Cyclotorsion of the eye is a factor that affects the accuracy of astigmatic correction after small incision lenticule extraction(SMILE), potentially leading to unexpected outcomes such as astigmatic undercorrection and an increase in higher-order aberrations. One possible explanation for these issues is the lack of active rotational tracking software in the VisuMax femtosecond laser system. Accurately measuring ocular cyclotorsion can effectively guide the design of the surgery and improve the postoperative visual quality. Several methods have been developed to measure and compensate for cyclotorsion during SMILE. This article reviews the characteristics of cyclotorsion in refractive surgery, the methods of cyclotorsion compensation, and the impact of cyclotorsion compensation on the outcomes of SMILE.

With the continuous development of refractive surgery, people's focus has gradually shifted from improving vision to improving visual quality, and personalized laser-assisted in situ keratomileusis(LASIK)surgery has gradually become people's preferred choice. Femtosecond laser-assisted keratoplasty provides better advantages for personalized LASIK surgery. This article mainly introduces the commonly used femtosecond laser-assisted personalized LASIK surgery(FS-LASIK)in recent years, such as wavefront-optimized, wavefront-guided, topography-guided, Q value-guided(aspheric cutting), personalized surgery “Wavelight Plus” and personalized surgery when correcting patients with age-related inadequate accommodation. This article focuses on analyzing the advantages and disadvantages of different personalized FS-LASIK, as well as the research progress in recent years, and also focuses on comparing the differences between different personalized surgeries.

AIM: To evaluate the safety and efficacy of allogeneic intrastromal lenticule implantation combined with corneal collagen cross-linking(CXL)in patients with moderate to advanced keratoconus.METHODS: A retrospective case series analysis was conducted. A total of 19 patients(20 eyes)with moderate to advanced keratoconus who underwent combined allogeneic intrastromal lenticule implantation and CXL at the Jinan Mingshui Eye Hospital from June 2021 to December 2023 were included. The uncorrected distance visual acuity(UCVA), thinnest corneal thickness, central corneal epithelial thickness, anterior corneal flat keratometry(Kf), steep keratometry(Ks), and mean keratometry(Km), as well as the first applanation time(A1T), the first applanation length(A1L), the velocity during the first applanation moment(VIN), the second applanation time(A2T), the second applanation length(A2L), the velocity during the second applanation moment(VOUT), highest concavity time(HCT), highest concavity radius(HCR), peak distance(PD), deformation amplitude(DA), stiffness parameter at first applanation(SP-A1), integrated radius(IR), central corneal thickness(CCT), intraocular pressure(IOP), corneal thickness-corrected IOP, biomechanically intraocular pressure IOP(bIOP), and corneal thickness variation rate(ARTH)were compared between the two groups before surgery and at 1 wk, 1, 3 and 6 mo after surgery.RESULTS: All patients successfully completed the surgery without any intraoperative complications. No significant differences were observed between pre-operative and post-operative measurements for UCVA or the corneal biomechanical parameters, including A1L, A2L, PD, A1T, A2T, VIN, VOUT, DA, IOP, and bIOP(all P>0.05). Significant differences were found between pre-operative and post-operative values for corneal thinnest point thickness, central corneal epithelial thickness, Kf, Ks, Km, and the corneal biomechanical parameters, including HCT, HCR, SP-A1, ARTH, IR, and CCT(all P<0.05). The anterior corneal curvature demonstrated an initial increase followed by a decrease post-operatively. Furthermore, significant differences were observed between pre-operative and post-operative values for HCT, HCR, SP-A1, ARTH, IR, and CCT(all P<0.005).CONCLUSION: Allogenic intrastromal lenticule implantation combined with corneal collagen cross-linking demonstrates favorable safety and stability in treating moderate-to-advanced keratoconus. This combined procedure effectively increases corneal thickness and rigidity, resulting in corneas that are more resistant to deformation postoperatively.

Keratoconus is a chronic non-inflammatory corneal disease characterized by thinning and localized protrusion of the corneal stroma in a conical shape. It often leads to irreversible irregular astigmatism and varying degrees of decline in corrected visual acuity. With the rise of femtosecond laser refractive surgery, corneal lenses were discovered as a good biological material. Corneal lens implantation of the cornea can increase the thickness of the cornea and delay the progression of keratoconus disease for further treatment. Currently, convex lenses obtained from myopic small incision lenticule extraction(SMILE)surgery and concave lenses obtained from farsighted SMILE surgery, as well as parallel lenses obtained from donors, can be implanted into the cornea with the aid of femtosecond lasers as lens materials. This article will summarize and discuss the above three lens material implantation methods to provide reference for the selection of keratoconus treatment.

