Objective:To evaluate the efficacy and safety of ophthalmic viscosurgical device (OVD)-assisted non-gas dependent pars plana vitrectomy (PPV) combined with an inverted internal limiting membrane (ILM) flap for the treatment of idiopathic macular hole (IMH).Methods:A retrospective cohort study. From June 2023 to February 2024, 33 patients (33 eyes) diagnosed with IMH in Department of Ophthalmology of Changshu Second People’s Hospital were included in the study. Best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations were performed on all affected eyes before surgery. BCVA examination was conducted using the international standard visual acuity chart, and the results were converted into the logarithm of the minimum angle of resolution (logMAR) visual acuity. The minimum diameter of the hole was measured using OCT. All affected eyes received standard 25G PPV treatment through the three channels of the flat part of the ciliary body. According to the surgical methods, they were divided into two groups: the OVD-assisted non-gas-dependent PPV combined with internal limiting membrane inversion and coverage treatment group (OVD group, 17 cases and 17 eyes) and the heavy water-assisted gas-dependent PPV combined with internal limiting membrane inversion and coverage treatment group (heavy water group, 16 cases and 16 eyes). Postoperatively, patients in the OVD group were not required to maintain a strict specific position, whereas those in the heavy water group needed to remain in a prone position for one week. The follow-up time points after the operation were 1 week, 1 month and 3 months. The main observation indicators included BCVA, intraocular pressure, hole closure rate and closure morphology of the two groups, as well as the occurrence of complications. The independent sample t test was used for comparison between groups. Pearson correlation analysis was used for the correlation between BCVA at 3 months after surgery and the minimum diameter of the surgical hole and BCVA before surgery. Results:Three months after the operation, the rate of hole closure in the OVD group and the heavy water group was 17 (100.0%, 17/17) and 15 (93.8%, 15/16) eyes, respectively. There was no statistically significant difference in the hole closure rate ( χ2=1.090) and closure type ( Z=?0.780) between the two groups ( P>0.05). Compared with before the operation, the logMAR BCVA at each time point after the operation in the OVD group and the heavy water group was significantly improved ( F=2.353, 1.375; P<0.05). One week after the operation, the BCVA in the OVD group was significantly better than that in the heavy water group ( t=-3.760, P<0.01). In terms of intraocular pressure, compared with the baseline value before the surgery, there was a statistically significant difference in the OVD group one week after the surgery ( Z=?3.454, P<0.05). There were statistically significant differences in the heavy water group at 1 week, 1 month and 3 months after the operation ( Z=?5.066, ?3.423, ?2.739; P<0.05). After the operation, one eye in the heavy water group had high intraocular pressure, which returned to normal after combined treatment with intraocular pressure-lowering drugs. No ocular or systemic complications occurred in the OVD group. The results of the correlation analysis showed that postoperative BCVA was correlated with the minimum diameter of the surgical hole and BCVA before the surgery ( r=0.543, 0.658; P<0.05). Conclusions:The treatment of IMH with OVD-assisted non-gas-dependent PPV combined with internal limiting membrane flip coverage has a good effect. It helps promote the early recovery of macular morphology and visual function after surgery, and at the same time can avoid the maintenance of forced position and reduce perioperative risks.

Objective:To evaluate the efficacy and safety of ophthalmic viscosurgical device (OVD)-assisted non-gas dependent pars plana vitrectomy (PPV) combined with an inverted internal limiting membrane (ILM) flap for the treatment of idiopathic macular hole (IMH).Methods:A retrospective cohort study. From June 2023 to February 2024, 33 patients (33 eyes) diagnosed with IMH in Department of Ophthalmology of Changshu Second People’s Hospital were included in the study. Best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations were performed on all affected eyes before surgery. BCVA examination was conducted using the international standard visual acuity chart, and the results were converted into the logarithm of the minimum angle of resolution (logMAR) visual acuity. The minimum diameter of the hole was measured using OCT. All affected eyes received standard 25G PPV treatment through the three channels of the flat part of the ciliary body. According to the surgical methods, they were divided into two groups: the OVD-assisted non-gas-dependent PPV combined with internal limiting membrane inversion and coverage treatment group (OVD group, 17 cases and 17 eyes) and the heavy water-assisted gas-dependent PPV combined with internal limiting membrane inversion and coverage treatment group (heavy water group, 16 cases and 16 eyes). Postoperatively, patients in the OVD group were not required to maintain a strict specific position, whereas those in the heavy water group needed to remain in a prone position for one week. The follow-up time points after the operation were 1 week, 1 month and 3 months. The main observation indicators included BCVA, intraocular pressure, hole closure rate and closure morphology of the two groups, as well as the occurrence of complications. The independent sample t test was used for comparison between groups. Pearson correlation analysis was used for the correlation between BCVA at 3 months after surgery and the minimum diameter of the surgical hole and BCVA before surgery. Results:Three months after the operation, the rate of hole closure in the OVD group and the heavy water group was 17 (100.0%, 17/17) and 15 (93.8%, 15/16) eyes, respectively. There was no statistically significant difference in the hole closure rate ( χ2=1.090) and closure type ( Z=?0.780) between the two groups ( P>0.05). Compared with before the operation, the logMAR BCVA at each time point after the operation in the OVD group and the heavy water group was significantly improved ( F=2.353, 1.375; P<0.05). One week after the operation, the BCVA in the OVD group was significantly better than that in the heavy water group ( t=-3.760, P<0.01). In terms of intraocular pressure, compared with the baseline value before the surgery, there was a statistically significant difference in the OVD group one week after the surgery ( Z=?3.454, P<0.05). There were statistically significant differences in the heavy water group at 1 week, 1 month and 3 months after the operation ( Z=?5.066, ?3.423, ?2.739; P<0.05). After the operation, one eye in the heavy water group had high intraocular pressure, which returned to normal after combined treatment with intraocular pressure-lowering drugs. No ocular or systemic complications occurred in the OVD group. The results of the correlation analysis showed that postoperative BCVA was correlated with the minimum diameter of the surgical hole and BCVA before the surgery ( r=0.543, 0.658; P<0.05). Conclusions:The treatment of IMH with OVD-assisted non-gas-dependent PPV combined with internal limiting membrane flip coverage has a good effect. It helps promote the early recovery of macular morphology and visual function after surgery, and at the same time can avoid the maintenance of forced position and reduce perioperative risks.

