Objective To analyze the biomechanical responses after small incision lenticule extraction(SMILE)based on personalized biomechanical parameters of the human eye.Methods Through the results from the correlation analysis between corneal stromal elastic modulus and biomechanical parameters,the cornea elastic modulus was predicted and the material parameters were obtained.Based on clinical measurement data,52 personalized myopic human eye models were reconstructed to analyze the corneal biomechanical response after SMILE.Results The biomechanical response of the cornea varied from patients,and the vertex displacement and stress of the corneal surface increased or decreased after SMILE.On average,when residual stromal thickness(RST)ranged from 278 μm to 332 μm and IOP was 16-20 mmHg(1 mmHg=0.133 kPa),the change of vertex displacement and stress on the corneal surface after SMILE were less than those under IOP=11-16 mmHg.Under RST＞332 μm and IOP=11-16 mmHg,the corneal biomechanics was relatively stable.In addition,the corrected diopters of patients increased,and the deformation of corneal surface after SMILE was more drastic.Conclusions RST and IOP are important factors influencing corneal biomechanics.The material parameters of corneal tissues were predicted based on corneal biomechanical parameters.The cutting profiles and surgical parameters of SMILE may be optimized through analyzing the surgical effect after refractive surgery by reconstructing personalized finite element model of human eyes.

Objective To investigate the protective effect and mechanism of Polygonatum sibiricum polysaccharides(PSP)on diabetic cardiomyopathy(DCM).Methods Forty SPF-grade male Sprague-Dawley rats were divided randomly into Control,Model,PSP,and metformin groups.After 4 weeks of feeding a high-fat diet,streptozotocin was injected intraperitoneally to establish a rat model of diabetes mellitus.The drug was administered by gavage for 12 weeks,and body mass and blood glucose were recorded every 2 weeks.Cardiac function was detected by non-invasive echocardiography at week 16.Myocardial histopathological changes and the degree of myocardial fibrosis were assessed by hematoxylin and eosin and Masson staining.Serum interleukin(IL)-6,IL-1β,IL-18,tumor necrosis factor-α(TNF-α),triglycerides,total cholesterol,low-density lipoprotein,and high-density lipoprotein were detected by enzyme-linked immunosorbent assay.Expression levels of the fibrosis-related proteins transforming growth factor(TGF)-β1,Smad2,Collagen-Ⅰ,Collagen-Ⅲ,and the pyroptosis-related proteins NOD-like receptor thermal protein domain associated protein 3(NLRP3),apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),and Caspase-1 were detected in rat myocardial tissues by Western blot.Cellular experiments were performed by exposing H9c2 cells to high glucose(40 mmol/L)to mimic the in vitro DCM model,cell viability was detected by Cell Counting Kit-8 assay,and the apoptotic cell ratio was detected by flow cytometry.Results Rats in the treatment group had significantly lower blood glucose,lipid,and serum inflammatory factor levels compared with the model group(P＜0.05),significantly higher ejection fraction and fractional shortening values(P＜0.05),and improved cardiac function.Myocardial fibers were better aligned and collagen fiber accumulation was reduced,and myocardial tissue levels of NLRP3,ASC,Caspase-1,Collagen-Ⅰ,Collagen-Ⅲ,TGF-β1,and Smad2 were significantly reduced(P＜0.05).In the cellular assay,PSP increased the viability and decreased the proportion of apoptotic cells in high glucose-induced H9c2 cardiomyocytes.Conclusions PSP can improve glucose-lipid metabolism,protect cardiac function,and delay the occurrence of myocardial fibrosis in diabetic rats,and can also improve the viability of cardiomyocytes.Its mechanism of action may be related to the inhibition of cellular pyroptosis and delayed occurrence of ventricular remodeling.

