BACKGROUND:Studies have shown that vision recovery with thinner grafts is faster and the risk of rejection is lower.In China,there is a lack of clinical efficacy analysis of different graftthicknesses after endothelial transplantation.Therefore,determining the optimal graftthickness is crucial for improving surgical efficacy. OBJECTIVE:To evaluate the effects of different graftthickness on vision recovery and other prognostic indexes after simple Descemet's stripping endothelial keratoplasty. METHODS:A total of 72 patients(72 eyes)with corneal endothelial decompensation who received simple Descemet's stripping endothelial keratoplasty at the General Hospital of Northern Theater Command from January 2013 to February 2023 were selected.There were 32 cases(32 eyes)in the thin graftgroup(＜100 μm)and 40 cases(40 eyes)in the thick graftgroup(≥100 μm).The best corrected visual acuity,corneal endothelial cell count,corneal graft transparency,postoperative complications and graftsurvival were observed in both groups before and 1,3,6,and 12 months after surgery. RESULTS AND CONCLUSION:The visual acuity after surgery was significantly improved in both groups,and the best corrected visual acuity 3 months after surgery in the thin graftgroup was better than that in the thick graftgroup(P＜0.05).There was no significant difference in the number of corneal endothelial cells and grafttransparency between the two groups 1 year after surgery(P＞0.05).There was no significant difference in the incidence of postoperative complications such as secondary glaucoma,graftimmune rejection and graftdisplacement between the two groups(P＞0.05).There was no significant difference in the 1-year survival rate of grafts between the two groups(93.8%vs.92.3%,P＞0.05).To conclude,simple Descemet's stripping endothelial keratoplasty is a safe and effective surgical method for corneal endothelial transplantation,and its postoperative efficacy is similar to that of traditional Descemet's stripping endothelial keratoplasty,and the graftimplantation method is simpler.Thinner grafts can provide optimal corrected vision earlier and complete corneal remodeling sooner.Therefore,in the treatment of corneal endothelial decompensation,thinner grafts are preferred to improve recovery time.

Objective:To investigate the dosimetric advantages of deep inspiration breath-hold (DIBH) technique in postoperative radiotherapy for left-sided breast cancer.Methods:A prospective study was conducted on patients requiring adjuvant radiotherapy after left-sided breast cancer surgery at Jiangsu Cancer Hospital from January 2018 to May 2023. CT simulation images were acquired under both free breathing (FB) and DIBH respiratory modes. Planning target volumes (PTV) and organs at risk (OAR) were delineated, and dosimetric parameters were compared between the two respiratory modes. Additionally, patients were grouped into subgroups [internal mammary lymph node irradiation (IMNI) vs. non-IMNI, breast-conserving surgery (BCS) followed by radiotherapy vs. modified radical mastectomy (MRM) followed by radiotherapy], and dosimetric differences among subgroups for both breathing modes were compared. The Velocity system was used to measure the minimum distances from the heart and left anterior descending coronary artery (LAD) to the PTV surface on CT images. These distances were defined as the heart-to-PTV and LAD-to-PTV distances. Pearson correlation analysis was performed to assess the relationships between heart D max and LAD D max, heart-to-PTV distance and heart D mean, and LAD-to-PTV distance and LAD D max under both respiratory modes. Results:A total of 132 patients were included. Compared to the FB, DIBH showed no significant difference in target dose distribution, but significantly reduced dose to OAR. Specifically, the heart D mean and D max decreased by 1.8 Gy and 8.1 Gy, respectively, and the LAD D max decreased by 7.9 Gy, and the affected lung V 5 Gy and V 20 Gy were reduced by 6.4% and 2.5%, respectively (all P<0.05). All subgroups benefited from DIBH, with greater decrease of dose to OAR in the IMNI subgroup (compared with the non-IMNI subgroup) and the subgroup of MRM followed by radiotherapy (compared with the BCS followed by radiotherapy group). Under both FB and DIBH modes, heart D max and LAD D max showed linear correlations ( r=0.62 and 0.84, respectively; both P<0.001), heart-to-PTV distance correlated with heart D mean ( r=-0.61 and -0.67, respectively; both P<0.001), and LAD-to-PTV distance correlated with LAD D max ( r=-0.58 and -0.63, respectively; both P<0.001). Conclusions:The DIBH technique can significantly reduce dose to the heart, LAD, and lungs in patients undergoing postoperative radiotherapy for left-sided breast cancer without compromising target dose. Patients receiving IMNI after left-sided breast cancer surgery benefit more from the DIBH technique.