Objective To explore the development and validation of a prediction model for severe communi-ty-acquired pneumonia in adults based on peripheral blood inflammatory indicators.Methods Venous blood samples of 204 community-acquired pneumonia in adults patients admitted to 7 hospitals in Chongqing area from April 2021 to August 2022 were collected to detect C-reactive protein(CRP),peripheral white blood cell count(WBC),neutrophil to lymphocyte ratio(NLR),cytokines,lymphocyte subgroups and neutrophil CD64 index.All of patients were divided into a training group and a validation group according to the time of admis-sion.Univariate and multivariate Logistic regression were used to analyze the data of the training group,the characteristic factors of severe progression for pneumonia were selected to construct the nomogram model,and the data of the validation group was used to verify the model.The receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA)were used to evaluate the prediction ability of the model for severe community-acquired pneumonia in adults.Results Logistic regression analysis showed that age,CRP,WBC,interleukin(IL)-4/interferon gamma ratio and IL-6/IL-10 ratio were independent risk factors for severe community-acquired pneumonia in adults.The area under the ROC curve of the nomogram model in the training group and the validation group was 0.893 and 0.880,respectively.The calibration curve and DCA results shown that the model had a good prediction effect for severe community-acquired pneumonia in adults.Conclusion The inflammatory indicators included in this model are simple and easy to obtain clinically.This model with good differentiation and accuracy,it can be used as a practical tool to predict severe community-ac-quired pneumonia in adults,and has certain clinical application value.

Keratoconus is a progressive disease that seriously affects the eyesight of young people. Keratoconus often causes high myopia, irregular astigmatism, and some patients with advanced corneal scar, visual acuity significantly decreased. In the course of diagnosis and treatment of keratoconus, refractive reconstruction of keratoconus is the focus of clinical attention. After years of research and exploration, a variety of treatment methods in different stages of disease(non-progressive, progressive, advanced)for keratoconus patients refractive reconstruction, so that they can obtain good visual function. This paper mainly reviews the refractive reconstruction schemes of keratoconus in different periods, analyzes the advantages and disadvantages of various treatment schemes at home and abroad, and summarizes the characteristics of different treatment methods, with a view to providing theoretical reference and new treatment ideas for the diagnosis and treatment of keratoconus.

Objective To explore the prognostic value of the coronary angiography-derived index of microcirculatory resistance(caIMR)for major adverse cardiovascular events(MACE)in patients with acute ST-segment elevation myocardial infarction(STEMI)after primary percutaneous coronary intervention(PCI).Methods Between September 2019 and March 2022,541 patients diagnosed with STEMI at the Affiliated Hospital of Xuzhou Medical University were enrolled.The caIMR was calculated using the FlashAngio system(Suzhou Rainmed Medical Technology Co.,Ltd.).The patients were divided into MACE and non-MACE groups according to the occurrence of MACE during hospitalization or follow-up,with MACE defined as all-cause mortality,heart failure readmission,and unplanned revascularization.COX regression analysis,receiver operating characteristic(ROC)curves,and Kaplan-Meier survival curves were used to evaluate the prognostic value of caIMR for STEMI patients after primary PCI.Results During the 1-year follow-up,61 patients(11.28％)experienced MACE.The patients in the MACE group had higher caIMR values than those in the non-MACE group.Multivariate COX analysis showed that caIMR was an independent risk factor for MACE.ROC curve analysis showed that caIMR predicted MACE with an area under the curve of 0.688,and the optimal cutoff value was 25.3 U.caIMR significantly increased the discriminant and reclassification indexes when added to a model with clinical risk factors.The patients were further divided into a low caIMR group(caIMR＜25 U,n=377)and a high caIMR group(caIMR ≥25 U,n=164).Kaplan-Meier curve showed that patients with caIMR≥25 U had a worse prognosis.Conclusions caIMR is an independent risk factor for poor prognosis after PCI in patients with STEMI,and patients with caIMR≥25 U had a worse prognosis.

