1.Ameliorating Effect of Yifei Tongluo Prescription on Bleomycin-induced Pulmonary Fibrosis in Rats via Regulating NLRP3/Caspase-1/GSDMD Signaling Pathway and Epithelial-mesenchymal Transition
Bowen ZHOU ; Zefeng LI ; Xian MA ; Xuannian LI ; Jingwen WANG ; Fei XU ; Huaman LIU ; Xinhua JIA
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):150-159
ObjectiveTo observe the effects of Yifei Tongluo prescription on the NOD-like receptor protein 3 (NLRP3)/Caspase-1/gasdermin D (GSDMD) pathway and epithelial-mesenchymal transition (EMT) in rats with pulmonary fibrosis. MethodsTracheal instillation of bleomycin was conducted to establish a rat model of pulmonary fibrosis. Thirty Sprague-Dawley (SD) rats were randomly divided into a blank group, a model group, a prednisone acetate group (1.17 mg·kg-1), and low- and high-dose Yifei Tongluo prescription groups (10.62 and 21.24 g·kg-1, respectively). Administration started on the 7th day after modeling, once a day for 28 consecutive days. The lung coefficient of each group was calculated. The pathological changes of lung tissues in each group were observed by hematoxylin-eosin (HE) staining and Masson staining. The expression of α-smooth muscle actin (α-SMA) and vimentin in rat lung tissues was detected by immunohistochemistry. The expression of NLRP3 inflammasome, E-cadherin (E-cad), and typeⅠ collagen (ColⅠ) in lung tissues was detected by immunofluorescence. The content of hydroxyproline (HYP), tumor necrosis factor (TNF)-α, interleukin (IL)-18, and IL-1β in rat serum was detected by enzyme-linked immunosorbent assay (ELISA). The mRNA expression levels of NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), IL-1β, and transforming growth factor (TGF)-β1 in rat lung tissues were determined by real-time quantitative polymerase chain reaction (Real-time PCR). The protein expression levels of NLRP3, GSDMD, ASC, and Caspase-1 in rat lung tissues were determined by Western blot. ResultsCompared with the blank group, the model group exhibited a significantly increased lung coefficient (P<0.01) and significantly increased range of pulmonary interstitial inflammation and collagen deposition. In addition, the levels of α-SMA, Vimentin, E-cad, and ColⅠ in lung tissues were significantly increased (P<0.01). The levels of fibrosis- and inflammation-related factors HYP, TNF-α, IL-18, and IL-1β in serum were significantly upregulated (P<0.01). The levels of factors related to the activation of NLRP3 inflammasome in lung tissues, including NLRP3, GSDMD, ASC, Caspase-1, IL-1β, and TGF-β1, were significantly upregulated (P<0.01). Compared with the model group, the Yifei Tongluo prescription groups showed improved lung coefficients. Additionally, the extent of lung inflammation and collagen deposition was significantly reduced. The expression of α-SMA, Vimentin, E-cad, and ColⅠ in lung tissue was significantly decreased (P<0.01). The levels of HYP, TNF-α, IL-18, and IL-1β in serum were significantly reduced (P<0.01). The expression levels of NLRP3, GSDMD, ASC, Caspase-1, IL-1β, and TGF-β1 in lung tissue were also significantly decreased (P<0.01). ConclusionYifei Tongluo prescription can regulate the NLRP3/Caspase-1/GSDMD pathway, down-regulate release of pro-inflammatory and pro-fibrotic cytokines, alleviate NLRP3 inflammasome-mediated pyroptosis and EMT, and thereby improve pulmonary fibrosis in rats.
