With the advent of the refractive era of cataract surgery, postoperative residual refractive error has become a key factor affecting visual quality. The accuracy of intraocular lens(IOL)power calculation is affected by multiple factors, including ocular biological parameters, calculation formulas, and lens constants. Currently, the lens constants widely used in clinical practice are mostly based on Western populations, which have a mismatch with the ocular characteristics of the Chinese population, such as shorter axial length and steeper cornea. Therefore, the personalized optimization of the constant has become a research hotspot. This review primarily summarizes the research progress on lens constant optimization in improving the accuracy of IOL power calculation. Currently, there is no consensus on lens constant optimization methods. Single-constant formulas can be optimized through iterative methods, while multi-constant formulas require the combination of linear or nonlinear strategies. Simplified gradient descent and data-driven techniques offer new optimization pathways, but cross-validation is needed to evaluate their performance. Segmented optimization based on axial length, corneal curvature, and anterior chamber depth has shown significant effectiveness in patients with special anatomical structures, effectively reducing postoperative refractive errors in different patient groups, but limitations remain in some extreme cases. The interaction of multiple parameters significantly impacts the predictive accuracy of complex cases. While new-generation formulas integrating multiple parameters or incorporating AI algorithms have improved accuracy, constant optimization still holds value. Currently, the complex relationships between multiple parameters and intraoperative dynamic changes require further in-depth research. Future research, including targeted population optimization studies, the development of real-time monitoring technologies, and innovative IOL designs, may make achieving zero postoperative refractive error a possibility.

Objective To explore the effects of air pressure, humidity, wind, and sunshine on the incidence of cardiovascular and cerebrovascular diseases (CVD) in Guiyang, and to provide reference for the prevention of CVD. Methods Using CVD incidence data from September 2021 to August 2022 in Guiyang City and meteorological data including average air pressure, average humidity, wind, and sunshine during the same period, the effects of meteorological factors on CVD incidence were explored and the importance of each factor was analyzed. Results When air pressure was below 868 hPa, above 887 hPa, or between 877 and 883 hPa, and when air pressure dropped less than 5.3 hPa within 24 hours, there was a higher risk of CVD. When the humidity was above 81%, the wind speed was small (<1.2 m/s) or high (>4m/s), and there was less sunlight (less than 3 hours), the risk of CVD was higher. Low humidity (<60%) was not conducive to the onset of CVD. There were highest risks at lag 5~10 days and 4-25 days for high pressure and low sunlight, respectively. When the relative humidity was saturated, there was an immediate effect. When the wind speed was low and high, the immediate effect and hysteresis effects were significant. Among the above meteorological factors, the impact of 24-hour variation of pressure and high or low atmospheric pressure on the incidence of CVD was the most significant, while the impact of sunlight and humidity was the weakest. The impact of diurnal variations in wind and atmospheric pressure was not clear. Conclusion The impact of air pressure on the incidence of CVD does not exhibit a simple linear relationship. The risk of CVD is high in high humidity, low light, and moderate or strong winds. It is necessary to fully consider changes in meteorological factors for CVD prevention and control.

The ancient space-time integration view is the ideological basis for the construction of the Chinese civilization system.As an important part of Chinese civilization,traditional Chinese medicine(TCM)combines the ancient space-time view with the human body to form a space-time view of TCM that unifies time,space and human body.The space-time integration view of"nine palaces and eight winds"as an early prototype of the space-time view of TCM is the basis for the formation and development of the space-time theory of TCM in later generations.Combining ancient and modern literature,this paper explores the formation,character-istics and application of the space-time integration view of"nine palaces and eight winds".The study found that the formation of this TCM time-space integration view is related to the ancient astronomical calendar for observing phenomena and telling time,the ancients' understanding of the time-space attributes of the human body and"wind",and the"nine palaces and eight winds"time-space view has the characteristics of combining Tao,numbers,and images,dynamics,and predictability,and it promotes the develop-ment of TCM and the inheritance of Chinese culture.