With the intensification of global aging,presbyopia has gradually become a global problem, and presbyopia correction surgery has emerged in recent years. The application of laser technology has brought great convenience to refractive surgery, and it also plays an increasingly important role in the correction of presbyopia. The emergence of excimer laser and femtosecond laser technology has opened a new world of surgical treatment for presbyopia, and brought new hope for surgical correction of presbyopia. In this paper, the application and new progress of excimer laser and femtosecond laser in presbyopia surgery are described.

Objective To investigate the application value of 3.0T MR apparent diffusion coefficient(ADC)in prognosis and pathological types of endometrial carcinoma(EC).Methods A total of 114 EC patients were retrospectively selected,and the ADC values of different pathological types were compared.The correlation between ADC and EC prognosis was analyzed by dividing the ADC quintile(Q1-Q5).Results The ADC parameters of EC patients with different pathological types were significantly different(P＜0.05).With the increase of ADC value,the correlation effect size between ADC and EC prognosis also increased(Ptrend＜0.001).ADC had a better predictive effect on EC prognosis.International Federation of Gynecology and Obstetrics(FIGO)stage,myographic invasion and ADC value had interaction with EC prognosis(P interaction＜0.05).Conclusion ADC can be used to distinguish the patho-logical types of EC.Also,ADC is significantly associated with EC prognosis while its correlation effect size increases with the increase of ADC value.ADC value interacted with FIGO stage,as well as with the degree of myographic invasion in predicting EC prognosis.

Objective:To investigate the changes in the morphology, structure and function of the bladders and their effects on the upper urinary tract dilatation(UUTD) after lumbosacral nerve transecting in rats.Methods:A total of 45 female SD rats were included, randomly divided into 3 groups with 15 rats in each group. Two groups were performed bilateral lumbar 6(L6) and cauda equina nerve shearing to establish neurogenic bladder(NB) model, which were nerve transected for 4 weeks(NB-4W) group and nerve transected for 12 weeks(NB-12W) group. Another group was performed bilateral L6 nerves and cauda equine exposing but not transecting, which was sham-operation (Sham) group. Cystometry and renal ultrasound examination were performed and rats in each group were killed to collect the kidney and bladder tissues in NB-4W group at 4 weeks, in Sham group and NB-12W group at 12 weeks after operation. HE, Masson staining, immunohistochemical staining and western blot were used to detect histological changes, expression of transforming growth factor-β1(TGF-β1) and α-smooth muscle actin(α-SMA).Results:All rats in NB-4W and NB-12W group showed acontractile detrusor. In the NB-4W and NB-12W group, the maximum cystometric capacity [(5.84±0.33) ml and (3.13±0.35) ml], the detrusor leak point pressure [(25.41±0.86) cm H 2O and (27.36±2.04) cm H 2O] (1 cm H 2O = 0.098 kPa), were significantly higher than those in the Sham group [(0.98±0.14) ml, (7.13±0.90) cm H 2O, both P<0.05]. Compliance in NB-4W group [(0.28±0.21) ml/cm H 2O] and NB-12W group [(0.17±0.12) ml/cm H 2O] were significantly lower than that of the Sham group [(0.34±0.26) ml/cm H 2O], and the compliance of NB-12W group was lower than that of NB-4W group significantly (all P<0.05). HE staining of the bladder showed that the inflammatory cell infiltration was obvious in the NB-4W and NB-12W group. Bladder collagen volume fractions in NB-4W group [(30.5±1.5) %] and NB-12W group [(45.2±3.8) %] were both higher than that of Sham group [(20.7±2.2) %, both P<0.05]. The expression of TGF-β1 and α-SMA in the bladder tissue of NB-4W group were higher than those of sham group, and that of NB-12W group were higher than NB-4W group. In NB-4W group and NB-12W group, 3 (20.0 %) and 7 (46.7 %) rats were found hydronephrosis, respectively. Additionally, HE staining showed that the degree of renal tubule injury and the number of inflammatory cell infiltration in the NB-4W and NB-12W group were higher than those in the Sham group. Masson staining showed that the volume fraction of collagen in kidneys of NB-4W and NB-12W group were (13.1±1.4) % and (21.6±1.9) %, respectively, which were significantly higher than that in sham operation group [(4.6±0.7) %, both P<0.05]. Conclusions:Bilateral L6 + cauda equina nerve transecting can induce NB with hydronephrosis in parts of rats. The degree of bladder fibrosis gradually increased with the time of nerve transection, and the incidence and severity of UUTD also increased with the time of nerve transection.