BACKGROUND Anterior cruciate ligament(ACL)reconstruction using bone-patellar tendon-bone(BPTB)autografts remains the gold standard for young,active individuals due to its superior biomechanical strength and bone-to-bo...BACKGROUND Anterior cruciate ligament(ACL)reconstruction using bone-patellar tendon-bone(BPTB)autografts remains the gold standard for young,active individuals due to its superior biomechanical strength and bone-to-bone healing.However,donor site morbidity,particularly anterior knee pain(AKP),limits its utilization despite its advantages.Various techniques have been proposed to reduce AKP,but they show variable outcomes and several limitations.AIM To assess the incidence and severity of AKP following BPTB ACL reconstruction using an autologous bone grafting technique.METHODS We conducted a retrospective observational study of 24 patients aged 20-45 years,who had primary ACL reconstruction with BPTB grafts.During surgery,autologous cancellous bone generated from tunnel drilling was used to fill the patellar and tibial donor site voids after graft fixation.All patients were followed up for at least twelve months.Using the Kujala Anterior Knee Pain Score,clinical outcomes were evaluated,including the pain-specific subcomponent.RESULTS With scores ranging from 86 to 100,the average overall Kujala score was 95.67±4.01.No patient scored below 85.There was no complication such as patellar fracture,tibial tuberosity fracture,or infection.Grouped data showed 20.8%of patients scored 100,whereas 54.2%scored between 95 and 99,and 25%scored between 86 and 94.One patient(4.2%)had an 8/10 pain subcomponent,whereas 23 patients(95.8%)had a 10/10.CONCLUSION This procedure is easy to incorporate into routine surgical practice,cost-effective and reproducible without requiring extra incisions or raising the patient’s surgical expenses.Excellent short-term results back up this technique.展开更多
Background:The analgesic effects of multiple electroacupuncture(EA)sessions and single EA sessions differ significantly in pain management.Area 24b(A24b)of the anterior cingulate cortex(ACC)is crucial in pain processi...Background:The analgesic effects of multiple electroacupuncture(EA)sessions and single EA sessions differ significantly in pain management.Area 24b(A24b)of the anterior cingulate cortex(ACC)is crucial in pain processing.EA relieves pain by targeting and modulating the neuronal activity within this subregion.However,whether the cumulative effect of EA antinociception is connected to A24b mechanisms has remained unclear.Methods:In our study,we used the Complete Freund's Adjuvant(CFA)model to induce inflammatory pain and the Spared Nerve Injury(SNI)model to induce neuropathic pain,and adult male C57BL/6,FosTRAP,and FosTRAP:Ai9 mice were used as experimental subjects to investigate the cumulative effect of EA antinociception and whether multiple EA sessions and a single EA session regulate different neuronal populations in the A24b.Results:We observed that EA effectively alleviated pain in mice,with three EA sessions yielding superior analgesic effects compared to a single session.Using chemical genetics combined with FosCreER technology to activate EA-TRAPed cells in the A24b,we found that pain relief was more pronounced with three EA sessions.Moreover,chemogenetic inhibition of EA-TRAPed cells in the A24b reversed the analgesic effects of a single EA session but not those of three EA sessions.Fluorescent in situ hybridization results indicated that three EA sessions significantly increased the number of GABAergic neurons in the A24b compared with a single session.Additionally,retrograde tracing revealed that the A24b circuit that monosynaptically innervates EA-TRAPed cells included projections from the central lateral nucleus(CL),lateral mediodorsal thalamic nucleus(MDL),lateral habenula(LHb),dorsal raphe nucleus(DR),caudal linear nucleus of the raphe(CLi),dorsal tuberomamillary nucleus(DTM),periventricular hypothalamic nucleus(Pe)and hippocampal fields CA1,CA2,and CA3.These findings suggest that multiple EA sessions and single EA sessions activated different neuronal populations in the A24b.The enhanced analgesic effect of multiple EA sessions may be attributed to an increase in the proportion of GABAergic neurons within the A24b.Conclusions:Multiple and single EA sessions recruit distinct neuronal populations in A24b,with the stronger analgesic effect of repeated EA linked to a higher proportion of GABAergic neurons in this region.展开更多
AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing techn...AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.展开更多
Objective: To investigate whether attaching a free lens anterior capsular disc to the corneal endothelial surface during femtosecond laser-assisted cataract surgery (FLACS) can effectively reduce postoperative corneal...Objective: To investigate whether attaching a free lens anterior capsular disc to the corneal endothelial surface during femtosecond laser-assisted cataract surgery (FLACS) can effectively reduce postoperative corneal endothelial cell loss. Methods: This prospective study included 97 cataract patients. Among them, 33 patients served as the experimental group, where a free lens anterior capsular disc was applied for corneal endothelial protection during FLACS. The remaining 64 patients formed the control group and underwent conventional FLACS. Changes in corneal endothelial cell density were compared between the two groups before surgery and one month postoperatively. Results: One month after surgery, corneal endothelial cell counts in both groups were lower than preoperative levels. However, the experimental group exhibited higher corneal endothelial cell counts than the control group, with a smaller reduction in cell counts (p < 0.05). The corneal endothelial cell loss rate in the experimental group was lower than that in the control group one month postoperatively (p < 0.05). At the one-month follow-up, there were no significant differences in LogMAR visual acuity or non-contact intraocular pressure between the two groups compared to preoperative values (p > 0.05). Additionally, no significant differences were observed between the experimental and control groups in terms of LogMAR visual acuity, non-contact intraocular pressure, improvements in LogMAR visual acuity, or changes in non-contact intraocular pressure (p > 0.05). Conclusion: Attaching a free lens anterior capsular disc to the corneal endothelial surface during FLACS can effectively reduce intraoperative corneal endothelial cell loss.展开更多
