Acute transient or permanent retinal arterial ischemia is ocular and systemic emergency requiring immediate diagnosis and treatment. Transient monocular vision loss is transient retinal arterial ischemia which leaves no permanent deficits. Central retinal arterial occlusion and branch retinal arterial occlusion lead to permanent visual function deficits in the majority of patients. Current treatment include lowering intraocular pressure, dilating blood vessels, hyperbaric oxygen therapy, intravenous or intra-arterial thrombolysis and so on, but there is still no standard treatment procedure. High risk groups should receive primary prevention measures in order to reduce the incidence of the disease. Patients with acute retinal arterial ischemia are at high risk of subsequent stroke and adverse cardiovascular events. Relevant risk factors should be identified in time, the primary disease should be treated actively, and appropriate secondary prevention measures should be taken to improve the prognosis. This review summarizes the recent treatment and prevention procedures of acute retinal arterial ischemia, to provide references for the management of these diseases.

AIM:To explore the use of attention mechanism and Pix2Pix generative adversarial network to predict the postoperative corneal topography of age-related cataract patients undergone femtosecond laser arcuate keratotomy.METHODS:In this retrospective case series study, the 210 preoperative and postoperative corneal topographies from 87 age-related cataract patients(105 eyes)undergoing femtosecond laser arcuate keratotomy at Shanxi Eye Hospital between March 2018 and March 2020 were selected and divided into a training set(180)and a test set(30)for model training and testing. The peak signal-to-noise ratio(PSNR), structural similarity(SSIM)and Alpins astigmatism vector analysis were used to compare the accuracy of postoperative corneal topography prediction under different attention mechanisms.RESULTS:The model based on attention mechanism and Pix2Pix network can predict postoperative corneal topography, among which the model based on Self-Attention mechanism has the best prediction effect, with PSNR and SSIM reaching 16.048 and 0.7661, respectively. There were no statistically significant differences in the difference vector, difference vector axis position, surgically induced astigmatism, and correction index between real and generated corneal topography on the 3mm and 5mm rings(all P>0.05).CONCLUSION:Based on the Self-Attention mechanism and Pix2Pix network, the postoperative corneal topography can be well predicted, which can provide reference for the surgical planning and postoperative effects of ophthalmic clinicians.

Objective: To investigate the influence of extending the waiting time on tumor regression after neoadjuvant chemoradiology (nCRT) in patients with locally advanced rectal cancer (LARC). Methods: Clinicopathological data from 728 LARC patients who completed nCRT treatment at the First Affiliated Hospital, Naval Medical University from January 2012 to December 2021 were collected for retrospective analysis. The primary research endpoint was the sustained complete response (SCR). There were 498 males and 230 females, with an age (M(IQR)) of 58 (15) years (range: 22 to 89 years). Logistic regression models were used to explore whether waiting time was an independent factor affecting SCR. Curve fitting was used to represent the relationship between the cumulative occurrence rate of SCR and the waiting time. The patients were divided into a conventional waiting time group (4 to <12 weeks, n=581) and an extended waiting time group (12 to<20 weeks, n=147). Comparisons regarding tumor regression, organ preservation, and surgical conditions between the two groups were made using the t test, Wilcoxon rank sum test, or χ² test as appropriate. The Log-rank test was used to elucidate the survival discrepancies between the two groups. Results: The SCR rate of all patients was 21.6% (157/728). The waiting time was an independent influencing factor for SCR, with each additional day corresponding to an OR value of 1.010 (95%CI: 1.001 to 1.020, P=0.031). The cumulative rate of SCR occurrence gradually increased with the extension of waiting time, with the fastest increase between the 9^th to <10^th week. The SCR rate in the extended waiting time group was higher (27.9%(41/147) vs. 20.0%(116/581), χ²=3.901, P=0.048), and the organ preservation rate during the follow-up period was higher (21.1%(31/147) vs. 10.7%(62/581), χ²=10.510, P=0.001). The 3-year local recurrence/regrowth-free survival rates were 94.0% and 91.1%, the 3-year disease-free survival rates were 76.6% and 75.4%, and the 3-year overall survival rates were 95.6% and 92.2% for the conventional and extended waiting time groups, respectively, with no statistical differences in local recurrence/regrowth-free survival, disease-free survival and overall survival between the two groups (χ²=1.878, P=0.171; χ²=0.078, P=0.780; χ²=1.265, P=0.261). Conclusions: An extended waiting time is conducive to tumor regression, and extending the waiting time to 12 to <20 weeks after nCRT can improve the SCR rate and organ preservation rate, without increasing the difficulty of surgery or altering the oncological outcomes of patients.

