Congenital cataract is a leading cause of childhood blindness worldwide. By inducing visual impairment from birth, it disrupts the normal development of the visual system and profoundly impacts patients' quality of life. Therefore, timely diagnosis and the implementation of effective, safe interventions, particularly during the critical period of visual development, are of paramount clinical importance. Cataract extraction is a cornerstone therapeutic intervention. The success of the surgery, as well as postoperative visual recovery and the incidence of complications in pediatric patients, largely depends on the selected surgical approach and instrumentation. Surgical approaches are primarily categorized into the anterior approach(via corneal or limbal incision)and the posterior approach(via pars plana). Surgical instruments are typically classified by the gauge of the vitreous cutter, such as 20 G, 23 G, and 25 G. The choice of surgical approach not only directly influences the incidence of postoperative complications but also significantly impacts visual recovery. This article reviews and analyzes these critical aspects to provide valuable guidance for clinical practice.

Ischemic stroke (IS) is a globally life-threatening disease. Presently, few therapeutic medicines are available for treating IS, and rt-PA is the only drug approved by the US Food and Drug Administration (FDA) in the US. In fact, many agents showing excellent neuroprotection but no blood flow-improving activity in animals have not achieved ideal clinical efficacy, while thrombolytic drugs only improving blood flow without neuroprotection have limited their wider application. To address these challenges and meet the huge unmet clinical need, we have designed and identified a novel compound AAPB with dual effects of neuroprotection and cerebral blood flow improvement. AAPB significantly reduced cerebral infarction and neural function deficit in tMCAO rats, pMCAO rats, and IS rhesus monkeys, as well as displayed exceptional safety profiles and excellent pharmacokinetic properties in rats and dogs. AAPB has now entered phase I of clinical trials fighting IS in China.

Objective To assess the value of cardiac magnetic resonance(CMR)imaging for predicting adverse left ventricular remodeling in patients with ST-segment elevation myocardial infarction(STEMI).Methods We retrospectively analyzed the clinical data and serial CMR(cine and LGE sequences)images of 86 STEMI patients within 1 week and 5 months after percutaneous coronary intervention(PCI),including 25 patients with adverse LV remodeling and 61 without adverse LV remodeling,defined as an increase of left ventricular end-systolic volume(LVESV)over 15%at the second CMR compared to the initial CMR.The CMR images were analyzed for LV volume,infarct characteristics,and global and infarct zone myocardial function.The independent predictors of adverse LV remodeling following STEMI were analyzed using univariate and multivariate Logistic regression methods.Results The initial CMR showed no significant differences in LV volume or LV ejection fraction(LVEF)between the two groups,but the infarct mass and microvascular obstructive(MVO)mass were significantly greater in adverse LV remodeling group(P<0.05).Myocardial injury and cardiac function of the patients recovered over time in both groups.At the second CMR,the patients with adverse LV remodeling showed a significantly lower LVEF,a larger left ventricular end-systolic volume index(LVESVI)and a greater extent of infarct mass(P<0.001)with lower global peak strains and strain rates in the radial,circumferential,and longitudinal directions(P<0.05),infarct zone peak strains in the 3 directions,and infarct zone peak radial and circumferential strain rates(P<0.05).The independent predictors for adverse LV remodeling following STEMI included the extent of infarct mass(AUC=0.793,95%CI:0.693-0.873;cut-off value:30.67%),radial diastolic peak strain rate(AUC=0.645,95%CI:0.534-0.745;cut-off value:0.58%),and RAAS inhibitor(AUC= 0.699,95%CI:0.590-0.793).Conclusion The extent of infarct mass,peak radial diastolic strain rate,and RAAS inhibitor are independent predictors of adverse LV remodeling following STEMI.

Objective:To observe the therapeutic effect of vibrating the abdomen on anorexia model rats,as well as its effects on cholecystokinin octapeptide(CCK-8)and motilin(MTL)in the peripheral blood. Methods:Forty young rats were randomly divided into a normal group(n=10)and a modeling group(n=30).Rats in the normal group were fed common feed.The anorexia model was established by the etiological simulation method in the modeling group,and these rats were further randomly divided into a drug group,a vibrating abdomen group,and a model group 3 weeks after the anorexia model was induced,with 10 rats in each group.The drug group was given Jian Wei Xiao Shi Pian by intragastric administration at a dose of 0.72 g/(kg·bw)(0.72 g drug was dissolved in 10 mL purified water).The normal group and the model group were given purified water once a day in the morning.The vibrating abdomen group was treated with vibrating the abdomen once a day for 21 times.The body mass,food intake,serum CCK-8,MTL,gastrin(GAS),neurotensin(NT)levels,and the intestinal propulsion rate of rats in each group were measured. Results:Compared with the model group,the body mass,food intake,serum MTL and GAS levels,and the small intestine propulsion rate increased significantly,and the serum CCK-8 and NT levels,the gastric residual rate decreased significantly in the vibrating abdomen group and the drug group(P<0.05).There were no significant differences between the vibrating abdomen group and the drug group(P>0.05). Conclusion:Vibrating the abdomen increases the food intake and body mass of anorexia model rats,reduces the residue of gastric contents,improves the small intestine propulsion rate,and therefore has a good therapeutic effect on anorexia.The mechanism may be related to inhibiting the secretion of CCK-8 and NT in plasma and promoting the release of MTL and GAS in serum.

