AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS...AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS:This postoperative cross-sectional study enrolled patients who underwent phacoemulsification combined with IOL implantation.Patients were divided into two groups:the bilateral ZXR00 group(ZXR00-only group)and the mixed IOL group(ZXR00+ZMB00 group).Primary outcome measures included uncorrected and corrected distance visual acuity(UDVA,CDVA),uncorrected and distance-corrected near visual acuity(UNVA,DCNVA),uncorrected and distance-corrected intermediate visual acuity(UIVA,DCIVA),and defocus curves.Secondary outcome measures were visual quality,spectacle independence,patient satisfaction,photic phenomena,and stereopsis.RESULTS:A total of 47 patients(94 eyes)were included,with 26 patients(11 males,15 females)in the ZXR00-only group(mean age:62.73±7.24y)and 21 patients(7 males,14 females)in the mixed group(mean age:65.71±9.16y).There was no statistically significant difference in age between the two groups(P=0.218).The mixed group showed significantly better binocular DCNVA compared to the ZXR00-only group(P=0.002).Defocus curve analysis revealed that the mixed group exhibited superior performance at−2.5 to−4.0 D but inferior performance at−0.5 and−1.5 D.Near stereoacuity was significantly poorer in the mixed group(Randot:5.589±0.744 vs 6.240±0.394 ln arcsec;Contour:4.966±0.973 vs 5.740±0.833 ln arcsec;both P<0.01).Both groups achieved high levels of spectacle independence and patient satisfaction,with no significant differences in photic phenomena or questionnaire scores.CONCLUSION:Mixed implantation of EDOF and bifocal IOLs improve near visual acuity but may compromise near stereopsis.This approach provides a viable option for patients prioritizing near vision;however,caution is recommended for individuals requiring fine stereoscopic vision for daily or professional tasks.展开更多
Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic ...Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.展开更多
Background The number of transcatheter aortic valve implantation(TAVI)procedures in patients with severe aortic stenosis(AS)is increasing worldwide.We aimed to assess the impact of a TAVI program on clinical profile,m...Background The number of transcatheter aortic valve implantation(TAVI)procedures in patients with severe aortic stenosis(AS)is increasing worldwide.We aimed to assess the impact of a TAVI program on clinical profile,management and outcomes of these patients and to describe predictors of length of hospital stay(LoS)in this context.Methods Retrospective single center study enrolling consecutive AS patients undergoing TAVI and surviving to discharge(January 2018-December 2022).A TAVI program was implemented in may 2021.Baseline clinical characteristics,management and in-hospital complications were registered.Predictors of long hospital stay(>7 day)were assessed by binary logistic regression.Results We included 614 patients,with mean age 80.5 years.Most patients(438/614,71.2%)presented conditions that precluded an early discharge.Mean hospital stay was 7.6 days.Patients admitted after the implementation of the program had a significantly lower burden of comorbidities.The rate of conduction disturbances after TAVI remained stable around 60%.However,permanent pacemaker requirement declined from 30.3%to 22.5%(P=0.028).LoS was reduced after the implementation of the program both in patients suitable for an early discharge(from 6.5 day to 4 day,P<0.001)and unsuitable patients(from 9.4 day to 7.7 day,P=0.014).The final predictive model for LoS included prior pacemaker and availability of TAVI program as protectors and other valvular diseases,day of the week,emergent procedures,and conduction disturbances and other complications as independent predictors of long stay after TAVI.Conclusions Most patients undergoing TAVI present conditions that preclude an early hospital discharge.The implementation of a TAVI program improved selection of patients,with a lower burden of comorbidities,a lower rate of complications and a marked reduction of hospital stay.展开更多
Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAV...Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAVI).Their efforts underscore the growing importance of frailty assessment in cardiovascular risk stratification.We would like to respectfully highlight several areas that,if addressed in future studies(Figure 1),could further enhance the utility and inclusivity of these assessments.展开更多
To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elas...To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elastic modulus(EM),degradation rate and in vitro cell experiments of the modified WE43 alloys were systematically studied.A modified layer composed of Mg,MgO,the implanted elements and their oxides was formed on the modified alloys.Since high-speed metal ions caused severe surface lattice damage,the surface hardness of the substrate considerable increased.Electrochemical tests demonstrated a substantial enhancement in the corrosion resistance of the modified alloys via the implantation of Ti and Zr ions,resulting in a reduction of the corrosion current density to 88.1±9.9 and 15.6±11.4μA cm^(−2),respectively,compared with the implantation of Fe and Zn ions.Biocompatibility tests showed that the implantation of Fe,Ti,Zn and Zr ions enhanced the anticoagulant and hemolytic resistance of the WE43 alloy.All surface-modified samples showed negligible cytotoxicity(0-1)at 12.5%extract concentration.Moreover,the alloys implanted with Fe,Ti and Zn ions significantly promoted proliferation of human umbilical vein endothelial cells(HUVEC)compared with the unmodified alloy.The results demonstrate that Ti ion implantation is the best choice for WE43 alloy modification to achieve outstanding corrosion resistance and biocompatibility.展开更多
Background Increased backfat thickness of sows in early gestation is negative to reproductive performance.Endometrial receptivity is an important determinant of reproductive success,but it is unclear whether the effec...Background Increased backfat thickness of sows in early gestation is negative to reproductive performance.Endometrial receptivity is an important determinant of reproductive success,but it is unclear whether the effect of sow backfat thickness on litter size is associated with endometrial receptivity and whether melatonin treatment may have benefits.The present study seeks to answer these questions through in vitro and in vivo investigations.Results Excessive lipid deposition and lower melatonin levels in the uterus are detrimental to endometrial receptivity and embryo implantation in high backfat thickness sows.In cells treated with melatonin,the MT2/PI3K/LIF axis played a role in reducing lipid accumulation in porcine endometrial epithelium cells and improved endometrial receptivity.Furthermore,we found a reduction of lipids in the uterus after eight weeks of intraperitoneal administration of melatonin to HFD mice.Notably,melatonin treatment caused a significant reduction in the deposition of endometrial collagen,an increase in the number of glands,and repair of the pinopode structure,ultimately improving endometrial receptivity,promoting embryo implantation,and increasing the number of litter size of mice.Conclusions Collectively,the finding reveals the harmful effects of high backfat thickness sows on embryo implantation and highlight the role of melatonin and the MT2/PI3K/LIF axis in improving endometrial receptivity by enhancing metabolism and reducing the levels of uterine lipids in obese animals.展开更多
