent influencing factors for poor OS, and the control of extracranial tumor (controlled vs. uncontrolled, HR = 0.062, 95% CI: 0.006-0.616, P = 0.018), cumulative brain metastasis volume (≤15 cm 3vs. >15 cm 3, HR = 0.440, 95% CI: 0.007-0.292, P = 0.001), and target area total bioequivalent dose (BED) (≤60 Gy vs. >60 Gy, HR = 5.299, 95% CI: 1.020-27.530, P = 0.047) were independent influencing factors for poor LRRFS. Only grade 1-2 headache [53.5% (31/58)], nausea and vomiting [36.2% (21/58)] and other adverse reactions occurred after treatment, and no ≥grade 3 adverse reactions occurred. Conclusions:CyberKnife treatment for NSCLC brain metastases has high local control rate and short-term survival rate with mild adverse effects. Karnofsky functional status score, control of extracranial tumor and cumulative brain metastasis volume may affect OS of CyberKnife-treated NSCLC patients with brain metastases, and the control of extracranial tumor, cumulative brain metastasis volume and total BED may affect local recurrence.