Irritable bowel syndrome(IBS)is one of the most common functional gastrointestinal disorders,of which diarrhea-predominant IBS(IBS-D)accounts for the largest proportion.The pathogenesis of IBS-D is complicated and diverse,and there is currently a lack of clinically effective drugs.The establishment of animal models is an essential tool for further studies of the disease mechanisms,evaluation of clinical efficacy,and drug development,and the preparation and evaluation standards of models are important factors affecting the quality of the research.Based on the currently accepted pathogenesis of IBS-D and the previous modeling experience of our research group,this review systematically summarizes the evaluation method used in animal models of IBS-D in terms of diarrhea observation,visceral sensitivity tests,and intestinal motility tests,to provide a reference for future studies.

Objective:To evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) for refractory glaucoma.Methods:A prospective multicenter observational case series study was conducted.A total of 63 refractory glaucoma patients (67 eyes) who underwent MP-TSCPC treatment were enrolled at Zhongshan Ophthalmic Center, Sun Yat-sen University, Chengdu First People's Hospital (Chengdu Integrated TCM& Western Medicine Hospital), and Changsha Aier Eye Hospital from August 2022 to April 2023.Among these cases, there were 40 eyes (59.7%) with unreduced intraocular pressure (IOP) after glaucoma surgery, 4 eyes (6.0%) with secondary glaucoma after vitrectomy, 2 eyes (3.0%) with secondary glaucoma after keratoplasty, 8 eyes (11.9%) with neovascular glaucoma, 3 eyes (4.5%) with secondary glaucoma due to iridocorneal endothelial syndrome, 6 eyes (9.0%) with primary open-angle glaucoma and 4 eyes (6.0%) with primary angle-closure glaucoma.Best corrected visual acuity (BCVA) was measured using the ETDRS chart and the IOP was measured using the Goldmann applanation tonometry before and 6 months after the surgery.The usage of anti-glaucoma medications before and after surgery and postoperative complications were recorded.Surgical success rate was calculated and surgical success was defined as an IOP reduction of more than 20% from baseline or a reduction in the number of ocular hypotensive medications with no change in IOP.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University (No.2022KYPJ225).Written informed consent was obtained from each subject.Results:There was a statistically significant overall difference in IOP at different time points before and after surgery ( F=60.10, P<0.001), and the IOP at different time points after surgery was significantly lower than that before surgery, with statistically significant differences (all at P<0.001).IOP reduction at 6 months after surgery was (43.7±20.7)%.The number of anti-glaucoma medications used postoperatively was 2(0, 3) types, which was significantly less than the 3(2, 3) types used preoperatively ( Z=-2.70, P=0.007).The 6-month postoperative BCVA (LogMAR) was 1.40(0.52, 2.70), which showed no significant change compared to the preoperative 1.40(0.70, 2.70) ( Z=-0.10, P=0.952).The surgical success rate was 83.6%(56/67) at 6 months postoperatively.Postoperative complications included mydriasis (11/67), conjunctival hemorrhage (11/67), mild anterior chamber inflammation (1/67), mild ciliary body detachment (3/67), local choroidal detachment (1/67), and cystoid macular edema (1/67), all of which were reversible after treatment. Conclusions:MP-TSCPC appears to be a safe and effective treatment option for refractory glaucoma.

Objective:To explore the medication law of wind drugs in Pi Wei Lun; To provide reference for the clinical application of wind drugs in the diagnosis and treatment of diseases. Methods:Through searching the prescriptions with wind drugs in Pi Wei Lun, wind drugs and the dosages were extracted. SPSS 25.0 software was used for descriptive statistics of wind drugs data. Traditional Chinese Medicine Inheritance Calculation Platform V3.0 was used for frequency statistics, dosage statistics and association rule analysis of Chinese materia medica. Results:Totally 40 prescriptions were included (40/61, 65.57%), involving 14 kinds of Chinese materia medica, mainly including Cimicifugae Rhizoma, Bupleuri Radix, Notopterygii Rhizoma et Radix, Saposhnikoviae Radix, Zingiberis Rhizoma Recens and so on. The ancient dosage of wind drugs was 0.68 g to 4.00 g, and the maximum was 8 g and the minimum was 0.09 g. However,the modern dosage was 3-10 g. The dosage ratio of commonly used of wind drugs was 3%-60%, and its efficacy varied. Through the analysis of association rules algorithm, the study gained 25 medicinal pairs, and the group Cimicifugae Rhizoma-Bupleuri Radix acquired the highest supporting degree. Under the conditions of a confidence level of 75% and support levels of 10%, 15%, and 20%, there were 14, 7, and 3 drug association rules, respectively. The efficacy of commonly used wind drugs varied depending on their ratio.Conclusion:Li Dongyuan attached great importance to develop and ascend the yang of spleen so that he used wind drugs more often for ascending yang, supplementing the original qi, dispelling wind, dispelling dampness, dissipating heat, resolving depression, purging the liver, relaxing the bowels, unblock the orifices and directing meridians.