Objective:To investigate the possible mechanism of Xieheyin in alleviating obese polycystic ovary syndrome with insulin resistance（PCOS-IR）and reducing inflammatory response. Method:Ten of sixty SPF femlae C57BL/6J mice were randomly selected as the normal group，and the rest mice were given letrozole 0.002 g·kg^-1 combined with fecal suspension 2 g·kg^-1 for 28 consecutive days to establish model of PCOS-IR.The mice that were successfully modeled were randomized into the model group，metformin group（0.25 g·kg^-1），and low（10 g·kg^-1），medium（20 g·kg^-1），and high-dose（40 g·kg^-1）Xieheyin groups，and administered with the corresponding drugs by gavage，once a day，for four consecutive weeks. Except the normal control group， the mice in the other groups were continuously given fecal suspension combined with letrozole solution to maintain the model during the treatment. The mice were weighed once a week.Levels of fasting blood glucose （FBG） were detected by blood glucose test strips.And enzyme-linked immunosorbent assay （ELISA） method was used to detect serum testosterone（T），follicle stimulating hormone（FSH），luteinizing hormone（LH），fasting insulin（FINS）level，and LH/FSH and Homeostasis model assesment of insulin resistance （HOMA-IR） were calculated．The uterus and ovaries were weighed and fixed.Hematoxylin-eosin（HE）staining was used to observe ovarian tissue pathology morphology. Western blot was used to detect the expression levels of tight junction key molecular zonula occludens 1（ZO-1），occludin in colon tissues，and the expression levels of Toll-like receptor 4/nuclear factor kappa B/Nod-like receptor protein 3（TLR4/NF-κB/NLRP3）signaling pathway and inflammation associated proteins cysteinyl aspartate specific proteinase-1（Caspase-1） and interleukin-1β（IL-1β） in colon tissues. Result:Compared with normal control group，the body weight of mice in the model control group increased significantly（P<0.01）. Serum FINS，FBG，HOMA-IR，T，LH/FSH were significantly increased（P<0.05，P<0.01）. The uterine organ ratio were decreased significantly（P<0.01），while the ovarian organ ratio were significantly increased（P<0.01）. The number of atresia follicles and cystic dilatation follicles increased significantly，and the number of corpus luteum significantly decreased，the thickness of follicular granulosa cells also decreased，while the white membrane thickness of the ovary increased. Tight junction related ZO-1，occludin proteins in colon tissues were all decreased（P<0.01）.The relative expression levels of inflammation-related protein IL-1β，Caspase-1 and TLR4/NF-κB/NLRP3 target protein signaling pathway were significantly increased（P<0.05）.Compared with model control group， the body weight of mice in the low，middle and high dose Xieheyin group decreased significantly（P<0.01）. The serum T，LH/FSH，FINS，FBG，HOMA-IR were significantly decreased（P<0.05，P<0.01）. The uterine organ ratio were increased（P<0.05），while the ovarian organ ratio were decreased（P<0.05）. The number of cystic follicles decreased and corpus luteum increased，the thickness of follicular granulosa cells increased and be arranged normally，while the white membrane thickness of the ovary increased slightly. The expressions of ZO-1，occludin proteins were increased（P<0.01）. The expression levels of IL-1β，Caspase-1 and TLR4/NF-κB/NLRP3 target protein in the high dose group were significantly decreased（P<0.01）. Conclusion:Xieheyin could activate intestinal TLR4/NF-κB/NLRP3 signaling pathway，inhibit pro-inflammatory factor secretion，improve obesity and IR，which was correlated with rebuilding intestinal mucosal barrier and inhibiting intestinal inflammation．