Objective To analyze the literature on acupuncture and moxibustion in promoting regeneration and repair published at home and abroad based on bibliometrics to identify the current status,hotspots,and trends of research in this field.Methods Chinese and English literature related to acupuncture and moxibustion in promoting regeneration and repair published in China Knowledge Network(CNKI)and Web of Science(WOS)Core Collection were visualized and analyzed using VOSviewer and Citespace software.Results Since the inception of the database to June 30,2024,1651 and 1437 documents were published in Chinese and English,respectively,showing a fluctuating upward trend over the past 20 years,with China being the country with the highest number of publications,Heilongjiang University of Traditional Chinese Medicine being the research institution with the highest number of publications in the CNKI database,and Beijing University of Traditional Chinese Medicine and Shanghai University of Traditional Chinese Medicine being the research institutions with the highest number of publications in the WOS database.The keyword analysis revealed that the research hotspot of acupuncture and moxibustion in promoting regeneration and repair focused on acupuncture therapies based on electroacupuncture,acupuncture and moxibustion,as well as research targets based on the brain,spinal cord and gastrointestinal mucosa,and the future research trend would be centered on the mechanism of action,focusing on the value of more acupuncture therapies in diseases such as spinal cord injury and ulcerative colitis.Conclusion In recent years,the research field of acupuncture and moxibustion in promoting regeneration and repair has developed rapidly,and various research teams have achieved rich results.The research hotspots have shown a diversified and deeper trend,and the application of acupuncture and moxibustion in promoting regeneration and repair has a broad prospect,and it is expected to provide more effective therapeutic means for the clinic.

BACKGROUND:If not detected and treated in a timely manner,immune-associated peripheral ulcerative keratitis can lead to corneal thinning,ulcers and even perforation,thereby causing visual loss and affecting the patient's quality of life.OBJECTIVE:To discuss the pathogenesis of immune-associated peripheral ulcerative keratitis and summarize the diagnosis and treatment ideas and the latest treatment methods for this disease.METHODS:Search terms were"peripheral ulcerative keratitis,immunity,immune system disease,pathogenesis,immunomodulatory therapy,surgical treatment,keratoplasty"in English and Chinese.Relevant literature on peripheral ulcerative keratitis published from database inception to October 2024 was searched by computer in CNKI,WanFang,PubMed,and El databases.A total of 68 papers were ultimately selected to comprehensively describe the new research progress in the research on immune-associated peripheral ulcerative keratitis.RESULTS AND CONCLUSION:Immune-associated peripheral ulcerative keratitis includes Mooren's ulcer,blepharokeratoconjunctivitis,superior limbic keratoconjunctivitis,and autoimmune related peripheral ulcerative keratitis.Due to the physiology of the corneal limbus,peripheral ulcerative keratitis is usually associated with an immune response,and the pathophysiologic mechanism is usually related to the deposition of immune complexes in the blood vessels at the limbus and the production of microangiitis.Systemic immunomodulatory therapy should be used whether or not an autoimmune disease is diagnosed prior to the onset of immune-associated peripheral ulcerative keratitis,which can help to reduce ocular complications associated with systemic inflammation.Nonsurgical treatment,such as immunomodulatory therapy,is beneficial for relieving ocular symptoms,but when nonsurgical treatment is ineffective or the lesion infiltrates the Descemet membrane,it can cause corneal perforation.Combined surgical treatment can help maintain the structural integrity of the eyeball.However,there is no clear evidence for the combination of immunomodulatory therapy and surgical treatment in the development of immune-associated Peripheral ulcerative keratitis.This article reviews the literature on the diagnosis and treatment of immune-associated peripheral ulcerative keratitiss.

