AIM: To analyze changes in the anterior chamber angle structure in patients with implantable collamer lens with central-port(ICL V4c)implantation, and to investigate their associations with preoperative anterior segment anatomical parameters.METHODS: Retrospective case study. Patients with myopia or myopia combined with astigmatism who underwent ICL V4c implantation in the Refractive Surgery Center of the Department of Ophthalmology, the 2nd Affiliated Hospital of Harbin Medical University between July 2024 and November 2024 were recruited. Preoperative and postoperative uncorrected visual acuity, best-corrected visual acuity, intraocular pressure, anterior chamber angle(ACA), white-to-white distance(WTW), anterior chamber depth(ACD), angle to angle distance(ATA), horizontal sulcus-to-sulcus distance(HSTS), vertical sulcus-to-sulcus distance(VSTS),crystalline lens rise(CLR), pupil diameter(PD), iris thickness at 750 μm from the scleral spur(IT750),maximal iris thickness(ITM), iris curvature(I-Curv), and iris cross-sectional area(I-Area), angle opening distance(AOD750), thetrabecular-iris angle(TIA750)and the trabecular-iris space area(TISA750)in the temporal, nasal, superior, and inferior directions,as well as the vault at various postoperative time points were measured.RESULTS: The study involved 40 patients(79 eyes)with myopia or myopia combined with astigmatism who underwent ICL V4c implantation(10 males and 30 females)with the mean age of 24.73±3.79 y. Compared with preoperative measurements, at 1 mo postoperatively, the AOD750, TIA750, and TISA750 parameters at the four angles(temporal, nasal, superior, and inferior)all showed a significant reduction(P<0.01). Statistically significant differences in vault were observed at postoperative 1d(0.49±0.1), postoperative 1 wk(0.43±0.14), and postoperative 1 mo(0.41±0.14)(all P<0.001). Correlation analysis indicated that the postoperative state of the anterior chamber angle was jointly influenced by anterior chamber parameters(ACD, ATA, HSTS、VSTS), iris morphology(I-Area, IT750), pupil size(PD), and surgical factors(ICL size, early vault), and that the combination of influencing factors varied across different orientations. Regression analysis showed that ACD was positively correlated with all postoperative anterior chamber angle parameters(P<0.05). IT750 exhibited negative correlations with the temporal and inferior angles(P<0.05). I-Area was positively correlated with temporal AOD750 and TISA750(P<0.05), and PD had negative correlations with temporal TIA750 and nasal AOD750(P<0.05).CONCLUSION: Postoperative anterior chamber angle narrowing is a common phenomenon after ICL V4c implantation. The degree of change exhibits a significant correlation with multiple preoperative anterior segment anatomical parameters. Preoperative comprehensive assessment of ACD, PD, and IT750 may facilitate the evaluation of the risk of postoperative angle changes and the enhancement of surgical safety.