OBJECTIVES: To develop a new Chinese medicine (CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome (ARDS) in COVID-19 patients. METHODS: A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized, controlled two-arm trial. The two arms of the trial consist of a control therapy (alpha interferon inhalation, 50 µg twice daily; and lopinavir/ritonavir, 400 and 100 mg twice daily, respectively) and a testing therapy (control therapy plus Keguan-1 19.4 g twice daily) by random number table at 1:1 ratio with 24 cases each group. After 2-week treatment, adverse events, time to fever resolution, ARDS development, and lung injury on newly diagnosed COVID-19 patients were assessed. RESULTS: An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events. Based on this result, the study was expanded to include a total of 48 participants (24 cases each arm). The results show that compared with the control arm, the testing arm exhibited a significant improvement in time to fever resolution (P=0.035), and a significant reduction in the development of ARDS (P=0.048). CONCLUSIONS Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients. (Trial registration No. NCT04251871 at www.clinicaltrials.gov ).
Administration, Inhalation ; Adult ; China ; Coronavirus Infections ; diagnosis ; drug therapy ; mortality ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Integrative Medicine ; Interferon-alpha ; administration & dosage ; Lopinavir ; administration & dosage ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral ; diagnosis ; drug therapy ; mortality ; Risk Assessment ; Severe Acute Respiratory Syndrome ; diagnosis ; drug therapy ; mortality ; Severity of Illness Index ; Survival Rate

A methodology of quantitative analysis on ginsenoside Re (G-Re) in rat plasma by ultra performance liquid chromatography-triple quadrupole mass spectrometry was developed for comparing the pharmacokinetic profiles between normal rats and Ultraviolet B (UVB) irradiation-induced damage rats after oral administration. The sample separation was carried out on an Ascentis?Express C18column (5.0 mm× 3.0 mm,2.7 μm) with 0.1% formic acid in water and acetonitrile as the mobile phase under gradient elution. MS analysis was operated in multiple-reaction monitoring (MRM) mode using electrospray ionization (ESI) with negative ion mode,and the ions for quantification were m/z 991.54/945.53/475.60. The limit of detection (LOD,S/N=3), limit of quantification (LOQ, S/N=10) were 4.0 ng/mL and 13.5 ng/mL, respectively. G-Re was in good linearity between 15 ng/mL and 20000 ng/mL(r=0.999),the intra-day and inter-day precisions, recovery, matrix effect and stability could meet the pharmacokinetic analysis requirement. The results indicated that the metabolic process of G-Re conformed to a two-compartment pharmacokinetic model after single oral administration in the normal and model groups. The t1/2αwere(0.21± 0.04) h and (0. 69 ± 0. 07) h, respectively; t1/2βwere (17. 08 ± 0. 53) and (21. 40 ± 16. 77) h, respectively;AUC(0-t)were (321.91±2.27) μg/(L·h) and (474.99±194.96) μg/(L·h), respectively;AUC(0-∞)were (332. 44 ± 1. 66) μg/(L·h) and (518. 64 ± 231. 39) μg/(L·h), respectively; the pharmacokinetic parameters were significantly different between normal and UVB irradiated rats (p<0.05), except for t1/2α. This UHPLC-QQQ-MS method showed excellent separation, accuracy, high sensitivity, specificity and good repeatability,and it was suitable for the pharmacokinetic study of G-Re in vivo.

In order to analyze the temporal distribution characteristics of human rabies in China and explore the incidence forecasting,R3.3.2 software were used to establish the optimal ARIMA model of monthly incidences from 2004 to 2015 in Chi-na.Then the monthly incidences from January to November 2016 were forecasted with the model and the prediction accuracy was evaluated.The annual incidences of human rabies in China were decreasing tendency since 2007,and the monthly incidence reached highly during August to October.The optimal model was ARIMA(2,1,1)(2,0,0)12and the mean absolute error (MASE)was 0.755.The mean relative error was 15.61% when predicting the incidences from January to November 2016.In conclusion,there exists seasonal variation for human rabies in China and ARIMA model can be applied for the short-term fore-casting.

