AIM: To investigate the predictive value of serum histone deacetylase 1(HDAC1)and endothelial nitric oxide synthase(eNOS)for infectious endophthalmitis after cataract surgery.METHODS: A total of 362 cataract patients(362 eyes)admitted to our hospital from January 2020 to January 2023 were selected as the research objects. According to the occurrence of postoperative infectious endophthalmitis, they were divided into infection group(15 cases, 15 eyes)and non-infection group(347 cases, 347 eyes). Enzyme linked immunosorbent assay(ELISA)was applied to detect the levels of serum HDAC1 and eNOS in all subjects, and the levels of serum HDAC1 and eNOS in both groups were compared; the influencing factors of infectious endophthalmitis were analyzed by multivariate Logistic regression; the receiver operative curve(ROC)was applied to analyze the predictive value of serum HDAC1 and eNOS levels for postoperative infectious endophthalmitis in cataract patients.RESULTS: The levels of serum HDAC1 and eNOS in the infected group were obviously higher than those in the uninfected group(all P<0.01). Surgical time, vitreous overflow, HDAC1, and eNOS were all risk factors for postoperative infectious endophthalmitis(all P<0.05). ROC results showed that the AUC of HDAC1 and eNOS in predicting postoperative infectious endophthalmitis in cataract patients was 0.878 and 0.877, respectively, with sensitivity of 88.7% and 87.7%, specificity of 70.4% and 7.8%, respectively, while the AUC of the two combination in predicting postoperative infectious endophthalmitis in cataract patients was 0.978, with a sensitivity of 86.7% and a specificity of 85.3%.CONCLUSION:The serum levels of HDAC1 and eNOS in patients with infectious endophthalmitis after cataract surgery are obviously increased, and the combined detection of serum HDAC1 and eNOS can improve the predictive efficacy of infectious endophthalmitis in cataract patients after surgery. Both can provide reference for clinical diagnosis and treatment.

AIM: To investigate the predictive value of serum histone deacetylase 1(HDAC1)and endothelial nitric oxide synthase(eNOS)for infectious endophthalmitis after cataract surgery.METHODS: A total of 362 cataract patients(362 eyes)admitted to our hospital from January 2020 to January 2023 were selected as the research objects. According to the occurrence of postoperative infectious endophthalmitis, they were divided into infection group(15 cases, 15 eyes)and non-infection group(347 cases, 347 eyes). Enzyme linked immunosorbent assay(ELISA)was applied to detect the levels of serum HDAC1 and eNOS in all subjects, and the levels of serum HDAC1 and eNOS in both groups were compared; the influencing factors of infectious endophthalmitis were analyzed by multivariate Logistic regression; the receiver operative curve(ROC)was applied to analyze the predictive value of serum HDAC1 and eNOS levels for postoperative infectious endophthalmitis in cataract patients.RESULTS: The levels of serum HDAC1 and eNOS in the infected group were obviously higher than those in the uninfected group(all P<0.01). Surgical time, vitreous overflow, HDAC1, and eNOS were all risk factors for postoperative infectious endophthalmitis(all P<0.05). ROC results showed that the AUC of HDAC1 and eNOS in predicting postoperative infectious endophthalmitis in cataract patients was 0.878 and 0.877, respectively, with sensitivity of 88.7% and 87.7%, specificity of 70.4% and 7.8%, respectively, while the AUC of the two combination in predicting postoperative infectious endophthalmitis in cataract patients was 0.978, with a sensitivity of 86.7% and a specificity of 85.3%.CONCLUSION:The serum levels of HDAC1 and eNOS in patients with infectious endophthalmitis after cataract surgery are obviously increased, and the combined detection of serum HDAC1 and eNOS can improve the predictive efficacy of infectious endophthalmitis in cataract patients after surgery. Both can provide reference for clinical diagnosis and treatment.

