ObjectiveTo investigate the mRNA expression profile and clinical significance of the RAB24 gene in hepatocellular carcinoma （HCC） based on multi-source database including The Cancer Genome Atlas （TCGA） and clinical cohort validation. MethodsData from TCGA （n=424） were utilized to evaluate the prognostic value of RAB24 expression via Kaplan-Meier analysis and Cox regression models. An independent clinical cohort comprising 90 HCC and 30 paracancerous tissues was established to validate protein expression and histopathological features through immunohistochemistry （IHC） and routine histological staining. The TIMER database was employed to analyze the association between RAB24 and the tumor microenvironment （TME）. Furthermore， integrated with LinkedOmics， GSEA and GSVA algorithms were used to quantitatively characterize the core molecular pathways regulated by RAB24. ResultsThe mRNA expression level of RAB24 in HCC was significantly higher than that in non-tumor liver tissues （P<0.05）. Kaplan-Meier analysis revealed that the overall survival （OS） of patients in the RAB24 low-expression group was significantly longer compared to the high-expression group （HR=1.570， Log-rank P=0.01）. Cox proportional hazards regression analysis demonstrated that RAB24 expression （HR=1.480， P=0.028）， T stage （HR=2.949， P<0.001）， M stage （HR=4.077， P=0.017）， and tumor residual status （HR=2.317， P<0.001） were independent prognostic factors for HCC. RAB24 expression was highly correlated with alpha-fetoprotein （AFP） levels and immune infiltration levels （P<0.01）， and showed a significant， low-level positive correlation with the TP53 gene （Rho=0.31， P<0.01）. Quantitative analysis of the RAB24 protein in clinical samples validated that RAB24 expression in HCC tissues was significantly elevated compared to non-tumor liver tissues （P<0.05）. TIMER analysis confirmed that RAB24 expression was highly associated with the infiltration of multiple immune cells （such as B cells and NK cells）， as well as stromal and tumor purity scores in tumor tissues （P<0.01）. GSEA/GSVA enrichment revealed that the P53， MYC， and mTORC1 signaling pathways were activated in the RAB24 high-expression group； correlation analysis confirmed that the RAB24 expression level exhibited a significant， low-level positive correlation with the ribosome pathway activity score （r=0.23， P<0.01）. ConclusionsThe RAB24 gene， as a poor prognostic factor for HCC patients， is a potential biomarker for HCC diagnosis， treatment and prognosis. The study is expected to lay a theoretical foundation for the precise diagnosis and treatment of clinical HCC.

AIM:To investigate the therapeutic effects of botulinum toxin A(BTXA)injection versus strabismus surgery in the treatment of acute acquired comitant esotropia(AACE).METHODS:Patient records of AACE cases treated at First People's Hospital of Nantong from January 2019 to September 2023 were retrospectively analyzed in this study. Patients were categorized into either strabismus surgery or BTXA injection groups based on treatment modality. Further stratification was performed according to preoperative deviation angles [>35 prism diopters(PD)vs ≤35 PD] and age(≥18 years adult group vs <18 years adolescent group). The baseline patient characteristics were collected, deviation angles at multiple timepoints before and after treatment were measured, and stereopsis test results were documented. Through comparative analysis of therapeutic outcomes across subgroups, we systematically evaluated the efficacy of different treatment approaches.RESULTS:A total of 43 AACE patients were included. At the final follow-up, both the surgery and BTXA injection groups showed a statistically significant decrease in deviation angle compared to pretreatment measurements(P<0.001). Significant differences were noted between the two groups in terms of the cure rate of strabismus and the recovery rate of stereopsis(P<0.05). For patients with deviations >35 PD, surgery yielded significantly better outcomes than injection therapy in postoperative angle, success rate, and stereopsis recovery(P<0.05). Similarly, in patients aged ≥18 years, surgical treatment was superior to injections in reducing strabismus angle, improving success rates, and restoring stereopsis(P<0.05).CONCLUSION:Both BTXA injection and strabismus surgery demonstrate therapeutic efficacy in AACE. Surgical treatment demonstrated superior efficacy compared to BTXA injection therapy, particularly in patients with deviations >35 PD and those aged ≥18 years. For patients with angles ≤35 PD or under 18 years, BTXA injection remains a viable treatment option.

