AIM: To explore the risk factors for postoperative anterior chamber exudation in cataract patients and construct a nomogram prediction model.METHODS: Retrospective study. From July 2019 to October 2024, 450 patients(467 eyes)with age-related cataract who underwent surgery in our hospital were collected as the study subjects. They were randomly grouped into a modeling group(315 cases, 327 eyes)and a validation group(135 cases, 140 eyes)roughly estimated at a 7:3 ratio using the random number table method. Both groups were separated into a non-exudative group and an exudative group based on whether anterior chamber exudation occurred after surgery. Clinical basic data was collected; multivariate Logistic regression was applied to analyze the influencing factors of anterior chamber exudation in patients with age-related cataract after surgery; R software was applied to draw a nomogram prediction model of anterior chamber exudation in patients with age-related cataract after surgery; the calibration curve and Hosmer Lemeshow(H-L)test were applied to evaluate the calibration of the column plot model in predicting the occurrence of anterior chamber exudation in patients with age-related cataract after surgery; ROC was applied to evaluate the efficacy of anterior chamber exudation in patients with age-related cataract after surgery.RESULTS:The clinical characteristics of the modeling group and the validation group were comparable. The high myopia, history of uveitis, preoperative intraocular pressure, lens nuclear grade, intraoperative cumulative dissipated energy, and intraoperative posterior capsular rupture of the lens were the influencing factors for postoperative anterior chamber exudation in patients with age-related cataract(all P<0.05). The results of the modeling group verifying the occurrence of anterior chamber exudation in patients with age-related cataract after surgery showed that the area under the ROC curve(AUC)was 0.986(95% CI: 0.966-0.996), the H-L test was χ2=6.494, P=0.592, indicating that the risk of anterior chamber exudation in patients with age-related cataract after surgery predicted by model had good consistency with actual risks, the AUC of postoperative anterior chamber exudation in patients with age-related cataract based on external validation was 0.982(95% CI: 0.960-0.994); and the H-L test suggested that the risk of anterior chamber exudation in CAT patients after surgery predicted by model had good consistency with actual risks(χ2=6.117, P=0.634).CONCLUSION:High myopia, history of uveitis, preoperative intraocular pressure, lens nuclear grade, intraoperative cumulative dissipated energy, and intraoperative posterior capsular rupture of the lens are risk factors for postoperative anterior chamber exudation in patients with age-related cataract; the nomogram prediction model constructed based on this has high predictive value, and can provide reference for individualized prevention of anterior chamber exudation in patients with age-related cataract after surgery.

Objective To investigate the value of total cerebral small vessel disease （CSVD） score combined with three-dimensional arterial spin labeling （3D-ASL） in predicting the prognosis of patients with acute ischemic stroke （AIS） after 90 days of intravenous thrombolysis. Methods A total of 189 AIS patients who were consecutively admitted to Department of Neurology， Changshu Hospital Affiliated to Nantong University， from January 2021 to June 2023 and underwent intravenous thrombolysis with alteplase were enrolled， and multimodal brain MRI was performed to assess total CSVD load and cerebral blood flow in the area of responsibility. A multivariate logistic regression analysis was used to identify the independent influencing factors for poor 90-day prognosis in AIS patients undergoing intravenous thrombolysis. The receiver operating characteristic （ROC） curve was used to investigate the value of total CSVD score and 3D-ASL used alone or in combination in predicting the prognosis of AIS. Results The multivariate regression analysis showed that diabetes （OR=3.601，95%CI 1.448‒8.954，P=0.006）， total CSVD score ≥3 points （OR=4.077， 95%CI 1.785‒9.313，P=0.001）， and baseline NIHSS score （for every 1-point increase：OR=1.167， 95%CI 1.061‒1.283， P=0.001） were independent risk factors for poor prognosis in AIS patients on day 90 after intravenous thrombolysis，while ASL hyperperfusion was an independent protective factor against poor prognosis （OR=0.16， 95%CI 0.050‒0.356，P=0.014）.The ROC curve analysis showed that the predictive model based on CSVD score and ASL perfusion had a C-value of 0.844 （95%CI 0.786‒0.902， P<0.05） and thus had the best predictive efficacy. Conclusion Total CSVD score combined with 3D-ASL can more comprehensively reflect the whole brain circulation network and has a better effect than each indicator alone in predicting the 90-day prognosis of AIS patients undergoing intravenous thrombolysis.