AIM: To investigate the expression changes and significance of serum microRNA-34a-5p(miR-34a-5p)and silent information regulator T1(SIRT1)in patients with endophthalmitis after cataract surgery.METHODS: Patients with endophthalmitis after cataract surgery from May 2020 to May 2024 were selected as infection group(20 cases), and patients without endophthalmitis were selected as control group(74 cases). Serum SIRT1 levels were detected by ELISA; the serum level of serum miR-34a-5p was detected by qRT-PCR; the correlation between miR-34a-5p and SIRT1 was analyzed by Pearson method; Logistic regression was used to analyze the influencing factors of endophthalmitis after cataract operation. Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum miR-34a-5p and SIRT1 levels in postoperative endophthalmitis.RESULTS: Compared with the control group, the serum level of miR-34a-5p in the infected group was significantly increased(P<0.001), and the serum level of SIRT1 was significantly decreased(P<0.001). Correlation analysis showed that miR-34a-5p was negatively correlated with SIRT1(r=-0.421, P<0.001). Logistic multivariate regression analysis showed that miR-34a-5p was an independent risk factor affecting endophthalmitis infection after cataract surgery(OR=3.532, P<0.05), and SIRT1 was a protective factor affecting endophthalmitis infection after cataract surgery(OR=0.875, P<0.05). The ROC curve showed that the area under curve(AUC)of serum miR-34a-5p combined with SIRT1 in the diagnosis of postoperative endophthalmitis was 0.933(95%CI: 0.861-0.975).CONCLUSION:Serum levels of miR-34a-5p are highly expressed and SIRT1 is lowly expressed in postoperative endophthalmitis, they are closely related to the occurrence and development of endophthalmitis after cataract surgery.

AIM: To explore the value of changes in the serum expression levels of triggering receptor expressed on myeloid cells-1(TREM-1)and matrix metalloproteinase-9(MMP-9)in early clinical diagnosis of postoperative endophthalmitis in patients with cataract surgery.METHODS: A total of 21 patients who underwent cataract surgery with infectious endophthalmitis in our hospital from May 2021 to May 2023 were selected as the study subjects(endophthalmitis group), and another 100 patients who underwent cataract surgery without endophthalmitis were selected as the non-endophthalmitis group. The serum levels of TREM-1, MMP-9, and the expression levels of inflammatory factors such as interleukin-1β(IL-1β), IL-17, and tumor necrosis factors-α(TNF-α)were detected and compared between the endophthalmitis group and the non-endophthalmitis group. The correlation between TREM-1 and MMP-9 was analyzed by Pearson method. Logistic regression was applied to analyze the factors that affected the occurrence of endophthalmitis in cataract patients after surgery. Receiver operating characteristic(ROC)curve was applied to analyze the early clinical diagnostic efficacy of TREM-1 and MMP-9 levels for postoperative endophthalmitis in cataract patients.RESULTS: Compared with the non-endophthalmitis group after cataract surgery, the expression levels of serum TREM-1, MMP-9, and inflammatory factors IL-1β, IL-17, and TNF-α in the endophthalmitis group were obviously increased(all P<0.05), and the TREM-1 was positively correlated with MMP-9(r=0.389, P<0.001). Logistic regression results showed that elevated levels of serum TREM-1 and MMP-9 expression, and vitreous overflow were independent risk factors for postoperative endophthalmitis in cataract patients(all P<0.05). ROC curve showed that the area under the curve(AUC)of TREM-1, MMP-9, and their combination in diagnosing postoperative endophthalmitis in cataract patients was 0.845, 0.844, and 0.935, respectively, and the clinical efficacy of the combination of the two in early diagnosis of postoperative endophthalmitis in cataract patients was better than that of serum TREM-1 and MMP-9 alone(all P<0.05).CONCLUSION: The expression levels of serum TREM-1 and MMP-9 in patients with endophthalmitis after cataract surgery are abnormally elevated, and the combination of the two has high clinical application value in early diagnosis of endophthalmitis after cataract surgery.

Objective:A recombinant adenoviral vector vaccine based on non-replicating human adenovirus type 5 (Ad5), encoding the conserved domain of respiratory syncytial virus G protein (RSV-G) was constructed. The immunogenicity and protective efficacy of this vaccine were subsequently evaluated in mice.Methods:The recombinant Ad5 vector plasmid (Ad5-Gbcc-Gacc) was constructed by inserted conserved domains of RSV A and RSV B. The recombinant adenovirus Ad5-Gbcc-Gacc was rescued in HEK293A cells. The genome of virus Ad5-Gbcc-Gacc was identified by multi-enzyme digestion, and the expression of Ad5-Gbcc-Gacc was verified by Western blot. Recombinant adenovirus was used to immunize BALB/c mice via intramuscular injection with signal dose, and then challenged with RSV Long strain at week 6. The levels of G specific IgG and antibody subtypes in serum were detected by enzyme-linked immunosorbent assay, the level of neutralizing antibodies was determined by micro-neutralization assay. After challenge, the mice′s weight was recorded daily, the copies of RSV virus in the lung and nasal tissues were detected. Pathological changes in lung tissue were also examined.Results:Western blot and multi-enzyme digestion identification confirmed the successful rescue of the recombinant adenovirus. Ad5-Gbcc-Gacc elicit high titers of specific IgG, robust neutralizing antibodies, and a balanced Th1/Th2 immune response in mice. In comparison to unimmunized controls, mice immunized with Ad5-Gbcc-Gacc reduced the viral copies in both lung and nasal tissue, and exhibited only minimal pathological damage of lung tissue following RSV challenge. In conclusion, Ad5-Gbcc-Gacc induced robust immunogenicity and offers protective effects against RSV infection in murine models.Conclusions:Ad5-Gbcc-Gacc induce robust immunogenicity and can protect mice from RSV challenge, which lays a foundation for further development of RSV vaccine based on G protein.