Objective To analyze the literature on acupuncture and moxibustion in promoting regeneration and repair published at home and abroad based on bibliometrics to identify the current status,hotspots,and trends of research in this field.Methods Chinese and English literature related to acupuncture and moxibustion in promoting regeneration and repair published in China Knowledge Network(CNKI)and Web of Science(WOS)Core Collection were visualized and analyzed using VOSviewer and Citespace software.Results Since the inception of the database to June 30,2024,1651 and 1437 documents were published in Chinese and English,respectively,showing a fluctuating upward trend over the past 20 years,with China being the country with the highest number of publications,Heilongjiang University of Traditional Chinese Medicine being the research institution with the highest number of publications in the CNKI database,and Beijing University of Traditional Chinese Medicine and Shanghai University of Traditional Chinese Medicine being the research institutions with the highest number of publications in the WOS database.The keyword analysis revealed that the research hotspot of acupuncture and moxibustion in promoting regeneration and repair focused on acupuncture therapies based on electroacupuncture,acupuncture and moxibustion,as well as research targets based on the brain,spinal cord and gastrointestinal mucosa,and the future research trend would be centered on the mechanism of action,focusing on the value of more acupuncture therapies in diseases such as spinal cord injury and ulcerative colitis.Conclusion In recent years,the research field of acupuncture and moxibustion in promoting regeneration and repair has developed rapidly,and various research teams have achieved rich results.The research hotspots have shown a diversified and deeper trend,and the application of acupuncture and moxibustion in promoting regeneration and repair has a broad prospect,and it is expected to provide more effective therapeutic means for the clinic.

BACKGROUND:If not detected and treated in a timely manner,immune-associated peripheral ulcerative keratitis can lead to corneal thinning,ulcers and even perforation,thereby causing visual loss and affecting the patient's quality of life.OBJECTIVE:To discuss the pathogenesis of immune-associated peripheral ulcerative keratitis and summarize the diagnosis and treatment ideas and the latest treatment methods for this disease.METHODS:Search terms were"peripheral ulcerative keratitis,immunity,immune system disease,pathogenesis,immunomodulatory therapy,surgical treatment,keratoplasty"in English and Chinese.Relevant literature on peripheral ulcerative keratitis published from database inception to October 2024 was searched by computer in CNKI,WanFang,PubMed,and El databases.A total of 68 papers were ultimately selected to comprehensively describe the new research progress in the research on immune-associated peripheral ulcerative keratitis.RESULTS AND CONCLUSION:Immune-associated peripheral ulcerative keratitis includes Mooren's ulcer,blepharokeratoconjunctivitis,superior limbic keratoconjunctivitis,and autoimmune related peripheral ulcerative keratitis.Due to the physiology of the corneal limbus,peripheral ulcerative keratitis is usually associated with an immune response,and the pathophysiologic mechanism is usually related to the deposition of immune complexes in the blood vessels at the limbus and the production of microangiitis.Systemic immunomodulatory therapy should be used whether or not an autoimmune disease is diagnosed prior to the onset of immune-associated peripheral ulcerative keratitis,which can help to reduce ocular complications associated with systemic inflammation.Nonsurgical treatment,such as immunomodulatory therapy,is beneficial for relieving ocular symptoms,but when nonsurgical treatment is ineffective or the lesion infiltrates the Descemet membrane,it can cause corneal perforation.Combined surgical treatment can help maintain the structural integrity of the eyeball.However,there is no clear evidence for the combination of immunomodulatory therapy and surgical treatment in the development of immune-associated Peripheral ulcerative keratitis.This article reviews the literature on the diagnosis and treatment of immune-associated peripheral ulcerative keratitiss.