2.Empirical study of input, output, outcome and impact of community-based rehabilitation stations
Xiayao CHEN ; Ying DONG ; Xue DONG ; Zhongxiang MI ; Jun CHENG ; Aimin ZHANG ; Didi LU ; Jun WANG ; Jude LIU ; Qianmo AN ; Hui GUO ; Xiaochen LIU ; Zefeng YU
Chinese Journal of Rehabilitation Theory and Practice 2026;32(1):83-89
ObjectiveTo investigate the present situation of input, output, outcome and impact of all registered community-based rehabilitation stations in Inner Mongolia in China, and analyze how the input predict the output, outcome and impact. MethodsFrom March 1st to April 30th, 2025, a questionnaire survey was conducted on all registered community-based rehabilitation stations in Inner Mongolia, covering four dimensions: input, output, outcome and impact. A total of 1 365 questionnaires were distributed. The input included four items: laws and policies, human resources, equipment and facilities, and rehabilitation information management. The output included two items: technical paths and benefits/effectiveness. The outcome included three items: coverage rates, rehabilitation interventions and functional results. The impact included two items: health and sustainability. Each item contained several questions, all of which were described in a positive way. Each question was scored from one to five. A lower score indicated that the situation of the community-based rehabilitation station was more in line with the content described in the question. Regression analysis was performed using the total score of each item of input dimension as independent variables, and the total scores of the output, outcome and impact dimensions as dependent variables. ResultsA total of 1 262 valid questionnaires were collected. The mean values of input, output, outcome and impact of community-based rehabilitation stations were 1.827 to 1.904, with coefficient of variation of 45.892% to 49.239%. The regression analysis showed that, rehabilitation information management, human resources, and laws and policies significantly predicted the output dimension (R² = 0.910, P < 0.001). Meanwhile, all four items in the input dimension predicted both the outcome (R² = 0.850, P < 0.001) and impact dimensions (R² = 0.833, P < 0.001). ConclusionInput, output, outcome and impact of the community-based rehabilitation stations in Inner Mongolia were generally in line with the content of the questions, although some imbalances were observed. Additionally, the input of community-based rehabilitation stations could significantly predict their output, outcome and impact.
3.Effect of Modified Shenling Baizhu Powder (参苓白术散) as an Adjuvant Therapy on Peripheral Blood Counts and Immune Function in Breast Cancer Patients with Chemotherapy-Induced Myelosuppression and Spleen-Kidney Insufficiency Syndrome:A Randomized,Double-Blind,Placebo-Controlled Trial
Zefeng WANG ; Luxia QI ; Zhanfei GUO ; Lili WANG
Journal of Traditional Chinese Medicine 2026;67(15):1627-1633
ObjectiveTo observe the effect of modified Shenling Baizhu Powder (参苓白术散, SBP) on peripheral blood counts and immune function in breast cancer patients with chemotherapy-induced myelosuppression and spleen-kidney insufficiency syndrome. MethodsA randomized, double-blind, placebo-controlled trial was conducted. A total of 102 breast cancer patients with chemotherapy-induced myelosuppression and spleen-kidney insufficiency syndrome were randomly divided into a treatment group and a control group, with 51 cases in each group. Both groups received granulocyte colony-stimulating factor (G-CSF) support therapy and blood component transfusion therapy after chemotherapy. The treatment group additionally took modified SBP orally at one dose per day, while the control group was administered with placebo orally at the same dosage. Each chemotherapy cycle lasted 21 days and was defined as one treatment course. A total of four treatment courses were administered, with either herbal medicine or placebo taken orally for three weeks during each course. The primary outcome measures were peripheral blood para-meters including white blood cell count (WBC), red blood cell count (RBC), platelet count (PLT), and hemoglobin (Hb) levels; secondary outcome measures were comprised of immune function parameters including CD3+ lymphocyte percentage, CD4+ lymphocyte percentage, CD8+ lymphocyte percentage, immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM), traditional Chinese medicine (TCM) syndrome scores, chemotherapy completion rate, and incidence of adverse reactions. ResultsDuring the study, 2 cases in the treatment group and 3 cases in the control group were lost, resulting in a final analysis of 49 cases in the treatment group and 48 cases in the control group. Compared with baseline values, WBC, RBC, PLT, Hb, CD3+, CD4+, CD4+/CD8+ ratio, IgA, IgG and IgM levels increased in both groups, while CD8+ lymphocyte percentage and TCM syndrome scores decreased (P<0.05). Compared to the control group after treatment, the treatment group had higher levels of WBC, PLT, Hb, CD3+, CD4+, IgA, IgG and IgM, and lower levels of CD8+ lymphocyte percentage and TCM syndrome scores (P<0.05). The chemotherapy completion rate in the treatment group was 91.84% (45/49), which was higher than 77.08% (37/48) in the control group (P<0.05). The overall incidence of adverse reactions in the treatment group was 30.61% (15/49), significantly lower than 56.25% (26/48) in the control group (P<0.05). ConclusionModified SBP as an adjuvant therapy can effectively improve the peripheral blood counts, enhance the body's immune function, and demonstrate favorable safety in breast cancer patients with myelosuppression and spleen-kidney insufficiency syndrome during chemotherapy.
