This review summarizes the applications and advancements of artificial intelligence(AI)in the analysis of retinal vascular parameters. Retinal vascular parameters, including vessel diameter, fractal dimension, vascular tortuosity, branching angles, and vessel density, are important indicators for assessing changes in the retinal vascular network structure. These parameters are not only related to various ophthalmic diseases but also reflect the conditions of systemic diseases such as diabetes and Alzheimer's disease. This article provides a detailed discussion on the advantages of AI technology in the automated identification and quantification of retinal vascular parameters, particularly in improving measurement efficiency and accuracy, and enabling the early detection and monitoring of various diseases. Additionally, the challenges faced by AI in the analysis of retinal vascular parameters were discussed, such as data standardization and insufficient sample diversity, and proposes directions for future research. By thoroughly analyzing the application of AI in retinal vascular parameter analysis, this article aims to offer new perspectives and methods for clinical diagnosis and early intervention of diseases, holding significant clinical significance and application prospects.

Alzheimer's disease(AD),the most common progressive neurodegenerative disease in dementia,is also a special lipid disease.From the perspective of modern medicine,cholesterol homeostasis is an important risk factor for AD.Amyloid-beta plaque deposition,neurofibrillary tangles,and large amount of lipid granule accumulation are typical pathological features of AD.From the perspective of TCM,turbidity is the key to the pathogenesis of AD.Phlegm turbid,stasis turbid and turbid toxin are the concrete derivation of turbidity,which are the standard of AD.Cholesterol is the greasy lipid which is produced from of the essence of water and food,the disturbance of cholesterol homeostasis is a typical embodiment of the pathogenesis mechanism of endogenous turbidity.Regulating cholesterol homeostasis by traditional Chinese medicine may be a new direction for the treatment of AD in the future.Focusing on the modern research of cholesterol homeostasis,taking the theory of turbidity as the starting point,this paper analyzed the correlation between the connotation of turbidity theory and the imbalance of cholesterol homeostasis as well as the pathogenesis mechanism,and further elucidated the clinical application results in the treatment of AD from the aspects of phlegm turbid,stasis turbid and turbid toxin,so as to better guide clinical practice and scientific research.

Objective To compare therapeutic efficacy of anticoagulation alone and combining with intervention for treating severe cerebral venous thrombosis(CVT).Methods Data of 65 severe CVT patients were retrospectively analyzed.The patients were divided into anticoagulation group(n=32)or combined group(n=33)according to therapeutic methods.The modified Rankin scale(mRS)score at admission and discharge,the prognosis of patients,vascular recanalization rate as well as incidence of complications during follow-up period were compared between groups.Results No significant difference of mRS scores at admission was found between groups(P＞0.05),while mRS scores of combined group were lower than of anticoagulation group at discharge(P＜0.05).The rate of good prognosis at discharge(84.85%vs.59.38%),6 months after discharge(87.88%vs.65.63%)and 12 months after discharge(93.94%vs.75.00%)in combined group were all higher than those in anticoagulation group(all P＜0.05).The vascular recanalization rate in combined group was higher than that in anticoagulant group(100%vs.75.00%,P＜0.05).At the end of follow-up,no significant difference of complication incidence was found between groups(15.15%vs.18.75%,P＞0.05).Conclusion For patients with severe CVT,anticoagulation combined with interventional therapy could significantly alleviate clinical symptoms and improve prognosis compared with anticoagulation alone.

Objective To observe the value of stent implantation for treating idiopathic intracranial hypertension(IIH)complicated with venous sinus stenosis(VSS).Methods Data of 54 patients with IIH complicated with VSS who underwent stent implantation were retrospectively analyzed.The papillary edema grade,lumbar puncture-opening pressure(LP-OP)and trans-stenotic pressure gradient of venous sinus(ΔP)before and after stent implantation were compared,and the symptom improvement and treatment-related complications during the follow-up period were recorded.Results Totally 60 stents were successfully implanted in 54 patients.Before stent implantation,the papillary edema grade was 3(3,3),LP-OP was(391.39±92.62)mmH2O and the ΔP was 18.50(15.00,25.00)mmHg,which decreased to 1(0,1),(208.80±62.31)mmH2O and 1.25(0.88,2.55)mmHg after stent implantation,respectively,all with significant differences(all P＜0.001).Clinical symptoms improved after stent implantation in all 54 patients.At the end of follow-up,disappearance of headache,papillary edema,visual disorder,abducent nerve paralysis and tinnitus were noticed in 30(30/37,81.08%),38(38/45,84.44%),41(41/45,91.11%),8(8/10,80.00%)and 9 cases(9/10,90.00%),respectively.Treatment-related complications occurred in 4 cases(4/54,7.41%),all improved after intervention.Conclusion Stent implantation was effective and safe for treating IIH complicated with VSS.