Objective To predict the monthly reported echinococcosis cases in China with the autoregressive integrated mov-ing average(ARIMA)model,so as to provide a reference for prevention and control of echinococcosis. Methods SPSS 24.0 software was used to construct the ARIMA models based on the monthly reported echinococcosis cases of time series from 2007 to 2015 and 2007 to 2014,respectively,and the accuracies of the two ARIMA models were compared. Results The model based on the data of the monthly reported cases of echinococcosis in China from 2007 to 2015 was ARIMA(1,0,0)(1,1, 0)12,the relative error among reported cases and predicted cases was-13.97%,AR(1)=0.367(t=3.816,P<0.001),SAR (1)=-0.328(t=-3.361,P=0.001),and Ljung-Box Q=14.119(df=16,P=0.590).The model based on the data of the monthly reported cases of echinococcosis in China from 2007 to 2014 was ARIMA(1,0,0)(1,0,1)12,the relative error among reported cases and predicted cases was 0.56%,AR(1)=0.413(t=4.244,P<0.001),SAR(1)=0.809(t=9.584, P<0.001),SMA(1)=0.356(t=2.278,P=0.025),and Ljung-Box Q=18.924(df=15,P=0.217).Conclusions The different time series may have different ARIMA models as for the same infectious diseases.It is needed to be further verified that the more data are accumulated,the shorter time of predication is,and the smaller the average of the relative error is.The estab-lishment and prediction of an ARIMA model is a dynamic process that needs to be adjusted and optimized continuously accord-ing to the accumulated data,meantime,we should give full consideration to the intensity of the work related to infectious diseas-es reported(such as disease census and special investigation).

Objective ToinvestigateanimportedcaseofZikavirusdiseaseinWenzhouCity,toexplorethesourceof infection,to analyse the problems during surveillance and diagnosis,and to provide evidence for prevention and control of Zikavirusdisease.Methods Byfieldinvestigation,medicalrecordsofthepatientwerecollectedandaface-to-face interview was conducted;blood,urine and saliva samples within 48 h were collected for RNA detection;assess the risk of diseasespreadingbymosquitosurveillanceandtakecontrolmeasures.Results Theonsetofthediseasewasonthepatient's way home from aboard on February 21st,2016.Before then,She lived in Paramaribo,the capital of Suriname in South America,which is an epidemic area of Zika virus.The patient had exposure history,with red,diffuse rash on her head,face, neck and limbs,and once was diagnosed as allergic eruption because of no fever.The two blood samples were both tested negative yet We detected urine and saliva samples showed positive.With the evidence above,the patient was finally diagnosed as an imported Zika virus case.The spreading risk of this case was low due to the low temperature.Conclusion there may be cases without fever or with blood sample tested RNA negative.As the weather gets warmer,missed diagnosis should be aware of,or the risk of spreading through mosquitos would increase.Therefore,in order to further improvement should lie in mosquito control and disease surveillance.

OBJECTIVETo observe the effect of Schisandra chinensis lignans (SCL) on neuronal apoptosis and PI3K/AKT signaling pathway of rats in the cerebral ischemia injury model, and study its possible mechanism.

METHODRats were orally administered SCL high, middle and low dose groups (100, 50, 25 mg x kg(-1)) for 14 days. The cerebral ischemia injury model was established by using the suture-occluded method to rate the neurological functions. The cerebral infarction area was observed by TTC staining. The pathological changes in brain tissues were determined by HE staining. Bcl-2 and Bax expressions were detected by immunohistochemical assay. The protein expressions of p-AKT and AKT were assayed by Western blotting.

RESULTCompared with the model group, SCL high, middle and low dose groups showed reduction in the cerebral infarction area to varying degrees, improve the pathological changes in brain tissues, promote the expression of apoptin Bcl-2 and p-AKT, and inhibit the expression of apoptin Bax.

CONCLUSIONSCL shows a protective effect on rats with cerebral ischemia injury. Its mechanism may be related to the increase in p-AKT ability and antiischemic brain injury capacity and the inhibition of nerve cells.

Administration, Oral ; Animals ; Apoptosis ; drug effects ; Blotting, Western ; Brain Ischemia ; metabolism ; pathology ; prevention & control ; Disease Models, Animal ; Dose-Response Relationship, Drug ; Immunohistochemistry ; Lignans ; administration & dosage ; pharmacology ; Male ; Neurons ; drug effects ; metabolism ; pathology ; Phosphatidylinositol 3-Kinases ; metabolism ; Phosphorylation ; Phytotherapy ; Proto-Oncogene Proteins c-akt ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Schisandra ; chemistry ; Signal Transduction ; drug effects ; bcl-2-Associated X Protein ; metabolism