Strabismus, a common ocular condition, arises from an imbalance in the extraocular muscle force and deviation of the visual axis due to various factors. Concomitant strabismus is the predominant form of exotropia, with its pathogenesis believed to be associated with hereditary factors, abnormal eye accommodation function, and anomalies in binocular anatomy. Surgical intervention is often necessary for aligning the visual axes of both eyes and facilitating the recovery and establishment of stereoscopic vision. Despite this, the etiology of concomitant exotropia remains incompletely understood. This review consolidates recent research on aberrant molecular expression and pathological morphological changes within extraocular muscles affected by concomitant exotropia, offering insights into disease causation at molecular and pathological levels to underpin future preventive measures and clinical interventions. The discussion encompasses histological changes observed under electron microscopy as well as the impact of heavy chain protein, satellite cells, cadherin, growth factors on extraocular muscle protein expression.

In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.

Glaucoma is the leading irreversible blinding eye disease worldwide,and intraocular pressure(IOP)plays a key role in the occurrence and development of glaucoma.However,the underlying IOP regulatory mechanism remains un-clear.Currently,clinical IOP-lowering drugs work either by reducing aqueous humor formation or increasing aqueous hu-mor outflow with limited reduction amplitude.Recent studies demonstrate that IOP may be regulated by autonomic nerves.To understand the distribution and regulatory mechanism of autonomic nerves in the aqueous humor outflow pathway and provide new ideas for IOP-lowering study and novel drug exploration,we review the roles of the autonomic nervous system in the formation and outflow of aqueous humor in this article.

Objective To investigate the effect of4-amino-2-trifluoromethyl-phenyl retinate(ATPR)on acute liver injury induced by lipopolysaccharide(LPS)in C57BL/6 mice and its related mechanism.Methods Fifteen 6-week-old male C57BL/6 strain mice were randomly divided into normal group,model group and ATPR group,with 5 mice in each group.Mice in the ATPR group were intraperitoneally injected with ATPR(15 mg/kg·d),and normal group and model group were given solvent.After continuous administration for one week,model group and ATPR group were intraperitoneally injected with LPS(6 mg/kg),and all mice were sacrificed 6 hours later.The contents of Alanine aminotransferase(ALT)and Aspartate aminotransferase(AST)in serum of mice were detec-ted.The mRNA levels of Interleukin-6(IL-6)and Tumor necrosis factor-alpha(TNF-α)were detected by qPCR.Hematoxylin-eosin(H&E)staining was used to observe the histopathological changes of liver in mice.The ultra-structural changes of mouse hepatocytes were observed by Transmission electron microscope(TEM).The expres-sion levels of mitochondrial damage-related proteins FUNDC1 and OPA1 and autophagy related proteins LC3B,P62,Beclin1 and ATG5 were detected by Western blot.Results Compared with the normal group,the content of ALT and AST in serum and the mRNA levels of IL-6 and TNF-α in liver tissue increased in the model group,and the changes were reversed in the ATPR group.H&E staining showed that the hepatic lobule structure was normal in the normal group,the hepatic cords were arranged radially,there was no hyperemia and inflammatory cell infiltra-tion,and the hepatocyte boundary was clear.In the model group,the intercellular space of liver was enlarged,the arrangement of hepatic cords was disordered,and inflammatory cells infiltrated.In the ATPR group,the intercellu-lar space of liver and the structure of hepatic cords were restored,and the inflammatory cell infiltration was less.TEM showed that the damaged mitochondria and lipid droplet accumulation in the hepatocytes of mice in the model group were compared with that in the normal group,and the morphology and quantity of mitochondria and lipid droplet in the hepatocytes of mice in the ATPR group tended to be normal.Western blot showed that compared with the normal group,the expression of FUNDC1 protein in the liver tissues of mice in the model group increased,the expression of OPA1 protein decreased,the ratio of LC3B Ⅱ to LC3B Ⅰ decreased,the expression of P62 protein in-creased,the expression of Beclin1 and ATG5 protein decreased,and the above changes were reversed in the ATPR group.Conclusion ATPR alleviates acute liver injury induced by lipopolysaccharide in mice by promoting autoph-agy.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