Minimally invasive glaucoma surgery (MIGS) has been successfully incorporated in clinical practice in recent years.Increasing evidence shows that MIGS also plays an increasingly important role in the treatment of primary angle-closure glaucoma (PACG). Surgical peripheral iridectomy (SPI) plus goniosynechialysis (GSL) and goniotomy (GT), as a new procedure, has been proven to be safe and effective in the treatment of PACG with no or mild cataracts.However, there is still a lack of uniform standards for indications, surgical procedures, and perioperative medication.Therefore, it is necessary to formulate a detailed and complete expert recommendations on surgical procedures to standardize the application of combined SPI+ GSL+ GT in the treatment.Some experts in glaucoma treatment and management in China have discussed the current problems and developing trend in MIGS for PACG and put forward the expert recommendations of standard process, including indications, anaesthetic methods, surgical site, operating procedure and rational administration of drugs in perioperation, in order to standardize the medical process of clinicians using combined SPI+ GSL+ GT in PACG treatment and lay a foundation for better evaluation of the efficacy of MIGS.

Objective:To evaluate the preliminary effectiveness and safety of surgical peripheral iridectomy (SPI) combined with goniosynechilysis (GSL) and goniotomy (GT) in the treatment of advanced primary angle-closure glaucoma (PACG).Methods:A multicenter observational case series study was performed.Thirty-five eyes of 27 patients with advanced PACG, who underwent SPI+ GSL+ GT with a follow-up of at least 6 months, were included from August 2021 to January 2022 at Zhongshan Ophthalmic Center, Handan City Eye Hospital, Shijiazhuang People's Hospital, West China Hospital of Sichuan University, and the Third Affiliated Hospital of Chongqing Medical University.The mean follow-up time was 9(7, 10) months.Pre- and post-operative best corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured with an ETDRS chart and a Goldmann applanation tonometer, respectively.The number of anti-glaucoma medications applied before and after surgery was recorded, and the complications after surgery were analyzed.Success rate of surgery was calculated.Complete surgical success was defined as an IOP of 5-18 mmHg (1 mmHg=0.133 kPa) and 20% reduction from baseline without anti-glaucoma medication or reoperation.Qualified success was defined as achieving criterion of complete success under anti-glaucoma medications.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Zhongshan Ophthalmic Center, Sun Yat-sen University (No.2021KYPJ177). Written informed consent was obtained from each subject.Results:The mean preoperative IOP was (30.83±8.87)mmHg, which was significantly decreased to (15.69±3.70)mmHg at 6 months after the surgery ( t=8.588, P<0.001), with a 44.00% (34.78%, 60.00%) decline of 13.00(8.00, 21.00)mmHg.The median number of anti-glaucoma medications was significantly reduced from 2(0, 3) preoperatively to 0 (0, 1) postoperatively ( Z=-3.659, P<0.001). The mean preoperative and postoperative 6-month BCVA were 0.80(0.63, 1.00) and 0.80(0.60, 1.00), respectively, showing no significant difference ( Z=-0.283, P=0.777). Complete surgical success rate was 62.86%(22/35), and the qualified success rate was 91.43%(32/35). Surgical complications mainly included hyphema (6/35), IOP spike (3/35), and shallow anterior chamber (4/35). There was no vision-threatening complication. Conclusions:SPI+ GSL+ GT is preliminarily effective and safe in the treatment of advanced PACG, which provides a new option for PACG.

Minimally invasive glaucoma surgery (MIGS) has been successfully incorporated in clinical practice in recent years.Increasing evidence shows that it also plays an important role in the treatment of primary angle-closure glaucoma (PACG). Goniosynechialysis (GSL) is a key surgical procedure used by MIGS for PACG, which involves separating the peripheral anterior synechia and reopening the angle.However, there is still a lack of uniform standards for indications and surgical procedures.Therefore, it is necessary to formulate a detailed and complete expert consensus on surgical procedures to standardize the application of clinicians in the treatment.