Background Embryo implantation in early gestation is crucial for reproductive success,while dietary fiber plays a key role in regulating sow fertility.However,the underlying mechanisms remain unclear.This study explor...Background Embryo implantation in early gestation is crucial for reproductive success,while dietary fiber plays a key role in regulating sow fertility.However,the underlying mechanisms remain unclear.This study explores the influence of dietary inulin on embryonic implantation using a sow model.Sows were fed a diet supplemented with 11 g/kg of inulin during early gestation and were slaughtered on gestation day 19(G19).Uterine fluid exosomes(UFEs)and endometrial tissues were collected for high-throughput sequencing and for analysis of the expression of angiogenesis-related genes and proteins,respectively.Furthermore,UFEs obtained from slaughtered sows were injected into G19 sows to investigate the effects on reproduction and angiogenesis.Results The results showed that inulin significantly increased the number of blood vessels in the endometrium and expression of the angiogenesis-related proteins MMP2 and ANGPT1 in G19 sows(P<0.05).Bioinformatics analysis revealed that inulin significantly downregulated miRNAs associated with angiogenesis inhibition in UFEs,while upregulating miRNAs related to trophoblast physiological activities and regulation of the uterine fluid microenvironment(P<0.05).Furthermore,intravenous injection of G19 sows with UFEs from sows fed a diet containing inulin had significantly promoted vascular formation in the endometrium and embryos,and increased the number of live embryos on gestation day 28(G28)(P<0.05).Additionally,the mRNA expression levels of MMP2,ANGPT1,and VEGF in the placentas of sows were significantly elevated on G28 and at farrowing in the UFEs injection group(P<0.05).Conclusion Dietary supplementation with inulin during early gestation in sows promoted embryo implantation by regulating angiogenesis at the maternal–fetal interface through the modulation of miRNA expression in UFEs.These findings provide a theoretical reference for the application of dietary fiber in sow nutrition.展开更多
Silicon Carbide (SiC) wafers have been widely used in micro- and nano-devices due to their excellent optical and material properties. However, polishing SiC wafers has been challenging and inefficient, tending to caus...Silicon Carbide (SiC) wafers have been widely used in micro- and nano-devices due to their excellent optical and material properties. However, polishing SiC wafers has been challenging and inefficient, tending to cause significant surface crack and subsurface damage. This work proposed modifying SiC surface properties by ion implantation to improve machining efficiency, suppress surface crack, and reduce damage. High-energy ion implantation disrupted the SiC crystal lattice, reducing hardness and elastic modulus while increasing brittle-ductile transition depth, thus changing the removal mode from brittle fracture to plastic removal. Theoretical models of material removal rate and surface roughness were established for abrasive polishing of the SiC wafers. Polishing experiments were conducted on ion-implanted, modified SiC samples. The improvement mechanisms of ion implantation on surface damage, removal rate, morphology, and residual stress were investigated. The effect of ion implantation on the polished surface quality of SiC was investigated through orthogonal experiments. The results showed that ion implantation can significantly improve the average material removal rate of the SiC samples. Additionally, the ion-implanted samples had exhibited remarkable reductions in surface roughness, surface damage, and tensile residual stress.展开更多
Infective endocarditis(IE) remains a severe and life-t hreatening disease, with rising incidence and a particularly high mortality rate, especially among elderly patients.^([1]) While antibiotics are the mainstay of t...Infective endocarditis(IE) remains a severe and life-t hreatening disease, with rising incidence and a particularly high mortality rate, especially among elderly patients.^([1]) While antibiotics are the mainstay of treatment, the success rate in left-sided IE is often limited,as nearly half of all patients eventually require surgical intervention for definitive management.^([2]) Heart failure is the main indication for surgery, but access to surgery is frequently restricted by several factors, particularly in patients with advanced age, often driven by the presence of comorbidities or hemodynamic instability.^([3,4])展开更多
Ion implantation technology is a crucial strategy for modulating the degradation behavior of biomedical magnesium alloys.In this study,Ag,Ti,and Zr ions were implanted into the surface of pure Mg at varying doses to i...Ion implantation technology is a crucial strategy for modulating the degradation behavior of biomedical magnesium alloys.In this study,Ag,Ti,and Zr ions were implanted into the surface of pure Mg at varying doses to investigate their effects on the microstructure and properties of pure Mg.The results revealed that differences in the affinities of Mg and the implanted elements for reacting with oxygen led to the formation of implanted layers with distinct compositions and structures.Specifically,Ag ion implantation resulted in a layer predominantly composed of elemental silver,while Ti and Zr ion implantation promoted the formation of a denser layer containing Mg,MgO,the implanted elements,and their respective oxides.This layer significantly enhanced the corrosion resistance of pure Mg by reducing its susceptibility to corrosive media.Electrochemical assessments showed a substantial reduction in corrosion current density following Ti and Zr ion implantation.However,increasing doses of Ag ions induced heightened susceptibility to galvanic corrosion due to the electrode potential differences between Ag and Mg,thereby accelerating the degradation of the pure Mg substrate.Additionally,first-principles calculations of the work functions for both the (0001) basal plane and the(101 0) prism plane of Mg corroborated the observed electrochemical trends.展开更多
Objective:To assess the effectiveness of machine learning in automating the prediction of vestibular abnormalities after cochlear implantation(CI)in patients with sensorineural hearing loss(SNHL),with the goal of deve...Objective:To assess the effectiveness of machine learning in automating the prediction of vestibular abnormalities after cochlear implantation(CI)in patients with sensorineural hearing loss(SNHL),with the goal of developing a practical model that can accurately predict long-term vestibular function outcomes and identify associated risk factors.Methods:Clinical data,including imaging,vestibular evoked myogenic potentials(VEMPs),and auditory information,were collected from patients with sensorineural hearing loss(SNHL)before and after CI.The decision tree algorithm was employed to address missing values and screen pre-CI clinical features.Six machine learning methods were subsequently utilized to predict the relationships between the extracted features and post-CI vestibular dysfunction.The best-performing method determined the ranking of feature importance,which was regarded as risk factors for predicting symptoms and VEMPs results after CI.Results:Logistic regression models effectively predicted both post-CI vestibular dysfunction and abnormal cervical VEMP(c VEMP),with accuracies of 80%and 78%,respectively.The relative importance of the features,in descending order,was as follows:c VEMP latency,c VEMP amplitude,and residual hearing threshold.Moreover,the support vector machine(SVM)model attained an accuracy of 88%in predicting abnormal ocular VEMP(o VEMP)post-CI.For the SVM model,the feature importance ranking was as follows:o VEMP latency,o VEMP amplitude,and residual hearing threshold.Conclusions:This study successfully leverages machine learning techniques,specifically support vector machines(SVM)and logistic regression models,to predict the impact of CI on vestibular function.These predictive models provide valuable insights for presurgical planning and decision-making in CI procedures.Moreover,the findings highlight the critical risk factors associated with vestibular dysfunction,offering a robust reference for guiding vestibular rehabilitation strategies.展开更多
Objective:The etiology and pathogenesis of recurrent implantation failure(RIF)remain unclear.This study aimed to delineate the immune landscape and identify the pivotal biomarkers of immune dysregulation in RIF.Method...Objective:The etiology and pathogenesis of recurrent implantation failure(RIF)remain unclear.This study aimed to delineate the immune landscape and identify the pivotal biomarkers of immune dysregulation in RIF.Methods:Comprehensive bioinformatics analyses,including differential expression,functional enrichment,gene set enrichment,weighted gene co-expression network analysis,protein-protein interaction network,and machine learning analyses,were conducted to explore the immunological underpinnings of RIF.Results:Our findings demonstrated a significant downregulation in the expression of several immune-related gene sets in the RIF cohort,including those related to antigen processing and presentation,antimicrobial responses,chemokines and their receptors,cytokines,and natural killer cell cytotoxicity.These results provide evidence of a significant association between RIF and maternal-fetal immune dysregulation.Three signature genes(ANK3,PTGS2,andSLC39A2)were identified using various machine-learning methods.The diagnostic value and immunological relevance of these genes were confirmed in both discovery and validation cohorts.Conclusion:This study investigated the immune landscape of RIF using extensive bioinformatic analyses.Modular genes associated with both immune activity and RIF dysregulation were identified,providing new perspectives for understanding the pathophysiology and treatment of RIF.展开更多