Objective:To investigate the dosimetric advantages of deep inspiration breath-hold (DIBH) technique in postoperative radiotherapy for left-sided breast cancer.Methods:A prospective study was conducted on patients requiring adjuvant radiotherapy after left-sided breast cancer surgery at Jiangsu Cancer Hospital from January 2018 to May 2023. CT simulation images were acquired under both free breathing (FB) and DIBH respiratory modes. Planning target volumes (PTV) and organs at risk (OAR) were delineated, and dosimetric parameters were compared between the two respiratory modes. Additionally, patients were grouped into subgroups [internal mammary lymph node irradiation (IMNI) vs. non-IMNI, breast-conserving surgery (BCS) followed by radiotherapy vs. modified radical mastectomy (MRM) followed by radiotherapy], and dosimetric differences among subgroups for both breathing modes were compared. The Velocity system was used to measure the minimum distances from the heart and left anterior descending coronary artery (LAD) to the PTV surface on CT images. These distances were defined as the heart-to-PTV and LAD-to-PTV distances. Pearson correlation analysis was performed to assess the relationships between heart D max and LAD D max, heart-to-PTV distance and heart D mean, and LAD-to-PTV distance and LAD D max under both respiratory modes. Results:A total of 132 patients were included. Compared to the FB, DIBH showed no significant difference in target dose distribution, but significantly reduced dose to OAR. Specifically, the heart D mean and D max decreased by 1.8 Gy and 8.1 Gy, respectively, and the LAD D max decreased by 7.9 Gy, and the affected lung V 5 Gy and V 20 Gy were reduced by 6.4% and 2.5%, respectively (all P<0.05). All subgroups benefited from DIBH, with greater decrease of dose to OAR in the IMNI subgroup (compared with the non-IMNI subgroup) and the subgroup of MRM followed by radiotherapy (compared with the BCS followed by radiotherapy group). Under both FB and DIBH modes, heart D max and LAD D max showed linear correlations ( r=0.62 and 0.84, respectively; both P<0.001), heart-to-PTV distance correlated with heart D mean ( r=-0.61 and -0.67, respectively; both P<0.001), and LAD-to-PTV distance correlated with LAD D max ( r=-0.58 and -0.63, respectively; both P<0.001). Conclusions:The DIBH technique can significantly reduce dose to the heart, LAD, and lungs in patients undergoing postoperative radiotherapy for left-sided breast cancer without compromising target dose. Patients receiving IMNI after left-sided breast cancer surgery benefit more from the DIBH technique.

Objective:To systematically evaluate the clinical efficacy of fire needle therapy and conventional western medicine in the treatment of patients with acute herpes zoster.Methods:Randomized controlled trials (RCTs) of fire needle therapy in the treatment of acute herpes zoster were retrieved from China National Knowledge Internet (CNKI), Wanfang, Database of Chinese Sci Tech Periodicals (VIP Database), China Biomedical Literature Database (CBM), Medline, Embase, and Cochrane Library from the establishment of the databases to May 30, 2022. According to the inclusion and exclusion criteria, the included literature was screened, and Review Manager 5.3 was used for system evaluation and meta-analysis.Results:7 articles were included for analysis after screening, involving 452 patients. There were 226 cases in the treatment group and 226 cases in the control group. The results of meta-analysis showed that fire needle therapy was superior to conventional western medicine in the total effective rate [ RR=0.36, 95% CI (0.20, 0.65), P=0.000 7], lower incidence of PHN [ RR=0.25, 95% CI (0.09, 0.72), P=0.01], lower VAS score [ MD=-1.19, 95% CI (-2.14, -0.24), P=0.01], and shorter scab forming time [ MD=-2.03, 95% CI (-2.42, -1.64), P<0.001]. Conclusion:The curative effect of fire needle therapy is more prominent than that of conventional western medicine in the treatment of acute herpes zoster.