ObjectiveTo investigate the homogeneity of trace elements and oxygen isotope composition of the calcitum by in situ micro-region analysis. MethodsSamples of calcitum were collected from Lannigou in Zhenfeng county， Guizhou province（LNG-1， LNG-2）， Taipingdong（TPD） and Zimudang（ZMD） in Xingren county， Guizhou province， Getang in Anlong county， Guizhou province（GT）， Gaolong（GL） and Badu（BD） in Tianlin county， Guangxi province， and Mingshan in Lingyun county， Guangxi province（MS）. The surface scanning of Ca， Mn and Fe elements in the microregions of TPD samples was analyzed by X-ray energy spectrum surface scanning method（EDS）. Cathodoluminescence method（CL） was used to analyze the luminescence properties of the thin slices of calcitum samples. The content and distribution uniformity of Mn， Fe and rare earth elements in the in situ microregions of LNG-1， TPD， GL and BD samples， and the δ¹⁸O and the distribution uniformity in the in situ microregions of the thin slices of LNG-2， ZMD， GT and MS samples were analyzed by laser ablation inductively coupled plasma mass spectrometry（LA-ICP-MS）. ResultsThe composition of elements and oxygen isotopes of calcitum from different origins were different. EDS analysis results showed that the Fe and Mn elements in calcitum had obvious girdle structure. The results of CL and LA-ICP-MS analysis showed that the cathode light in different regions of calcitum was red and varied in brightness， and the contents of Mn， Fe and rare earth elements were important factors affecting the brightness of the cathode light of calcitum. Regions with high content of Fe and low content of Mn had darker cathode light color， while regions with low content of Fe and high content of Mn had brighter cathode light color. When the total content of rare earth elements was>10 μg·g^-1， the brightness of the cathode light would be affected， and the higher the total content of the region， the brighter the cathode light color would be. Among the samples from different origins， the calcitum tested in MS area had the largest δ¹⁸O heterogeneity， and the δ¹⁸O difference ring band with micron level was formed. Meanwhile， the δ¹⁸O content was lower in the region with darker cathode light， on the contrary， the content was higher. ConclusionThe composition of Fe， Mn， rare earth elements and δ¹⁸O of calcitum is uneven and has obvious chemical compositional ring bands， among which the calcitum in Lannigou area has good quality because of its relatively uniform chemical composition and high content of Fe and Mn elements. This study can provide experimental basis for the formulation of quality standard of calcitum.

ObjectiveTo investigate the homogeneity of trace elements and oxygen isotope composition of the calcitum by in situ micro-region analysis. MethodsSamples of calcitum were collected from Lannigou in Zhenfeng county， Guizhou province（LNG-1， LNG-2）， Taipingdong（TPD） and Zimudang（ZMD） in Xingren county， Guizhou province， Getang in Anlong county， Guizhou province（GT）， Gaolong（GL） and Badu（BD） in Tianlin county， Guangxi province， and Mingshan in Lingyun county， Guangxi province（MS）. The surface scanning of Ca， Mn and Fe elements in the microregions of TPD samples was analyzed by X-ray energy spectrum surface scanning method（EDS）. Cathodoluminescence method（CL） was used to analyze the luminescence properties of the thin slices of calcitum samples. The content and distribution uniformity of Mn， Fe and rare earth elements in the in situ microregions of LNG-1， TPD， GL and BD samples， and the δ¹⁸O and the distribution uniformity in the in situ microregions of the thin slices of LNG-2， ZMD， GT and MS samples were analyzed by laser ablation inductively coupled plasma mass spectrometry（LA-ICP-MS）. ResultsThe composition of elements and oxygen isotopes of calcitum from different origins were different. EDS analysis results showed that the Fe and Mn elements in calcitum had obvious girdle structure. The results of CL and LA-ICP-MS analysis showed that the cathode light in different regions of calcitum was red and varied in brightness， and the contents of Mn， Fe and rare earth elements were important factors affecting the brightness of the cathode light of calcitum. Regions with high content of Fe and low content of Mn had darker cathode light color， while regions with low content of Fe and high content of Mn had brighter cathode light color. When the total content of rare earth elements was>10 μg·g^-1， the brightness of the cathode light would be affected， and the higher the total content of the region， the brighter the cathode light color would be. Among the samples from different origins， the calcitum tested in MS area had the largest δ¹⁸O heterogeneity， and the δ¹⁸O difference ring band with micron level was formed. Meanwhile， the δ¹⁸O content was lower in the region with darker cathode light， on the contrary， the content was higher. ConclusionThe composition of Fe， Mn， rare earth elements and δ¹⁸O of calcitum is uneven and has obvious chemical compositional ring bands， among which the calcitum in Lannigou area has good quality because of its relatively uniform chemical composition and high content of Fe and Mn elements. This study can provide experimental basis for the formulation of quality standard of calcitum.