Objective To investigate the effects of Zhuang medicinal thread moxibustion on apoptosis of interstitial cells of Cajal(ICC)in gastric smooth muscle of diabetic gastroparesis(DGP)rats via regulation of the p38MAPK signaling pathway.Methods Totally 60 rats were randomly divided into a blank group(10 rats)and a modeling group(50 rats).DGP models were established in the modeling group via intraperitoneal injection of streptozotocin.50 successfully modeled rats were further randomized into model group,Western medication group,prevention+treatment group,prevention group and treatment group,with 10 rats in each group.The Western medication group was administered mosapride citrate by gavage for 3 weeks starting at week 10;the prevention+treatment group underwent Zhuang medicinal thread moxibustion("Zhongwan",bilateral"Neiguan"and"Zusanli")intervention for 6 weeks starting at week 7;the prevention group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 7;and the treatment group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 10,3 cones per point,once a day;the blank group and model group received handling only.The random blood glucose and body mass of rats were detected,and the gastric emptying rate and intestinal propulsion rate were calculated.HE staining was used to observe the morphology of gastric smooth muscle tissue,TUNEL staining was used to detect the apoptosis of gastric smooth muscle tissue,ELISA was used to detect the contents of Caspase-3,TNF-α,IL-1β and IL-6 in gastric smooth muscle tissue,immunohistochemistry was used to detect the positive expressions of Cx43 and c-kit in gastric smooth muscle tissue,Western blot was used to detect the expressions of p38MAPK,p-p38MAPK,BAX and Bcl-2 protein in gastric smooth muscle tissue.Results Compared with the blank group,the random blood glucose significantly increased in the model group(P<0.01),and the body mass,gastric emptying rate and small intestinal propulsion rate significantly decreased(P<0.01),the blood vessels of gastric tissue were not clear,the surface was not smooth,the mucosal folds were less,the arrangement of gastric smooth muscle cells was disordered,the nuclear membrane was not clear,and there were vacuole like changes between cells,the apoptosis rate significantly increased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the protein expressions of p38MAPK,p-p38MAPK and BAX in gastric smooth muscle tissue significantly increased(P<0.01),and the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio significantly decreased(P<0.01).Compared with the model group,the random blood glucose of rats in each intervention group decreased,and the body mass,gastric emptying rate and intestinal propulsion rate increased(P<0.01),the blood vessels of gastric tissue were clear,the inner surface of stomach was smooth,the mucosal folds were not rich,no ulcer was found,the shape of gastric smooth muscle cells was complete,the nuclear membrane was clear,and the arrangement of muscle cells was regular,the apoptosis rate significantly decreased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the expressions of p38MAPK,p-p38MAPK,BAX protein in gastric smooth muscle tissue decreased(P<0.05,P<0.01),the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio increased(P<0.05,P<0.01).The overall effect of the prevention+treatment group was better than that of the Western medication group,prevention group and treatment group(P<0.05,P<0.01).Conclusion Zhuang medicinal thread moxibustion may reduce gastric inflammation and ICC apoptosis in DGP rats by inhibiting p38MAPK signaling pathway,so as to improve DGP gastric motility disorder,and the effect of early intervention is more significant.

Objective To explore the value of amide proton transfer(APT)imaging combined with diffusion weighted imaging(DWI)in the assessment of neurovascular invasion(NVI)of stage T3/T4 rectal cancer.Methods The clinical and MR imaging data of 46 patients with rectal cancer were analyzed retrospectively and divided into NVI positive group and NVI negative group according to the pathological results of NVI.The differences of APT values[maximum APT(APTmax)value,minimum APT(APTmin)value,mean APT(APTmean)value]and apparent diffusion coefficient(ADC)value between the two groups were compared,and the diagnostic efficiency was analyzed by receiver operating characteristic(ROC)curve.Results The APTmax and APTmean values in the NVI positive group were significantly higher than those in the NVI negative group,while the ADC value in the NVI positive group was significantly lower than that in the NVI negative group(P＜0.05).The area under the curve(AUC)of APTmax,APTmean and ADC values for NVI identification were 0.717,0.722 and 0.751,respectively.The AUC of the three indexes combined to identify NVI was 0.858.The combined AUC of the three indexes was larger than that of APTmax,APTmean and ADC alone(P＜0.05).Conclusion APT imaging combined with DWI has a high value in the evaluation of NVI of stage T3/T4 rectal cancer,which can provide guidance for clinical treatment.

Objective To investigate the mortality and risk factors of HIV-infected patients complicated with progressive multifocal leukoencephalopathy(PML)to inform the outcomes of these patients.Methods The clinical data of people living with HIV related PML who were treated at Chongqing Public Health Medical Treatment Center from January 1,2019 to December 31,2023 were retrospectively analyzed.Kaplan-Meier method was used for survival analysis.Log-rank test was performed.Cox regression model was used for multivariate analysis.Results A total of 42 people living with HIV related PML were enrolled,including 34 males(81.0％).The median age was 44.5(36.3,51.0)years.PML was confirmed in 76.2％(32/42)of patients,and possible PML was diagnosed in 23.8％(10/42)of patients.The median time to diagnosis was 32.5(14.8,58.3)days.The median CD4+T cell count was 69.0(39.8,112.0)cells/μL.The median HIV viral load was 5.05(2.62,5.77)log10 copies/mL.The overall mortality rate was 54.8％(23/42)for patients with HIV related PML.CD4+T cell count ≤50 cells/μL and initial modified Rankin scale(mRS)score ≥4 points were independent risk factors for the overall mortality of people living with HIV related PML(P＜0.05).Conclusions People living with HIV related PML have a high mortality rate.Low CD4+T cell count and high initial mRS score were independent risk factors for the mortality of patients with HIV related PML.Currently,no definitive and effective drug treatment is available for PML.Early detection,diagnosis and initiation of antiretroviral therapy may improve the outcomes of patients.