Objective:To investigate the ocular pathogen spectrum and drug sensitivity characteristics of patients to be diagnosed with infectious keratitis within 10 years in two tertiary hospitals in Nantong City, Jiangsu Province, eastern China.Methods:A cross-sectional study was conducted.Microbial culture specimens from consecutive 1 404 patients with suspected infectious keratitis admitted to the Department of Ophthalmology at the First People's Hospital of Nantong City and Nantong University Affiliated Hospital from January 2014 to October 2023 were collected.The patients' general data, etiology and drug sensitivity test results were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Nantong First People's Hospital (No.2021KT273) and Nantong University Affiliated Hospital (No.2019-K068).Results:Among 1 404 patients with suspected infectious keratitis, the positive rate of microbial culture was 37.04%(520/1 404).A total of 537 strains were isolated and cultured, with fungi accounting for 69.09%(371/537) and bacteria accounting for 30.91%(166/537).The common bacterial genera in fungal keratitis were Fusarium (47.17%, 175/371), Alternaria (15.90%, 59/371), Aspergillus (14.56%, 54/371), Certospora (10.78%, 40/371) and Penicillium (3.50%, 13/371).The annual composition ratio of Fusarium showed a downward trend, while Certospora showed an upward trend.The common bacteria in bacterial keratitis were Staphylococcus epidermidis (24.10%, 40/166), Streptococcus pneumoniae (17.47%, 29/166), Pseudomonas aeruginosa (13.25%, 22/166), Staphylococcus aureus (6.63%, 11/166) and Corynebacterium macginleyi (4.22%, 7/166).The annual composition ratio of Pseudomonas aeruginosa showed an increasing trend.The resistance rates of gram-positive bacteria to levofloxacin and vancomycin were 36.26% and 0% respectively, and the resistance rates of gram-negative bacteria to aminoglycosides and ceftazidime were <10%.A total of 61 bacterial strains (40.94%) were multi-drug resistant. Conclusions:Fusarium is common in fungal keratitis, and Corynebacterium macginleyi in bacterial keratitis may be a microbial feature in Nantong City.Levofloxacin may no longer be suitable as a first-line antibiotic for topical ocular use.

Objective:To investigate the ocular pathogen spectrum and drug sensitivity characteristics of patients to be diagnosed with infectious keratitis within 10 years in two tertiary hospitals in Nantong City, Jiangsu Province, eastern China.Methods:A cross-sectional study was conducted.Microbial culture specimens from consecutive 1 404 patients with suspected infectious keratitis admitted to the Department of Ophthalmology at the First People's Hospital of Nantong City and Nantong University Affiliated Hospital from January 2014 to October 2023 were collected.The patients' general data, etiology and drug sensitivity test results were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Nantong First People's Hospital (No.2021KT273) and Nantong University Affiliated Hospital (No.2019-K068).Results:Among 1 404 patients with suspected infectious keratitis, the positive rate of microbial culture was 37.04%(520/1 404).A total of 537 strains were isolated and cultured, with fungi accounting for 69.09%(371/537) and bacteria accounting for 30.91%(166/537).The common bacterial genera in fungal keratitis were Fusarium (47.17%, 175/371), Alternaria (15.90%, 59/371), Aspergillus (14.56%, 54/371), Certospora (10.78%, 40/371) and Penicillium (3.50%, 13/371).The annual composition ratio of Fusarium showed a downward trend, while Certospora showed an upward trend.The common bacteria in bacterial keratitis were Staphylococcus epidermidis (24.10%, 40/166), Streptococcus pneumoniae (17.47%, 29/166), Pseudomonas aeruginosa (13.25%, 22/166), Staphylococcus aureus (6.63%, 11/166) and Corynebacterium macginleyi (4.22%, 7/166).The annual composition ratio of Pseudomonas aeruginosa showed an increasing trend.The resistance rates of gram-positive bacteria to levofloxacin and vancomycin were 36.26% and 0% respectively, and the resistance rates of gram-negative bacteria to aminoglycosides and ceftazidime were <10%.A total of 61 bacterial strains (40.94%) were multi-drug resistant. Conclusions:Fusarium is common in fungal keratitis, and Corynebacterium macginleyi in bacterial keratitis may be a microbial feature in Nantong City.Levofloxacin may no longer be suitable as a first-line antibiotic for topical ocular use.