Objective To observe the therapeutic effect of endovascular embolization for perimedullary arteriovenous fistula(PMAVF).Methods Data of 8 PMAVF patients who underwent endovascular embolization were retrospectively analyzed.Findings of digital subtraction angiography(DSA)immediately and 6 months after treatment were reviewed,and the modified Aminoff-Logue score(mALS)was compared before and 6 months after treatment.Results Among 8 cases of PMAVF,there were 2 cases of type Ⅰ,5 cases of type Ⅱand 1 case of type Ⅲ,among them 3 were treated with Onyx glue while 5 with Glubrane glue.The immediate DSA results after treatment showed complete embolization of the fistula in all 8 cases,while those 6 months after treatment showed no recurrence.One case recovered and the other 7 cases improved,and mALS(2.25±2.12)6 months after treatment was lower than that(5.50±2.39)before treatment(P＜0.05).Conclusion Endovascular embolization could safely and effectively treat PMAVF.

Alzheimer's disease （AD） is a common chronic degenerative neurological disease in the elderly and is mainly manifested by the impairment of cognition， memory， and behaviors. At present， the etiology and pathogenesis of this disease have not been fully unraveled， and the research on related drugs for alleviating the disease progression is still in clinical trials. Traditional Chinese medicine （TCM） believes that the elderly have reduced visceral function. Deficiency of vital Qi and turbid phlegm obscuring orifices are the core pathogenesis of AD. Qi deficiency and phlegm obstruction run through the whole pathological process of AD， and the important role of therapeutic principles of supplementing Qi and resolving phlegm is emphasized in treatment. In recent years， the Chinese medicinal compounds effective in supplementing Qi and resolving phlegm represented by Kaixin Powder have been widely used in the clinical and basic research of AD. As reported， in addition to the improvement of the cognitive function of AD， it can also reduce β amyloid （Aβ） deposition， inhibit tau hyperphosphorylation， improve neurotransmitter activity， regulate neuronal synaptic plasticity， resist oxidant stress injury， and inhibit the central inflammatory response and neuronal apoptosis. Therefore， this article reviewed and analyzed the theoretical basis of the treatment of AD by supplementing Qi and resolving phlegm and the mechanism of Chinese medicinal compounds effective in supplementing qi and resolving phlegm against AD to provide theoretical support and a scientific basis for the clinical application of TCM in the prevention and treatment of AD.

Artificial intelligence (AI) is an emerging science and technology that studies and develops theories, methods, technologies, and application systems for simulating and expanding human intelligence. AI has made great breakthroughs in the field of intelligent medicine, and has shown great potential in the diagnosis and treatment of diabetic retinopathy (DR), retinopathy of prematurity, and other fundus diseases. A number of clinical trials on the application of AI technologies to DR screening have been carried out in the domestic and overseas, which not only have a high accuracy rate, but also save doctors' reading time and reduce the burden of society, medical work and patients. However, due to the lack of evaluation system for DR intelligent diagnosis technology, the accuracy of AI system still lacks of big data verification. Secondly, most of the color fundus photographs are taken in the posterior 45°, which only show the most vulnerable areas, making some lesions undetectable. In addition, the current DR screening system has not yet been applied to the clinic, most of which are in the stage of prospective research and trials. There are still many obstacles from the environment to the hospital or the clinic. Doctors cannot use real patient data to evaluate the AI system, so it is not popular in clinical practice. In the future, DR screening algorithms and diagnostic models can be further improved and established to make DR AI screening more accurate.

Objective:To investigate the value of pericoronary adipose tissue histogram parameters based on coronary CT angiography (CTA) images for the differentiation of acute coronary syndrome and stable coronary artery disease.Methods:The clinical data and CTA images of 93 patients with coronary CTA examination in Suzhou Kowloon Hospital from 2013 to 2018 were analyzed retrospectively. There were 39 patients with acute coronary syndrome (acute coronary syndrome group) and 54 patients with stable coronary artery disease (stable coronary artery disease group). A region of interest (ROI) was drawn around the stenosis of the coronary arteries, with CT attenuation ranging from-190 to -30 HU to exclude non-adipose tissue. The CT attenuation of ROI excluding non-adipose were measured and histogram analysis was performed. The obtained parameters included the mean value, median value and the 5th, 10th, 45th, 55th, 70th and 95th percentiles. The differences in histogram parameters between the two groups were compared, and then the value of each parameter in differentiating acute coronary syndrome and stable coronary artery disease was evaluated based on receiver operating characteristic (ROC) analysis. The stepwise regression of multivariate logistic regression analysis was used to identify the useful features and establish the final prediction model. The ROC curve of the final model was calculated and its value was analyzed.Results:The mean, median and the 5th, 10th, 45th, 55th,70th and 95th percentile differences between the acute coronary syndrome group and the stable coronary artery disease group were statistically significant (all P<0.05). The ROC curve for the median and the 95th percentile had the same area under curve (AUC) of 0.73. The sensitivity, specificity and AUC of the diagnostic model established by multiple logistic regression were 82.1%, 89.1% and 0.90 respectively. Conclusion:CT attenuation histogram of pericoronary adipose tissue is of high value in differentiating acute coronary syndrome from stable coronary artery disease.

