Objective:To evaluate the efficacy and safety of transepithelial photorefractive keratectomy (Trans-PRK) combined with accelerated corneal cross-linking (CXL) for refractive error in patients with thin or irregular corneas, excluding keratoconus.Methods:An observational case series study was performed.Fifty-five right eyes of 55 myopic patients diagnosed with thin or irregular corneas, who underwent Trans-PRK combined with prophylactic CXL surgery, were included at Baotou Chaoju Eye Ophthalmic Hospital from August 2017 to July 2018.Uncorrected distance visual acuity (UDVA) of the operated eye was measured using international standard visual acuity charts, and refractive diopters were measured by computer and comprehensive refraction before surgery and at 1 week, 1, 3, 6, and 12 months after surgery.Corneal morphology was assessed with the Pentacam anterior segment analyzer before surgery and at 3, 6, and 12 months after surgery.Intraocular pressure (IOP) was measured with a non-contact tonometer before surgery and at 1, 3, 6, and 12 months after surgery.The incidence of postoperative complications was recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Baotou Chaoju Ophthalmic Hospital (No.btcj-u-1). Written informed consent was obtained from each subject.Results:Preoperative, 1-week, 1-, 3-, 6-, and 12-month postoperative UDVA (LogMAR) were 0.52(0.55, 0.78), 0.22(0.12, 0.17), 0.10(0.04, 0.07), 0.00(-0.04, -0.16), -0.08(-0.05, -0.03) and -0.08(-0.06, -0.04), respectively, showing a statistically significant overall difference ( Z=249.44, P<0.001). UDVA at each postoperative time point was improved compared to preoperative, and UDVA at 3, 6, and 12 months postoperatively was significantly improved compared to 1 week and 1 month postoperatively (all at P<0.001). The spherical diopter at each postoperative time point decreased significantly compared to preoperative, with the spherical diopter at 1, 3, 6, and 12 months postoperatively being lower than that at 1 week postoperatively, and the 12-month postoperative spherical diopter being lower than that at 3 and 6 months postoperatively, showing statistically significant differences (all at P<0.001). The cylindrical degree at 1, 3, 6, and 12 months postoperatively was lower than that at preoperative and 1 week postoperatively, with statistically significant differences (all at P<0.05). After the operation, the spherical equivalent of the operated eye gradually decreased with time, tending toward emmetropia.The spherical equivalent at each postoperative time point decreased compared to preoperative, with the spherical equivalent at 1, 3, 6, and 12 months postoperatively being lower than that at 1 week postoperatively, and the spherical equivalent at 12 months postoperatively being lower than that at 3 and 6 months postoperatively, showing statistically significant differences (all at P<0.001). The corneal K1 and K2 values at 3, 6, and 12 months postoperatively were significantly lower than preoperatively (all at P<0.001), and the corneal K1 and K2 values at 3 months postoperatively tended to stabilize.The IOP of the operated eye at 3, 6, and 12 months postoperatively was significantly lower than preoperatively, and the IOP at 6 and 12 months postoperatively was lower than that at 1 and 3 months postoperatively, with statistically significant differences (all at P<0.001). One eye developed grade 0.5 corneal haze at 1 week postoperatively, which spontaneously resolved to transparency at 1 month postoperatively. Conclusions:Trans-PRK combined with accelerated CXL has good efficacy, stability and safety for refractive error patients with thin or irregular corneas, except for keratoconus.

Autophagy is a highly conserved cellular degradation pathway that degrades lipid droplets through a process called"lipophagy".Lipophagy can selectively recognize lipid substances and degrade them,promoting β oxidation and thereby maintaining the balance of intracellular lipid metabolism.The liver regulates lipid droplet metabolism through lipophagy signaling pathways or key molecules,thereby alleviating hepatic steatosis and improving nonalcoholic fatty liver disease(NAFLD).This article reviews the latest advances in the degradation of hepatic lipid droplets through the three autophagic pathways of macroautophagy,molecular chaperone-mediated autophagy,and microautophagy.The major signaling pathways of AMPK/mTOR-ULK1,ATGL-SIRT1,FGF21-JMJD3,and Akt are involved in the regulation of the lipophagy process and help to maintain the homeostasis of lipid metabolism in the liver,so as to provide new ideas for clinical prevention and treatment of NAFLD.