Background:Recurrent implantation failure(RIF)is a difficult problem with a multifaceted cause.Recent studies have demonstrated that stimulator of interferon genes-induced immune-related genes(STIRGs)are associated wi...Background:Recurrent implantation failure(RIF)is a difficult problem with a multifaceted cause.Recent studies have demonstrated that stimulator of interferon genes-induced immune-related genes(STIRGs)are associated with immune disorders that may affect the endometrial immune micro-environment.However,the effect of STRIGs on RIF remains unknown.Methods:Training(GSE111974)and validation(GSE106602)cohorts were acquired from the Gene Expression Omnibus database.STIRGs were extracted from the Molecular Signatures Database and relevant studies.Consensus clustering analysis was used to identify RIF molecular subtypes.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment and immune infiltration analyses were performed between RIF subtypes.Drug-related potential therapeutic target genes were discovered.Results:Two distinct molecular subtypes were discovered in both the training and validation groups according to STIRGs.In subtype C2,there was a notable decrease in the presence of different types of immune cells,such as natural killer cells and macrophages.Furthermore,the examination of Gene Ontology and Kyoto Encyclopedia of Genes and Genomes indicated a decrease in numerous immune-related biological processes within subtype C2.Finally,nine hub genes(CXCR4,POU5F1,PPARG,TLR2,EGFR,CSF1,BCL2A1,BTK,and SRGN)were identified as potential therapeutic targets for RIF.Conclusion:Based on STIRGs,we identified a new molecular subtype with significantly reduced immune infiltration in RIF.Nine genes might be potential therapeutic targets for RIF.展开更多
To enhance the corrosion resistance and electrical conductivity, the surface of 316L stainless steel was modified by the ion implantation of Mo. By investigating various accelerating voltages and implantation doses, i...To enhance the corrosion resistance and electrical conductivity, the surface of 316L stainless steel was modified by the ion implantation of Mo. By investigating various accelerating voltages and implantation doses, it was found that the corrosion resistance of stainless steel was enhanced by 50%-80% and the surface conductivity by 15%-28% at most. The minimum stabilized current density is 0.72 μA/cm^(2). This is due to the formation of a Cr and Mo riched modified layer on the surface of the stainless steel. Mo oxides synergize with Cr oxides in the form of a solid solution to enhance the corrosion resistance of passivation films on the stainless steel surface. The optimum parameters were Cr in the proportion of 6%-8% and Mo in the proportion of 4%-5%.展开更多
BACKGROUND Despite advances in the use of in vitro fertilization-embryo transfer(ET)in couples with infertility,recurrent implantation failure(RIF)after ET is still a major problem affecting women,with great psycholog...BACKGROUND Despite advances in the use of in vitro fertilization-embryo transfer(ET)in couples with infertility,recurrent implantation failure(RIF)after ET is still a major problem affecting women,with great psychological and economic burdens for the patient and his/her family.AIM To investigate the psychological burden(anxiety and depression)and evaluate the clinical benefits of endometrial receptivity testing(ERT)in patients experiencing RIF following frozen-thawed ET.METHODS A retrospective cohort study analyzed 371 patients experiencing RIF after assisted reproductive treatment at the First People’s Hospital of Changde City between January 2021 and June 2024.Demographic and clinical data were systematically collected through standardized questionnaires.Psychological assessment utilized validated instruments:The Self-Rating Depression Scale for depression evaluation and the Self-Rating Anxiety Scale for anxiety assessment.Participants were stratified by psychological status(anxiety/non-anxiety and depression/nondepression)to analyze influencing factors for anxiety and depression.The cohort was further categorized into the ERT and non-ERT groups based on ERT implementation to comparatively analyze their clinical outcomes.Additionally,they were divided into clinical and nonclinical pregnancy groups to identify factors affecting clinical pregnancy using univariate and multivariate logistic regression models.Compared with the non-ERT group,the 226 patients who underwent ERT-guided ET achieved a higher clinical pregnancy rate,thicker endometrium on transfer day,fewer embryos transferred,and a lower miscarriage rate.RESULTS The study identified a substantial psychological burden,with anxiety prevalence at 55.0%(mean Self-Rating Anxiety Scale score,50.89±9.34)and depression at 61.2%(mean Self-Rating Depression Scale score,55.55±9.48).Multivariate analysis identified annual household income>100000 yuan as protective factors against both anxiety and depression,whereas advanced maternal age(>35 years)and multiple implantation failures(≥3)served as risk factors.Additionally,anxiety-specific risk factors included prolonged infertility treatment(>5 years)and the spouse’s status as an only child.As to depression-specific risks,chronic infertility(>3 years)and higher educational attainment(college/bachelor’s degree or higher)were key determinants,whereas urban residence was a protective factor.Age>35 years was a risk factor for clinical pregnancy in patients experiencing RIF,whereas blastocyst-stage ET,a higher number of embryos transferred,and thicker endometrium were protective factors.CONCLUSION Patients experiencing RIF are particularly susceptible to anxiety and depression,and advanced maternal age and multiple implantation failures represent salient risk factors.Clinicians should implement proactive and evidencebased interventions to mitigate these psychological burdens.For patients experiencing RIF,ERT-guided ET demonstrates significant potential to improve assisted reproductive outcomes.展开更多
PurposeThe study aimed to investigate the otology-specific and general health-related quality of life(HRQoL)after cochlear implantation,and scrutinize the variables associated with them.MethodsThe Ear Outcome Survey-1...PurposeThe study aimed to investigate the otology-specific and general health-related quality of life(HRQoL)after cochlear implantation,and scrutinize the variables associated with them.MethodsThe Ear Outcome Survey-16(EOS-16),which assesses ear-specific symptoms and quality of life(QoL),was administered before and after cochlear implantation along with the post-operative administration of the 15D questionnaire that evaluates general HRQoL.The authors investigated post-implantation changes in the EOS-16 total scores and its category responses,examining their relationship with pre-and post-operative hearing levels,speech perception in noise,and the follow-up period length(time elapsed since cochlear implantation).ResultsThere were positive changes noted for the hearing,need for care,and QoL categories of the EOS-16 after implantation.The length of the follow-up period was a significant factor associated with improvements in subjective outcome measures.Changes in self-perceived hearing and HRQoL post-implantation seem independent of pre-and post-implantation hearing performance.ConclusionThese results suggest that while patients regain their hearing abilities shortly after implant activation,their subjective hearing-related benefits and QoL improve over time.展开更多
