Objective To investigate the prognostic significance of the neutrophil-to-platelet ratio(NPR)in combination with C-reactive protein(CRP)in patients with lower extremity arteriosclerosis obliterans(ASO).Methods A retrospective analysis was conducted on the clinical data of 209 patients with lower extremity ASO admitted to the Department of Critical Care Medicine at Zhongshan Hospital Affiliated to Fudan University(Xiamen)between January 2020 and February 2024.Patients were categorized into either the survival group or the death group based on their in-hospital prognosis.The NPR was calculated on the day of ICU admission,as was the level of CRP.Differences in NPR,CRP,and the combination of NPR and CRP between the two groups were then com-pared.The prognostic value of NPR,CRP,and their combined use for predicting outcomes in patients with lower extremity ASO was evaluated using receiver operating characteristic(ROC)curve analysis.Based on the optimal cutoff value derived from the ROC curve for the combination of NPR and CRP,patients were divided into two groups.Kaplan-Meier survival analysis was subsequently performed to assess differences in survival outcomes between these two groups.Results The levels of NPR,CRP,alanine aminotransferase,aspartate aminotransferase,creatinine,B-type natriuretic peptide,troponin,and procalcitonin,as well as the proportion of patients with kidney disease in the survival group,were significantly lower than those in the death group,and the differences were statistically significant(P<0.05).The albumin level in the survival group was significantly higher than that in the death group,with a statistically significant difference(P<0.05).Binary logistic regression analysis revealed that NPR,CRP,the combination of NPR and CRP,and the presence of comorbid kidney disease were independent risk factors influencing patient survival prognosis.ROC curve analysis showed that the areas under the curve(AUC)for NPR,CRP,and the combination of NPR and CRP were 0.648,0.812,and 0.828,respectively.Both CRP and the combination of NPR and CRP demonstrated statistically significant(P<0.05).Compared with either NPR or CRP alone,their combined use showed improved predictive performance.Based on the ROC curve for the combination of NPR and CRP,the optimal cutoff value was determined as 0.029 using the maximum Youden Index.Patients were then divided into high and low NPR+CRP groups according to this cutoff.Kaplan-Meier sur-vival analysis revealed that the in-hospital survival rate in the low NPR+CRP group was significantly higher than that in the high NPR+CRP group,and the difference in survival between the two groups was statistically significant(P=0.001).Conclusion NPR combined with CRP is associated with the prognosis of patients with lower extremity ASO and may serve as an effective predictive indicator for their clinical outcomes.

Objective:To investigate the effect of monocular form deprivation (MD) during the pre-critical period of visual development on the density and morphology of dendritic spines in mouse primary visual cortex (V1) neurons.Methods:Twenty SPF male C57BL/6J mice with eyes opened on postnatal day 14 (P14) were selected and divided into MD and control groups using a random number table, with 10 mice in each group.The MD group was fed to P18 after 4 days of MD in the right eye, and the control group was raised to P18 under the same feeding conditions.All mice were decapitated after cardiac perfusion, and the sections were stained with the cell membrane fluorescent probe 1, 1′-dioctadecyl-3, 3′, 3′-tetramethylindocarbocyanine perchlorate, and imaged by laser scanning confocal microscopy to observe and compare the differences in density and morphology of dendritic spines in bilateral V1 neurons between the control group and the MD group.This study was approved by the Animal Ethics Committee of Tianjin Medical University (No.TMUaMEC2022004).Results:The total density of dendritic spines in the V1 area on the left side of the control group, the right side of the control group, the left side of the MD group, and the right side of the MD group were (7.57±0.25), (7.42±0.25), (6.54±0.18), and (7.51±0.29)spines/10 μm, respectively, with a statistically significant overall difference ( F=3.818, P<0.05).The total density of dendritic spines in the left V1 area of mice in the MD group was significantly lower than that in the left side of the control group and the right side of the MD group, and the differences were statistically significant (both P<0.05).There was a significant difference in the proportion of the four types of dendritic spines in V1 neurons on both sides between the two groups ( χ2=26.295, P=0.002).There was a significant difference in the proportion of the four types of dendritic spines between the left V1 of the MD group and the left and right V1 of the control group (both P<0.008 3).There was a significant difference in the filopodia-type dendritic spine density in bilateral V1 neurons between the two groups ( F=3.253, P<0.05).Compared with the left V1 area of the control group, the density of filopodia-type dendritic spines in the left V1 area of the MD group decreased significantly, with a statistical significance ( P<0.05).There was no significant difference in the density of thin-type, mushroom-type, and stubby-type dendritic spines in bilateral V1 area neurons between the two groups ( F=1.760, 2.618, 1.749; all P>0.05). Conclusions:MD during the pre-critical period of visual development can cause a decrease in the total density of dendritic spines and significant changes in the compositional proportions in the V1 contralateral to the deprived eye, and is mainly manifested by a decrease in the number of filopodia, suggesting that abnormal visual experience can cause plastic changes in the number and structure of synapses in the visual cortex during the pre-critical period of visual development.

