AIM: To investigate the effects of Conbercept on various optical coherence tomography(OCT)biomarkers in patients with retinal vein occlusion-related macular edema(RVO-ME), and to analyze the correlation of these biomarker changes with visual prognosis.METHODS: Retrospective study. A total of 57 patients(57 eyes)with RVO-ME, including 25 patients(25 eyes)with central retinal vein occlusion(CRVO)and 32 patients(32 eyes)with branch retinal vein occlusion(BRVO), were enrolled in this study. All the patients received intravitreal injection of conbercept once a month, three times in total. The preoperative and postoperative best-corrected visual acuity(BCVA), and changes in OCT biomarkers, including central macular thickness(CMT), the length of disorganization of the retinal inner layers(DRIL), the number of hyperreflective dots(HRD), the area of intraretinal fluid(IRF), the area of subretinal fluid(SRF), and the length of ellipsoid zone(EZ)disruption were compared. Furthermore, the relationship of these changes with BCVA was analyzed.RESULTS:Compared with the baseline, at 3 mo post-treatment, BCVA(LogMAR)was improved, CMT was decreased, the length of DRIL was shortened, the number of HRD was reduced, the area of IRF was decreased, the area of SRF was reduced, and the length of EZ disruption was shortened(all P<0.05). Spearman correlation analysis showed that there was no correlation between the changes in CMT, the length of DRIL, the number of HRD, the area of IRF, the area of SRF and the change in BCVA before and after treatment(P>0.05). However, the change in the length of EZ disruption was positively correlated with the change in BCVA(rs=0.34, P=0.011), and the R2 value of the fitting curve between the change in the length of EZ disruption and the change in BCVA was 0.113(P=0.011). When comparing the pre- and post-treatment changes in BCVA, the length of DRIL, the number of HRD, the area of IRF, the area of SRF, and the length of EZ disruption between patients in the CRVO group and BRVO group, no significant differences were observed(all P>0.05). In contrast, a significant difference was found in the change in CMT between the two groups(P=0.002).CONCLUSION:Conbercept effectively improves multiple OCT biomarkers in patients with RVO-ME. Repair of EZ disruption is a key driver of visual recovery, and its stability may serve as a novel indicator for personalized decision-making in anti-vascular endothelial growth factor therapy.

Objective To investigate the clinical characteristics,distribution of traditional Chinese medicine(TCM)syndrome types,and the anxiety and depression status in patients with colorectal polyps.Methods From January 2022 to December 2023,a total of 200 cases of patients with colorectal polyps(polyp group)and 100 patients without intestinal abnormalities(non-polyp group)under colonoscope who received colonoscopy or treatment at the Endoscopy Center of Dongguan Hospital,Guangzhou University of Chinese Medicine were enrolled.The relevant medical information of the patients in the two groups were collected,and then TCM syndrome differentiation of patients with colorectal polyps were carried out,the general infromation including gender,age,body mass index(BMI),smoking history and alcohol-intake history was recorded,and Hospital Anxiety and Depression Scale(HAD)score was calculated for assessing their anxiety and depression status.Results(1)The investigation of clinical characteristics showed that between the polyp group and the non-polyp group,the differences in the general information of gender,age,BMI,smoking history and alcohol-intake history were statistically significant(P<0.05 or P<0.01).As for the gender,the polyp group was predominated by the male(63.5%),while the non-polyp group was predominated by the female(58.0%),indicating that male patients were more likely to suffer from colorectal polyps.In terms of the age,the age group of 51-60 years old accounted for a higher percentage(36.0%)in the polyp group,while the age group of 41-50 years old accounted for a higher percentage(38.0%)in the non-polyp group,indicating that the polyp group had an elder average age than the non-polyp group.In addition,the percentages of patients with obesity(BMI≥28.0 kg/m2),smoking history,and alcohol-intake history in the polyp group were higher than those in the non-polyp group.(2)The analysis of features of colorectal polyps showed that the polyps were mostly seen in the left colon,accounting for 53.5%in the polyp group;adenomatous polyps accounted for 57.0%of all polyps;the size of colorectal polyps was usually less than one centimeter,accounting for 81.5%of all polyps;single colorectal polyps accounted for 45.5%,and multiple colorectal polyps accounted for 54.5%,indicating that colorectal polyps were usually multiple.(3)Among the 200 patients with colorectal polyps,there were 93 cases of syndrome of stagnation dampness due to spleen deficiency(46.5%),59 cases of dampness-heat in large intestine syndrome(29.5%),27 cases of liver depression and qi stagnation syndrome(13.5%),and 21 cases of dampness and blood stasis obstruction syndrome(10.5%).There were no statistically significant differences in the distribution of TCM syndrome types among colorectal polyp patients with different genders,ages,BMIs and alcohol consumption(P>0.05).The difference in the distribution of TCM syndrome types among colorectal polyp patients with or without smoking history was statistically significant(P<0.05).No statistically significant differences were shown in the distribution of TCM syndrome types among the colorectal polyp patients with various foci,number of polyps,and pathological types(P>0.05).The difference in the distribution of TCM syndrome types in colorectal polyp patients with different polyp sizes was statistically significant(P<0.05).In the patients with the polyp size0.05).In addition,the differences of anxiety scores and depression scores in the patients with various TCM syndrome types were not statistically significant(P>0.05).Conclusion(1)The distribution of TCM syndrome types of colorectal polyps is predominated by the syndrome of stagnation dampness due to spleen deficiency and dampness-heat in large intestine syndrome.The distribution of TCM syndrome types has no correlation with anxiety and depression,and the polyp foci,number of polyps,and pathological types of polyps,but has certain correlation with the size of the polyps.(2)Anxiety and depression may be the risk factors for colorectal polyps,but the polyp foci,number of polyps,and pathological types of polyps have no correlation with anxiety and depression,and the size of polyps may have certain correlation with anxiety.(3)Gender,age,smoking history and alcohol-intake history may be the risk factors for colorectal polyps.