4.Effect of Modified Shenling Baizhu Powder (参苓白术散) as an Adjuvant Therapy on Peripheral Blood Counts and Immune Function in Breast Cancer Patients with Chemotherapy-Induced Myelosuppression and Spleen-Kidney Insufficiency Syndrome:A Randomized,Double-Blind,Placebo-Controlled Trial
Zefeng WANG ; Luxia QI ; Zhanfei GUO ; Lili WANG
Journal of Traditional Chinese Medicine 2026;67(15):1627-1633
ObjectiveTo observe the effect of modified Shenling Baizhu Powder (参苓白术散, SBP) on peripheral blood counts and immune function in breast cancer patients with chemotherapy-induced myelosuppression and spleen-kidney insufficiency syndrome. MethodsA randomized, double-blind, placebo-controlled trial was conducted. A total of 102 breast cancer patients with chemotherapy-induced myelosuppression and spleen-kidney insufficiency syndrome were randomly divided into a treatment group and a control group, with 51 cases in each group. Both groups received granulocyte colony-stimulating factor (G-CSF) support therapy and blood component transfusion therapy after chemotherapy. The treatment group additionally took modified SBP orally at one dose per day, while the control group was administered with placebo orally at the same dosage. Each chemotherapy cycle lasted 21 days and was defined as one treatment course. A total of four treatment courses were administered, with either herbal medicine or placebo taken orally for three weeks during each course. The primary outcome measures were peripheral blood para-meters including white blood cell count (WBC), red blood cell count (RBC), platelet count (PLT), and hemoglobin (Hb) levels; secondary outcome measures were comprised of immune function parameters including CD3+ lymphocyte percentage, CD4+ lymphocyte percentage, CD8+ lymphocyte percentage, immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM), traditional Chinese medicine (TCM) syndrome scores, chemotherapy completion rate, and incidence of adverse reactions. ResultsDuring the study, 2 cases in the treatment group and 3 cases in the control group were lost, resulting in a final analysis of 49 cases in the treatment group and 48 cases in the control group. Compared with baseline values, WBC, RBC, PLT, Hb, CD3+, CD4+, CD4+/CD8+ ratio, IgA, IgG and IgM levels increased in both groups, while CD8+ lymphocyte percentage and TCM syndrome scores decreased (P<0.05). Compared to the control group after treatment, the treatment group had higher levels of WBC, PLT, Hb, CD3+, CD4+, IgA, IgG and IgM, and lower levels of CD8+ lymphocyte percentage and TCM syndrome scores (P<0.05). The chemotherapy completion rate in the treatment group was 91.84% (45/49), which was higher than 77.08% (37/48) in the control group (P<0.05). The overall incidence of adverse reactions in the treatment group was 30.61% (15/49), significantly lower than 56.25% (26/48) in the control group (P<0.05). ConclusionModified SBP as an adjuvant therapy can effectively improve the peripheral blood counts, enhance the body's immune function, and demonstrate favorable safety in breast cancer patients with myelosuppression and spleen-kidney insufficiency syndrome during chemotherapy.