Objective To compare the dosimetric disparities among static intensity-modulated radiotherapy(IMRT),volumetric modulated arc therapy(VMAT),and tomotherapy(TOMO)techniques in cervical cancer radiotherapy for providing data support for clinical decision-making scheme of radiotherapy.Methods The clinical data of 19 cervical cancer patients,treated at the Affiliated Cancer Hospital and Institute of Guangzhou Medical University from February to May in 2024,were analyzed.Three plans were devised for each case using IMRT,VMAT,and TOMO techniques,followed by dosimetric evaluation in terms of various metrics such as dose volume parameters of the target areas as well as organs-at-risk(OAR),conformity index(CI),homogeneity index(HI),and delivery time.Results All 3 plans met the clinical prescription requirements for the target areas.Compared with static IMRT and VMAT,TOMO had significantly lower Dmean and Dmaxof PCTV and PGTVnd.For OAR,TOMO demonstrated significant advantages over IMRT and VMAT in the Dmean of the bladder,the Dmean,Dmax,V30,V40of the rectum,the Dmean,Dmax,V20,V30of left and right femoral heads,and the Dmean,V20,V50of the pelvis(P<0.05).In addition,the TOMO group showed significantly higher CI for both PCTV and PGTVnd as compared with IMRT and VMAT groups,and lower PGTVnd HI than IMRT group(all P<0.05).Although there was trivial difference among 3 groups in term of PCTV HI,TOMO group performed slightly better than the other two groups.Notably,VMAT technique had the shortest treatment time.Conclusion In various treatment modalities for cervical cancer,TOMO is superior to IMRT and VMAT in terms of target dose coverage,OAR dose distribution,CI,and HI.However,VMAT has the highest efficiency.

Objective To investigate the effects of Zhuang medicinal thread moxibustion on apoptosis of interstitial cells of Cajal(ICC)in gastric smooth muscle of diabetic gastroparesis(DGP)rats via regulation of the p38MAPK signaling pathway.Methods Totally 60 rats were randomly divided into a blank group(10 rats)and a modeling group(50 rats).DGP models were established in the modeling group via intraperitoneal injection of streptozotocin.50 successfully modeled rats were further randomized into model group,Western medication group,prevention+treatment group,prevention group and treatment group,with 10 rats in each group.The Western medication group was administered mosapride citrate by gavage for 3 weeks starting at week 10;the prevention+treatment group underwent Zhuang medicinal thread moxibustion("Zhongwan",bilateral"Neiguan"and"Zusanli")intervention for 6 weeks starting at week 7;the prevention group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 7;and the treatment group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 10,3 cones per point,once a day;the blank group and model group received handling only.The random blood glucose and body mass of rats were detected,and the gastric emptying rate and intestinal propulsion rate were calculated.HE staining was used to observe the morphology of gastric smooth muscle tissue,TUNEL staining was used to detect the apoptosis of gastric smooth muscle tissue,ELISA was used to detect the contents of Caspase-3,TNF-α,IL-1β and IL-6 in gastric smooth muscle tissue,immunohistochemistry was used to detect the positive expressions of Cx43 and c-kit in gastric smooth muscle tissue,Western blot was used to detect the expressions of p38MAPK,p-p38MAPK,BAX and Bcl-2 protein in gastric smooth muscle tissue.Results Compared with the blank group,the random blood glucose significantly increased in the model group(P<0.01),and the body mass,gastric emptying rate and small intestinal propulsion rate significantly decreased(P<0.01),the blood vessels of gastric tissue were not clear,the surface was not smooth,the mucosal folds were less,the arrangement of gastric smooth muscle cells was disordered,the nuclear membrane was not clear,and there were vacuole like changes between cells,the apoptosis rate significantly increased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the protein expressions of p38MAPK,p-p38MAPK and BAX in gastric smooth muscle tissue significantly increased(P<0.01),and the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio significantly decreased(P<0.01).Compared with the model group,the random blood glucose of rats in each intervention group decreased,and the body mass,gastric emptying rate and intestinal propulsion rate increased(P<0.01),the blood vessels of gastric tissue were clear,the inner surface of stomach was smooth,the mucosal folds were not rich,no ulcer was found,the shape of gastric smooth muscle cells was complete,the nuclear membrane was clear,and the arrangement of muscle cells was regular,the apoptosis rate significantly decreased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the expressions of p38MAPK,p-p38MAPK,BAX protein in gastric smooth muscle tissue decreased(P<0.05,P<0.01),the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio increased(P<0.05,P<0.01).The overall effect of the prevention+treatment group was better than that of the Western medication group,prevention group and treatment group(P<0.05,P<0.01).Conclusion Zhuang medicinal thread moxibustion may reduce gastric inflammation and ICC apoptosis in DGP rats by inhibiting p38MAPK signaling pathway,so as to improve DGP gastric motility disorder,and the effect of early intervention is more significant.