Objective: To investigate the effect of obstructive sleep apnoea-hypoapnoea syndrome(OSAHS)on diabetic retinopathy(DR)in elderly patients with type 2 diabetes mellitus(T2DM)and analyze risk factors for DR process. Methods: Data of elderly diabetic patients without DR admitted into our hospital from January 2012 to December 2014 were retrospectively analyzed.Based on whether or not to combine OSAHS, patients were divided into the OSAHS group(n=42)and the control group(n=85). After 36 months' follow-up, the incidence and progression of DR were compared, and the effect of different degree of OSAHS on DR was analyzed.Multivariate logistic regression analysis was used to analyze the risk factors for DR. Results: The systolic pressure, diastolic pressure and Epworth sleepiness scores were higher in the OSAHS group than in the control group(P<0.05). At the(34.5±6.7)months of follow-up versus baseline, body mass index, renal function and cardiac function were markedly decreased in both groups(P<0.05). The systolic pressure, diastolic pressure, 2-h postprandial blood glucose and Epworth sleepiness scores were higher in the OSAHS group than in the control group; and the glomerular filtration rate(GFR)and left ventricular ejection fraction were lower in the OSAHS group than in the control group(P<0.05). The incidences of mild, moderate and severe non-proliferative DR were higher in the OSAHS group than in the control group(P<0.05). The results of subgroup analysis showed that the incidence of DR was higher in patients with moderate to severe OSAHS than in controls(OR=4.57, 95%CI: 1.24~13.78, P=0.002), while the incidence of DR in patients with mild OSAHS was similar to that in the controls(OR=2.33, 95%CI: 0.66~12.56, P=0.29). Multivariate logistic regression analysis showed that T2DM duration ≥7 years(OR=3.24, 95%CI: 1.80-9.59, P<0.05), haemoglobin A1c(HbA1c)≥7.5%(OR=2.07, 95%CI: 1.41-8.52, P<0.05), GFR<60 ml/min(OR=4.52, 95%CI: 1.75-14.26, P<0.05)and apnea/hyponea index ≥15/h(OR=2.03, 95%CI: 1.37-11.24, P<0.05)were independent risk factors for DR. Conclusions OSAHS patients tend to have hypertension and high glucose level, and are more prone to cardiac and renal dysfunction and DR.T2DM duration ≥7 years, HbA1c ≥7.5%, GFR<60 ml/min and AHI ≥15/h are independent risk factors for DR progression.And more studies are needed to confirm the independent risk factors.

Objective To explore the correlations of dyslipidemia and hypertension with diabetic retinopathy in diabetic patients aged 80 years and over. Methods The 487 diabetic patients admitted to endocrine department of our hospital from January 2013 to June 2017 were recruited and their medical records were retrospectively analyzed. According to the results of examination ,they were divided into three groups :non-diabetic retinopathy group (n = 306 ) ,non-proliferative diabetic retinopathy group (n = 143)and proliferative diabetic retinopathy group (n = 38).The course of diabetes ,levels of blood glucose and lipids ,and the course of hypertension were compared among the three groups. Results Prevalence of diabetic retinopathy was 37.2% (181/487) ,and was increased along with the prolongation of diabetes duration ,and occurrence of coexisted hypertension and dyslipidemia.Statistically significant differences were found among the 3 groups(all P＜0.05)in the levels of glycosylated hemoglobin A1c ,low-density lipoprotein cholesterol ,high-density lipoprotein cholesterol ,triglyceride ,apolipoprotein A ,apolipoprotein B and the ratio of apolipoprotein A over apolipoprotein B.Multivariate analysis showed that the levels of glycosylated hemoglobin A 1c ,low-density lipoprotein cholesterol and the ratio of apolipoprotein A and apolipoprotein B were correlated with the development and progression of diabetic retinopathy ( OR = 3.00 ,0.22 and 2.96 , respectively). Conclusions The incidence of diabetic retinopathy is higher in diabetic patients aged 80 years and over.Dyslipidemia is correlated with development and progression of diabetic retinopathy.