BACKGROUND Hemorrhage following pancreaticobiliary surgery is a high-risk complication,with a mortality rate of 16%-38%.At present,minimally invasive endovascular intervention comprising superselective arterial emboli...BACKGROUND Hemorrhage following pancreaticobiliary surgery is a high-risk complication,with a mortality rate of 16%-38%.At present,minimally invasive endovascular intervention comprising superselective arterial embolization(SAE)and covered stent implantation(CSI)is the treatment of choice.However,in certain cases,both SAE and CSI become infeasible.AIM To evaluate the effectiveness of coil-assisted N-butyl cyanoacrylate(NBCA)embolization in comparison with that of CSI in managing delayed hemorrhage after hepatobiliary–pancreatic surgery when SAE is infeasible.METHODS Ninety-eight continuous patients(n=105 cases;mean age,58.4 years)with delayed massive hemorrhage who were treated with coil-assisted NBCA embolization(NBCA group,n=45)and/or CSI(CSI group,n=60)were retrospectively evaluated between March 2014 and December 2023.Data on technical and clinical success,30-day mortality,and severe intervention-related adverse events were collected and analyzed.RESULTS The technical and clinical success rates in the NBCA group(100%and 93.3%,respectively)were significantly higher than those in the CSI group(88.3%and 73.3%,respectively),with a statistically significant difference between the two groups(P=0.019 and 0.010,respectively).The 30-day mortality rates and major intervention-related complications were 17.8%and 0%,respectively,in the NBCA group and 18.3%and 1.7%in the CSI group,respectively,with no statistically significant difference between the two groups.CONCLUSION In terms of technical and clinical success,coil-assisted NBCA embolization was more effective than CSI for managing delayed hemorrhage after hepatobiliary–pancreatic surgery when SAE was not feasible.展开更多
Integrating the magneto-optical effect into a waveguide-based photonic device becomes more and more interesting.In the work,the planar optical waveguide firstly was prepared in a terbium gallium garnet crystal(TGG)via...Integrating the magneto-optical effect into a waveguide-based photonic device becomes more and more interesting.In the work,the planar optical waveguide firstly was prepared in a terbium gallium garnet crystal(TGG)via the proton implantation with the energy of 4×10^(-1)MeV and the fluence of 6×10^(8)ions/μm^(2).Subsequently,a femtosecond laser with a central wavelength of 800 nm and a power of 3 mW was used to ablate the surface of the planar waveguide,forming the ridge optical waveguide.The dark-mode curve of the planar waveguide was measured by a prism coupling technique.The top-view morphology of the ridge waveguide was observed via a Nikon microscope.The mode field distributions of the planar and ridge waveguides were obtained by an end-face coupling system,and the propagation losses of the two waveguides were measured to be 2.26 dB/cm and 2.58 dB/cm,respectively.The Verdet constants were measured to be-72.7°/T·cm for the TGG substrate and-60.7°/T·cm for the ridge waveguide.The TGG waveguides have a potential in the fabrication of magneto-optical waveguide devices.展开更多
AIM:To present a case series of rapid-onset neovascular glaucoma(NVG)accompanied by vitreous haemorrhage(VH)following cataract surgery in diabetic patients,and to evaluate the efficacy of pars plana vitrectomy(PPV)com...AIM:To present a case series of rapid-onset neovascular glaucoma(NVG)accompanied by vitreous haemorrhage(VH)following cataract surgery in diabetic patients,and to evaluate the efficacy of pars plana vitrectomy(PPV)combined with Ahmed glaucoma valve(AGV)implantation.METHODS:This is a retrospective,single-center,consecutive case series.All patients underwent 23-gauge PPV with AGV implantation 2–3d after intravitreal ranibizumab injection(IVR).The minimum postoperative follow-up period lasted 12mo.The primary outcome measures included bestcorrected visual acuity(BCVA),intraocular pressure(IOP),and topical hypotensive medications.RESULTS:Fifteen diabetic patients(age,46–81y)with rapid-onset NVG and VH following uncomplicated phacoemulsification were included.The median time to the initial NVG diagnosis following cataract surgery was within 4wk.After PPV combined with AGV implantation,the mean BCVA(logMAR)improved from 1.9(range:1.0 to 2.6)preoperatively to 1.2(range:0.2 to 2.6)at the final follow-up.Baseline BCVA and the presence of diabetic nephropathy(DN)were significantly associated with the final BCVA in the multiple regression model.The mean postoperative IOP at all follow-up visits was significantly reduced compared to baseline.At the final follow-up,9 patients required one or two topical ocular hypotensive medications,while the other 6 needed not.Success was achieved in 87%,and the reoperation rate was 20%.The majority of NVG cases(9/15)were primarily attributed to the rapid progression of proliferative diabetic retinopathy.However,a notable subset(6 eyes)was complicated retinal vein occlusion or carotid artery occlusion.CONCLUSION:PPV combined with AGV implantation after adjuvant IVR for rapid-onset NVG with VH following diabetic cataract surgery is one of the safe and effective treatments.Baseline BCVA and preexisting DN may be potential indicators for visual outcomes.展开更多
BACKGROUND Phakic intraocular lens(IOL)implantation is a common treatment for high myopia.However,pre-and postoperative psychological changes,particularly anxiety and depression,are noteworthy concerns.Multiple studie...BACKGROUND Phakic intraocular lens(IOL)implantation is a common treatment for high myopia.However,pre-and postoperative psychological changes,particularly anxiety and depression,are noteworthy concerns.Multiple studies have indicated a close relationship between ophthalmic diseases,including high myopia,glaucoma,anxiety,and depression.AIM To evaluate the impact of phakic IOL implantation on anxiety and depression in patients with high myopia.METHODS Data from 136 patients with high myopia,who underwent phakic IOL implantation at the authors’hospital between June 2024 and December 2024,were retrospectively analyzed.Clinical data were collected from the hospital’s electronic medical records system.Preoperative and one-month postoperative data were compared.Anxiety,depression,sleep quality,and quality of life were evaluated using the Hamilton anxiety scale,Hamilton depression scale,Pittsburgh Sleep Quality Index,and 36-item Short Form Health Survey,respectively.RESULTS Of 136 patients,67.65%(n=92)were female and 32.35%(n=44)were male,with a mean±SD age of 28.02±5.72 years.The mean uncorrected visual acuity before and 1 month after treatment was 1.83±0.24 log minimum angle of resolution(MAR)and 0.03±0.07 log MAR,respectively.The mean best corrected visual acuity before and 1 month after treatment was 0.04±0.07 log MAR and 0.01±0.02 log MAR,respectively.All differences were statistically significant(P<0.05).Compared with pretreatment,Hamilton anxiety scale and Hamilton depression scale scores significantly decreased 1 month post-treatment(P<0.05).Furthermore,the Pittsburgh Sleep Quality Index score was significantly lower after than that before treatment(P<0.05).The 36-item Short Form Health Survey quality of life score significantly improved after treatment(P<0.05).CONCLUSION Phakic IOL implantation significantly reduces anxiety and depression and improves sleep quality and quality of life in patients with high myopia.This study provides new concepts for treating high myopia.展开更多
文摘AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS:This postoperative cross-sectional study enrolled patients who underwent phacoemulsification combined with IOL implantation.Patients were divided into two groups:the bilateral ZXR00 group(ZXR00-only group)and the mixed IOL group(ZXR00+ZMB00 group).Primary outcome measures included uncorrected and corrected distance visual acuity(UDVA,CDVA),uncorrected and distance-corrected near visual acuity(UNVA,DCNVA),uncorrected and distance-corrected intermediate visual acuity(UIVA,DCIVA),and defocus curves.Secondary outcome measures were visual quality,spectacle independence,patient satisfaction,photic phenomena,and stereopsis.RESULTS:A total of 47 patients(94 eyes)were included,with 26 patients(11 males,15 females)in the ZXR00-only group(mean age:62.73±7.24y)and 21 patients(7 males,14 females)in the mixed group(mean age:65.71±9.16y).There was no statistically significant difference in age between the two groups(P=0.218).The mixed group showed significantly better binocular DCNVA compared to the ZXR00-only group(P=0.002).Defocus curve analysis revealed that the mixed group exhibited superior performance at−2.5 to−4.0 D but inferior performance at−0.5 and−1.5 D.Near stereoacuity was significantly poorer in the mixed group(Randot:5.589±0.744 vs 6.240±0.394 ln arcsec;Contour:4.966±0.973 vs 5.740±0.833 ln arcsec;both P<0.01).Both groups achieved high levels of spectacle independence and patient satisfaction,with no significant differences in photic phenomena or questionnaire scores.CONCLUSION:Mixed implantation of EDOF and bifocal IOLs improve near visual acuity but may compromise near stereopsis.This approach provides a viable option for patients prioritizing near vision;however,caution is recommended for individuals requiring fine stereoscopic vision for daily or professional tasks.