Objective To compare the dosimetric disparities among static intensity-modulated radiotherapy(IMRT),volumetric modulated arc therapy(VMAT),and tomotherapy(TOMO)techniques in cervical cancer radiotherapy for providing data support for clinical decision-making scheme of radiotherapy.Methods The clinical data of 19 cervical cancer patients,treated at the Affiliated Cancer Hospital and Institute of Guangzhou Medical University from February to May in 2024,were analyzed.Three plans were devised for each case using IMRT,VMAT,and TOMO techniques,followed by dosimetric evaluation in terms of various metrics such as dose volume parameters of the target areas as well as organs-at-risk(OAR),conformity index(CI),homogeneity index(HI),and delivery time.Results All 3 plans met the clinical prescription requirements for the target areas.Compared with static IMRT and VMAT,TOMO had significantly lower Dmean and Dmaxof PCTV and PGTVnd.For OAR,TOMO demonstrated significant advantages over IMRT and VMAT in the Dmean of the bladder,the Dmean,Dmax,V30,V40of the rectum,the Dmean,Dmax,V20,V30of left and right femoral heads,and the Dmean,V20,V50of the pelvis(P<0.05).In addition,the TOMO group showed significantly higher CI for both PCTV and PGTVnd as compared with IMRT and VMAT groups,and lower PGTVnd HI than IMRT group(all P<0.05).Although there was trivial difference among 3 groups in term of PCTV HI,TOMO group performed slightly better than the other two groups.Notably,VMAT technique had the shortest treatment time.Conclusion In various treatment modalities for cervical cancer,TOMO is superior to IMRT and VMAT in terms of target dose coverage,OAR dose distribution,CI,and HI.However,VMAT has the highest efficiency.