Yttrium-90 microsphere selective internal radiation therapy (⁹⁰Y-SIRT) has been widely used in the treatment of malignant liver cancers, and its safety and efficacy have been fully validated. As an important local therapeutic method, ⁹⁰Y-SIRT has been utilized for the treatment of multiple metastatic liver cancers in many cancer diagnosis and treatment centers at home and abroad, demonstrating significant therapeutic potential. This article reviews the basic principle, development history, indications and contraindications of ⁹⁰Y microsphere, as well as the specific applications in treatment of different types of metastatic liver cancers, aiming to provide references for further research and optimization of treatment strategies.

ObjectiveTo investigate the key targets of Jianpi Yiqi prescription （JYP） in the treatment of hepatocellular carcinoma （HCC） based on network pharmacology and explore the effect of JYP on the invasion and proliferation of hepatocellular carcinoma cells via protein tyrosine phosphatase， non-receptor type 1 （PTPN1） by bioinformatics analysis and CRISPR/Cas9. MethodsThe potential targets of JYP in the treatment of HCC were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）， SwissTargetPrediction， GeneCards， NCBI， and CTD. Additionally， the active components of JYP that could interact with PTPN1 were screened out， and then molecular docking between the targets and active components was performed in Autodock 4.0. UALCAN， HPA， and LinkedOmics were used to analyze the expression of PTPN1 in the HCC tissue， and the relationship of PTPN1 expression with the overall survival （OS） of HCC patients was discussed. CRISPR/Cas9 was used to knock down the expression of PTPN1 in HepG2 and SK-hep-1 cells， and the knockdown effect was examined by sequencing， Real-time PCR， and Western blot. HepG2 cells were classified into blank control， low-， medium-， and high-dose JYP （5.25， 10.5， 21 g·kg^-1）， and PTPN1 knockout groups. Real-time PCR and Western blot were employed to determine the mRNA and protein levels， respectively， of PTPN1 in HepG2 cells of each group. The effects of JYP and PTPN1 knockdown on the proliferation， invasion， and apoptosis of HepG2 cells were detected by Cell Counting Kit-8 （CCK-8）， Transwell， and Annexin V-FITC/PI methods， respectively. ResultsJYP had the most active components targeting PTPN1， and 31 of the active components had the binding energy less than -5.0 kcal·mol^-1 in molecular docking. The mRNA and protein levels of PTPN1 in the HCC tissue were higher than those in the normal tissue （P<0.01）. Compared with that in the normal tissue， the mRNA level of PTPN1 in the HCC tissue was up-regulated at the pathological stages Ⅰ-Ⅲ and grades G₁-G₃ （P<0.01）， and it was not significantly up-regulated at the stage Ⅳ or grade G₄. The mRNA level of PTPN1 in the TP53-mutated HCC tissue was higher than that in the TP53-unmutated HCC tissue （P<0.01）. The high mRNA level of PTPN1 was associated with the OS reduction （P<0.01）. After treatment with the JYP-containing serum or knockdown of PTPN1， HepG2 cells demonstrated decreased proliferation and invasion and increased apoptosis （P<0.01）. ConclusionPTPN1 may be one of the core targets of JYP in the treatment of HCC. It is highly expressed in the HCC tissue and cells， which is associated with the poor prognosis of patients. The expression level of PTPN1 is significantly up-regulated in the HCC tissue of the patients with TP53 mutation. However， TP53 mutation or deletion does not affect the expression of PTPN1 in HCC cells. JYP can significantly down-regulate the expression of PTPN1 to inhibit the proliferation and invasion and promote the apoptosis of HCC cells.