5.Association between cardiovascular health scores and visual impairment among U.S. adults: A crosssectional study using NHANES 2013 to 2018
Mengyu LIU ; Qinghua REN ; Baohua LI ; Mingming ZHANG ; Xinyue HOU ; Jianquan WANG ; Xin YAN ; Danyu LI ; Juan CHENG ; Zefeng KANG
Science of Traditional Chinese Medicine 2026;4(3):270-279
Background: Visual impairment is increasingly prevalent, underscoring the need for effective prevention strategies. This study investigated the association between cardiovascular health and visual impairment using three progressively developed metrics: Life’s Simple 7 (LS7), a cardiovascular health score developed by the American Heart Association based on 7 components, including physical activity, smoking status, body mass index (BMI), diet, blood glucose, blood pressure, and total cholesterol; Life’s Essential 8(LE8), which adds sleep health as an additional component; and Life’s Crucial 9 (LC9), which further incorporates mental health. We aimed to evaluate whether these expanded metrics provide additional explanatory value and to inform future public health strategies. Objective: To investigate the associations among LS7, LE8, and LC9 cardiovascular health scores and visual impairment in National Health and Nutrition Examination Survey 2013 to 2018, assess the added value of sleep and mental health components, and identify key contributing subcomponents using regression and machine learning methods. Methods: We analyzed data from 9891 participants in the 2013 to 2018 National Health and Nutrition Examination Survey. Multivariable logistic regression, restricted cubic spline modeling, and subgroup analyses were conducted to evaluate the association between cardiovascular health and visual impairment. Machine learning methods, including Random Forest and SHapley Additive exPlanations, a model interpretation approach used to assess feature importance, were applied. The Boruta algorithm, a feature selection method, was used to identify key subcomponents of cardiovascular health. Results: Participants with visual impairment were older, had lower poverty-to-income ratios, and exhibited lower cardiovascular health scores (LS7, LE8, and LC9). Higher cardiovascular health scores were negatively associated with visual impairment. Each one standard deviation increase in LS7, LE8, and LC9 was associated with approximately 8%, 2%, and 3% lower odds of visual impairment, respectively. LS7 showed the strongest negative association, whereas LE8 and LC9 emerged as the most important predictors in the machine learning models. Key subcomponents such as blood glucose, blood pressure, and BMI, as well as mental health status, were strongly associated with visual impairment. Conclusion: Higher cardiovascular health scores were negatively associated with visual impairment. LS7 demonstrated the strongest statistical association, whereas LE8 and LC9 were the most influential features in the machine learning models. Blood glucose, blood pressure, BMI, and mental health status were important correlates of visual impairment. From the perspective of the “prevention and treatment of diseases” in traditional Chinese medicine and the holistic concept, the aforementioned research findings confirm that severe visual impairment is indeed an external manifestation of overall health imbalance (such as organ dysfunction and Qi deficiency and blood stasis). The prevention strategy lies in comprehensively adjusting lifestyle, emotional factors, and metabolic indicators (corresponding to the key factors in the study) to restore the body’s internal balance and achieve prevention before disease arises.
6.Research progress on the health communication capacity of clinicians
Dingbin CAI ; Luis Manuel Dias MARTINS ; Zefeng LU ; Sanhao HUANG ; Shuangmiao WANG ; Qini HUANG ; Zhaoji LONG ; Xinxin CHEN ; Siyang YE ; Dong WANG
China Occupational Medicine 2025;52(2):216-221
Health communication aims to improve public health attitudes and behaviors by propagating health information. It plays an important role in promoting public health literacy and "Healthy China Initiative". The basic theories of health communication include "7 W" and Theory of Planned Behavior. Clinicians with profound medical expertise and a wealth of clinical practice play key roles in the communication, and they hold an unparalleled advantage in health communication by delivering authoritative and trustworthy information to the public. The capacity of health communication among clinicians in the nation is determined by various factors including professional characteristics, policy support, dissemination platforms and pathways, time and effort. Meanwhile, some problems in the research on the health communication capacity of clinicians remain, such as lack of well-established motivation systems, limited dissemination pathways, and imperfect evaluation frameworks. In some regions of China, health communication performance has been considered as part of the professional title evaluation for clinical physicians. Medical institutions and universities have also initiated relevant training and practice programs. It is crucial to improve evaluation frameworks, strengthen training pathways and effectiveness assessment, promote interdisciplinary integration, and enhance the role of clinicians in health communication in the future.
