Compared to other refractive surgeries, the implantable collamer lens(ICL)implantation procedure has become one of the most popular surgical options in refractive surgery. ICL surgery offers advantages such as reversibility, high-definition visual outcomes, and preservation of the corneal anatomical structure. The V4c model, which features a central port, is currently the most widely used in clinical practice and eliminates the need for peripheral iridotomy during the perioperative period. Although excellent uncorrected visual acuity can be achieved postoperatively, some patients may experience visual disturbances in the early postoperative period, such as halo and glare, which may affect visual comfort particularly under low-light conditions. This article reviews visual quality metrics after ICL V4c implantation, including higher-order aberrations(HOA), modulation transfer function(MTF), and contrast sensitivity(CS), along with influencing factors, and discusses potential relative deficits in postoperative visual quality and their underlying mechanisms.

This paper systematically reviews the core concepts and lines of theoretical inheritance of major spleen-stomach theories in traditional Chinese medicine （TCM）， including spleen deficiency theory， spleen-stomach damp-heat theory， and liver-spleen disharmony theory. It is found that these theories have all undergone a developmental trajectory characterized by classical foundation， refinement of therapeutic methods， systematization of pathogenesis， and modern innovation. The evolution of spleen-stomach theory has achieved a shift from a singular focus on tonifying the spleen to regulating dynamic middle-jiao （焦） balance， and from localized spleen-stomach regulation to the circular movement of qi involving all five zang organs. In terms of modern disease-syndrome integrative research， spleen deficiency syndrome is shown to be closely associated with impairment of the gastrointestinal mucosal barrier， metabolic disorders， and gene polymorphisms related to Helicobacter pylori-associated gastric diseases. Spleen-stomach damp-heat syndrome is closely linked to hyperactive energy metabolism， inflammatory cytokines， and abnormal expression of aquaporins. Liver-spleen disharmony syndrome is mainly associated with dysregulation of the brain-gut axis and microbiota-related metabolic disorders. It is proposed that future research on spleen-stomach diseases and syndromes should further elucidate their potential multidimensional differential biological characteristics， thereby promoting the modernization of the TCM discipline of spleen-stomach studies.

Objective:To investigate the correlation between the hemodynamic pattern of non-culprit vessel stenosis and long-term vessel-oriented composite outcome(VOCO) in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods:From January 2019 to December 2021, 233 consecutive patients with STEMI and non-culprit vessel stenosis were prospectively enrolled at Shanghai East Hospital. The median follow-up duration was 3.9 years. The 367 non-culprit vessels of the 233 patients were divided into the VOCO group (33 vessels, 9.0%) and the non-VOCO group (334 vessels, 91.0%). Parameters pertaining to the hemodynamic pattern of non-culprit vessel stenosis between the two groups were compared. Receiver operating characteristic (ROC) curves were used to assess the correlation between hemodynamic pattern and VOCO, and Cox multivariate regression and logistic multivariate regression analyses were applied to identify independent predictors of VOCO.Results:The 233 enrolled patients were aged (62.5±12.9) years, with 193 males (82.8%). In the VOCO group, the maximum quantitative flow ratio (QFR) decreased within 20 mm of the QFR-assessed segment, the difference in QFR across the entire vessel, the length of functionally significant vessel, and the maximum gradient of QFR decrease (dQFR/dsmax) were significantly greater than those in the non-VOCO group. ROC curve analysis showed that the optimal threshold for predicting VOCO using dQFR/dsmax was 0.009 6 (area under the curve: 0.691, 95% CI: 0.606-0.775, P<0.001). Multivariable Cox regression analysis revealed that dQFR/dsmax was an independent predictor of VOCO ( HR=1.199, 95% CI: 1.070-1.343, P=0.002). When anatomical and functional stenosis severities were included in the model, a high pullback pressure gradient (PPG) index ( HR=1.572, 95% CI: 1.052-2.351, P=0.027) emerged as an independent predictor of VOCO. Multivariable logistic regression analysis revealed that a low PPG index( OR=2.851, 95% CI: 1.945-4.178, P<0.001) was an independent predictor of QFR≤0.80 without long-term VOCO. Conclusion:In patients with STEMI, localized hemodynamic patterns of coronary artery stenosis, characterized by high dQFR/dsmax and high PPG index, are associated with long-term VOCO.