文摘Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.
文摘Background The number of transcatheter aortic valve implantation(TAVI)procedures in patients with severe aortic stenosis(AS)is increasing worldwide.We aimed to assess the impact of a TAVI program on clinical profile,management and outcomes of these patients and to describe predictors of length of hospital stay(LoS)in this context.Methods Retrospective single center study enrolling consecutive AS patients undergoing TAVI and surviving to discharge(January 2018-December 2022).A TAVI program was implemented in may 2021.Baseline clinical characteristics,management and in-hospital complications were registered.Predictors of long hospital stay(>7 day)were assessed by binary logistic regression.Results We included 614 patients,with mean age 80.5 years.Most patients(438/614,71.2%)presented conditions that precluded an early discharge.Mean hospital stay was 7.6 days.Patients admitted after the implementation of the program had a significantly lower burden of comorbidities.The rate of conduction disturbances after TAVI remained stable around 60%.However,permanent pacemaker requirement declined from 30.3%to 22.5%(P=0.028).LoS was reduced after the implementation of the program both in patients suitable for an early discharge(from 6.5 day to 4 day,P<0.001)and unsuitable patients(from 9.4 day to 7.7 day,P=0.014).The final predictive model for LoS included prior pacemaker and availability of TAVI program as protectors and other valvular diseases,day of the week,emergent procedures,and conduction disturbances and other complications as independent predictors of long stay after TAVI.Conclusions Most patients undergoing TAVI present conditions that preclude an early hospital discharge.The implementation of a TAVI program improved selection of patients,with a lower burden of comorbidities,a lower rate of complications and a marked reduction of hospital stay.
文摘Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAVI).Their efforts underscore the growing importance of frailty assessment in cardiovascular risk stratification.We would like to respectfully highlight several areas that,if addressed in future studies(Figure 1),could further enhance the utility and inclusivity of these assessments.
基金supported by National Natural Science Foundation of China(52271117)Educational Commission of Hunan Province of China(23A0107)High Technology Research and Development Program of Hunan Province of China(2022GK4038).
文摘To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elastic modulus(EM),degradation rate and in vitro cell experiments of the modified WE43 alloys were systematically studied.A modified layer composed of Mg,MgO,the implanted elements and their oxides was formed on the modified alloys.Since high-speed metal ions caused severe surface lattice damage,the surface hardness of the substrate considerable increased.Electrochemical tests demonstrated a substantial enhancement in the corrosion resistance of the modified alloys via the implantation of Ti and Zr ions,resulting in a reduction of the corrosion current density to 88.1±9.9 and 15.6±11.4μA cm^(−2),respectively,compared with the implantation of Fe and Zn ions.Biocompatibility tests showed that the implantation of Fe,Ti,Zn and Zr ions enhanced the anticoagulant and hemolytic resistance of the WE43 alloy.All surface-modified samples showed negligible cytotoxicity(0-1)at 12.5%extract concentration.Moreover,the alloys implanted with Fe,Ti and Zn ions significantly promoted proliferation of human umbilical vein endothelial cells(HUVEC)compared with the unmodified alloy.The results demonstrate that Ti ion implantation is the best choice for WE43 alloy modification to achieve outstanding corrosion resistance and biocompatibility.
基金supported by the China Agriculture Research System(CARS-35-PIG)the National Natural Science Foundation of China(32272847,U22A20516)+1 种基金the National Key Research and Development Program of China(No.2021YFF1000602)the Key Research and Development Program of Shaanxi Province(No.2022ZDLNY01–04)。
文摘Background Increased backfat thickness of sows in early gestation is negative to reproductive performance.Endometrial receptivity is an important determinant of reproductive success,but it is unclear whether the effect of sow backfat thickness on litter size is associated with endometrial receptivity and whether melatonin treatment may have benefits.The present study seeks to answer these questions through in vitro and in vivo investigations.Results Excessive lipid deposition and lower melatonin levels in the uterus are detrimental to endometrial receptivity and embryo implantation in high backfat thickness sows.In cells treated with melatonin,the MT2/PI3K/LIF axis played a role in reducing lipid accumulation in porcine endometrial epithelium cells and improved endometrial receptivity.Furthermore,we found a reduction of lipids in the uterus after eight weeks of intraperitoneal administration of melatonin to HFD mice.Notably,melatonin treatment caused a significant reduction in the deposition of endometrial collagen,an increase in the number of glands,and repair of the pinopode structure,ultimately improving endometrial receptivity,promoting embryo implantation,and increasing the number of litter size of mice.Conclusions Collectively,the finding reveals the harmful effects of high backfat thickness sows on embryo implantation and highlight the role of melatonin and the MT2/PI3K/LIF axis in improving endometrial receptivity by enhancing metabolism and reducing the levels of uterine lipids in obese animals.
基金supported by the National Natural Science Foundation of China (32102554)Sichuan Province “145” Breeding Tackle Project (2021YFYZ0008)China Agriculture Research System (CARS-35).