Objective To explore the protective effect of wogonin on retinal ganglion cells(RGC)in mice with glau-coma and its related mechanism.Methods Ten(10 eyes)C57BL/6J mice were included in the control group,and 40(40 eyes)DBA/2J mice were selected to prepare glaucoma models,which were divided into the model group,experiment 1,2 and 3 groups,with 10 mice per group.Mice in the control and model groups were given normal saline intragastrically,and mice in the experiment 1,2 and 3 groups were intragastrically given 50,100 and 150 mg·kg-1 wogonin,respectively.The right eyes were selected as experimental eyes.The intraocular pressure(IOP)of mice was compared among the five groups before and after 2,4 and 8 weeks of intragastric administration.The RGC number and retinal thickness of mice in each group were compared after hematoxylin-eosin staining.The levels of superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)and nitric oxide synthase(NOS)in the retinal tissues of mice were detected by colorimetry.The levels of inter-leukin(IL)-6,IL-1 β and tumor necrosis factor-α(TNF-α)in the retinal tissues of mice were detected by enzyme-linked im-munosorbent assay.The expression levels of nucleotide oligomerization domain-like receptor family 3(NLRP3),Caspase-1 and apoptosis-associated speck-like protein(ASC)in the retinal tissues of mice were detected by Western blot.Results Compared with the control group,IOP in the model group and the experiment 1,2 and 3 groups increased(all P＜0.05)before intragastric administration.After 2,4 and 8 weeks of intragastric administration,IOP in the model group and the ex-periment 1,2 and 3 groups increased compared with the control group(all P＜0.05);IOP in the experiment 1,2 and 3 groups decreased compared with the model group(all P＜0.05);IOP in the experiment 2 and 3 groups decreased compared with the experiment 1 group(both P＜0.05);IOP in the experiment 3 group decreased compared with the experiment 2 group(P＜0.05).Compared with the control group,the number of RGC,retinal thickness,SOD and GSH-Px levels in the model group and the experiment 1,2 and 3 groups decreased,while the expression levels of NOS,IL-6,IL-1 β,TNF-α,and NLRP3,Caspase-1 and ASC proteins increased,and the differences were statistically significant(all P＜0.05).Compared with the model group,the number of RGC,retinal thickness,SOD and GSH-Px levels in the experiment 1,2 and 3 groups increased,while the expression levels of NOS,IL-6,IL-1β,TNF-α,and NLRP3,Caspase-1 and ASC proteins decreased,and the differences were statistically significant(all P＜0.05).Compared with the experiment 1 group,the number of RGC,retinal thickness,SOD and GSH-Px levels in the experiment 2 and 3 groups increased,while the expression levels of NOS,IL-6,IL-1 β,TNF-α,and NLRP3,Caspase-1 and ASC proteins decreased(all P＜0.05);compared with the experi-ment 2 group,the number of RGC,retinal thickness,SOD and GSH-Px levels in the experiment 3 group increased,while the expression levels of NOS,IL-6,IL-1β,TNF-α,and NLRP3,Caspase-1 and ASC proteins decreased(all P＜0.05).Conclusion Wogonin can improve the retinal thickness of mice with glaucoma and alleviate retinal oxidative damage and inflammatory reaction,which may be related to inhibiting the activation of NLRP3 inflammasomes.

Objective To explore the relationship between the early stage HbA1c level and two-year prognosis in the patients with first time onset of acute ischemic stroke(AIS).Methods A total of 513 inpa-tients with first time AIS in this hospital during 2018-2019 were selected as the study subjects.The clinical data,biochemical indicators and discharge situation were collected.The multivariate logistic regression was used to analyze the influencing factors of adverse reactions outcome within 2 years.The Kaplan-Meier survival curve was used to analyze the all-cause mortality and stroke recurrence situation within 2 years.Results The sex,age,TOAST type,,diseases history such as diabetes,arrhythmia and coronary heart disease,medication history such as antidiabetic drugs,lipid-lowering drugs and anticoagulants,BMI,Urea,Crea,ALT,SBP,fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),HDL-C,NIHSS score at admission,discharge mode,NIHSS score at discharge,hospitalization duration and hospitalization costs had statistical difference a-mong the patients with different HbA1c levels(P＜0.05).The multivariate logistic regression analysis showed that HbA1c＞7.4％was the independent risk factor for adverse outcome within 2 years(OR=4.470,95％CI:1.105-18.087,P=0.036).The Kaplan-Meier survival curve analysis showed that the survival time within 2 years had statistical difference among the patients with different HbA1c levels(P=0.009).The higher the HbA1c level,the shorter the survival time.Conclusion The high HbA1c level has the influence on the stroke recurrence and all-cause mortality within 2 years in the patients with first onset occurrence of AIS.