There are differences in the images of the same visual object projected onto the retinas of the two eyes.Stereopsis is the perceptual ability of the brain to discern three-dimensional depth from these two-dimensional images with binocular disparities,enabling humans to accurately perceive the relative distance between objects and assess their relative depth in space.Panum's fusional area(PFA)encompasses the depth range,including the horopter where the visual object lies and the areas in front of and behind it,within which fused single vision can be achieved.Visual function within the PFA is closely related to the formation of depth perception.The monocular visual direction,the depth of the binocular horopter position,and the measurement methods and models for the theoretical horopter and empirical horopter are all closely asso-ciated with the characteristics of depth perception within the PFA range.This holds significant importance for studying the construction process of stereopsis.

There are differences in the images of the same visual object projected onto the retinas of the two eyes.Stereopsis is the perceptual ability of the brain to discern three-dimensional depth from these two-dimensional images with binocular disparities,enabling humans to accurately perceive the relative distance between objects and assess their relative depth in space.Panum's fusional area(PFA)encompasses the depth range,including the horopter where the visual object lies and the areas in front of and behind it,within which fused single vision can be achieved.Visual function within the PFA is closely related to the formation of depth perception.The monocular visual direction,the depth of the binocular horopter position,and the measurement methods and models for the theoretical horopter and empirical horopter are all closely asso-ciated with the characteristics of depth perception within the PFA range.This holds significant importance for studying the construction process of stereopsis.

Objective:To investigate the correlation between the hemodynamic pattern of non-culprit vessel stenosis and long-term vessel-oriented composite outcome(VOCO) in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods:From January 2019 to December 2021, 233 consecutive patients with STEMI and non-culprit vessel stenosis were prospectively enrolled at Shanghai East Hospital. The median follow-up duration was 3.9 years. The 367 non-culprit vessels of the 233 patients were divided into the VOCO group (33 vessels, 9.0%) and the non-VOCO group (334 vessels, 91.0%). Parameters pertaining to the hemodynamic pattern of non-culprit vessel stenosis between the two groups were compared. Receiver operating characteristic (ROC) curves were used to assess the correlation between hemodynamic pattern and VOCO, and Cox multivariate regression and logistic multivariate regression analyses were applied to identify independent predictors of VOCO.Results:The 233 enrolled patients were aged (62.5±12.9) years, with 193 males (82.8%). In the VOCO group, the maximum quantitative flow ratio (QFR) decreased within 20 mm of the QFR-assessed segment, the difference in QFR across the entire vessel, the length of functionally significant vessel, and the maximum gradient of QFR decrease (dQFR/dsmax) were significantly greater than those in the non-VOCO group. ROC curve analysis showed that the optimal threshold for predicting VOCO using dQFR/dsmax was 0.009 6 (area under the curve: 0.691, 95% CI: 0.606-0.775, P<0.001). Multivariable Cox regression analysis revealed that dQFR/dsmax was an independent predictor of VOCO ( HR=1.199, 95% CI: 1.070-1.343, P=0.002). When anatomical and functional stenosis severities were included in the model, a high pullback pressure gradient (PPG) index ( HR=1.572, 95% CI: 1.052-2.351, P=0.027) emerged as an independent predictor of VOCO. Multivariable logistic regression analysis revealed that a low PPG index( OR=2.851, 95% CI: 1.945-4.178, P<0.001) was an independent predictor of QFR≤0.80 without long-term VOCO. Conclusion:In patients with STEMI, localized hemodynamic patterns of coronary artery stenosis, characterized by high dQFR/dsmax and high PPG index, are associated with long-term VOCO.