Objective To analyze the biomechanical responses after small incision lenticule extraction(SMILE)based on personalized biomechanical parameters of the human eye.Methods Through the results from the correlation analysis between corneal stromal elastic modulus and biomechanical parameters,the cornea elastic modulus was predicted and the material parameters were obtained.Based on clinical measurement data,52 personalized myopic human eye models were reconstructed to analyze the corneal biomechanical response after SMILE.Results The biomechanical response of the cornea varied from patients,and the vertex displacement and stress of the corneal surface increased or decreased after SMILE.On average,when residual stromal thickness(RST)ranged from 278 μm to 332 μm and IOP was 16-20 mmHg(1 mmHg=0.133 kPa),the change of vertex displacement and stress on the corneal surface after SMILE were less than those under IOP=11-16 mmHg.Under RST＞332 μm and IOP=11-16 mmHg,the corneal biomechanics was relatively stable.In addition,the corrected diopters of patients increased,and the deformation of corneal surface after SMILE was more drastic.Conclusions RST and IOP are important factors influencing corneal biomechanics.The material parameters of corneal tissues were predicted based on corneal biomechanical parameters.The cutting profiles and surgical parameters of SMILE may be optimized through analyzing the surgical effect after refractive surgery by reconstructing personalized finite element model of human eyes.

Objective To investigate the protective effect and mechanism of Polygonatum sibiricum polysaccharides(PSP)on diabetic cardiomyopathy(DCM).Methods Forty SPF-grade male Sprague-Dawley rats were divided randomly into Control,Model,PSP,and metformin groups.After 4 weeks of feeding a high-fat diet,streptozotocin was injected intraperitoneally to establish a rat model of diabetes mellitus.The drug was administered by gavage for 12 weeks,and body mass and blood glucose were recorded every 2 weeks.Cardiac function was detected by non-invasive echocardiography at week 16.Myocardial histopathological changes and the degree of myocardial fibrosis were assessed by hematoxylin and eosin and Masson staining.Serum interleukin(IL)-6,IL-1β,IL-18,tumor necrosis factor-α(TNF-α),triglycerides,total cholesterol,low-density lipoprotein,and high-density lipoprotein were detected by enzyme-linked immunosorbent assay.Expression levels of the fibrosis-related proteins transforming growth factor(TGF)-β1,Smad2,Collagen-Ⅰ,Collagen-Ⅲ,and the pyroptosis-related proteins NOD-like receptor thermal protein domain associated protein 3(NLRP3),apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),and Caspase-1 were detected in rat myocardial tissues by Western blot.Cellular experiments were performed by exposing H9c2 cells to high glucose(40 mmol/L)to mimic the in vitro DCM model,cell viability was detected by Cell Counting Kit-8 assay,and the apoptotic cell ratio was detected by flow cytometry.Results Rats in the treatment group had significantly lower blood glucose,lipid,and serum inflammatory factor levels compared with the model group(P＜0.05),significantly higher ejection fraction and fractional shortening values(P＜0.05),and improved cardiac function.Myocardial fibers were better aligned and collagen fiber accumulation was reduced,and myocardial tissue levels of NLRP3,ASC,Caspase-1,Collagen-Ⅰ,Collagen-Ⅲ,TGF-β1,and Smad2 were significantly reduced(P＜0.05).In the cellular assay,PSP increased the viability and decreased the proportion of apoptotic cells in high glucose-induced H9c2 cardiomyocytes.Conclusions PSP can improve glucose-lipid metabolism,protect cardiac function,and delay the occurrence of myocardial fibrosis in diabetic rats,and can also improve the viability of cardiomyocytes.Its mechanism of action may be related to the inhibition of cellular pyroptosis and delayed occurrence of ventricular remodeling.

T-cell therapy,as an emerging strategy for bladder cancer treatment,primarily includes tumor-infiltrating lymphocyte(TIL)therapy,T cell receptor-engineered T-cell(TCR-T)therapy,and chimeric antigen receptor T-cell(CAR-T)therapy.TIL therapy involves extracting,expanding,and reinfusing tumor-infiltrating T cells,aiming to promote tumor regression,which has achieved initial progress in the field of bladder cancer.TCR-T therapy involves genetically modifying T cells to specifically recognize tumor antigens presented by MHC,with clinical trials targeting NY-ESO-1 and other targets progressing in an orderly manner.CAR-T therapy utilizes artificially designed CAR molecules to target bladder cancer-highly expressed antigens such as prostate-specific membrane antigen(PSMA)and human epidermal growth factor receptor 2(HER2),with multiple studies confirming its potent cytotoxic effects.This article systematically summarizes the existing research,advantages and limitations of T-cell therapy in bladder cancer,so as to provide reference for exploring new options for the next-generation immunotherapy strategies of bladder cancer.