Osteosarcoma, a highly malignant tumor originating from bone tissue, is characterized by a high mortality along with a poor prognosis. The heterogeneity of the tumor microenvironment plays a pivotal role in its development and prognosis. Single-cell sequencing technology emerges as a crucial tool in elucidating this heterogeneity by delineating the functional characteristics and gene expression patterns of tumor cells, immune cells, and stromal cells within osteosarcoma tissues. This technology enables the depiction of the intricate interaction network between these cells. Utilizing the high-resolution advantage of single-cell sequencing, novel cell subtypes such as SPP1 (+) macrophages, C1QC (+) macrophages, and CLEC11A (+) B cells have been identified in osteosarcoma tissues, contributing to tumor growth and invasion within the tumor microenvironment. Identification of osteosarcoma stem cell subpopulations suggests that SERPINA1_CSCL1, FUS_CSCL2, and SPP1_CSCL3 populations may serve as the origin of osteosarcoma cells. Moreover, single-cell sequencing has revealed that mregDCs promote immune escape and tumor progression by selectively expressing CCR7, CCL17, CCL19, and CCL22 factors, thereby recruiting Treg cells. Additionally, this technology aids in the development of personalized chemotherapy regimens by pinpointing potential drug resistance targets in osteosarcoma, leading to the establishment of a drug resistance risk score model. In terms of disease prognosis, single-cell sequencing has identified immune infiltration-associated genes in osteosarcoma (e.g., EPHX2, FDPS, GBP1, MMD, ZYX), facilitating the construction of a prognostic analysis model for osteosarcoma patients, thus aiding in prognostic prediction.

Gastric cancer is one of the most common malignant tumors worldwide,with high morbidity and mortality rates.This malignancy poses a grave threat to human life and health.Its early onset symptoms are not typical,and many patients are diagnosed in the middle and late stages;multidisciplinary comprehensive treatment remains the primary treatment for patients with advanced and unresectable gastric cancer.Comprehensive surgery is typically performed for patients with gastric cancer who are eligible for surgery.Preoperative arterial infu-sion chemotherapy is gradually receiving attention as a novel treatment method.Compared with traditional chemotherapy,it has the ad-vantages of higher efficiency,fewer side effects,and a higher surgical resection rate in later stages.It has been gradually applied in clinical practice and has achieved certain results.This article discusses the application and development of arterial infusion chemotherapy in the neoadjuvant therapy for gastric cancer.

Objective To assess the value of cardiac magnetic resonance(CMR)imaging for predicting adverse left ventricular remodeling in patients with ST-segment elevation myocardial infarction(STEMI).Methods We retrospectively analyzed the clinical data and serial CMR(cine and LGE sequences)images of 86 STEMI patients within 1 week and 5 months after percutaneous coronary intervention(PCI),including 25 patients with adverse LV remodeling and 61 without adverse LV remodeling,defined as an increase of left ventricular end-systolic volume(LVESV)over 15%at the second CMR compared to the initial CMR.The CMR images were analyzed for LV volume,infarct characteristics,and global and infarct zone myocardial function.The independent predictors of adverse LV remodeling following STEMI were analyzed using univariate and multivariate Logistic regression methods.Results The initial CMR showed no significant differences in LV volume or LV ejection fraction(LVEF)between the two groups,but the infarct mass and microvascular obstructive(MVO)mass were significantly greater in adverse LV remodeling group(P<0.05).Myocardial injury and cardiac function of the patients recovered over time in both groups.At the second CMR,the patients with adverse LV remodeling showed a significantly lower LVEF,a larger left ventricular end-systolic volume index(LVESVI)and a greater extent of infarct mass(P<0.001)with lower global peak strains and strain rates in the radial,circumferential,and longitudinal directions(P<0.05),infarct zone peak strains in the 3 directions,and infarct zone peak radial and circumferential strain rates(P<0.05).The independent predictors for adverse LV remodeling following STEMI included the extent of infarct mass(AUC=0.793,95%CI:0.693-0.873;cut-off value:30.67%),radial diastolic peak strain rate(AUC=0.645,95%CI:0.534-0.745;cut-off value:0.58%),and RAAS inhibitor(AUC= 0.699,95%CI:0.590-0.793).Conclusion The extent of infarct mass,peak radial diastolic strain rate,and RAAS inhibitor are independent predictors of adverse LV remodeling following STEMI.