Objective To compare the applied signification of optical and ultrasonic biometry in observing the axial length of eyes with vitreous hemorrhage and retinal detachment. Methods This is a prospective clinical study. We randomly selected 57 cases (57 eyes) with vitreous hemorrhage and (or) retinal detachment from May 1, 2016 to May 31. Patients had not been performed eye surgery, also denied the history of ocular trauma and excluded other eye diseases. 25 eyes with vitreous hemorrhage, 24 eyes with retinal detachment, 8 eyes complicated with vitreous and retinal detachment hemorrhage. At 24 hours before surgery, we measured axial length using the Lenstar LS 900, immersion B-ultrasound (IB) and immersion A-ultrasound (IA). The differences between three methods were assessed with paired sample t-test. Results IB and IA data was collected from all 57 eyes, there was no statistical significance between measurements of IB and IA (P > 0.05). In the eyes with serious refractive medium opacity (36 eyes), the results showed no statistical significance difference between measurements of IB and IA (P > 0.05). The measurements of three groups can be obtained from the rest eyes (21 eyes): significant statistical difference of the measurements between IB and Lenstar was detected[(24.057±1.441)mm vs(23.470±1.775)mm],(t=3.099, P < 0.05) same results between IA and Lenstar was obtained [(23.962±1.443) mm vs (23.470±1.775) mm], difference was statistically significant (t=2.643, P < 0.05). But the measurements showed no statistical significance difference between the measurements of IB and IA (P > 0.05). Conclusions In the eyes with vitreous hemorrhage and (or) retinal detachment, the measurements of axial length could not be achieved or existed deviations on account of refractive medium opacity when using optical biometry. Under such circumstances, we should choose IA or IB as the optimization method to obtain measurements, in order to get much more accurate results.

Background Small incision lenticule extraction (SMILE) was a new procedure which is miniinvasion and flapless,but few attentions were paid to the visual quality after SMILE.To understand the changes of intraocular straylight after SMILE is of important significance for the assession of the visual quality after the procedure.Objective This study was to compare the characteristic of straylight between SMILE and femtosecond laser assisted laser in situ keratomileusis (FS-LAISK) after surgery.Methods A retrospective study was designed.Written informed consent was obtained from each patient prior to accepting the surgery.One hundred and twenty-seven eyes of 68 patients with myopia and myopic astigmatism were included in Tianjin Eye Hospital from January 2011 to July 2013.SMILE was performed on 64 eyes of 35 patients and FS-LASIK was carried out in 63 eyes of 33 patients at the same period.Stray light was detected with C-Quant stray light meter before and 1 week,1 month and 6 months after surgery.The changes of stray light values following the surgery were compared between the two groups,and the correlations between postoperative stray light values with operative parameters were analyzed.Results The mean stray light values were (1.03 ±0.19)D and (0.95±0.16)D at 1 week and 1 month after surgery,which were higher than (0.88 ±0.18)D at preoperation in the FS-LASIK group (P =0.000,0.012).The stray light values were (0.98±0.16),(0.95±0.14) and (0.94±0.16)D at 1 week,1 month or 6 months after surgery,and no statistically significant differences were found in comparison with (0.91 ±0.15)D in preoperation in the SMILE group (all at P＞0.05).No significant intergroup difference was seen in the stray light values (Fgroup =0.077,P=0.781).The stray light differences of various time points after surgery and before surgery were increased in the FS-LASIK group compared with SMILE group (Fgroup =14.798,P＜0.001),with the significant difference in postoperative 1 week between the two groups (P＜0.01).The negative correlations were found between stray light values at 1 week,1 month and 6 months after SMILE with the lenticule thickness/central corneal thickness (CCT) (R2=0.123,0.145,0.098,all at P＜0.05) or between stray light change.Conclusions Intraocular stray light appears less change in operative eyes after SMILE.However,intraocular stray light increases in the eyes received FS-LASIK,especially at early stage after operation.The stray light shifts return to normal with the lapse of postoperative time.