Portal vein thrombosis(PVT)is a common and severe complication in patients with liver cirrhosis,and alterations in portal hemodynamics are closely associated with the development of PVT.The presence of large spontaneous splenorenal shunt(SSRS)may lead to reductions in portal vein perfusion and blood flow velocity,which may compromise the anticoagulant effect on PVT.This article reports the treatment strategies of SSRS embolization combined with anticoagulant therapy that help to achieve complete recanalization of the portal vein;however,high-quality clinical studies are still needed to further validate and support the effectiveness of this strategy.

Objective To investigate the current status of home medicine cabinet management and unmet needs for home-based pharmaceutical services among elderly hypertensive patients in Hubei Province,and to provide evidence for optimizing home pharmaceutical care models.Methods From July 2022 to March 2023,310 elderly hypertension patients across Hubei Province were enrolled.Pharmacists conducted home visits to administer structured questionnaires capturing demographics and blood pressure control rates,perform medication categorization and quality assessments of home medicine cabinets and document cabinet management issues in real-time.Results Among 290 valid questionnaires,binary logistic regression revealed better blood pressure control in non-working and non-smoking individuals.Medicine cabinet audits identified three critical issues:failure to separate Chinese and chemical medicines,duplicate medications with similar ingredients and missing original packaging.Post-intervention,all cabinets demonstrated proper medication categorization and storage compliance.Conclusions Significant medication safety hazards exist in elderly hypertensive patients'home medicine cabinets.Pharmacist-led home interventions effectively cleared substandard medications and improved medication safety.Future home pharmaceutical services should focus on optimizing cabinet management protocols,enhancing medication safety awareness and personalizing pharmaceutical care to ensure precise and effective home-based medication management.

Objective To investigate the diagnostic efficacy of targeted biopsy(TB)combined with ipsilateral hemiglandular systematic biopsy(SB)of the dominant lesion,so as to explore a novel reduced-core biopsy strategy.Methods A retrospective analysis was conducted on the clinical data of 299 patients treated in our hospital during Sep.1,2022,and Feb.28,2023,who had a Prostate Imaging Reporting and Data System(PI-RADS)score ≥3 and underwent combined TB and SB.The dominant lesion was defined as the lesion with the highest PI-RADS score on multi-parametric magnetic resonance imaging(mpMRI);in cases of identical scores,the largest was designated as the dominant.SB was categorized as ipsilateral(ipsi-SB)or contralateral(contra-SB)to the dominant lesion.The consistency in detecting clinically significant prostate cancer(csPCa)was compared between TB with ipsi-SB(TB+ipsi-SB),TB with contra-SB(TB+contra-SB),and TB with SB(TB+SB).Subgroup analyses were performed based on PI-RADS score,prostate-specific antigen(PSA)level,prostate volume(PV),and mpMRI lesion distribution to evaluate csPCa detection rates across different variables.Results TB+ipsi-SB demonstrated comparable detection rate to TB+SB(46.2％vs.46.8％).The K values for TB+ipsi-SB and TB+contra-SB relative to TB+SB were 0.987(95％CI:0.969-1.000,P＜0.01)and 0.933(95％CI:0.892-0.974,P＜0.01),respectively.Across all subgroups,TB+ipsi-SB showed the highest agreement with TB+SB.Notably,in subgroups with PI-RADS 3 and 5,PSA＞0-20 ng/mL,PV＜25 mL,bilateral or multiple mpMRI lesions,TB+ipsi-SB achieved complete concordance with TB+SB in csPCa detection[K=1.000(95％CI:1.000-1.000),P＜0.01].Conclusion For patients with PI-RADS score ≥3,TB+ipsi-SB exhibits near-perfect consistency with TB+SB in csPCa detection while requiring fewer biopsy cores.TB+ipsi-SB represents a promising refinement of the TB+SB approach.