Abstract: To investigate the factors affecting lean non-alcoholic fatty liver disease (NAFLD), so as to provide the reference for the prevention and treatment of lean NAFLD. Methods: Individuals who underwent physical examination at Huzhou Central Hospital from January 1, 2023 to March 31, 2024 and had a body mass index (BMI) <23 kg/m2 was selected. Demographic information, lifestyle behaviors, dietary habits and physical examination data were collected through questionnaire surveys. Lean NAFLD was assessed using abdominal ultrasonography combined with BMI. Factors affecting lean NAFLD were analyzed by using a multivariable logistic regression model. Results: A total of 627 individuals were surveyed, with a mean BMI of (20.83±2.01) kg/m2. There were 349 males (55.66%) and 278 females (44.34%). Lean NAFLD was detected in 74 cases, with a detection rate of 11.80%. Multivariable logistic regression analysis identified BMI (OR=1.830, 95%CI: 1.165-2.869), gender (male, OR=2.615, 95%CI: 1.402-4.875), triglycerides (OR=3.062, 95%CI: 1.613-5.812), alanine aminotransferase (OR=1.587, 95%CI: 1.106-2.277), vegetable and fruit intake (150-300 g/d, OR=0.416, 95%CI: 0.230-0.752; >300 g/d, OR=0.303, 95%CI: 0.141-0.649), dairy product intake (≥300 mL/d, OR=0.369, 95%CI: 0.195-0.701) and sugared beverage intake (1-250 mL/d, OR=1.601, 95%CI: 1.071-2.393; >250 mL/d, OR=2.438, 95%CI: 1.363-4.354) as factors affecting lean NAFLD. Conclusion The risk of lean NAFLD is associated with BMI, gender, triglyceride, alanine aminotransferase, and the vegetable and fruit, dairy product and sugared beverage intake.

Objective To systematically evaluate the efficacy and safety of dronedarone in preventing early recurrence of atrial fibrillation(AF)after ablation.Methods PubMed,Web of Science,Cochrane Library,Embase,CNKI,WanFang Data and VIP databases were electronically searched to collect the clinical studies on the efficacy and safety of dronedarone in preventing early recurrence of AF after ablation from the inception to April 16,2024.Two researchers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Meta-analysis was performed by using RevMan 5.3 software.Results A total of three randomized controlled trials and eight cohort studies were ultimately included,including 1 534 patients.The results of meta-analysis showed that there was no statistically significant difference in the early recurrence rate of AF after ablation between the dronedarone group and the amiodarone group(RR=1.15,95％CI 0.90 to 1.47,P=0.25).Compared with the amiodarone group,the dronedarone group had a higher incidence of bleeding(RR=2.28,95％CI 1.08 to 4.81,P＜0.05),a higher incidence of gastrointestinal adverse reactions(RR=3.87,95％CI 1.39 to 10.74,P=0.009)and a lower incidence of thyroid dysfunction(RR=0.15,95％CI 0.06 to 0.40,P＜0.001).There was no statistically significant difference in the incidence of postoperative bradycardia,liver and kidney dysfunction,and total adverse drug reactions between the two groups(P＞0.05).Compared with the propafenone group,the dronedarone group had a lower early recurrence rate of AF after ablation(RR=0.31,95％CI 0.17 to 0.57,P＜0.001).However,there was no statistically significant difference in the incidence of adverse reactions between them(P＞0.05).Conclusion Current evidence suggests that dronedarone is as effective in preventing early recurrence after AF ablation as amiodarone,but more effective than propafenone.In terms of safety,compared to amiodarone,dronedarone has a lower risk of thyroid dysfunction,but a higher risk of gastrointestinal adverse reactions and bleeding.Due to the limited quality and quantity of the included studies,more large sample,multi-center and high-quality studies are needed to verify the above conclusion.