The American Burn Association updated and released the " Clinical practice guidelines on burn shock resuscitation" in December 2023. This guideline is an extension and refinement of the " Practice guidelines on burn shock resuscitation" released in 2008. It mainly provides evidence-based recommendations for acute fluid resuscitation in adults with burn shock. In order to enable clinicians to better apply the 2023 guideline, this article focuses on the interpretation of the guideline.

Objective To observe the impact of cold circulation liquid temperature on ablation focus morphology of microwave ablation(MWA)for in vitro porcine liver tissue.Methods Twenty in vitro fresh porcine liver blocks were randomly divided into ice water circulation group(group A)and normal temperature circulation group(group B),respectively.Ten target ablations in each subgroups in group A and group B,i.e.A1 and B1(50 W,1 min),A2 and B2(50 W,5 min),A3 and B3(60 W,1 min),A4 and B4(60 W,5 min),A5 and B5(70 W,1 min)as well as A6 and B6(70 W,5 min)subgroups were performed using different ablation power(50,60,70 W)and ablation time(1,5 min),respectively.Then the morphology indexes of ablation foci,including longitudinal diameter(LD),transverse diameter(TD),roundness index(RI)and volume(V)were compared between subgroups in group A and B,also among subgroups within group A and B.Results Under the same ablation power and time,LD of ablation foci in subgroups of group A were all smaller than those of group B(all P＜0.05).Significant differences of RI of ablation foci were found between A1 and B1,A2 and B2,A4 and B4,A5 and B5 as well as A6 and B6 subgroups(all P＜0.05),but not between A3 and B3 subgroups(P＞0.05).However,the main effect of cold circulation liquid temperature on ablation focus TD(F=1.125)nor V(F=3.332)was not significant(both P≥0.05).Under the same cold circulation liquid temperature,significant differences of the morphology indexes of ablation foci were detected between A1 and A2,A3 and A4 as well as A5 and A6 subgroups,also between corresponding subgroups in group B(all P＜0.05).Conclusion During MWA for in vitro porcine liver tissue under constant ablation power and time,taken ice water as the cold circulation liquid was benefit to ablation focus shaped spherically.With the extension of ablation time,the larger the ablation focus,the higher the RI.

Objective To explore the biological effect of transcription factor B1,mitochondrial(TFB1M)on hepatocellular carcinoma(HCC)cells,and to explore the molecular mechanism of its regulation on malignant metastasis of HCC.Methods The expression level of TFB1M in liver cancer and its relationship with clinical characteristics of patients with HCC was analyzed based on TCGA-LIHC and GEO databases.Based on the median expression level of TFB1M,the TCGA-LIHC samples were divided into low expression group of TFB1 M(n=170)and high expression group of TFB1M(n=170),and GSEA was used for gene set enrichment analysis.The overexpressed TFB1M plasmid was constructed to transfect HepG2 and Huh7 cells.Cell migration and invasion were assessed by scratch healing and Transwell chamber assays.Results The expression of TFB1M was significantly decreased in HCC,and the expression of TFB1M was related with gender in HCC.The results of GSEA analysis indicated that the low expression of TFB1M might be related to liver cancer subclass proliferation up gene set,stem cell hepatocellular carcinoma gene set,and extracellular matrix assembly gene set in HCC.Overexpression of TFB1M remarkably attenuated the migration and invasion activity of HCC cells.Conclusions The expression of TFB1M was significantly decreased in HCC,and overexpression of TFB1M could attenuated the migration and invasion activity of HCC cells.