Objective:To investigate the effect of monocular form deprivation (MD) during the pre-critical period of visual development on the density and morphology of dendritic spines in mouse primary visual cortex (V1) neurons.Methods:Twenty SPF male C57BL/6J mice with eyes opened on postnatal day 14 (P14) were selected and divided into MD and control groups using a random number table, with 10 mice in each group.The MD group was fed to P18 after 4 days of MD in the right eye, and the control group was raised to P18 under the same feeding conditions.All mice were decapitated after cardiac perfusion, and the sections were stained with the cell membrane fluorescent probe 1, 1′-dioctadecyl-3, 3′, 3′-tetramethylindocarbocyanine perchlorate, and imaged by laser scanning confocal microscopy to observe and compare the differences in density and morphology of dendritic spines in bilateral V1 neurons between the control group and the MD group.This study was approved by the Animal Ethics Committee of Tianjin Medical University (No.TMUaMEC2022004).Results:The total density of dendritic spines in the V1 area on the left side of the control group, the right side of the control group, the left side of the MD group, and the right side of the MD group were (7.57±0.25), (7.42±0.25), (6.54±0.18), and (7.51±0.29)spines/10 μm, respectively, with a statistically significant overall difference ( F=3.818, P<0.05).The total density of dendritic spines in the left V1 area of mice in the MD group was significantly lower than that in the left side of the control group and the right side of the MD group, and the differences were statistically significant (both P<0.05).There was a significant difference in the proportion of the four types of dendritic spines in V1 neurons on both sides between the two groups ( χ2=26.295, P=0.002).There was a significant difference in the proportion of the four types of dendritic spines between the left V1 of the MD group and the left and right V1 of the control group (both P<0.008 3).There was a significant difference in the filopodia-type dendritic spine density in bilateral V1 neurons between the two groups ( F=3.253, P<0.05).Compared with the left V1 area of the control group, the density of filopodia-type dendritic spines in the left V1 area of the MD group decreased significantly, with a statistical significance ( P<0.05).There was no significant difference in the density of thin-type, mushroom-type, and stubby-type dendritic spines in bilateral V1 area neurons between the two groups ( F=1.760, 2.618, 1.749; all P>0.05). Conclusions:MD during the pre-critical period of visual development can cause a decrease in the total density of dendritic spines and significant changes in the compositional proportions in the V1 contralateral to the deprived eye, and is mainly manifested by a decrease in the number of filopodia, suggesting that abnormal visual experience can cause plastic changes in the number and structure of synapses in the visual cortex during the pre-critical period of visual development.

Visual system is a critical sensory system in humans and a vital component of the central nervous system, which is responsible for over 80% of external information acquisition.Visual function is a key indicator of overall health.With socioeconomic development, the public has higher expectations for eye health, shifting the focus of eye health initiatives from disease treatment to comprehensive public eye health.Key scientific challenges include how to effectively prevent, diagnose, and treat blindness and visual impairment at an early stage; how to enhance the overall visual quality of patients to ensure not just sight but clear and comfortable vision; and how to meet the public's diverse and multi-tiered eye health needs.Visual science is an interdisciplinary field exploring the development of the visual system, the mechanisms of vision, and brain-related perceptual, cognitive and behavioral processes involving sight.Prioritizing and advancing visual science research is of great significance for promoting comprehensive eye health and implementing the Healthy China Strategy.This article first outlines the concept and research significance of visual science.It then highlights the key scientific questions in visual science pertaining to several major eye diseases, such as myopia, amblyopia, cataract, fundus diseases, glaucoma, and corneal diseases, reviews the historical foundation of visual science research in China, selectively summarizes key achievements and ongoing progress in this field, analyzes the landscape and challenges faced by domestic research, and proposes, to this end, strategies to advance visual science in China.These recommendations are designed to promote visual science research in China and ultimately advance comprehensive eye health.