文摘Background Embryo implantation in early gestation is crucial for reproductive success,while dietary fiber plays a key role in regulating sow fertility.However,the underlying mechanisms remain unclear.This study explores the influence of dietary inulin on embryonic implantation using a sow model.Sows were fed a diet supplemented with 11 g/kg of inulin during early gestation and were slaughtered on gestation day 19(G19).Uterine fluid exosomes(UFEs)and endometrial tissues were collected for high-throughput sequencing and for analysis of the expression of angiogenesis-related genes and proteins,respectively.Furthermore,UFEs obtained from slaughtered sows were injected into G19 sows to investigate the effects on reproduction and angiogenesis.Results The results showed that inulin significantly increased the number of blood vessels in the endometrium and expression of the angiogenesis-related proteins MMP2 and ANGPT1 in G19 sows(P<0.05).Bioinformatics analysis revealed that inulin significantly downregulated miRNAs associated with angiogenesis inhibition in UFEs,while upregulating miRNAs related to trophoblast physiological activities and regulation of the uterine fluid microenvironment(P<0.05).Furthermore,intravenous injection of G19 sows with UFEs from sows fed a diet containing inulin had significantly promoted vascular formation in the endometrium and embryos,and increased the number of live embryos on gestation day 28(G28)(P<0.05).Additionally,the mRNA expression levels of MMP2,ANGPT1,and VEGF in the placentas of sows were significantly elevated on G28 and at farrowing in the UFEs injection group(P<0.05).Conclusion Dietary supplementation with inulin during early gestation in sows promoted embryo implantation by regulating angiogenesis at the maternal–fetal interface through the modulation of miRNA expression in UFEs.These findings provide a theoretical reference for the application of dietary fiber in sow nutrition.
基金support from the China Postdoctoral Science Foundation(No.2023M742735)the Postdoctoral Fellowship Program of CPSF,China(No.GZC20232029)+5 种基金the National Natural Science Foundation of China(No.52475530)the Shaanxi Postdoctoral Science Foundation,China(No.2023BSHEDZZ175)the Innovation Capability Support Program of Shaanxi Province,China(No.2021TD-23)the Key Industrial Chain Core Technology Research Project in Xi’an,China(No.23LLRH0029)the Natural Science Basic Research Program of Shaanxi,China(No.2024JC-YBQN-0490)the Fundamental Research Funds for the Central Universities,China(No.ZYTS24023).
文摘Silicon Carbide (SiC) wafers have been widely used in micro- and nano-devices due to their excellent optical and material properties. However, polishing SiC wafers has been challenging and inefficient, tending to cause significant surface crack and subsurface damage. This work proposed modifying SiC surface properties by ion implantation to improve machining efficiency, suppress surface crack, and reduce damage. High-energy ion implantation disrupted the SiC crystal lattice, reducing hardness and elastic modulus while increasing brittle-ductile transition depth, thus changing the removal mode from brittle fracture to plastic removal. Theoretical models of material removal rate and surface roughness were established for abrasive polishing of the SiC wafers. Polishing experiments were conducted on ion-implanted, modified SiC samples. The improvement mechanisms of ion implantation on surface damage, removal rate, morphology, and residual stress were investigated. The effect of ion implantation on the polished surface quality of SiC was investigated through orthogonal experiments. The results showed that ion implantation can significantly improve the average material removal rate of the SiC samples. Additionally, the ion-implanted samples had exhibited remarkable reductions in surface roughness, surface damage, and tensile residual stress.
文摘Infective endocarditis(IE) remains a severe and life-t hreatening disease, with rising incidence and a particularly high mortality rate, especially among elderly patients.^([1]) While antibiotics are the mainstay of treatment, the success rate in left-sided IE is often limited,as nearly half of all patients eventually require surgical intervention for definitive management.^([2]) Heart failure is the main indication for surgery, but access to surgery is frequently restricted by several factors, particularly in patients with advanced age, often driven by the presence of comorbidities or hemodynamic instability.^([3,4])
基金financially supported by the National Natural Science Foundation of China(Nos.52271117 and 52401064)Hunan Provincial Natural Science Foundation of China(Nos.2021JJ30646 and 2023JJ10020)+2 种基金Educational Commission of Hunan Province of China(No.23A0107)Scientific Research Fund of Hunan Provincial Education Department(No.24B0172)Shaanxi Provincial Key R&D Program(No.2024CY2-GJHX-71)
文摘Ion implantation technology is a crucial strategy for modulating the degradation behavior of biomedical magnesium alloys.In this study,Ag,Ti,and Zr ions were implanted into the surface of pure Mg at varying doses to investigate their effects on the microstructure and properties of pure Mg.The results revealed that differences in the affinities of Mg and the implanted elements for reacting with oxygen led to the formation of implanted layers with distinct compositions and structures.Specifically,Ag ion implantation resulted in a layer predominantly composed of elemental silver,while Ti and Zr ion implantation promoted the formation of a denser layer containing Mg,MgO,the implanted elements,and their respective oxides.This layer significantly enhanced the corrosion resistance of pure Mg by reducing its susceptibility to corrosive media.Electrochemical assessments showed a substantial reduction in corrosion current density following Ti and Zr ion implantation.However,increasing doses of Ag ions induced heightened susceptibility to galvanic corrosion due to the electrode potential differences between Ag and Mg,thereby accelerating the degradation of the pure Mg substrate.Additionally,first-principles calculations of the work functions for both the (0001) basal plane and the(101 0) prism plane of Mg corroborated the observed electrochemical trends.
基金a grant from the Beijing Hospitals Authority Youth Programme(grant:QML20230204)a grant from National Natural Science Foundation of China(No.82471179)a grant from the National Key Research and Development Plan(grant:2022YFC2402705)。
文摘Objective:To assess the effectiveness of machine learning in automating the prediction of vestibular abnormalities after cochlear implantation(CI)in patients with sensorineural hearing loss(SNHL),with the goal of developing a practical model that can accurately predict long-term vestibular function outcomes and identify associated risk factors.Methods:Clinical data,including imaging,vestibular evoked myogenic potentials(VEMPs),and auditory information,were collected from patients with sensorineural hearing loss(SNHL)before and after CI.The decision tree algorithm was employed to address missing values and screen pre-CI clinical features.Six machine learning methods were subsequently utilized to predict the relationships between the extracted features and post-CI vestibular dysfunction.The best-performing method determined the ranking of feature importance,which was regarded as risk factors for predicting symptoms and VEMPs results after CI.Results:Logistic regression models effectively predicted both post-CI vestibular dysfunction and abnormal cervical VEMP(c VEMP),with accuracies of 80%and 78%,respectively.The relative importance of the features,in descending order,was as follows:c VEMP latency,c VEMP amplitude,and residual hearing threshold.Moreover,the support vector machine(SVM)model attained an accuracy of 88%in predicting abnormal ocular VEMP(o VEMP)post-CI.For the SVM model,the feature importance ranking was as follows:o VEMP latency,o VEMP amplitude,and residual hearing threshold.Conclusions:This study successfully leverages machine learning techniques,specifically support vector machines(SVM)and logistic regression models,to predict the impact of CI on vestibular function.These predictive models provide valuable insights for presurgical planning and decision-making in CI procedures.Moreover,the findings highlight the critical risk factors associated with vestibular dysfunction,offering a robust reference for guiding vestibular rehabilitation strategies.