Objective:To investigate the relationship between the cardia morphology under magnetically controlled capsule gastroscopy and the clinical characteristics of subjects.Methods:A total of 216 subjects with gastrointestinal symptoms or receiving physical examination who underwent magnetically controlled capsule gastroscopy at the Department of Gastroenterology, Beijing Chao-Yang Hospital, Capital Medical University from August 2022 to November 2022 were enrolled. All subjects took gastroesophageal reflux disease questionnaire (Gerd-Q) survey. Clinical data of subjects were collected, and images of cardia morphology under magnetically controlled capsule gastroscopy were recorded. The subjects were divided into 4 groups according to differrent cardia morphology based on the degree of relaxation. The clinical characteristics of each group were compared, and the influencing factors for cardia morphology were analyzed.Results:In non-swallowing state, 116 subjects showed good continuous closure of the cardia in plum shape (group A), 33 subjects radial closure of cardia (group B), 46 subjects slightly relaxed linear cardia (group C) and 21 subjects relaxed and continuous opening of cardia in the shape of cave (group D). The ages of subjects in group A, B, C and D were 35.00 (31.00, 42.00) years, 53.00 (37.50, 60.50) years, 61.50 (41.50, 68.25) years and 52.00 (39.00, 70.00) years, respectively, with significant differences ( H=44.348, P<0.001). The Gerd-Q scores of subjects in group A, B, C and D were 1.50 (1.00, 2.00), 3.00 (2.00, 6.50), 8.00 (5.75, 9.00) and 8.00 (7.50, 9.00), respectively, with significant differences ( H=90.788, P<0.001). The body mass index (BMI) of subjects in group A, B, C and D were 22.66 (19.53, 24.70) kg/m 2, 23.44 (21.41, 27.05) kg/m 2, 23.77 (21.19, 26.93) kg/m 2 and 23.73 (19.63,24.79) kg/m 2, respectively, with significant differences ( H=8.114, P=0.044). The degree of cardia relaxation was positively correlated with the age ( rs=0.456, P<0.001), Gerd-Q score ( rs=0.648, P<0.001) and BMI ( rs=0.146, P=0.032) of subjects. Conclusion:The magnetically controlled capsule gastroscopy provides good visualisation of cardia morphology in non-swallowing state. There is a positive correlation between the degree of cardia relaxation under magnetically controlled capsule gastroscopy in non-swallowing state and the subjects' age, Gerd-Q score, and BMI.

Objective:To summarize the experience and the clinical data of patients with primary hyperparathyroidism undergoing endoscopic parathyroidectomy.Methods:A total of 24 patients who underwent endoscopic parathyroidectomy for primary hyperparathyroidism in Peking Union Medical College Hospital during Feb. 2021 to May. 2022 were concluded in this study (20 cases of parathyroidectomy via axillary approach and 4 cases of parathyroidectomy via thoracic and breast approach) . The operation time, postoperative drainage, length of stay, level of parathyroid hormone and serum calcium of those patients were collected. Postoperative complications and recurrence of hyperparathyroidism were also observed.Results:The postoperative levels of serum parathyroid hormone and serum calcium were significantly reduced (over 50%) compared with preoperative level ( P<0.05) . The average operation time was (96±22) min (64-157 min) . The mean postoperative drainage volume was (47±16) ml on day 1, (46±11) ml on day 2, and (30±9) ml on day 3, respectively. The average length of postoperative hospital stay was (2.8±1.1) days (2-6 days) . In one case of parathyroidectomy via axillary approach, the operation was converted to open surgery because of the low position of lesion. Other cases completed endoscopic surgery and obtained satisfactory cosmetic results. There were no postoperative complications such as bleeding, permanent hoarseness, coughing while drinking water, or surgical site infection. The mean follow-up time was (7.4±4.2) months (1-16 months) . There was no obvious discomfort and no recurrence during follow-up. Conclusion:Endoscopic parathyroidectomy is safe and effective in the treatment of primary hyperparathyroidism, which can be used as a surgical option for patients with cosmetic requirements.