Objective:To quickly identify the causes of morphological abnormalities of microcytic hypochromic erythrocytes that are detected during health checkups for recruitment of flying cadets, and to explore its role in medical selection.Methods:Students with hemoglobin (Hb)≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes detected during the 2023 medical selection of flying cadets by Guangzhou Selection Center were selected. Their medical history was collected, and iron metabolism, Hb electrophoresis and hemoglobin H (HbH) inclusion bodies were examined to screen for thalassemia and iron deficiency. The diagnosis of thalassemia was confirmed by thalassemia gene testing. Those with iron deficiency received iron supplementation therapy and the recovery of Hb was observed.Results:Ninety-one students were diagnosed with Hb≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes, accounting for 4.35% of the total. Among these cases, 85 with abnormal Hb electrophoresis and/or positive HbH inclusion body detection were confirmed as thalassemia minor via thalassemia genetic testing, and 3 cases with normal iron metabolism, Hb electrophoresis, and negative HbH inclusion body detection. A total of 88 cases of thalassemia minor were diagnosed, accounting for 96.70% of the total. Among them, 2 cases were complicated with iron deficiency while 3 were diagnosed with iron deficiency erythropoiesis. Out of the 91 students with Hb≥110 g/L and morphological abnormalities of microcytic hypochromic erythrocytes, 9 were recruited, including 7 cases with thalassemia minor (Hb≥130 g/L), 1 case with thalassemia minor combined with iron deficiency erythropoiesis (Hb≥130 g/L after iron supplementation), and 1 case with iron deficiency erythropoiesis (Hb≥130 g/L after iron supplementation). Among the 9 recruits, 8 were followed up for over one year and the results of their military physical fitness tests all reached or exceeded the standards, but the remaining one dropped out and lost contact.Conclusions:Among physical examinees during medical selection of flying cadets in South China, thalassemia is the leading cause of morphological abnormalities of microcytic hypochromic erythrocytes. Results of iron metabolism, Hb electrophoresis, and HbH inclusion body detection can help identify thalassemia and iron deficiency quickly. Cases of morphological abnormalities of microcytic hypochromic erythrocytes caused by iron deficiency can be considered eligible for selection after Hb levels return to normal following iron supplementation therapy. Students who are diagnosed with thalassemia with Hb<130 g/L can be determined as ineligible. Such rapid identification can facilitate the medical selection of the above 2 types of students.

Visual system is a critical sensory system in humans and a vital component of the central nervous system, which is responsible for over 80% of external information acquisition.Visual function is a key indicator of overall health.With socioeconomic development, the public has higher expectations for eye health, shifting the focus of eye health initiatives from disease treatment to comprehensive public eye health.Key scientific challenges include how to effectively prevent, diagnose, and treat blindness and visual impairment at an early stage; how to enhance the overall visual quality of patients to ensure not just sight but clear and comfortable vision; and how to meet the public's diverse and multi-tiered eye health needs.Visual science is an interdisciplinary field exploring the development of the visual system, the mechanisms of vision, and brain-related perceptual, cognitive and behavioral processes involving sight.Prioritizing and advancing visual science research is of great significance for promoting comprehensive eye health and implementing the Healthy China Strategy.This article first outlines the concept and research significance of visual science.It then highlights the key scientific questions in visual science pertaining to several major eye diseases, such as myopia, amblyopia, cataract, fundus diseases, glaucoma, and corneal diseases, reviews the historical foundation of visual science research in China, selectively summarizes key achievements and ongoing progress in this field, analyzes the landscape and challenges faced by domestic research, and proposes, to this end, strategies to advance visual science in China.These recommendations are designed to promote visual science research in China and ultimately advance comprehensive eye health.

Portal vein thrombosis(PVT)is a common and severe complication in patients with liver cirrhosis,and alterations in portal hemodynamics are closely associated with the development of PVT.The presence of large spontaneous splenorenal shunt(SSRS)may lead to reductions in portal vein perfusion and blood flow velocity,which may compromise the anticoagulant effect on PVT.This article reports the treatment strategies of SSRS embolization combined with anticoagulant therapy that help to achieve complete recanalization of the portal vein;however,high-quality clinical studies are still needed to further validate and support the effectiveness of this strategy.