7.Mechanism of Mingshi Prescription in Regulating Opn4-dopamine Axis to Inhibit Endoplasmic Reticulum Stress and Delay Myopia Progression
Baohua LI ; Zefeng KANG ; Lulu WANG ; Xin YAN ; Jianquan WANG ; Xinyue HOU ; Bobiao NING ; Shanshan YE ; Mengyu LIU ; Yipeng SHI ; Danyu LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):58-67
ObjectiveTo investigate the mechanism by which Mingshi prescription regulates the retinal melanopsin-dopamine (Opn4-DA) axis in myopic mice to inhibit endoplasmic reticulum (ER) stress in the retina and sclera, thereby delaying axial elongation associated with myopia. MethodsSixty 4-week-old male SPF-grade C57BL/6J mice were randomly divided into a normal group, a form-deprived myopia group (FDM group), an intrinsically photosensitive retinal ganglion cells ablation group (ipRGCs group), a Mingshi Prescription group (MSF group, 5.2 g·kg-1), and an ipRGCs + MSF group (5.2 g·kg-1). Except for the normal group, all other groups underwent FDM modeling. Additionally, the ipRGCs and ipRGCs + MSF groups received retinal ipRGC ablation. Three weeks after modeling, the MSF and ipRGCs + MSF groups were administered Mingshi prescription via continuous gavage for six weeks. After refraction and axial length were measured in all mice, eyeballs were collected along with retinal and scleral tissues. Pathological and morphological changes in the retina, choroid, and sclera were observed using periodic acid-Schiff (PAS) staining. Western blot was employed to detect the relative protein expression levels of dopamine D1 receptor (DRD1), C/EBP homologous protein (CHOP), and glucose-regulated protein 78 (GRP78) in the retina, and CHOP and GRP78 in the sclera. Real-time PCR was used to detect the relative mRNA expression of Opn4, CHOP, and GRP78 in the retina, and CHOP and GRP78 in the sclera. Immunofluorescence staining (IF) was performed to detect the expression of Opn4 and DRD1 in retinal tissues. ResultsCompared with the normal group, the FDM group showed a significant myopic shift in refraction (P<0.05) and a significant increase in axial length (P<0.05). The retinal layers were thinner, the number of ganglion cells was reduced, and collagen fibers in the sclera were loosely arranged with evident gaps. Opn4 and DRD1 protein and mRNA expression in the retina were significantly decreased (P<0.05), while CHOP and GRP78 protein and mRNA expression in both retinal and scleral tissues were significantly increased (P<0.05). Compared with the FDM group, the ipRGCs group exhibited further increases in myopic refraction and axial length (P<0.05), more pronounced thinning and looseness in the retinal, choroidal, and scleral layers, lower expression of Opn4 and DRD1 protein and mRNA in the retina (P<0.05), and higher expression of CHOP and GRP78 protein and mRNA in the retina and sclera (P<0.05). Compared with the FDM group, the MSF group showed significantly reduced refractive error and axial length (P<0.05), with improved cellular number, arrangement, and thickness in ocular tissues, increased Opn4 and DRD1 protein and mRNA expression in the retina (P<0.05), and reduced CHOP and GRP78 protein and mRNA expression in both retina and sclera (P<0.05). Similarly, the ipRGCs + MSF group showed significant improvements in terms of the above items compared with the ipRGCs group (P<0.05). ConclusionMingshi Prescription delays myopic axial elongation and refractive progression by regulating the Opn4-DA axis in the retina of myopic mice, thereby inhibiting ER stress in the retina and sclera. This intervention promotes Qi and blood nourishment of the eyes, softens the fascia, and restores ocular rhythm.