Objective To explore the feasibility and safety of prolonging the use time of non-corng needles in totally implantable venous access ports for patients with breast cancer.Methods A total of 100 breast cancer patients implanted in the chest wall totally implantable venous access ports of Zhejiang Cancer Hospital in June to December 2022 were randomly divided equally into 7-day group and 8-day group by means of random number table according to the time of removing the non-destructive needle.Catheter function evaluation,catheter-related complications,comfort evaluation and cost calculation were used for investigation and analysis.Results In both groups,blood was returned from the infusion port catheter and the catheter flushed smoothly.There were 1 case of local skin allergy in 7-day group and 2 cases in 8-day group.In the comfort evaluation,comfort accounted for 86%in 7d group and 90%in 8d group,and the difference was not statistically significant(P>0.05).The maintenance cost of the infusion port per capita in the 7d group was higher than that in the 8d group,and the difference was statistically significant(P<0.05).Conclusion Under certain circumstances,after evaluation by nurses,the use time of non-corng needles in totally implantable venous access ports of breast cancer patients can be appropriately prolonged,which can improve work efficiency and reduce costs.

[Objective]To analyse the academic characteristics of Jiudetang Yi'an by the famed Qing Dynasty physician LI Yongcui,so as to braoden the schemes of the clinical diagnosis and treatment.[Methods]Using the 67 medical cases recorded in the Jiudetang Yi'an as the primary research subjects,this paper extracted and analyzed the main symptoms,disease locations,syndrome types,treatment principles and prescriptions from these cases.Additionally,this paper referenced other relevant classical texts to summarize LI's academic thoughts and clinical experiences.[Results]LI inherited family medical teachings from a young age and extensively absorbed the essence of various schools of thought,supplementing areas unexplored by his predecessors.Academically,he was grounded in the Huangdi Neijing and was profoundly influenced by Dongyuan's theories,developing unique insights into"Yin fire".In clinical practice,LI strictly adhered to holistic principles,selecting medications based on timing;treating upper body ailments by addressing lower body issues with skillful differentiation;advocating spleen regulation as fundamental while emphasizing the liver harmony and protecting the spleen and kidney functions.LI prioritized complexion and pulse diagnosis,excelling particularly in pulse diagnosis,and basing treatments on pulse-symptom discrepancies.His approach favored mild medications,cautiously employing aggressive treatments,effectively utilizing channel-guiding and envoy drugs,and skillfully incorporating hematite in prescriptions.[Conclusion]Jiudetang Yi'an presents a collection of meticulously selected cases,comprehensive in theory,methodology,prescription,and medication.The distinctive diagnostic and therapeutic features of LI's practice,as encapsulated in these records,offer valuable insights for expanding syndrome differentiation thinking and guiding clinical diagnosis and treatment.This work merits in-depth study and inheritance by future generations of practitioners.