T-cell therapy,as an emerging strategy for bladder cancer treatment,primarily includes tumor-infiltrating lymphocyte(TIL)therapy,T cell receptor-engineered T-cell(TCR-T)therapy,and chimeric antigen receptor T-cell(CAR-T)therapy.TIL therapy involves extracting,expanding,and reinfusing tumor-infiltrating T cells,aiming to promote tumor regression,which has achieved initial progress in the field of bladder cancer.TCR-T therapy involves genetically modifying T cells to specifically recognize tumor antigens presented by MHC,with clinical trials targeting NY-ESO-1 and other targets progressing in an orderly manner.CAR-T therapy utilizes artificially designed CAR molecules to target bladder cancer-highly expressed antigens such as prostate-specific membrane antigen(PSMA)and human epidermal growth factor receptor 2(HER2),with multiple studies confirming its potent cytotoxic effects.This article systematically summarizes the existing research,advantages and limitations of T-cell therapy in bladder cancer,so as to provide reference for exploring new options for the next-generation immunotherapy strategies of bladder cancer.

Objective To explore the effect of different post-processing methods of total spinal CT angiography(CTA)for displaying spinal dural arteriovenous fistula(SDAVF).Methods Total spinal CTA data of 55 patients with SDAVF were retrospectively analyzed.Traditional post-processing of original CTA images(modified tissue growth boneless volume rendering[VR]and full-range axial maximum intensity projection[MIP])were performed,while the axial,sagittal and coronal MIP reconstructions,axial,sagittal and coronal VR reconstructions,as well as axial,sagittal and coronal MIP+VR reconstructions of original CTA images on lesion layers were completed,respectively.Taken digital subtraction angiography(DSA)as the gold standards,a 5-point scale was used to subjectively evaluate the effect of displaying the location,the range and feeding artery of fistula shown on CTA images based on different post-processing methods.Results No significant difference of subjective score of location nor feeding artery of fistula was found among axial MIP,VR and MIP+VR images(all P＞0.05),which were all higher than that of CTA images reconstructed using other post-processing methods(all P＜0.05).Meanwhile,no significant difference of subjective scores of the range of SDAVF was detected among sagittal MIP,VR and MIP+VR images(all P＞0.05),which were all higher than that of CTA images obtained using other post-processing methods(all P＜0.05).Conclusion The location and feeding artery of SDAVF could be observed based on axial MIP,VR and MIP+VR reconstructions of the total spinal CTA,while sagittal MIP,VR and MIP+VR reconstructions were conducive to display the range of SDAVF.Combination of multiple post-processing methods was helpful for comprehensive understanding the composition and range of SDAVF.

Objective To explore the effect of different post-processing methods of total spinal CT angiography(CTA)for displaying spinal dural arteriovenous fistula(SDAVF).Methods Total spinal CTA data of 55 patients with SDAVF were retrospectively analyzed.Traditional post-processing of original CTA images(modified tissue growth boneless volume rendering[VR]and full-range axial maximum intensity projection[MIP])were performed,while the axial,sagittal and coronal MIP reconstructions,axial,sagittal and coronal VR reconstructions,as well as axial,sagittal and coronal MIP+VR reconstructions of original CTA images on lesion layers were completed,respectively.Taken digital subtraction angiography(DSA)as the gold standards,a 5-point scale was used to subjectively evaluate the effect of displaying the location,the range and feeding artery of fistula shown on CTA images based on different post-processing methods.Results No significant difference of subjective score of location nor feeding artery of fistula was found among axial MIP,VR and MIP+VR images(all P＞0.05),which were all higher than that of CTA images reconstructed using other post-processing methods(all P＜0.05).Meanwhile,no significant difference of subjective scores of the range of SDAVF was detected among sagittal MIP,VR and MIP+VR images(all P＞0.05),which were all higher than that of CTA images obtained using other post-processing methods(all P＜0.05).Conclusion The location and feeding artery of SDAVF could be observed based on axial MIP,VR and MIP+VR reconstructions of the total spinal CTA,while sagittal MIP,VR and MIP+VR reconstructions were conducive to display the range of SDAVF.Combination of multiple post-processing methods was helpful for comprehensive understanding the composition and range of SDAVF.