Objective:The impact of bystander CD8 + T cells (CD8 + Tbys) within the tumor microenvironment on the prognosis of early-stage non-small cell lung cancer (NSCLC) remains unclear, particularly concerning their infiltration differences at the invasive margin (IM) and tumor center (TC). Methods:We retrospectively collected postoperative specimens from 173 patients with primary early-stage NSCLC who underwent radical surgery at the Affiliated Tumor Hospital of Shandong First Medical University from 2014 to 2018. Tissue microarrays encompassing IM and TC regions were prepared and subjected to multicolor immunofluorescence staining (CK/CD8/CD103/DAPI). Image processing and phenotype recognition (CD8 + T cells, CK -CD8 +; CD8 + T bys, CK -CD8 +CD103 -) were performed using inFrom software, and automatic quantitative cell density analysis was conducted using R language. Differences in CD8 + T and CD8 + T bys densities at IM and TC were analyzed using the Mann-Whitney U test. The relationship between CD8 + T, CD8 + T bys and clinicopathological features was examined using the Kruskal-Wallis H test. The impact of CD8 + T and CD8 + T bys on recurrence-free survival (RFS) was evaluated using Kaplan-Meier, log-rank, and Cox proportional hazards models. Results:A total of 173 patients with stage ⅠA-ⅡA NSCLC were included, with a recurrence rate of 26.6% (46/173) and a median RFS of 62.3 months (range: 44.7-71.9 months). CD8 + T and CD8 + T bys densities (1/1 000) were significantly higher in the IM region than in the TC region [70(32, 155) vs. 37(18, 88), P＜0.001; 25(11, 46) vs. 18(7, 34), P=0.002]. No significant association was found between CD8 + T, CD8 + T bys and age, gender, smoking history, histological type, or pathological stage (all P＞0.05). Patients with low-density IM CD8 + T cells had lower RFS compared to those with high-density IM CD8 + T cells ( P=0.021; median RFS not reached), Further analysis revealed that patients with low-density IM CD8 + T bys cell had lower RFS compared to those with high-density IM CD8 + T bys ( P=0.047; median RFS not reached), and low-density IM CD8 + T cell was an independent risk factor for postoperative recurrence ( HR=1.836, 95% CI:1.007-3.347, P=0.048). Joint analysis of IM and TC revealed that patients with low IM CD8 + T bys and high TC CD8 + T bys had significantly lower RFS compared to the other three groups ( P=0.006), and this combination was an independent risk factor for postoperative recurrence in early-stage NSCLC ( HR=2.090, 95% CI:1.162-3.760, P=0.014). Conclusions:The spatial distribution of bystander CD8 + T cells within the primary tumor influences the prognosis of patients with early-stage NSCLC. Patients with low-density IM CD8 + T bys and high-density TC CD8 + T bys are more prone to recurrence after radical surgery.

Objective To investigate the mortality and risk factors of HIV-infected patients complicated with progressive multifocal leukoencephalopathy(PML)to inform the outcomes of these patients.Methods The clinical data of people living with HIV related PML who were treated at Chongqing Public Health Medical Treatment Center from January 1,2019 to December 31,2023 were retrospectively analyzed.Kaplan-Meier method was used for survival analysis.Log-rank test was performed.Cox regression model was used for multivariate analysis.Results A total of 42 people living with HIV related PML were enrolled,including 34 males(81.0％).The median age was 44.5(36.3,51.0)years.PML was confirmed in 76.2％(32/42)of patients,and possible PML was diagnosed in 23.8％(10/42)of patients.The median time to diagnosis was 32.5(14.8,58.3)days.The median CD4+T cell count was 69.0(39.8,112.0)cells/μL.The median HIV viral load was 5.05(2.62,5.77)log10 copies/mL.The overall mortality rate was 54.8％(23/42)for patients with HIV related PML.CD4+T cell count ≤50 cells/μL and initial modified Rankin scale(mRS)score ≥4 points were independent risk factors for the overall mortality of people living with HIV related PML(P＜0.05).Conclusions People living with HIV related PML have a high mortality rate.Low CD4+T cell count and high initial mRS score were independent risk factors for the mortality of patients with HIV related PML.Currently,no definitive and effective drug treatment is available for PML.Early detection,diagnosis and initiation of antiretroviral therapy may improve the outcomes of patients.

Objective To explore the value of amide proton transfer(APT)imaging combined with diffusion weighted imaging(DWI)in the assessment of neurovascular invasion(NVI)of stage T3/T4 rectal cancer.Methods The clinical and MR imaging data of 46 patients with rectal cancer were analyzed retrospectively and divided into NVI positive group and NVI negative group according to the pathological results of NVI.The differences of APT values[maximum APT(APTmax)value,minimum APT(APTmin)value,mean APT(APTmean)value]and apparent diffusion coefficient(ADC)value between the two groups were compared,and the diagnostic efficiency was analyzed by receiver operating characteristic(ROC)curve.Results The APTmax and APTmean values in the NVI positive group were significantly higher than those in the NVI negative group,while the ADC value in the NVI positive group was significantly lower than that in the NVI negative group(P＜0.05).The area under the curve(AUC)of APTmax,APTmean and ADC values for NVI identification were 0.717,0.722 and 0.751,respectively.The AUC of the three indexes combined to identify NVI was 0.858.The combined AUC of the three indexes was larger than that of APTmax,APTmean and ADC alone(P＜0.05).Conclusion APT imaging combined with DWI has a high value in the evaluation of NVI of stage T3/T4 rectal cancer,which can provide guidance for clinical treatment.