AIM: To investigate the abnormal conditions and change patterns of accommodative facility in patients with different refractive states before and after small incision lenticule extraction(SMILE)surgery.METHODS:A prospective clinical cohort study was conducted. A total of 59 patients(118 eyes)who underwent SMILE surgery and had visual function files established in our hospital from June to December 2023 were randomly selected, including 37 males and 22 females, aged 18-35 years(with an average age of 25.19±5.65 years). According to the preoperative spherical equivalent(SE), they were divided into two groups: the low-to-moderate myopia group(SE≥-6.00 DS)with 40 patients(80 eyes), and the high myopia group(SE<-6.00 DS)with 19 patients(38 eyes). The monocular and binocular accommodative facility before surgery and at 1 wk and 1 mo after surgery were compared, and the changes in accommodative facility before and after SMILE surgery in the two groups of patients were analyzed.RESULTS:All surgeries were completed successfully. In the low-to-moderate myopia group, 33 cases(66 eyes)completed the 1-month follow-up after surgery, with a loss to follow-up rate of 17.5%(7/40). In the high myopia group, 15 patients(30 eyes)completed the 1-month follow-up after surgery, with a loss to follow-up rate of 21.1%(4/19). After SMILE surgery, the uncorrected visual acuity and SE of both low-to-moderate myopia and high myopia were significantly improved(all P<0.05). The accommodative facility of the right eyes in all the patients at 1 mo after surgery was better than that before surgery and at 1 wk after surgery(P=0.002, 0.006), the accommodative facility of the left eyes was significantly increased at 1 mo after surgery than that at 1 wk after surgery(P=0.005), and the binocular accommodative facility at 1 mo after surgery was significantly increased compared with that before surgery(P<0.017). Furthermore, there were statistical significance in accommodative facility of the right eyes in the low-to-moderate group at 1 mo compared with that before surgery and at 1 wk after surgery(P=0.011, 0.004); it was significantly increased in the left eyes at 1 mo after surgery compared with that at 1 wk after surgery(P=0.001), and binocular accommodative facility at 1 mo after surgery was significantly better than that before surgery(P<0.001). Furthermore, there was no statistical significance in the right, left and binocular accommodative facility of patients in the high myopia group(all P>0.017).CONCLUSION: After SMILE surgery, the monocular accommodative facility shows a transient decrease and then exceeds the preoperative level at 1 mo after surgery, and the binocular accommodative facility gradually improves after surgery. SMILE surgery has a positive impact on the monocular and binocular accommodative facility in patients with low-to-moderate myopia, but has no significant impact on the accommodative facility in patients with high myopia. It is of clinical significance to strengthen the detection of monocular and binocular accommodative facility before and after SMILE surgery.