BACKGROUND: Interleukin-1 (IL-1β) and intercellular adhesion molecule-1 (ICAM-1 ) can mediate neutrophilic infiltration, which is closely relevant to cerebral ischemia-reperfusion injury.OBJECTIVE: To investigate the effect of physcion on cerebral inflammatory reaction after ischemia-reperfusion injury.DESIGN: A completely randomized study based on animals.SETTING: Neurological department in a university hospital.MATERIALS: From September to December 2003, the study was conducted in the Animal Laboratory, Hebei Staff and Workers Medical College. Totally 91 healthy male SD rats, supplied by Laboratory Animal Center of Hebei Medical University, were used in the experiments. They were divided into sham operation (SO) group, ischemia-reperfusion group, normal control group, 20 mg/kg physcion group and 40 mg/kg physcion group.Each of the former two groups would be divided into 4 subgroups named as the 6th-hour-after-reperfusion group, the 12th-hour-after-reperfusion group, the 24th-hour-after-reperfusion group and the 48th-hour-after-reperfusion group. Each of the latter two groups were divided into 2 subgroups named as the 12thhour-after-reperfusion group and the 24th-hour-after-reperfusion group. Each subgroup contained 7 rats.INTERVENTIONS: Middle cerebral artery occlusion model (MCAO model) was applied, and IL-1β was measured by radioimmunoassay and ICAM-1 was detected by immunohistochemical staining.MAIN OUTCOME MEASUREMENTS: The IL-1 β level and the positive expression of ICAM-1 in the rats' cerebella were observed.RESULTS: Cerebral ischemia-reperfusion injury in the rats reached its peak 6 hours after reperfusion, and then it decreased gradually. In the 12-hour-after-reperfusion subgroup amd the 24-hour-after-reperfusion subgroup of the 40 mg/kg physcion group, and the 12-hour-after-reperfusion subgroup of the 20 mg/kg physcion group, IL-1β in the injured parts of the cerebella decreased dramatically, compared with MCAO model controls ( P＜ 0.01 ). In the normal control group and SO group, a small quantity of ICAM-1 was detected in rat' s cerebral cortex, and some fulvous staining substance was observed in the plasma and membrane of cerebral vascular endothelium cells. In the cerebral ischemia-reperfusion injury group, positive staining substance could be observed 24 hours after the reperfusion, then darkened gradually (integral absorbency value: 31.89 ± 4.38, area density value: 0. 018 5 ± 0. 003 1). In the 12-hour-after-reperfusion subgroup of the 40 mg/kg physcion group (integral absorbency value: 13.33 ±6. 12, area density value: 0. 007 6 ± 0. 002 2) and the 24-hour-after-reperfusion subgroup of the 40 mg/kg physcion group (integral absorbency value: 20.04 ±4.65,area density value: 0. 012 9 ±0. 003 6), and in the 24-hour-after-reperfusion subgroup of the 20 mg/kg physcion group (integral absorbency value:23.73 ±4.51 area density value: 0. 014 1 ±0. 003 8), expressions of ICAM-1 around the infarctions significantly decreased as compared with those in the MCAO model controls respectively ( P ＜ 0.01 or P ＜ 0.05).CONCLUSION: Physcion tends to decrease the expressing of IL-1β and ICAM-1 in a cerebellum after ischemia-reperfusion injury, thus, it may help alleviate the ischemia-reperfusion injury.