ObjectiveTo investigate the features of liver histopathological damage in patients with indeterminate phase of chronic HBV infection， as well as the timing for initiating antiviral therapy in such patients. MethodsA retrospective screening was performed for the patients with chronic HBV infection who were hospitalized in The Fifth Medical Center of Chinese PLA General Hospital and underwent liver biopsy from March 2018 to April 2022， among whom the patients who met the criteria for indeterminate phase defined in Chinese guidelines for chronic hepatitis B prevention and treatment （2022 edition） were enrolled， and their clinical data were collected. Liver histopathological stage was determined using the Scheuer scoring system， with stages 0 — 4 for inflammation grade （G） and stages 0 — 4 for fibrosis degree （S）， and the patients were divided into groups based on the presence of significant necroinflammation （≥G2） and significant liver fibrosis （≥S2）. The independent samples t-test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. A Spearman’s rank correlation analysis was used to investigate the correlation between liver histopathology and clinical factors， and the Logistic regression model was used to identify the independent influencing factors for significant necroinflammation and liver fibrosis. ResultsA total of 271 patients with indeterminate phase of chronic HBV infection were enrolled， among whom 61 （22.5%） had significant necroinflammation （≥G2） and 124 （45.8%） had significant liver fibrosis （≥S2）. The Logistic regression analysis showed that alanine aminotransferase ≥30 U/L （for male patients） or ≥19 U/L （for female patients） （odds ratio ［OR］=2.69， 95% confidence interval ［CI］： 1.39 — 5.21， P=0.003）， HBV DNA ≥2 000 IU/mL （OR=2.75， 95%CI： 1.38 — 5.48， P=0.004）， and liver stiffness measurement （LSM） ≥6.0 kPa （OR=4.57， 95%CI： 2.17 — 9.62， P<0.001） were independent risk factors for significant inflammation. HBV DNA ≥2 000 IU/mL （OR=1.82， 95%CI： 1.01 — 3.32， P=0.049） and LSM ≥6.0 kPa （OR=2.06， 95%CI： 1.23 — 3.43， P=0.006） were independent influencing factors for significant liver fibrosis. ConclusionAmong the patients with indeterminate phase of chronic HBV infection， a substantial proportion of patients have significant liver histopathological damage. Antiviral therapy should be initiated in a timely manner for patients with high-risk factors.

Objective To investigate the high-risk factors associated with acute postoperative hypertension (APH) following laparoscopic sleeve gastrectomy(LSG) in obese patients and to establish a predictive model. Methods A retrospective analysis was conducted on clinical data and laboratory parameters of obese patients who underwent LSG at Department of Metabolic Surgery in our hospital from August 2021 to December 2023. Logistic-LASSO regression analysis was used to identify independent risk factors for APH. A nomogram predictive model was developed based on these factors. The predictive performance and clinical utility of the model were assessed using the receiver operating characteristic (ROC) curve, Bootstrap resampling, calibration curve, Hosmer-Lemeshow (H-L) test, decision curve analysis (DCA), and clinical impact curve (CIC). Results The incidence of APH was 55.90%. Body mass index (BMI), platelet count, globulin, uric acid, sodium, fibrinogen, fasting blood glucose, and preoperative diastolic pressure had potential predictive value. Among them, BMI (OR=1.066, 95% CI: 1.003-1.137, P=0.046), platelet count (OR=0.994, 95% CI: 0.998-0.999, P=0.027), fibrinogen (OR=1.943, 95% CI: 1.128-3.479, P=0.02), and preoperative diastolic blood pressure (OR=0.953, 95% CI: 0.918-0.985, P = 0.006) were identified as independent high-risk factors. The area under the curve (AUC) of the nomogram was 0.783 (95% CI: 0.711-0.855), with a sensitivity of 0.817 and a specificity of 0.689. The AUC based on Bootstrap resampling was 0.776 (95% CI: 0.702-0.849). The H-L test yielded P>0.05, and the calibration curve showed good model fit. Both DCA and CIC demonstrated favorable screening efficiency. Conclusions BMI, platelet count, fibrinogen, and preoperative diastolic blood pressure are independent high-risk factors for APH following LSG. The developed nomogram model exhibits good predictive performance and clinical applicability, providing a valuable tool for early screening and prevention of APH in LSG patients.