Objective:To investigate the clinical effects of a single lateral-rectus approach (LRA) in the Ti-Robot-assisted treatment of acetabular fractures involving the posterior column.Methods:A retrospective study was conducted to analyze the clinical data of 16 patients with acetabular fracture who had been admitted to Department of Trauma Orthopedics, Taihe Hospital from August 2021 to March 2023. There were 13 males and 3 females with a mean age of 51.5 (35.8, 56.8) years. By the Judet-Letournel classification, there were 4 anterior and posterior semi-transverse fractures, 2 T-shaped fractures, and 10 double-column fractures. The time from injury to operation was 6.0 (5.3, 7.8) d. All their acetabular fractures involving the posterior column were treated by a single LRA with the assistance of a Ti-Robot. Operation time, blood loss, complications, quality of fracture reduction, modified Merle d'Aubigné & Postel scores and acetabular recovery at the last follow-up were recorded.Results:In this cohort, the operation time was (4.1±0.6) h and the blood loss 400 (300, 575) mL. By the Matta evaluation, the fracture reduction was excellent in 10 cases, good in 5 cases, and poor in 1 case. The follow-up time was (11.3±3.9) months. Bone union was achieved in all fractures after 3.0 (2.3, 4.0) months. By the modified Merle d'Aubigné & Postel scores at the last follow-up, 9 cases were excellent, 6 cases were good and 1 case was fair. Injury to the lateral femoral cutaneous nerve occurred in 1 patient, and deep venous thrombosis in 6 patients. Follow-ups revealed no iatrogenic vascular injury, loosening or rupture of internal fixation, or incision infection.Conclusion:A single LRA approach can be used in the minimally invasive treatment assisted by a Ti-Robot for acetabular fractures involving the posterior column, demonstrating advantages of minimal invasion, high reduction quality and good functional recovery of the hip joint.

Objective : To investigate the effect and mechanism of all-trans retinoic acid (ATRA) on lipopolysaccharide (LPS) -induced acute myocardial injury in C57BL/6 mice． Methods : Male mice of C57BL/6 strain were randomly divided into normal group，model group，ATRA group，and ferrostatin-1 group．Mice in the ATRA group were injected intraperitoneally with ATRA 15mg / (kg · d) ，ferrostatin-1 group received ferrostatin-1 2 mg / ( kg · d) ，the normal group and the model group were given solvent．After one week of continuous administration，the model group，ATRA group ，and ferrostatin-1 group were intraperitoneally injected with LPS 6 mg / kg． All mice were sacrificed after 6 hours．The contents of malondialdehyde ( MDA) and glutathione ( GSH) in serum of mice were detected． qPCR was used to detect mRNA levels of interleukin-6 ( IL-6 ) and tumor necrosis factor-alpha (TNF-α) in heart tissue．Hematoxylin-eosin ( HE) staining was used to observe the changes of heart tissue in mice．Transmission electron microscopy (TEM) was used to observe the structure of mouse myocardial mitochondria．Western blot was used to detect the expression of ferroptosis markers glutathione peroxidase 4 ( GPX4) ，ferritin heavy chain 1 ( FTH1 ) ，Solute carrier family 7 member 11 ( SLC7A11 ) ，acyl-CoA synthetase long-chain family member 4 (ACSL4) and related regulatory proteins，Nuclear factor erythroid 2-related factor 2 ( NRF2 ) ，kelchlike ECH-associated protein 1 (KEAP1) . Results: Compared with the normal group，the MDA content in the serum of the model group increased and the GSH content decreased，the above changes were reversed in the ATRA group as well as in the ferrostatin-1 group．Compared with normal group，the mRNA levels of IL-6 and TNF-α in the heart tissue of model group increased steeply，the above changes were relieved in the ATRA group and the ferrostatin-1 group．There was no significant difference in HE staining of myocardial tissue among the groups of mice. Compared with the normal group，myocardial mitochondria in the model group showed the phenomenon of cristaereduction or disappearance under TEM，while myocardial mitochondrial injury was alleviated in the ATRA group and the ferrostatin-1 group．Western blot showed that GPX4，FTH1，SLC7A11，and NRF2 expression were reduced in the myocardial tissue of mice in the model group compared with the normal group，ACSL4 and KEAP1 expression increased．The above changes were reversed in the ATRA group as well as in the ferrostatin-1 group． Conclusion ATRA alleviates lipopolysaccharide-induced acute myocardial injury in mice by inhibiting ferroptosis.