Objective To measure the specificactivity of natural and synthetic radionuclides in the environmental soil of Panjin, China and determine the content of radionuclides in the surface soil, and to conduct a scientific assessment of the radiation health risks of residents in this area. Methods Thirty-one surface soil samples were collected within the jurisdiction of Panjin, and a high-purity germanium detector was used for γ spectrum analysis to obtain the content of radionuclides and the current environmental radioactivity level. The two independent samples mean t-test was used to compare the specific activity data of radionuclides in soil samples between Panjin and Liaoning Province or China. Results The meanspecific activities of natural radionuclides ²³⁸U, ²²⁶Ra, ²³²Th, ⁴⁰K, and synthetic radionuclide ¹³⁷Cs in the surface soil samples of Panjin were 18.7 Bq/kg, 19.6 Bq/kg, 23.5 Bq/kg, 604.6 Bq/kg, and 0.9 Bq/kg, respectively. Conclusion The specific activities of natural and synthetic radionuclides in the surface soil samples of Panjin Area at the background level, causing a very low health risk to the people in this area.

Objective:To explore the pharmacological molecular mechanisms of metformin against diabetic retinopathy (DR) based on network pharmacology approach.Methods:After chemical constitution of metformin was acquired from Pubchem database, target genes of metformin were identified by PharmMapper, SwissTargetPrediction and DrugBank database, and the pathological genes were obtained from GeneCards and DisGeNET database.Subsequently, the intersection of metformin targets and pathologic targets of DR were served as therapeutic targets of metformin against DR.The construction of protein-protein interaction (PPI) network was constructed by STRING, gene ontology (GO) and functional pathway were analyzed by Metascape.Results:Overall 31 therapeutic target genes of metformin against DR were obtained.Biological process of the PPI network was mainly enriched in reactive oxygen species metabolic process and nucleotide metabolism; cellular component was mainly enriched in microvillus and adherens junction; molecular function was mainly enriched in cofactor binding and nitric oxide synthase (NOS) activity.Functional pathway was mainly enriched in hemostasis and signaling by vascular endothelial growth factor (VEGF).Conclusions:Metformin prevents the development of DR mainly through affecting cellular tight junctions and reaction to hypoxia, modulating NOS and VEGF signaling pathways.

Objective To investigate the effect of restrictive intravenous fluid on the complications and quality of life in the advanced hepatocellular carcinoma patients.Methods Clinical data of Three hundred and fifty-seven cases with advanced hepatocellular carcinoma from Mar 2010 to Mar 2016 was retrospectively analyzed.One hundred and sixty-eight cases were recruited in the restrictive intravenous fluid (RIF) group,and One hundred and eighty-nine cases were involved in the control group.The average volume of intravenous fluid of each day,plasma albumin concentration,splanchnocoel hydrops rate,phlebitis,incidence of vomiting,cancer related pain degree,anxiety degree were compared in the two groups.Results The average volume of intravenous fluid of each day in the RIF group [(720.29 ± 106.84) ml] were much lower than that in the control group [(1 820.36±342.12)ml] (P ＜0.05).The plasma albumin concentration in the RIF group [(35.65 ± 2.21)g/L] were higher than that in the control group [(32.25 ±2.32)g/L] (P ＜0.05).The rate of splanchnocoel hydrops,phlebitis,vomiting,bedsores,and hypstatic pneumonia in RIF group were 6.25％,4.69％,8.59％,3.9％,11.72％ and those in the control group were 13.97％,10.92％,17.47％,10.04％,and 24.45％,respectively (P ＜ 0.05).Moreover,the scores of cancer related pain and anxiety were much lower in the RIF group (5.21 ± 1.09,39.12 ± 5.54) than those in the control group(5.68 ± 1.18,41.56 ± 6.78) (P ＜ 0.01).Conclusions Restrictive intravenous fluid therapy can decrease the cancer associated complications and improved the quality of life in the advanced hepatocellular carcinoma patients.