8.Chaihu and Longgu Mulitang Regulates ERK/CREB Signaling Pathway to Ameliorate Hippocampal Nerve Injury in Mouse Model of Depression
Shiyu JI ; Li WANG ; Zhuo ZHANG ; Yingzhe GAO ; Zefeng ZHANG ; Siyu CHEN ; Guangjing XIE ; Ping WANG ; Panpan HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(22):1-9
ObjectiveTo investigate the effects of Chaihu and Longgu Mulitang (CLMT) on hippocampal neural damage in the mouse model of depression via the extracellular signal-regulated protein kinase (ERK)/cAMP-response element-binding protein (CREB) signaling pathway. MethodsSeventy-eight male C57BL/6 mice were randomly allocated into normal control, model, low/medium/high-dose (2.89, 5.78, and 11.56 g·kg-1, respectively) CLMT, and paroxetine (10 mg·kg-1) groups. A depression model was established by chronic unpredictable mild stress (CUMS) combined with social isolation. Behavioral tests were carried out to evaluate depressive-like behaviors. Hematoxylin-eosin staining and Nissl staining were performed to assess hippocampal morphology and neuronal damage. Immunofluorescence was employed to detect glial fibrillary acidic protein (GFAP) and ionized calcium-binding adapter molecule 1 (Iba1). Real-time PCR was employed to measure the mRNA levels of ERK and CREB. Western blot was employed to determine the expression of ERK/CREB pathway proteins and brain-derived neurotrophic factor (BDNF) in the hippocampal tissue. Molecular Operating Environment (MOE) software was used for molecular docking to evaluate the interactions between CLMT components and target proteins. ResultsCompared with the normal control group, the model group showed decreased sucrose preference (P0.01), increased tail-suspension immobility time (P0.01), decreased activity in the central region of the open field test (P0.01), and decreased activity in the middle and open-arm region of the elevated plus maze test (P0.01). The hippocampal area in the model group showed wrinkled cells and a reduction in the number of cells, neurons with reduced sizes and Nissl bodies, enhanced fluorescence intensity of GFAP and Iba1 (P0.01), and down-regulated expression of phosphorylated (p)-ERK, p-CREB, and BDNF (P0.05, P0.01) and mRNA levels of ERK and CREB (P0.01). Compared with the model group, the CLMT group showed increased body weight (P0.05, P0.01), restored cell morphology, with only a small number of ruptured cells, normal neuronal structure and morphology with obvious nuclei and abundant Nissl bodies, weakened fluorescence intensity of GFAP and Iba1 (P0.05, P0.01), up-regulated mRNA levels of ERK and CREB (P0.05, P0.01) and protein levels of phosphorylated (p)-ERK, p-CREB, and BDNF in the hippocampal tissue (P0.05, P0.01). The results of molecular docking indicated that nine active ingredients in CLMT had good binding affinity with ERK and CREB. ConclusionCLMT may ameliorate the hippocampal nerve injury in the mouse model of depression by regulating the ERK/CREB pathway.
9.Microbiome and its genetic potential for carbon fixation in small urban wetlands.