Objective To quantitatively assess the correlation between the skeletal muscle index(SMI)of patients and the occur-rence of anastomotic leakage(AL)in rectal cancer patients after surgery,and to analyze the risk factors for AL in rectal cancer patients and the influencing factors of sarcopenia.Methods The clinical,pathological,and related imaging data of 362 patients who under-went radical surgery for rectal cancer were retrospectively analyzed.All patients underwent pelvic MRI and abdominal CT scans(plain/enhanced)within one month before surgery,and the third lumbar vertebra skeletal muscle area(L3-SMA)was measured from the images.All patients were divided into AL group(56 cases)and control group(306 cases)based on the presence or absence of postoperative complications.The differences in clinical characteristics and imaging parameters between the two groups were analyzed.A logistic risk prediction model was established.Results Significant differences were observed between the two groups in sarcopenia,type of surgery,surgical approach,serum albumin level,operation duration,stoma type,and extramural vascular invasion(EMVI)(P＜0.05).These factors were incorporated in a multivariate logistic regression analysis model,the area under the curve(AUC)of receiver operating characteristic(ROC)curve of the model was 0.810[95％confidence interval(CI)0.743-0.876,P＜0.001],with a sensitivity of 0.865 and specificity of 0.669.Conclusion Sar-copenia is a significant risk factor for AL after rectal cancer surgery.It enhances the predictive efficacy for postoperative AL and serves as a basis for identifying high-risk populations for AL in clinical practice.

Purpose To develop and validate a nomogram incorporating high-resolution MRI and clinicopathological indicators for predicting distant metastasis after curative resection of mid-low rectal cancer.Materials and Methods This retrospective study analyzed 219 patients with pathologically confirmed mid-low rectal cancer from Tianjin Union Medical Center(December 2016 to December 2021).Patients were categorized into metastasis(n=46)and non-metastasis(n=173)groups based on postoperative distant metastasis occurrence.All patients underwent preoperative pelvic MRI with measurement of posterior mesangial thickness(PMT),mesentery fat area(MFA)and mesenteric fascia envelopment volume(MFEV)on high-resolution T2WI.Clinicopathological and imaging data were collected.Cox proportional hazards model identified predictive factors for distant metastasis,and a risk probability nomogram was constructed.Predictive performance,goodness-of-fit and clinical applicability were evaluated.Results Kaplan-Meier analysis demonstrated significantly higher distant metastasis risk in patients with PMT≤1.43 cm,MFA≤19.31 cm2 and MFEV≤137.46 cm3 compared to those with higher values(χ2=29.07,8.71,19.05;all P<0.05).Cox regression identified tumor differentiation(HR=0.536,95％CI 0.290-0.990),pathological N stage(HR=0.397,95％CI 0.210-0.747),perirectal structure invasion(HR=0.242,95％CI 0.068-0.865)and PMT(HR=0.334,95％CI 0.168-0.664)as independent predictors.The nomogram achieved a concordance index of 0.775 with good calibration.Decision curve analysis demonstrated substantial net benefit across wide probability thresholds,indicating excellent clinical applicability.Conclusion Patients with PMT≤1.43 cm,MFA≤19.31 cm2 and MFEV≤137.46 cm3 exhibit elevated distant metastasis risk.The nomogram incorporating tumor differentiation,pathological N stage,perirectal structure invasion and PMT effectively predicts distant metastasis after curative resection of mid-low rectal cancer.