Objective:To explore the effect of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive behavioral therapies (CBT) on the cognitive function and alcohol craving in patients with alcohol dependence.Methods:From March 2019 to September 2021, a total of 150 patients with alcohol dependence were enrolled and randomly divided into rTMS treatment group (rTMS+ sham CBT, n=41), CBT treatment group (CBT+ sham rTMS, n=34), rTMS+ CBT treatment group( n=36) and control group (sham rTMS+ sham CBT, n=39). At baseline (before treatment), 2nd week, 8th week, 12th week and 24th week, alcohol dependence scale (ADS) was used to evaluate the degree of alcohol dependence, the obsessive compulsive drinking scale (OCDS) was used to assess patients' drinking craving, and Montreal cognitive assessment scale (MoCA) was used to assess the overall cognitive level of patients.SPSS 23.0 statistical software was used to compare the differences of ADS, OCDS and MoCA scale scores of the four groups by repeated measure ANOVA and simple effect analysis. Results:(1)The patients in the four groups were evaluated with ADS scale at baseline, 12th week and 24th week respectively.The interaction of group×time( F=1.279, P=0.279) and the main effect of group were not significant ( F=0.882, P=0.454), and the main effect of time was significant ( F=12.925, P<0.001) .Further simple effect analysis showed that the ADS score of rTMS+ CBT group was lower than that of baseline(14.48±5.70, 10.00±6.51) ( P=0.01) at 24th week.(2)Patients in the four groups were assessed with OCDs scale at baseline, 2nd week, 8th week, 12th week and 24th week, and the interaction of group×time was significant ( F=2.015, P=0.042). Further simple effect analysis showed that the OCDs scores of rTMS group and rTMS+ CBT group at each follow-up time node were lower than those at baseline period (all P<0.05). (3)Patients in the four groups were assessed with MoCA scale at baseline, 8th week, 12th week and 24th week, and the interaction of group×time was not significant ( F=1.660, P=0.106), and the main effect of group and the main effect of time were significant ( F=2.964, P=0.038; F=14.239, P<0.001). Further simple effect analysis showed that the score of MoCA scale in CBT group at the 24th week was higher than that at baseline (21.73±5.81, 24.60±3.98)( P=0.029), the score of MoCA scale in rTMS+ CBT group at the 24th week was higher than that at the 8th week (23.50±6.01, 25.95±2.87) ( P=0.006), and the score of MoCA scale in rTMS group at the 12th week was higher than that in control group (22.08±6.64, 26.64±2.46)( P=0.009). Conclusion:rTMS combined with CBT can be effective in improving alcohol craving and cognitive function in patients with alcohol dependence, and has a good long-term effect.