Minghai LIN ; Lianxin HU ; Liping HAO ; Zefeng WANG
Chinese Journal of Biotechnology 2025;41(6):2415-2431
Small urban wetlands are widely distributed and susceptible to human activities, serving as important sources and sinks of carbon. Microorganisms play a crucial role in carbon cycle, while limited studies have been conducted on the microbial diversity in small urban wetlands and the functions of microbiome in carbon fixation and metabolism. To probe into the microbiome-driven carbon cycling in small urban wetlands and dissect the composition and functional groups of microbiome, we analyzed the relationships between the microbiome structure, element metabolism pathways, and habitat physicochemical properties in sediment samples across three small wetlands in Huzhou City, and compared them with natural wetlands in the Zoige wetland. High-throughput sequencing of 16S rRNA gene amplicons and metagenomics was employed to determine the species and functional groups. Sixty medium to high-quality metagenome-assembled genomes (MAGs) were constructed, including 55 bacterial and 5 archaeal taxa, and their potential in driving elemental cycles were analyzed, with a focus on carbon fixation. Several bacterial species were found to encode a nearly complete carbon fixation pathway, including the Calvin cycle, the reductive tricarboxylic acid cycle, the Wood-Ljungdahl pathway, and the reductive glycine pathway. There were several potential novel carbon-fixing bacterial members, such as those belonging to Syntrophorhabdus (Desulfobacterota) and UBA4417 (Bacteroidetes), which had high relative abundance in the wetland microbiome. Unveiling the genetic potential of these functional groups to facilitate element cycling is of great scientific importance for enhancing the carbon sequestration capacity of small urban wetlands.
Wetlands
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Microbiota/genetics*
;
Carbon Cycle/genetics*
;
Bacteria/classification*
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RNA, Ribosomal, 16S/genetics*
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China
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Cities
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Geologic Sediments/microbiology*
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Archaea/classification*
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Metagenomics
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Metagenome
10.The Application Value of Intraoperative Optical Coherence Tomography(iOCT)in the Surgery of Idiopathic Macular Holes
Fang LI ; Yan LUO ; Zefeng XIAO
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong 2025;54(1):112-116
Objective To evaluate the application value of intraoperative optical coherence tomography(iOCT)in the treat-ment of idiopathic macular holes(IMH)using various surgical techniques.Methods A retrospective analysis was conducted on patients who underwent vitrectomy assisted by iOCT for IMH at Wuhan No.1 Hospital from January 2021 to December 2021.All the included patients were categorized based on the different surgical methods:internal limiting membrane(ILM)peel-ing,inverted ILM coverage,and ILM filling.All patients underwent iOCT examinations to assess morphological changes in the retinal layers of the macular region,the integrity of ILM peeling,the morphology of the macular hole edges,and any intraopera-tive retinal microdamage.The closure rates of macular holes,changes in best-corrected visual acuity(BCVA),and postoperative complications were compared among three surgical approaches.Results After selection,a total of 72 patients were included in the study,consisting of 23 males and 49 females,with an average age of(57.88±7.21)years and a follow-up period of 6 months.After completing ILM peeling,iOCT revealed morphological changes at the edges of the macular holes in 15 eyes,and intraoperative retinal microdamage occurred in 18 eyes(25%).Among these,12 eyes exhibited abnormalities in the nerve fiber layer,such as hemorrhage,while 6 showed mild elevation of the inner retinal structures.iOCT indicated that 8 eyes(11.1%)still had remnants of the anterior membrane after the initial peeling,suggesting incomplete peeling and a second peeling was per-formed.The remaining 64 eyes had complete peeling.BCVA significantly improved in the ILM peeling group,ILM filling group,and ILM inversion coverage group at 1 week,1 month,and 6 months post-surgery compared to preoperative values(P<0.05).The closure rates for the macular holes in the ILM peeling group,ILM filling group,and ILM inversion coverage group were 89.7%,91.3%,and 95.0%,respectively,with no significant differences among the groups(P>0.05).No severe complication related to the surgical procedure was observed in any of the three groups during or after surgery.Conclusion ILM peeling,ILM filling,and ILM inversion coverage are all effective surgical techniques for treating IMH.iOCT can clearly and dynamically ob-serve the morphology of the retina in the macular area in real time during the operation,especially the subtle structural changes of the macular hole.It is beneficial to improve the surgeon's understanding of the surgical area,guide the operation,optimize the surgical decision,and improve the postoperative visual acuity of patients.

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