基金Shenzhen Science and Technology Program(JCYJ20220818103013028)National Key Research and Development Program of China(2022YFC2702500 and 2022YFC2702503)。
文摘Objective:The etiology and pathogenesis of recurrent implantation failure(RIF)remain unclear.This study aimed to delineate the immune landscape and identify the pivotal biomarkers of immune dysregulation in RIF.Methods:Comprehensive bioinformatics analyses,including differential expression,functional enrichment,gene set enrichment,weighted gene co-expression network analysis,protein-protein interaction network,and machine learning analyses,were conducted to explore the immunological underpinnings of RIF.Results:Our findings demonstrated a significant downregulation in the expression of several immune-related gene sets in the RIF cohort,including those related to antigen processing and presentation,antimicrobial responses,chemokines and their receptors,cytokines,and natural killer cell cytotoxicity.These results provide evidence of a significant association between RIF and maternal-fetal immune dysregulation.Three signature genes(ANK3,PTGS2,andSLC39A2)were identified using various machine-learning methods.The diagnostic value and immunological relevance of these genes were confirmed in both discovery and validation cohorts.Conclusion:This study investigated the immune landscape of RIF using extensive bioinformatic analyses.Modular genes associated with both immune activity and RIF dysregulation were identified,providing new perspectives for understanding the pathophysiology and treatment of RIF.
文摘Background:Recurrent implantation failure(RIF)is a difficult problem with a multifaceted cause.Recent studies have demonstrated that stimulator of interferon genes-induced immune-related genes(STIRGs)are associated with immune disorders that may affect the endometrial immune micro-environment.However,the effect of STRIGs on RIF remains unknown.Methods:Training(GSE111974)and validation(GSE106602)cohorts were acquired from the Gene Expression Omnibus database.STIRGs were extracted from the Molecular Signatures Database and relevant studies.Consensus clustering analysis was used to identify RIF molecular subtypes.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment and immune infiltration analyses were performed between RIF subtypes.Drug-related potential therapeutic target genes were discovered.Results:Two distinct molecular subtypes were discovered in both the training and validation groups according to STIRGs.In subtype C2,there was a notable decrease in the presence of different types of immune cells,such as natural killer cells and macrophages.Furthermore,the examination of Gene Ontology and Kyoto Encyclopedia of Genes and Genomes indicated a decrease in numerous immune-related biological processes within subtype C2.Finally,nine hub genes(CXCR4,POU5F1,PPARG,TLR2,EGFR,CSF1,BCL2A1,BTK,and SRGN)were identified as potential therapeutic targets for RIF.Conclusion:Based on STIRGs,we identified a new molecular subtype with significantly reduced immune infiltration in RIF.Nine genes might be potential therapeutic targets for RIF.
基金supported by the National Natural Science Foundation of China(22005140)Scientific Research Foundation for the Introduction of Talents by Nanjing Institute of Technology(YKJ201996)Postgraduate Research&Practice Innovation Program of Jiangsu Province(KYCX22_1370).
文摘To enhance the corrosion resistance and electrical conductivity, the surface of 316L stainless steel was modified by the ion implantation of Mo. By investigating various accelerating voltages and implantation doses, it was found that the corrosion resistance of stainless steel was enhanced by 50%-80% and the surface conductivity by 15%-28% at most. The minimum stabilized current density is 0.72 μA/cm^(2). This is due to the formation of a Cr and Mo riched modified layer on the surface of the stainless steel. Mo oxides synergize with Cr oxides in the form of a solid solution to enhance the corrosion resistance of passivation films on the stainless steel surface. The optimum parameters were Cr in the proportion of 6%-8% and Mo in the proportion of 4%-5%.
文摘BACKGROUND Despite advances in the use of in vitro fertilization-embryo transfer(ET)in couples with infertility,recurrent implantation failure(RIF)after ET is still a major problem affecting women,with great psychological and economic burdens for the patient and his/her family.AIM To investigate the psychological burden(anxiety and depression)and evaluate the clinical benefits of endometrial receptivity testing(ERT)in patients experiencing RIF following frozen-thawed ET.METHODS A retrospective cohort study analyzed 371 patients experiencing RIF after assisted reproductive treatment at the First People’s Hospital of Changde City between January 2021 and June 2024.Demographic and clinical data were systematically collected through standardized questionnaires.Psychological assessment utilized validated instruments:The Self-Rating Depression Scale for depression evaluation and the Self-Rating Anxiety Scale for anxiety assessment.Participants were stratified by psychological status(anxiety/non-anxiety and depression/nondepression)to analyze influencing factors for anxiety and depression.The cohort was further categorized into the ERT and non-ERT groups based on ERT implementation to comparatively analyze their clinical outcomes.Additionally,they were divided into clinical and nonclinical pregnancy groups to identify factors affecting clinical pregnancy using univariate and multivariate logistic regression models.Compared with the non-ERT group,the 226 patients who underwent ERT-guided ET achieved a higher clinical pregnancy rate,thicker endometrium on transfer day,fewer embryos transferred,and a lower miscarriage rate.RESULTS The study identified a substantial psychological burden,with anxiety prevalence at 55.0%(mean Self-Rating Anxiety Scale score,50.89±9.34)and depression at 61.2%(mean Self-Rating Depression Scale score,55.55±9.48).Multivariate analysis identified annual household income>100000 yuan as protective factors against both anxiety and depression,whereas advanced maternal age(>35 years)and multiple implantation failures(≥3)served as risk factors.Additionally,anxiety-specific risk factors included prolonged infertility treatment(>5 years)and the spouse’s status as an only child.As to depression-specific risks,chronic infertility(>3 years)and higher educational attainment(college/bachelor’s degree or higher)were key determinants,whereas urban residence was a protective factor.Age>35 years was a risk factor for clinical pregnancy in patients experiencing RIF,whereas blastocyst-stage ET,a higher number of embryos transferred,and thicker endometrium were protective factors.CONCLUSION Patients experiencing RIF are particularly susceptible to anxiety and depression,and advanced maternal age and multiple implantation failures represent salient risk factors.Clinicians should implement proactive and evidencebased interventions to mitigate these psychological burdens.For patients experiencing RIF,ERT-guided ET demonstrates significant potential to improve assisted reproductive outcomes.
文摘PurposeThe study aimed to investigate the otology-specific and general health-related quality of life(HRQoL)after cochlear implantation,and scrutinize the variables associated with them.MethodsThe Ear Outcome Survey-16(EOS-16),which assesses ear-specific symptoms and quality of life(QoL),was administered before and after cochlear implantation along with the post-operative administration of the 15D questionnaire that evaluates general HRQoL.The authors investigated post-implantation changes in the EOS-16 total scores and its category responses,examining their relationship with pre-and post-operative hearing levels,speech perception in noise,and the follow-up period length(time elapsed since cochlear implantation).ResultsThere were positive changes noted for the hearing,need for care,and QoL categories of the EOS-16 after implantation.The length of the follow-up period was a significant factor associated with improvements in subjective outcome measures.Changes in self-perceived hearing and HRQoL post-implantation seem independent of pre-and post-implantation hearing performance.ConclusionThese results suggest that while patients regain their hearing abilities shortly after implant activation,their subjective hearing-related benefits and QoL improve over time.