Objective:To investigate the effect and mechanism of SIRT7 in epithelial mesenchymal transformation (EMT) of pancreatic cancer cells.Methods:The pancreatic cancer cells were divided into siControl, siSIRT7, over-expression SIRT7, siSIRT7+siCOL4A1, and siSIRT7+siSLUG groups using siRNA or plasmid transfection. The proliferation, migration and invasion of pancreatic cancer cells were detected by EdU, wound healing assay and Transwell experiments, respectively. The expression of EMT and cancer stem cell (CSC) markers were detected by quantitative real-time reverse transcription polymerase chain reaction assay (qRT-PCR) and western blot. RNA sequencing (RNA-seq) in SIRT7 knockdown PANC-1 cells was performed to explore the signaling pathways and target genes regulated by SIRT7. Then the target genes directly regulated by SIRT7 were identified with quantitative chromatin immunoprecipitation experiment (q-ChIP) and chromatin immunoprecipitation polymerase chain reaction (ChIP-PCR). The expressions of SIRT7 and target genes were detected by immunohistochemical (IHC) in pancreatic cancer tissues, and the correlation between SIRT7 and target gene expression was analyzed using TCGA dataset. The correlation between expression of SIRT7 or target genes and survival was analyzed on KM-plotter website. Finally, GeneMANIA, STRING and ENCORI were used to predict SIRT7-related proteins and miRNAs.Results:EdU assay showed that the cell proliferation rates in SIRT7-overexpressed PANC-1 [(19.33±0.35)%] and BxPC-3 cells [(17.00±1.89)%] were lower than those in the control group [(31.60±1.37)% and (24.33±0.78)%, respectively, P＜0.05]. The proliferation rates of SIRT7-knockdown PANC-1 [(23.94±1.00)% and (27.08±0.97)%] and BxPC-3 cells [(22.00±1.86)% and (25.96±1.61)%] were higher than those of the siControl group [(11.80±1.86)% and (13.42±1.39)%, respectively, P＜0.05]. In PANC-1 cells, the wound healing assay showed that the relative migration rate of SIRT7-overexpression cells [(76.67±2.74)%] was lower than that of control cells [(100.00±2.13)%, P＜0.05]; the relative migration rate of cells with SIRT7 knockdown [(134.22±4.08)% and (199.82±9.20)%, respectively] was higher than that of siControl group [(102.24±3.13)%, P＜0.05]. Compared with the control group, SIRT7 overexpression decreased the number of migrated BxPC-3 cells (45.66±1.69 vs 28.33±2.62, P＜0.05); while SIRT7 knockdown increased these numbers (65.66±2.86 and 82.00±2.94 versus 33.00±0.81, P＜0.01). Transwell experiment revealed that the number of invaded cells in SIRT7 overexpression groups (16.33±2.05 and 34.66±1.69) was lower than that control groups (54.33±4.64 and 58.66±5.90, P＜0.05); with SIRT7 knockdown, the numbers of invaded PANC-1 (63.66±2.49 and 69.33±3.29) and BxPC-3 cells (134.33±3.09 and 181.66±4.02) were higher than those in control groups (35.33±2.49 and 42.00±0.81, P?0.05). Also, SIRT7 knockdown decreased the expressions of epithelial markers and increased the expressions of mesenchymal and CSC markers. RNA-seq analysis showed that SIRT7 was involved in regulating a variety of cancer-related signaling pathways, including the pancreatic cancer pathway and the EMT pathway. Furthermore, SIRT7 could directly bind to the promoter regions of target genes, such as COL4A1 and SLUG. SIRT7 was negatively correlated with the expression and function of COL4A1 and SLUG in pancreatic cancer cells. The expressions of SIRT7, COL4A1, SLUG and SOX2 were verified in pancreatic cancer tissues by IHC. Finally, SIRT7 was predicted to be associated with many proteins and miRNAs based on GeneMANIA, STRING, and ENCORI online tools. Conclusions:SIRT7 can inhibit the EMT of pancreatic cancer cells through transcriptionally inhibiting the expression of target genes, such as COL4A1 and SLUG. Thus, SIRT7 may serve as a potential tumor suppressor gene in pancreatic cancer.