Urinary extracellular vesicles (uEV) have recently garnered significant attention as crucial components in urine. Advances in high-throughput omics and single-vesicle technologies have deepened our understanding of the origins and contents of uEV, which include proteins, lipids, RNA, and DNA. These vesicles reflect the pathophysiological status of their source organs. uEV are highly stable, traceable, and can be enriched with various contents, making them promising biomarkers, particularly for urogenital diseases.

OBJECTIVES: Surgical robot system has broken the limitation of traditional surgery and shown excellent performance in surgery, and has been widely used in minimally invasive treatment in most areas of surgery. This study aims to verify the basic performance of the domestic surgical robot system and the safety and effectiveness of the integrated bipolar electrocoagulation and ultrasonic knife. METHODS: The basic performance of the domestic surgical robot system was evaluated by completing the square knot and surgical knot, vertical and horizontal perforation and right ring perforation and suture, as well as picking up beans. Compared with laparoscopy, the safety and effectiveness of the domestic surgical robot after integrated interconnection bipolar electrocoagulation and ultrasonic scalpel were evaluated by detecting the vascular closure performance and the degree of histopathological damage in animals. RESULTS: Compared with freehand knotting, domestic robot knotting speed and circumference were slightly worse, but better than laparoscopic knotting. There was no statistical significance in the tension difference of the surgical knots among the 3 methods (P>0.05), but the tension of the square knots made by the freehand and the domestic surgical robot was greater than that of the laparoscopy (P<0.05). The space required for both the left and right forceps heads of knots was smaller than that of laparoscopy (P<0.001), which successfully completed the 4 quadrant suture tasks, and the time of picking up beans was significantly less than that of laparoscopy (P<0.05). There was no significant difference in the temperature of the liver tissue after the bipolar electrocoagulation between the interconnected domestic surgical robot and the laparoscopy (P>0.05), and the acute thermal injury was observed under the light microscope. The temperature of the liver tissue treated by the domestic robotic ultrasound knife was higher than that of the laparoscopic ultrasound knife (P<0.05). CONCLUSIONS Domestic surgical robots are obviously superior to laparoscopy in suturing, knotting, and moving objects, and domestic surgical robots' interconnect bipolar electrocoagulation and ultrasonic knife have achieved success in animal experiments, and hemostasis is considered to be safe and effective.
Animals ; Robotics ; Laparoscopy/methods* ; Ultrasonography

In the context of non-alcoholic fatty liver disease (NAFLD), characterized by dysregulated lipid metabolism in hepatocytes, the quest for safe and effective therapeutics targeting lipid metabolism has gained paramount importance. Sanhuang Xiexin Tang (SXT) and Baihu Tang (BHT) have emerged as prominent candidates for treating metabolic disorders. SXT combined with BHT plus Cangzhu (SBC) has been used clinically for Weihuochisheng obese patients. This retrospective analysis focused on assessing the anti-obesity effects of SBC in Weihuochisheng obese patients. We observed significant reductions in body weight and hepatic lipid content among obese patients following SBC treatment. To gain further insights, we investigated the effects and underlying mechanisms of SBC in HFD-fed mice. The results demonstrated that SBC treatment mitigated body weight gain and hepatic lipid accumulation in HFD-fed mice. Pharmacological network analysis suggested that SBC may affect lipid metabolism, mitochondria, inflammation, and apoptosis-a hypothesis supported by the hepatic transcriptomic analysis in HFD-fed mice treated with SBC. Notably, SBC treatment was associated with enhanced hepatic mitochondrial biogenesis and the inhibition of the c-Jun N-terminal kinase (JNK)/nuclear factor-kappa B (NF-κB) and extracellular signal-regulated kinase (ERK)/NF-κB pathways. In conclusion, SBC treatment alleviates NAFLD in both obese patients and mouse models by improving lipid metabolism, potentially through enhancing mitochondrial biogenesis. These effects, in turn, ameliorate inflammation in hepatocytes.
Humans ; Mice ; Animals ; Non-alcoholic Fatty Liver Disease/metabolism* ; NF-kappa B/metabolism* ; Organelle Biogenesis ; Retrospective Studies ; Mice, Inbred C57BL ; Obesity/metabolism* ; Liver ; Inflammation/metabolism* ; Body Weight ; Lipid Metabolism ; Lipids ; Diet, High-Fat/adverse effects*