Objective:To investigate the incidence and influencing factors of olfactory dysfunction in postoperative laryngeal cancer patients.Methods:From November 2022 to August 2023, totally 76 postoperative laryngeal cancer patients admitted to the Department of Head and Neck Surgery at Zhejiang Cancer Hospital were selected by convenience sampling. General information questionnaire and the T&T olfactometer were used for assessment. Multiple linear regression analysis was conducted to explore the influencing factors of olfactory dysfunction in postoperative laryngeal cancer patients.Results:The T&T olfactometer score for the 76 postoperative laryngeal cancer patients at two weeks post-surgery was (4.74±0.93). Olfactory dysfunction occurred in 76 patients, with 25 cases of anosmia, 33 cases of severe hyposmia, 17 cases of moderate hyposmia, and one case of mild hyposmia. Multiple linear regression analysis revealed that age, educational level, surgical method, and smoking history were influencing factors for olfactory dysfunction in these postoperative laryngeal cancer patients.Conclusions:Postoperative laryngeal cancer patients experience varying degrees of olfactory dysfunction. Healthcare providers should pay special attention to older patients, those with lower educational levels, those undergoing total laryngectomy, and those with a history of smoking. Designing practical olfactory rehabilitation programs and implementing early olfactory training methods can help reduce the incidence of olfactory dysfunction.

Objective:To explore the clinical application value of 18F-FDG PET/CT radiomics in predicting B-cell lymphoma-2 (BCL-2)/immunoglobulin heavy chain (IgH) fusion gene expression status in follicular lymphoma (FL) patients. Methods:A retrospective analysis was conducted on the clinical and imaging data of 90 FL patients (46 males and 44 females, age (48.7±10.5) years) who underwent 18F-FDG PET/CT examinations at Henan Cancer Hospital from January 2016 to August 2023. According to the expression status, patients were divided into positive group and negative group. Patients were randomly divided into training set ( n=62) and validation set ( n=28) at a ratio of 7∶3. PET and CT radiomics features were extracted by LIFEx 7.3.11 software. After using least absolute shrinkage and selection operator (LASSO) regression and ten-fold cross-validation for feature selection, PET and CT radiomics models were constructed. Univariate and multivariate analyses were used to select important clinical features and construct clinical model. Finally, a combined model was established by combining the radiomics features with clinical features. ROC curve and AUC were used to evaluate the predictive performance of models, and Delong test was used to compare the differences in AUCs. Results:After features selection, a total of 3 PET radiomics features, 3 CT radiomics features and 2 clinical features were selected for the construction of radiomics model and clinical model respectively. Multivariate analysis of clinical data showed that pathological grade (odds ratio ( OR)=0.201, 95% CI: 0.052-0.699, P=0.014) and maximum diameter of the maximum lesion (D max) ( OR=1.033, 95% CI: 1.009-1.065, P=0.017) were associated with BCL-2/IgH expression status. In the training set, the AUCs of clinical model, PET radiomics model, CT radiomics model and combined model were 0.84, 0.80, 0.80 and 0.91 respectively. In the validation set, the AUCs of the four models were 0.55, 0.61, 0.66 and 0.71 respectively. The combined model exhibited a trend toward higher in AUC than other three models in both the training and validation sets ( z values: 0.50-1.71, P values: 0.087-0.620). Conclusion:It is valuable to predict BCL-2/IgH fusion gene expression status based on PET/CT radiomics combined with clinical features.

Changes in structure of oral solid dosage forms (OSDF) elementally determine the drug release and its therapeutic effects. In this research, synchrotron radiation X-ray micro-computed tomography was utilized to visualize the 3D structure of enteric coated pellets recovered from the gastrointestinal tract of rats. The structures of pellets in solid state and in vitro compendium media were measured. Pellets in vivo underwent morphological and structural changes which differed significantly from those in vitro compendium media. Thus, optimizations of the dissolution media were performed to mimic the appropriate in vivo conditions by introducing pepsin and glass microspheres in media. The sphericity, pellet volume, pore volume and porosity of the in vivo esomeprazole magnesium pellets in stomach for 2 h were recorded 0.47, 1.55 × 10⁸ μm³, 0.44 × 10⁸ μm³ and 27.6%, respectively. After adding pepsin and glass microspheres, the above parameters in vitro reached to 0.44, 1.64 × 10⁸ μm³, 0.38 × 10⁸ μm³ and 23.0%, respectively. Omeprazole magnesium pellets behaved similarly. The structural features of pellets between in vitro media and in vivo condition were bridged successfully in terms of 3D structures to ensure better design, characterization and quality control of advanced OSDF.