Objective:To investigate the effect and mechanism of SIRT7 in epithelial mesenchymal transformation (EMT) of pancreatic cancer cells.Methods:The pancreatic cancer cells were divided into siControl, siSIRT7, over-expression SIRT7, siSIRT7+siCOL4A1, and siSIRT7+siSLUG groups using siRNA or plasmid transfection. The proliferation, migration and invasion of pancreatic cancer cells were detected by EdU, wound healing assay and Transwell experiments, respectively. The expression of EMT and cancer stem cell (CSC) markers were detected by quantitative real-time reverse transcription polymerase chain reaction assay (qRT-PCR) and western blot. RNA sequencing (RNA-seq) in SIRT7 knockdown PANC-1 cells was performed to explore the signaling pathways and target genes regulated by SIRT7. Then the target genes directly regulated by SIRT7 were identified with quantitative chromatin immunoprecipitation experiment (q-ChIP) and chromatin immunoprecipitation polymerase chain reaction (ChIP-PCR). The expressions of SIRT7 and target genes were detected by immunohistochemical (IHC) in pancreatic cancer tissues, and the correlation between SIRT7 and target gene expression was analyzed using TCGA dataset. The correlation between expression of SIRT7 or target genes and survival was analyzed on KM-plotter website. Finally, GeneMANIA, STRING and ENCORI were used to predict SIRT7-related proteins and miRNAs.Results:EdU assay showed that the cell proliferation rates in SIRT7-overexpressed PANC-1 [(19.33±0.35)%] and BxPC-3 cells [(17.00±1.89)%] were lower than those in the control group [(31.60±1.37)% and (24.33±0.78)%, respectively, P＜0.05]. The proliferation rates of SIRT7-knockdown PANC-1 [(23.94±1.00)% and (27.08±0.97)%] and BxPC-3 cells [(22.00±1.86)% and (25.96±1.61)%] were higher than those of the siControl group [(11.80±1.86)% and (13.42±1.39)%, respectively, P＜0.05]. In PANC-1 cells, the wound healing assay showed that the relative migration rate of SIRT7-overexpression cells [(76.67±2.74)%] was lower than that of control cells [(100.00±2.13)%, P＜0.05]; the relative migration rate of cells with SIRT7 knockdown [(134.22±4.08)% and (199.82±9.20)%, respectively] was higher than that of siControl group [(102.24±3.13)%, P＜0.05]. Compared with the control group, SIRT7 overexpression decreased the number of migrated BxPC-3 cells (45.66±1.69 vs 28.33±2.62, P＜0.05); while SIRT7 knockdown increased these numbers (65.66±2.86 and 82.00±2.94 versus 33.00±0.81, P＜0.01). Transwell experiment revealed that the number of invaded cells in SIRT7 overexpression groups (16.33±2.05 and 34.66±1.69) was lower than that control groups (54.33±4.64 and 58.66±5.90, P＜0.05); with SIRT7 knockdown, the numbers of invaded PANC-1 (63.66±2.49 and 69.33±3.29) and BxPC-3 cells (134.33±3.09 and 181.66±4.02) were higher than those in control groups (35.33±2.49 and 42.00±0.81, P?0.05). Also, SIRT7 knockdown decreased the expressions of epithelial markers and increased the expressions of mesenchymal and CSC markers. RNA-seq analysis showed that SIRT7 was involved in regulating a variety of cancer-related signaling pathways, including the pancreatic cancer pathway and the EMT pathway. Furthermore, SIRT7 could directly bind to the promoter regions of target genes, such as COL4A1 and SLUG. SIRT7 was negatively correlated with the expression and function of COL4A1 and SLUG in pancreatic cancer cells. The expressions of SIRT7, COL4A1, SLUG and SOX2 were verified in pancreatic cancer tissues by IHC. Finally, SIRT7 was predicted to be associated with many proteins and miRNAs based on GeneMANIA, STRING, and ENCORI online tools. Conclusions:SIRT7 can inhibit the EMT of pancreatic cancer cells through transcriptionally inhibiting the expression of target genes, such as COL4A1 and SLUG. Thus, SIRT7 may serve as a potential tumor suppressor gene in pancreatic cancer.

Hepatocellular carcinoma is the most common malignancy of the liver and poses serious health burdens on China and the whole world. However， most patients with hepatocellular carcinoma are already in the advanced stage at the time of diagnosis， with fewer opportunities for surgery and limited treatment options. In recent years， the advances in molecular targeted therapies have brought new hope for patients with advanced hepatocellular carcinoma. Among these therapies， lenvatinib is the second first-line drug after sorafenib approved by the US Food and Drug Administration for the treatment of advanced hepatocellular carcinoma， and it has attracted widespread attention for its powerful anti-tumor properties. However， the efficacy of lenvatinib is severely limited by its drug resistance. This article reviews the research advances in the molecular mechanisms of lenvatinib resistance in hepatocellular carcinoma and discusses possible ways to improve the efficacy of lenvatinib， so as to improve its efficacy.

Humans ; COVID-19/genetics* ; SARS-CoV-2/genetics* ; Clustered Regularly Interspaced Short Palindromic Repeats/genetics* ; CRISPR-Cas Systems/genetics* ; RNA, Viral/genetics*