Myasthenia gravis(MG)is an autoimmune disease characterized primarily by skeletal muscle weakness and,in severe cases,respiratory involvement.Western medical treatment predominantly relies on immunosuppressants,but long-term administration often leads to notable side effects.In contrast,traditional Chinese medicine(TCM)offers the advantage of multi-target interventions.However,the pathogenesis of MG has not been fully elucidated,and the establishment of animal models that accurately reflect the clinical characteristics of both Chinese and Western medicine is essential for mechanism research and new drug development.This paper systematically reviews the etiology and pathogenesis,diagnostic criteria,and progress of animal model research for MG from both Chinese and Western medicine perspectives.In Western medicine,the pathogenesis of MG is closely related to genetic susceptibility,environmental factors,and autoantibody-mediated postsynaptic membrane damage.In TCM,MG is classified under the category of"flaccidity syndrome",attributed to congenital deficiencies and acquired malnourishment.Western diagnostic criteria involve a combination of clinical symptoms,fatigue testing,serum antibody assays,and electrophysiological evaluation.In contrast,TCM diagnosis emphasizes the integration of primary and secondary symptoms with tongue and pulse pattern differentiation.Currently available animal models mainly include experimental autoimmune myasthenia gravis(EAMG)and passive transfer myasthenia gravis(PTMG).The Toredo acetylcholine receptor(AChR)induced EAMG model aligns well with Western diagnostic criteria,but poorly matches secondary symptoms in TCM.The synthetic AChR peptide model is widely used,but shows low conformity with TCM syndromes.Models induced by muscle-specific tyrosine kinase(MuSK),low-density lipoprotein receptor-related protein 4(LRP4),and transgenic models demonstrate high innovation but exhibit low clinical conformity.Evaluation of these models requires integration of behavioral,electrophysiological,and immunological indicators.However,a systematic framework for modelling TCM syndromes is still lacking.Future research should integrate TCM-based etiological modelling methods with the Western pathological mechanisms to construct disease-syndrome combination models.Additionally,it is crucial to establish a TCM syndrome evaluation system based on"validation by prescription",as well as to improve the scientific rigor and practicality of animal models by the incorporation of emerging technologies.This review provides a theoretical foundation for optimizing MG animal model design,advancing the research on the combination of Chinese and Western medicine,and supporting efficacy assessment and mechanism exploration of Chinese herbal prescriptions.

It is proposed that the brain Xuanfu and the glymphatic system(GS)have commonality in physiological structure and similarity in functions such as transporting brain substances,transmitting brain information and clearing metabolites.It is believed that GS may be the substantial manifestation of the brain Xuanfu,and GS dysfunction is the key pathological link of depression.Xuanfu stagnation and Shenji dysfunction are the core pathogenesis of depression.Taking"Brain Xuanfu-GS"as the starting point,the patho-logical mechanism of depression is deeply explored,providing a theoretical basis for the clinical diagnosis and treatment of depression in traditional Chinese medicine.

[Objective]To explore the connotation of"liver corresponding to dampness evil"in Lingshu·Jiugong Bafeng.[Methods]Based on the analysis of the original text of Lingshu·Jiugong Bafeng,the mechanisms for the"liver corresponding to dampness evil"were explored through the collection and collation of relevant ancient and modern literature,Combine with modern clinical application,and the clinical prevention and treatment of"dampness injury caused by the abnormal liver Qi"was analyzed in combination with modern clinical application.[Results]Through the analysis of the original text of Lingshu·Jiugong Bafeng,it can be seen that the text unifies time and space by describing the law of Taiyi marches in the nine palaces,reflecting the ancient unified view of time and space.Through describing the divination methods in the course of the tour,it is proposed that Taiyi tour will cause wind and rain,and the"wind"is divided into deficiency and excess,and the human body is connected with time and space through the deficient wind of eight directions,forming the early traditional Chinese medicine(TCM)view of time and space,which unifies time,space and viscera.Liver corresponding to dampness evil,from the perspective of time and space,the spring and the east are corresponding to the liver,the spring is rainy,and the east is near the sea,which can make the eastern deficient wind and excessive moisture;in the autumn equinox in the west,it is easy to be attacked by the dampness of the eastern deficient wind,the western viscera should be the lung,and the eastern viscera should be the liver.From the perspective of the viscera,it is deficiency of the lung Qi,the liver Qi invading the lung,and the imbalance of Qi movement leads to the internal dampness,which leads to the external dampness invasion.According to the clinical application,the irregular liver Qi can cause the body to be injured by dampness.In the prevention and treatment process,it is necessary to regulate the liver,harmonize the liver and lung,take care of the spleen and stomach,comply with the four seasons,and nourish the body and spirit.[Conclusion]"Liver corresponding to dampness evil"in Lingshu·Jiugong Bafeng is related to the early TCM view of time and space reflected in the original text,which can be understood by combining time and space with organs.The unregulated liver Qi can cause the body to be harmed by dampness,it is necessary to regulate the liver,combined with regulating the lung,spleen and stomach,and obey the law of four seasons to nourish the body and spirit in the process of prevention and treatment.