Although immune checkpoint inhibitors(ICIs)are widely used in cancer therapy,showing great advantages and development potential,it is accompanied by a series of immune-related adverse reactions,of which myositis is a potentially fatal adverse event,which has attracted great attention.Herein,we reported a case of advanced esophageal cancer with myositis after treatment with camrelizumab,which was characterized by myasthenia gravis(MG)with myasthenic crisis,and recovered after active rescue by multidisciplinary cooperation.

Objective:To investigate the clinical effect of ultrapulse fractional carbon dioxide laser combined with stromal vascular fraction gel (SVF-Gel) transplantation in the treatment of scars.Methods:Retrospective analysis of the clinical data of patients with scars treated at the General Hospital of Jilin Chemical Industry Group from January 2018 to January 2022. Application of ultrapulse fractional carbon dioxide laser for treatment: Scaar FX mode treatment for hypertrophic scars, micro FX energy: 80-150 mJ, frequency: 250 Hz, density: 3%. Deep FX mode treatment for superficial scars and atrophic scars, micro FX energy: 30-50 mJ, frequency: 300 Hz, density: 5%. Manual fractional technology(MFT) mode treatment for hyperplastic scars, atrophic scars with scar contracture site, energy: 150-175 mJ, frequency: 40 Hz, distance between holes: 4-5 mm, treatment time 2-3 s. Superficial scar and atrophic scar were treated 2 times, hypertrophic scar was treated 3 times, and the time interval was 2 months. Transplantation of SVF-Gel for scar treatment around 30 days after the first laser treatment. Thigh fatty tissue was extracted to prepare SVF-Gel. The SVF-Gel was injected into the basal layer and deep layer of inside the scar by multi-point and multi-tunnel injection. All patients were followed up for 6 months to evaluate the therapeutic effect. Assess the Vancouver scar scale (VSS) score and the difference of transepidermal water loss (TEWL) between scar skin and adjacent normal skin was measured after treatment, compared with before treatment. The data were analyzed by SPSS 20.0, data in Mean±SD represents. Paired t-test was used to compare the difference between the VSS score and TEWL before and after treatment. P<0.05 indicates a statistically significant difference. Results:A total of 30 patients were enrolled, including 17 males and 13 females, aged (32.7 ± 11.2) years old. Among the 30 patients, 10 patients were superficial scars, 10 patients were hypertrophic scars, 10 patients were atrophic scars. The scars’ formation time was (17.5 ± 4.5) months. (1) The VSS score of superficial scars after treatment was 1.8±0.7, which was lower than 4.7±0.8 before treatment( t=9.26, P=0.001). The difference in TEWL after treatment was (2.48±0.61) g·m -2·h -1, which was lower than (6.85±1.17) g·m -2·h -1 before treatment( t=13.28, P<0.001). (2) The VSS score of hyperplastic scars after treatment was 3.9±1.1, which was lower than 10.6±1.7 before treatment( t=9.37, P=0.001). The difference in TEWL after treatment was (4.91±0.87) g·m -2·h -1, which was lower than (9.92±0.75) g·m -2·h -1 before treatment( t=18.22, P<0.001). (3) The VSS score of atrophic scars after treatment was 3.5±1.2, lower than 7.7±2.3 before treatment ( t=5.81, P=0.005). The difference in TEWL after treatment was (3.73±1.22) g·m -2·h -1, lower than (6.52±1.51) g·m -2·h -1 before treatment ( t=9.52, P=0.001). Conclusion:Ultrapulse fractional carbon dioxide laser combined with SVF-Gel transplantation is effective in the treatment of scars. It can improve the color, thickness, vascular distribution, softness, and skin barrier function of scars.