基金Supported by Tengfei Project of Third Affiliated Hospital of the Naval Medical University,No.TF2024TJYQ02.
文摘BACKGROUND Hemorrhage following pancreaticobiliary surgery is a high-risk complication,with a mortality rate of 16%-38%.At present,minimally invasive endovascular intervention comprising superselective arterial embolization(SAE)and covered stent implantation(CSI)is the treatment of choice.However,in certain cases,both SAE and CSI become infeasible.AIM To evaluate the effectiveness of coil-assisted N-butyl cyanoacrylate(NBCA)embolization in comparison with that of CSI in managing delayed hemorrhage after hepatobiliary–pancreatic surgery when SAE is infeasible.METHODS Ninety-eight continuous patients(n=105 cases;mean age,58.4 years)with delayed massive hemorrhage who were treated with coil-assisted NBCA embolization(NBCA group,n=45)and/or CSI(CSI group,n=60)were retrospectively evaluated between March 2014 and December 2023.Data on technical and clinical success,30-day mortality,and severe intervention-related adverse events were collected and analyzed.RESULTS The technical and clinical success rates in the NBCA group(100%and 93.3%,respectively)were significantly higher than those in the CSI group(88.3%and 73.3%,respectively),with a statistically significant difference between the two groups(P=0.019 and 0.010,respectively).The 30-day mortality rates and major intervention-related complications were 17.8%and 0%,respectively,in the NBCA group and 18.3%and 1.7%in the CSI group,respectively,with no statistically significant difference between the two groups.CONCLUSION In terms of technical and clinical success,coil-assisted NBCA embolization was more effective than CSI for managing delayed hemorrhage after hepatobiliary–pancreatic surgery when SAE was not feasible.
基金supported by the Postgraduate Research and Innovation Program of Jiangsu Province,China(Grant No.KYCX241133)the National Natural Science Foundation of China(Grant No.11405041)+1 种基金the Key Research and Development Program of Jiangxi Province,China(Grant No.20223BBE51020)the Opening Fund of Key Laboratory of Rare Earths(Chinese Academy of Sciences).
文摘Integrating the magneto-optical effect into a waveguide-based photonic device becomes more and more interesting.In the work,the planar optical waveguide firstly was prepared in a terbium gallium garnet crystal(TGG)via the proton implantation with the energy of 4×10^(-1)MeV and the fluence of 6×10^(8)ions/μm^(2).Subsequently,a femtosecond laser with a central wavelength of 800 nm and a power of 3 mW was used to ablate the surface of the planar waveguide,forming the ridge optical waveguide.The dark-mode curve of the planar waveguide was measured by a prism coupling technique.The top-view morphology of the ridge waveguide was observed via a Nikon microscope.The mode field distributions of the planar and ridge waveguides were obtained by an end-face coupling system,and the propagation losses of the two waveguides were measured to be 2.26 dB/cm and 2.58 dB/cm,respectively.The Verdet constants were measured to be-72.7°/T·cm for the TGG substrate and-60.7°/T·cm for the ridge waveguide.The TGG waveguides have a potential in the fabrication of magneto-optical waveguide devices.
基金Supported by Shanghai Municipal Health Commission(No.202140183).
文摘AIM:To present a case series of rapid-onset neovascular glaucoma(NVG)accompanied by vitreous haemorrhage(VH)following cataract surgery in diabetic patients,and to evaluate the efficacy of pars plana vitrectomy(PPV)combined with Ahmed glaucoma valve(AGV)implantation.METHODS:This is a retrospective,single-center,consecutive case series.All patients underwent 23-gauge PPV with AGV implantation 2–3d after intravitreal ranibizumab injection(IVR).The minimum postoperative follow-up period lasted 12mo.The primary outcome measures included bestcorrected visual acuity(BCVA),intraocular pressure(IOP),and topical hypotensive medications.RESULTS:Fifteen diabetic patients(age,46–81y)with rapid-onset NVG and VH following uncomplicated phacoemulsification were included.The median time to the initial NVG diagnosis following cataract surgery was within 4wk.After PPV combined with AGV implantation,the mean BCVA(logMAR)improved from 1.9(range:1.0 to 2.6)preoperatively to 1.2(range:0.2 to 2.6)at the final follow-up.Baseline BCVA and the presence of diabetic nephropathy(DN)were significantly associated with the final BCVA in the multiple regression model.The mean postoperative IOP at all follow-up visits was significantly reduced compared to baseline.At the final follow-up,9 patients required one or two topical ocular hypotensive medications,while the other 6 needed not.Success was achieved in 87%,and the reoperation rate was 20%.The majority of NVG cases(9/15)were primarily attributed to the rapid progression of proliferative diabetic retinopathy.However,a notable subset(6 eyes)was complicated retinal vein occlusion or carotid artery occlusion.CONCLUSION:PPV combined with AGV implantation after adjuvant IVR for rapid-onset NVG with VH following diabetic cataract surgery is one of the safe and effective treatments.Baseline BCVA and preexisting DN may be potential indicators for visual outcomes.
文摘BACKGROUND Phakic intraocular lens(IOL)implantation is a common treatment for high myopia.However,pre-and postoperative psychological changes,particularly anxiety and depression,are noteworthy concerns.Multiple studies have indicated a close relationship between ophthalmic diseases,including high myopia,glaucoma,anxiety,and depression.AIM To evaluate the impact of phakic IOL implantation on anxiety and depression in patients with high myopia.METHODS Data from 136 patients with high myopia,who underwent phakic IOL implantation at the authors’hospital between June 2024 and December 2024,were retrospectively analyzed.Clinical data were collected from the hospital’s electronic medical records system.Preoperative and one-month postoperative data were compared.Anxiety,depression,sleep quality,and quality of life were evaluated using the Hamilton anxiety scale,Hamilton depression scale,Pittsburgh Sleep Quality Index,and 36-item Short Form Health Survey,respectively.RESULTS Of 136 patients,67.65%(n=92)were female and 32.35%(n=44)were male,with a mean±SD age of 28.02±5.72 years.The mean uncorrected visual acuity before and 1 month after treatment was 1.83±0.24 log minimum angle of resolution(MAR)and 0.03±0.07 log MAR,respectively.The mean best corrected visual acuity before and 1 month after treatment was 0.04±0.07 log MAR and 0.01±0.02 log MAR,respectively.All differences were statistically significant(P<0.05).Compared with pretreatment,Hamilton anxiety scale and Hamilton depression scale scores significantly decreased 1 month post-treatment(P<0.05).Furthermore,the Pittsburgh Sleep Quality Index score was significantly lower after than that before treatment(P<0.05).The 36-item Short Form Health Survey quality of life score significantly improved after treatment(P<0.05).CONCLUSION Phakic IOL implantation significantly reduces anxiety and depression and improves sleep quality and quality of life in patients with high myopia.This study provides new concepts for treating high myopia.