Defining and visualizing the three-dimensional (3D) structures of pharmaceuticals provides a new and important tool to elucidate the phenomenal behavior and underlying mechanisms of drug delivery systems. The mechanism of drug release from complex structured dosage forms, such as bilayer osmotic pump tablets, has not been investigated widely for most solid 3D structures. In this study, bilayer osmotic pump tablets undergoing dissolution, as well as after dissolution in a desiccated solid state were examined, and visualized by synchrotron radiation micro-computed tomography (SR-μCT). In situ formed 3D structures at different in vitro drug release states were characterized comprehensively. A distinct movement pattern of NaCl crystals from the push layer to the drug layer was observed, beneath the semi-permeable coating in the desiccated tablet samples. The 3D structures at different dissolution time revealed that the pushing upsurge in the bilayer osmotic pump tablet was directed via peripheral "roadways". Typically, different regions of the osmotic front, infiltration region, and dormant region were classified in the push layer during the dissolution of drug from tablet samples. According to the observed 3D microstructures, a "subterranean river model" for the drug release mechanism has been defined to explain the drug release mechanism.

Objective To analyze the therapeutic effect and tolerability of decitabine monotherapy or combined with arsenic trioxide for the treatment of patients with myelodysplastic syndromes (MDS). Methods Clinical characteristics of 32 patients with primary MDS in North Hospital of Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University from January 2014 to April 2017 were retrospectively analyzed. The clinical data of these patients were collected, and the patients were followed up. Decitabine combined with arsenic trioxide was used in 23 cases, decitabine (20 mg·m-·2d-1) and arsenic trioxide (0.16 mg/kg) were administrated from day 1 to day 5 and was repeated every 4-6 weeks. For the remaining 9 cases, only decitabine was applied, decitabine(20 mg·m-2·d-1) was administrated from day 1 to day 5 and was repeated every 4-6 weeks. The clinicopathological characteristics and the effect of genetic mutations on the efficacy of treatment were investigated. Results Of the 32 patients with primary MDS, 18 were male and 14 were female. The patients were 17-72 years old with a median age of 56 years old. Genetic analysis revealed 10 cases with TP53 mutations, 8 cases with TET2 mutations, 4 cases with U2AF1 mutations, 3 cases with RUNX1 mutations, 3 cases with ASXL1 mutations, 2 cases with NRAS mutations, 2 cases with DNMT3A mutations and 1 case with JAK2 V617 mutation. The follow﹣up time was 2-23 months with a median follow﹣up time of 8 months. A total of 21 cases (65.6%) attained treatment response. Among them, there were 10 cases (31.3%) with complete remission (CR), 5 cases (15.6%) with bone marrow complete remission (MCR), and 6 cases (18.7%) with hematological improvement. There was no significant difference in the efficiency and CR rate between the combination group and the monotherapy group (P＝0.441, P＝0.681). Ten cases were found to have TP53 mutations, of which 7 cases had CR. Multivariate analysis demonstrated that TP53 mutation was an independent risk factor for CR (P＝ 0.037). All patients developed myelosuppression after treatment, of which 16 cases developed pulmonary infection. Conclusions Decitabine combined with arsenic trioxide in the treatment of MDS is effective and well tolerated. The therapeutic effects of decitabine monotherapy or decitabine combined with arsenic trioxide for treatment of patients with TP53 mutations are better than the average levels.

POEMS syndrome is a rare paraneoplastic disorder. A 60-year-old female patient was admitted to the Department of Gastroenterology, Xiangya Hospital of Central South University (Changsha, China), complaining of abdominal distension, severe edema of both lower limbs and shortness of breath for more than 1 year. After intensive and careful medical investigations, the patient manifested with polyneuropathy, M-proteinemia, splenomegaly, lymphadenopathy, hypothyroidism, extravascular volume overload, sclerotic bone lesions, elevated VEGF and pulmonary hypertension. According to the latest diagnostic criteria of POEMS syndrome, this patient met two mandatory major criteria, two other major criteria and three minor criteria, the diagnosis was clear after ruling out differential diagnosis. The patient was treated with dexamethasone and lenalidomide, which relieved her clinical symptoms. The pathogenesis of POEMS syndrome is not fully understood; however, increased levels of vascular endothelial growth factor may contribute to most of the clinical manifestations. This patient had been in physical discomfort for more than 14 months, which seriously affected her quality of life. Clinically, the awareness of early diagnosis and treatment of POEMS syndrome should be improved.
China ; Dyspnea ; Edema ; Female ; Humans ; Lower Extremity ; Middle Aged ; POEMS Syndrome ; Quality of Life ; Vascular Endothelial Growth Factor A