Objective:To investigate the clinical effect of ultrapulse fractional carbon dioxide laser combined with stromal vascular fraction gel (SVF-Gel) transplantation in the treatment of scars.Methods:Retrospective analysis of the clinical data of patients with scars treated at the General Hospital of Jilin Chemical Industry Group from January 2018 to January 2022. Application of ultrapulse fractional carbon dioxide laser for treatment: Scaar FX mode treatment for hypertrophic scars, micro FX energy: 80-150 mJ, frequency: 250 Hz, density: 3%. Deep FX mode treatment for superficial scars and atrophic scars, micro FX energy: 30-50 mJ, frequency: 300 Hz, density: 5%. Manual fractional technology(MFT) mode treatment for hyperplastic scars, atrophic scars with scar contracture site, energy: 150-175 mJ, frequency: 40 Hz, distance between holes: 4-5 mm, treatment time 2-3 s. Superficial scar and atrophic scar were treated 2 times, hypertrophic scar was treated 3 times, and the time interval was 2 months. Transplantation of SVF-Gel for scar treatment around 30 days after the first laser treatment. Thigh fatty tissue was extracted to prepare SVF-Gel. The SVF-Gel was injected into the basal layer and deep layer of inside the scar by multi-point and multi-tunnel injection. All patients were followed up for 6 months to evaluate the therapeutic effect. Assess the Vancouver scar scale (VSS) score and the difference of transepidermal water loss (TEWL) between scar skin and adjacent normal skin was measured after treatment, compared with before treatment. The data were analyzed by SPSS 20.0, data in Mean±SD represents. Paired t-test was used to compare the difference between the VSS score and TEWL before and after treatment. P<0.05 indicates a statistically significant difference. Results:A total of 30 patients were enrolled, including 17 males and 13 females, aged (32.7 ± 11.2) years old. Among the 30 patients, 10 patients were superficial scars, 10 patients were hypertrophic scars, 10 patients were atrophic scars. The scars’ formation time was (17.5 ± 4.5) months. (1) The VSS score of superficial scars after treatment was 1.8±0.7, which was lower than 4.7±0.8 before treatment( t=9.26, P=0.001). The difference in TEWL after treatment was (2.48±0.61) g·m -2·h -1, which was lower than (6.85±1.17) g·m -2·h -1 before treatment( t=13.28, P<0.001). (2) The VSS score of hyperplastic scars after treatment was 3.9±1.1, which was lower than 10.6±1.7 before treatment( t=9.37, P=0.001). The difference in TEWL after treatment was (4.91±0.87) g·m -2·h -1, which was lower than (9.92±0.75) g·m -2·h -1 before treatment( t=18.22, P<0.001). (3) The VSS score of atrophic scars after treatment was 3.5±1.2, lower than 7.7±2.3 before treatment ( t=5.81, P=0.005). The difference in TEWL after treatment was (3.73±1.22) g·m -2·h -1, lower than (6.52±1.51) g·m -2·h -1 before treatment ( t=9.52, P=0.001). Conclusion:Ultrapulse fractional carbon dioxide laser combined with SVF-Gel transplantation is effective in the treatment of scars. It can improve the color, thickness, vascular distribution, softness, and skin barrier function of scars.

Objective:To evaluate the effectiveness and safety of phacoemulsification cataract extraction combined with intraocular lens implantation (PEI) plus goniosynechilysis (GSL) and goniotomy (GT) for advanced primary angle-closure glaucoma (PACG).Methods:An observational case series study was performed.Fifty eyes of 50 patients with advanced PACG were enrolled in Zhongshan Ophthalmic Center from August 2020 to June 2021.All the patients received PEI+ GSL+ GT and were followed up for over 6 months, with a mean follow-up of 7.5 (6, 10) months.Intraocular pressure (IOP) was measured with a Goldmann applanation tonometer.Best corrected visual acuity (BCVA) was examined with an ETDRS chart and converted to logarithm of the minimum angle of resolution (LogMAR) units for analysis.Types and number of anti-glaucoma medications applied before and after surgery, and the surgical complications were collected.Success rate of surgery was calculated.Complete surgical success was defined as an IOP of 5-18 mmHg (1 mmHg=0.133 kPa) with a reduction of 20% from baseline without anti-glaucoma medication, no vision-threatening complications, no loss of light perception, and no reoperation.Qualified success was defined as an IOP of 5-18 mmHg with a reduction of 20% from baseline with or without anti-glaucoma medication, no vision-threatening complications, no loss of light perception, and no reoperation.This study adhered to the Declaration of Helsinki.This research protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center (No.2021KYPJ177). Written informed consent was obtained from each subject before entering the cohort.Results:The mean preoperative IOP was (28.81±7.81)mmHg, and the IOP at the end of follow-up was (13.41±4.10)mmHg, showing a statistically significant decrease ( t=12.260, P<0.001). The postoperative IOP was decreased by 13.80 (9.10, 19.40)mmHg, with a percentage decrease of 51.1% (38.6%, 67.1%). The mean preoperative and postoperative BCVA was (0.92±0.11) LogMAR and (0.88±0.10) LogMAR, respectively, and no significant difference was found ( t=-0.560, P=0.580). The number of anti-glaucoma medications was reduced from 2 (1, 3) before operation to 0 (0, 0) after operation.The complete success rate of surgery was 80% (40/50), and the qualified success rate was 94% (47/50). Surgical complications mainly included hyphema in 7 eyes, IOP spike in 7 eyes, and corneal edema in 3 eyes.No vision-threatening complication occurred. Conclusions:PEI+ GSL+ GT is preliminarily effective and safe for advanced PACG by reducing IOP and application of anti-glaucoma medications with few complications.