Objective:To investigate the correlation between serum levels of heme oxygenase-1 (HO-1) and lipoxin A4 (LXA4) and diabetic nephropathy, and to analyze the value of HO-1 and LXA4 in the diagnosis of diabetic nephropathy.Methods:A prospective cohort study was conducted in 185 patients with type 2 diabetes admitted to the Department of Endocrinology, Yan'an Hospital Affiliated to Kunming Medical University from January 2016 to January 2020. There were 96 cases with diabetic nephropathy (nephropathy group) and 89 cases without diabetic nephropathy (non nephropathy group). According to the stage of chronic kidney disease,the nephrotic group was divided into three subgroups: stage 1-2 group (31 cases), stage 3-4 group (40 cases) and stage 5 group (25 cases). Another 82 healthy volunteers were selected as the control group.Serum HO-1, LXA4, oxidative stress,inflammatory factors, glucose metabolism and renal function were detected. Pearson analysis of HO-1, LXA4 and oxidative stress, inflammatory factors, glucose metabolism and renal function index correlation, binary logistic regression analysis of diabetic nephropathy factors.Results:The serum HO-1 ((0.60 ± 0.20) μg/L) and LXA4 levels ((435.12 ± 22.42) ng/L) in nephrotic group were lower than those in non nephrotic ((0.72 ± 0.23) μg/L, (498.21 ± 29.48) ng/L)( t=29.351, 24.135, all P<0.05). The serum HO-1 and LXA4 levels in the 5 stage group were lower than those in the 3-4 stage and 1-2 stage group (all P<0.05). The serum HO-1 and LXA4 levels in the 3-4 stage group were lower than those in the 1-2 stage group (all P<0.05). Pearson correlation analysis showed that HO-1 was positively correlated with total antioxidant capacity (T-AOC), superoxide dismutase (SOD) and estimated glomerular filtration rate (EGFR) ( r=0.516, 0.602, 0.617; all P<0.05), and was positively correlated with malondialdehyde (MDA) and homeostasis model insulin resistance (homeostasis model insulin resistance) Model assessment insulin resistance (HOMA-IR), urinary albumin creatinine ratio (UACR) LXA4 was negatively correlated with T-AOC, SOD and EGFR ( r=-0.559, 0.597, 0.637; all P<0.05), and positively correlated with MDA, IL-6, TGF-β1, HOMA-IR and UACR There was a negative correlation ( r=-0.498, -0.623, -0.725; all P<0.05). Binary logistic regression analysis showed that malondialdehyde ( OR=1.587, 95% CI 1.402-1.603, P=0.016), TGF-β1 ( OR=1.679, 95% CI 1.642-1.739, P=0.012), HOMA-IR ( OR=1.699、95% CI 1.534-1.739, P=0.009) were risk factors of diabetic nephropathy (all P<0.05). HO-1 ( OR=0.506, 95% CI 0.423-0.653, P<0.001) and LXA4 ( OR=0.492, 95% CI 0.409-0.535, P<0.001) were protective factors for DN ( P<0.001). After adjusting for MDA, TGF-β1 and HOMA-IR, HO-1 ( OR=0.485, 95% CI:0.402-0.564, P<0.001) and LXA4 ( OR=0.416, 95% CI:0.386-0.475, P<0.001) were still associated with DN. ROC analysis showed that the area under curve (AUC) of HO-1 and LXA4 were 0.820 (95% CI:0.760-0.880, P<0.001) and 0.763 (95% CI:0.691-0.836, P<0.001), respectively. The sensitivity and specificity were 71.88%, 80.90%, 75.00% and 84.27%, respectively. Conclusion:The decrease of serum LXA4 and HO-1 levels is closely related to diabetic nephropathy, which can be used as a biological indicator for the diagnosis of diabetic nephropathy.

Background: Long non-coding RNA (lncRNA) has been regarded as a new tumor biomarker in recent years, but studies on effect of lncRNA in the pathogenesis of colorectal cancer is limited. Aims: To investigate the relationship between the changes of lncRNA and clinicopathologic features, prognosis of colorectal cancer. Methods: LncRNA related to the prognosis of colorectal cancer patients collected from TCGA data were screened by Cox analysis, and the correlation between lncRNA and clinicopathologic features was analyzed. Colorectal cancer cell line stably low-expressed with LINC00327 was constructed. Real-time quantitative PCR was used to detect gene expression, cell proliferation was measured by CCK-8 assay, and cell invasion was determined by Transwell experiment. Results: There were 94 lncRNA that varied in frequency between 5% and 31%, 7 of which with mRNA expression changes (DSCR4A, DSCR8, FAM138F, LINC00161, LINC00303, LINC00313, LINC00315) were associated with low overall survival rate; 6 of which with copy number alteration (LINC00327, LINC00352, LINC00362, LINC00424, LINC00566, LINC00621) were related to tumor recurrence. The above mentioned mRNA expression change was significantly correlated with age and lymph node metastasis. Copy number alteration was closely correlated with clinical stage and vascular infiltration. The down-regulation of LINC00327 could inhibit the proliferation and invasion of tumor cells. Conclusions: LncRNA that related to the prognosis and clinicopathologic features of colorectal cancer patients can be used for early diagnosis, prediction of progression and analysis of prognosis of colorectal cancer. LINC00327 may be considered as a potential oncogene.