Objective:To assess the performance of machine learning(ML),and integrate the clinical parameters with coronary artery calcium(CAC)score of computed tomography(CT)and quantification of automated epicardial adipose tissue(EAT),so as to predict the long-term risk of myocardial infarction(MI)and cardiogenic death in asymptomatic patients.Methods:A total of 1 058 subjects with cardiovascular risk factors and without symptoms of coronary heart disease who underwent physical examination at the Fifth Medical Center of Chinese PLA General Hospital from January 2013 to October 2015 were selected as this study subjects.A long-term follow-up was conducted on them after CAC score.EAT volume and density were quantified using a fully automated deep learning method.ML extreme gradient boosting was trained by using clinical data,risk score of atherosclerotic cardiovascular disease,CAC score and automated EAT measure,and the repeated 10-fold cross validation was used to verify the model.Results:During the 8-year follow-up period,61 cases of 1 058 subjects occurred events of MI and(or)cardiac death.The area under curve(AUC)value of ML was significantly higher than that of the atherosclerotic cardiovascular disease(ASCVD)risk and the predicting events of CAC score(ML:0.82,ASCVD:0.77,CAC:0.77).Compared with ML with only clinical variable,machine learning based on ASCVD,CAC and EAT had more predictive ability for MI and cardiac death[AUC 0.82(95%CI:77-87)vs.0.78(95%CI:0.72-0.84),P=0.02].The survival rate of subjects with high ML scores had a greater decline degree with the increasing of time,therefore,the subjects with higher ML scores were more likely to experience events.Conclusion:ML,which integrated clinical and quantitative imaging variables,can provide long-term risk prediction for patients with cardiovascular risk factors.

Objective:To investigate the feasibility and value of participatory bilingual teaching in nuclear medicine teaching.Methods:With the same chapter of Nuclear Medicine as the teaching contents, the traditional method of cramming bilingual teaching was used for the clinical medical students in the class of 2014 of the seven-year program and the five-year program, and the method of participatory bilingual teaching was used for the students in the class of 2015. The methods of periodical achievement test, questionnaire survey, and final examination were used to evaluate the teaching effect of the above two teaching modes.Results:In the periodical achievement test, the participatory bilingual teaching group had significantly higher scores than the cramming teaching group in terms of mean score, case analysis, and English questions [seven-year program: (82.13±10.72), (35.74±4.13), and (23.03±3.40) vs. (79.21±11.31), (33.86±5.23), and (22.12±2.75), P<0.05; five-year program: (78.66±12.75), (34.30±5.59), and (22.45±2.91) vs. (75.29±10.81), (32.70±6.04), and (21.36±3.09), P<0.05]. The questionnaire survey showed that participatory bilingual teaching had a better degree of satisfaction than cramming teaching. The participatory bilingual teaching group had a better score than the cramming teaching group in the final examination, but with no significant difference between the two groups. Conclusions:In the teaching of nuclear medicine, the participatory bilingual teaching mode can significantly improve teaching effect and achieve the teaching goal efficiently.

Objective To observe the value of ultrasound for diagnosing esophageal foreign body in children.Methods Ultrasonic manifestations of 45 children with esophageal foreign body were retrospectively analyzed,and the diagnostic value of ultrasound was evaluated.Results Among 45 cases,cervical esophageal foreign body was found in 40 cases(40/45,88.89%),while thoracic esophageal foreign body was detected in 5 cases(5/45,11.11%).Ultrasound correctly diagnosed 44 cases of esophageal foreign body,with an accuracy rate of 97.78%(44/45).Among different kinds of foreign bodies,fruit pits mainly presented as arc strong echogenicity accompanied by behind sound shadow,plastic stickers exhibited strong echogenicity with clear edges in the form of stripes,fish bones presented as irregular or slender strong echogenicity,button batteries demonstrated in arc/short strip strong echogenicity accompanied by sound shadows in the rear,while cooked albumen appeared as irregular chunks without echo,and the sarcocarp,toy parts and coins often presented as different shaped moderate/strong/mixed echogenicity,metallic foreign bodies with"comet tail"sign behind the strong echoes.Among 44 cases ultrasound correctly diagnosed esophageal foreign body,no abnormal changes of surrounding esophageal wall was found in 31 cases(31/44,70.45%),whereas mucosal necrosis injury and ulcer formation were detected in 7 cases(7/44,15.91%),inflammatory edema of esophageal wall were noticed in 3 cases(3/44,6.82%),and 3 cases(3/44,6.82%)were found with esophageal perforation.Conclusion Ultrasound was convenient and feasible for diagnosing esophageal foreign body in children with high accuracy.