Obstructive sleep apnea (OSA) is an increasingly widespread sleep-breathing disordered disease, and is an independent risk factor for many high-risk chronic diseases such as hypertension, coronary heart disease, stroke, arrhythmias and diabetes, which is potentially fatal. The key to the prevention and treatment of OSA is early diagnosis and treatment, so the assessment and diagnostic technologies of OSA have become a research hotspot. This paper reviews the research progresses of severity assessment parameters and diagnostic technologies of OSA, and discusses their future development trends. In terms of severity assessment parameters of OSA, apnea hypopnea index (AHI), as the gold standard, together with the percentage of duration of apnea hypopnea (AH%), lowest oxygen saturation (LSpO₂), heart rate variability (HRV), oxygen desaturation index (ODI) and the emerging biomarkers, constitute a multi-dimensional evaluation system. Specifically, the AHI, which measures the frequency of sleep respiratory events per hour, does not fully reflect the patients’ overall sleep quality or the extent of their daytime functional impairments. To address this limitation, the AH%, which measures the proportion of the entire sleep cycle affected by apneas and hypopneas, deepens our understanding of the impact on sleep quality. The LSpO₂ plays a critical role in highlighting the potential severe hypoxic episodes during sleep, while the HRV offers a different perspective by analyzing the fluctuations in heart rate thereby revealing the activity of the autonomic nervous system. The ODI provides a direct and objective measure of patients’ nocturnal oxygenation stability by calculating the number of desaturation events per hour, and the biomarkers offers novel insights into the diagnosis and management of OSA, and fosters the development of more precise and tailored OSA therapeutic strategies. In terms of diagnostic techniques of OSA, the standardized questionnaire and Epworth sleepiness scale (ESS) is a simple and effective method for preliminary screening of OSA, and the polysomnography (PSG) which is based on recording multiple physiological signals stands for gold standard, but it has limitations of complex operations, high costs and inconvenience. As a convenient alternative, the home sleep apnea testing (HSAT) allows patients to monitor their sleep with simplified equipment in the comfort of their own homes, and the cardiopulmonary coupling (CPC) offers a minimal version that simply analyzes the electrocardiogram (ECG) signals. As an emerging diagnostic technology of OSA, machine learning (ML) and artificial intelligence (AI) adeptly pinpoint respiratory incidents and expose delicate physiological changes, thus casting new light on the diagnostic approach to OSA. In addition, imaging examination utilizes detailed visual representations of the airway’s structure and assists in recognizing structural abnormalities that may result in obstructed airways, while sound monitoring technology records and analyzes snoring and breathing sounds to detect the condition subtly, and thus further expands our medical diagnostic toolkit. As for the future development directions, it can be predicted that interdisciplinary integrated researches, the construction of personalized diagnosis and treatment models, and the popularization of high-tech in clinical applications will become the development trends in the field of OSA evaluation and diagnosis.

19 cinnamamide/ester-triazole compounds were designed, synthesized and evaluated for their anti-Alzheimer's disease (AD) activity. Among them, compound 4f displayed excellent anti-β-amyloid protein (Aβ)-mediated cytotoxicity (EC₅₀ = 2.03 ± 2.45 μmol·L^-1) in APPswe cells and acetylcholinesterase inhibiton (IC₅₀ = 4.88 ± 4.70 μmol·L^-1). Further study indicated that, at dosages of (1, 5 and 25 mg·kg^-1), compound 4f was effective in improving spatial learning and memory deficits in Aβ_1-42-impaired mice, which was achieved by promoting the nonamyloidogenic signaling and inhibiting the amyloidogenic pathway, along with the suppression of Aβ-induced Tau phosphorylation. All animal experiments in this study were approved by the Experimental Animal Care and Use Committee of the Institute of Medicinal Biotechnology (IMB-20220908D701). In conclusion, compound 4f holds promise as a lead candidate for AD treatment, and the present study lays the foundation for its subsequent development.

Intrahepatic cholangiocarcinoma （ICC） is a highly malignant liver tumor， and due to the absence of symptoms in its early stage and the lack of effective treatment measures， patients tend to have an extremely low 5-year survival rate. The tumor stroma-immune microenvironment （TSIME） is a complex ecosystem that changes dynamically during tumorigenesis and evolution and consists of a variety of cellular and non-cellular components， and it plays an important role in the development， proliferation， invasion， and progression of ICC and determines the heterogeneity and malignancy of ICC to a certain degree. This article reviews the cellular components （such as T cells， B cells， natural killer cells， dendritic cells， neutrophils， macrophages， myeloid-derived suppressor cells） and non-cellular components （such as chemokines and cytokines） within the ICC TSIME， as well as the complex mechanisms of interaction between these components， and it also reviews the spatial interactions between immune cells and tumor cells， in order to provide potential research directions for ICC immunotherapy and new ideas for the effective and precise treatment of ICC in the future.