【Objective】 To analyze differences of eplets between the patient who generated HLA allele-specific antibodies after platelet transfusion with donors. 【Methods】 The HLA genotypes of the patient and donors were detected by PCR-SBT, and the Luminex single antigen beads coating was used to screen HLA-Ⅰ antibodies in the patient’s serum. HLA Matchmaker was utilized to analyze different amino acids and eplets. 【Results】 The patient carried HLA-A^*02∶03 allele, and HLA-A2 antibodies were found in his serum after platelet transfusion (A^*02∶01, A^*02∶06, and A^*02∶07). Sequence alignment showed that the patient′s A^*02∶03 has a difference in position 149, which resulted in a different eplet between A^*02∶03 and A^*02∶01, A^*02∶06, A^*02∶07 and then induced the production of antibodies. 【Conclusion】 HLA antibodies are specific for HLA epitopes that have structural differences due to amino acid differences between HLA alleles, suggesting that high-resolution typing of HLA-A, -B need to be conducted in patients and donors, and the acceptable mismatch of HLA should be determined based on epitopes rather than antigens, so as to reduce alloimmune response and improve platelet count after transfusion.

Objective:To investigate the risk factors of restenosis after dilation of anastomotic stenosis in patients with esophageal cancer surgery.Methods:Clinical data of 997 patients who underwent endoscopic dilation due to anastomotic stenosis after esophageal cancer radical surgery in the Affiliated Huai′an First Hospital of Nanjing Medical University from June 2015 to July 2021, were retrospectively analyzed. There were 486 cases receiving single dilation (single dilation group) and 511 cases receiving more than two dilations (multiple dilation group). The risk factors of restenosis were explored using univariate and multivariate logistic regression analysis.Results:There were 682 males and 315 females with a median age of 65 years, the median distance between the stenosis and incisor was 20 (20, 22) cm, the median stenosis diameter was 4 (3, 5) mm, and the median stenosis diameter after dilation was 11 (11, 13) mm. Univariate analysis showed that there were significant differences in the distance of the stenosis and incisor ( Z=-2.303, P<0.05), stenosis diameter ( Z=-4.637, P<0.05) and stenosis diameter after dilation ( Z=-5.773, P<0.05) between single and multiple dilation groups. Stratified multivariate logistic regression showed that for male patients, risk of multiple dilations dropped by approximately 3% for every 1-mm increase in the distance between the stenosis and incisor ( OR=0.97, 95% CI:0.93-1.00, P=0.047); the risk of multiple dilations decreased by about 15%, for every 1-mm increase in stenosis diameter ( OR=0.85, 95% CI:0.76-0.94, P=0.004); the risk of multiple dilations decreased by about 13% for every 1-mm increase in stenosis diameter after dilation ( OR=0.87, 95% CI:0.78-0.96, P=0.007). For females patients under 60 years old, the risk of multiple dilations decreased by about 31%, for every 1-mm increase in stenosis diameter after dilation ( OR=0.69, 95% CI:0.47-0.98, P=0.049); for female patients≥60 years old, the risk decreased by about 5%, for every 1-year increase in age ( OR=0.95, 95% CI:0.91-1.00, P=0.037), risk of multiple dilations dropped by 17%( OR=0.83, 95% CI:0.70-0.99, P=0.039) for every 1 mm increase in stenosis diameter after dilation. Stratified smooth curve fitting indicated that the distance between the stenosis and incisor≤23 mm, stenosis diameter≤4.5 mm, stenosis diameter after dilation≤12 mm were risk factors for multiple dilations. Conclusions:The study indicates that patients with the distance between the stenosis and incisor≤23 mm, stenosis diameter≤4.5 mm, stenosis diameter after dilation≤12 mm may need multiple dilations; and the first dilation should expand the stenosis diameter to 12 mm or above as far as possible to reduce the risk of restenosis in patients receiving esophageal cancer radical surgery.

ObjectiveTo investigate the demand, supply and satisfaction of the Chinese people on assistive technology. MethodsBased on the data from the World Health Organization rapid Assistive Technology Assessment (rATA) questionnaire in six provinces and cities in China, the assistive technology of the whole population in China was described from three aspects of demand, supply and satisfaction. ResultsA total of 15 234 valid questionnaires were obtained. In terms of demand, the proportion of visual impairment was the highest in all the functional impairment categories, the highest demands in the list were glasses (low-vision, short/long distance etc.) and walking sticks (canes/sticks, tripod and quadripod), while the highest demand outside the list was anti-skid pad. In terms of supply, the private sector was the main one, followed by government facility and public hospital, and most users took "paid out-of-pocket (self)" to obtain assistive technology, the distance to access the assistive technology was concentrated at "less than five kilometers", and the biggest obstacle to obtain assistive technology was lack of knowledge about assistive technology. Overall satisfaction with assistive technology was optimistic, the adaptation degree and service quality of assistive technology were the most unsatisfactory factors for users. ConclusionIn China, the satisfaction of assistive technology is optimistic, and there is a few amount of unmet assistive technology. It is necessary to propagandize assistive technology, and its manual should be readable, the assistive technical service team should be multidisciplinary, enterprises should promote independent innovation, and the professionals should be regulated.