Objective:To investigate the effect of pre-pregnancy body mass index (BMI) on the cumulative live birth rate (CLBR) and perinatal outcomes in women with polycystic ovary syndrome (PCOS) undergoing first in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI).Methods:The clinical data of 1 013 patients with PCOS who received first IVF/ICSI treatment in Reproductive Medicine Center, Henan Provincial People′s Hospital from January 2017 to June 2020 were retrospectively analyzed. According to BMI China standard, they were divided into: normal weight group (18.5≤BMI<24.0 kg/m 2, 388 cases), overweight group (24.0≤BMI<28.0 kg/m 2, 367 cases), obese group (BMI≥28.0 kg/m 2, 258 cases). The effect of BMI on CLBR was analyzed by univariate analysis, multivariate logistic regression analysis and smooth curve fitting. The role of homeostasis model assessment of insulin resistance index (HOMA-IR) in the process of BMI on CLBR was analyzed by mediation analysis. Results:Among three groups, female age, basal level of follicle stimulating hormone, type of infertility and ovulation induction regimens were similar (all P>0.05). The infertility duration, basal testosterone level, HOMA-IR, the ovulation induction time and the total gonadotropin dosage increased with BMI (all P<0.01), anti-Müllerian hormone, basal luteinizing hormone level, the number of retrieved oocytes and available embryos decreased with BMI (all P<0.05). CLBR decreased with BMI increasing [84.08% (301/358) vs 74.26% (251/338) vs 71.88% (161/224); P<0.001]. The incidence of hypertensive disorder in pregnancy was highest in obese group, while premature rupture of membranes rate, premature delivery rate, low birth weight rate and macrosomia birth rate were the lowest in normal weight group. After adjusting for confounding factors, both smooth curve fitting and multiple logistic regression analysis revealed a significant trend: CLBR declined with increasing BMI ( OR=0.93, 95% CI: 0.89-0.97; P=0.002), with a reduction of 41% ( OR=0.59, 95% CI: 0.39-0.91; P=0.020) in overweight group, and a reduction of 48% ( OR=0.52, 95% CI: 0.32-0.83; P=0.010) in obese group. HOMA-IR mediated the effect of BMI on CLBR by 27.5% ( P<0.05). Conclusions:High BMI before IVF/ICSI in PCOS patients negatively impacts CLBR and raises maternal and infant risks during pregnancy and the perinatal period. 27.5% of the effect of BMI on CLBR is mediated by HOMA-IR. Thus, PCOS patients should manage their BMI and enhance insulin sensitivity prior to pregnancy.

The ancient space-time integration view is the ideological basis for the construction of the Chinese civilization system.As an important part of Chinese civilization,traditional Chinese medicine(TCM)combines the ancient space-time view with the human body to form a space-time view of TCM that unifies time,space and human body.The space-time integration view of"nine palaces and eight winds"as an early prototype of the space-time view of TCM is the basis for the formation and development of the space-time theory of TCM in later generations.Combining ancient and modern literature,this paper explores the formation,character-istics and application of the space-time integration view of"nine palaces and eight winds".The study found that the formation of this TCM time-space integration view is related to the ancient astronomical calendar for observing phenomena and telling time,the ancients' understanding of the time-space attributes of the human body and"wind",and the"nine palaces and eight winds"time-space view has the characteristics of combining Tao,numbers,and images,dynamics,and predictability,and it promotes the develop-ment of TCM and the inheritance of Chinese culture.