Platelet rich plasma(PRP)is an autologous blood product rich in platelets,showing promise in reducing inflammation and accelerating healing.While extensively utilized in plastic surgery,dermatology,and osteoarthritis ...Platelet rich plasma(PRP)is an autologous blood product rich in platelets,showing promise in reducing inflammation and accelerating healing.While extensively utilized in plastic surgery,dermatology,and osteoarthritis treatment,its application in anterior cruciate ligament(ACL)injuries is limited.This article examines PRP's potential in ACL reconstruction(ACLR),exploring its history,current usage,controversies and future directions.PRP has demonstrated significant early benefits in ligamentisation and vascularisation post-ACLR,though its long-term efficacy is inconsistent.Studies suggest that PRP may serve as both an adjunct therapy in ACLR to enhance initial healing and reduce postoperative complications,and as a non-surgical alternative for small ACL tears.Despite these promising findings,outcome variability necessitates further high-quality research to optimize PRP formulations and determine its most effective applications.The exploration of PRP as a treatment modality in ACLR offers promising but varied outcomes.PRP holds considerable promise as both an adjunct and alternative to traditional ACLR.This article underscores the need for targeted research to fully realize PRP's therapeutic potential in ACL treatment,aiming to inform future studies and clinical practices.By understanding PRP's mechanisms of efficacy and identifying the most beneficial patient populations,PRP could significantly impact orthopaedics and sports medicine,improving recovery pathways and patient outcomes.展开更多
BACKGROUND Bioabsorbable interference screws are a widely used option for graft fixation in anterior cruciate ligament(ACL)reconstruction.Their ability to degrade over time and avoid secondary hardware removal makes t...BACKGROUND Bioabsorbable interference screws are a widely used option for graft fixation in anterior cruciate ligament(ACL)reconstruction.Their ability to degrade over time and avoid secondary hardware removal makes them advantageous.However,complications such as breakage and intra-articular migration of screws can cause significant clinical issues,including joint pain,swelling,and cartilage damage.Early diagnosis and management are critical in such cases.CASE SUMMARY A 26-year-old male presented with knee pain and swelling one year after ACL reconstruction using a hamstring graft and bioabsorbable tibial interference screw.The patient had been engaged in rigorous physical activity as part of military training.Clinical examination revealed mild effusion without instability,and imaging showed screw breakage with intra-articular migration.Therapeutic arthroscopy confirmed intact graft tension,and broken screw fragments were removed successfully.The patient resumed normal activity two weeks after surgery.CONCLUSION This case highlights the potential complications associated with bioabsorbable screws,emphasizing the need for meticulous surgical technique,postoperative monitoring,and timely intervention.A comprehensive review of the literature illustrates the mechanisms,risk factors,and preventive strategies associated with screw-related complications.展开更多
BACKGROUND Recovering from anterior cruciate ligament(ACL)reconstruction can be challenging.While standard rehabilitation helps restore knee function,many patients still face a slow or incomplete recovery.Extracorpore...BACKGROUND Recovering from anterior cruciate ligament(ACL)reconstruction can be challenging.While standard rehabilitation helps restore knee function,many patients still face a slow or incomplete recovery.Extracorporeal shockwave therapy(ESWT)has recently gained attention as a potential way to speed up healing and improve outcomes when added to traditional rehab.AIM To explore whether combining ESWT with standard postoperative rehabilitation truly leads to better recovery compared with rehab alone.METHODS A systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines,evaluating participant status following ACL reconstruction with standard rehabilitation and without augmented ESWT.This meta-analysis included six studies(five randomized controlled trials,one non-randomized clinical study).The outcome measures were the Lysholm score,International Knee Documentation Committee score,visual analog score,and KT-1000 measurements.To compare the control and intervention groups,the weighted mean differences were calculated along with the 95%confidence intervals.The heterogeneity of the studies and publication bias were analyzed.RESULTS ESWT modestly improved Lysholm scores(weighted mean difference:3.72;95%confidence interval:-0.27 to 7.71)with high heterogeneity(I2:96%,P<0.001)when compared with standard rehabilitation.Focused ESWT showed greater benefits compared with radial ESWT.No significant differences were found in the International Knee Documentation Committee scores,visual analog score,or KT-1000 measurements.Substantial variability and publication bias were noted.CONCLUSION ESWT improved Lysholm scores but did not show other significant benefits.Due to the limited evidence,further standardized,placebo-controlled trials are needed to confirm its effectiveness in ACL reconstruction.展开更多
Dear Editor,We report a surgical method for treating repeat Descemet’s membrane(DM)detachments in two cases with DM micro-perforation during deep anterior lamellar keratoplasty(DALK).DM micro-perforation is a common ...Dear Editor,We report a surgical method for treating repeat Descemet’s membrane(DM)detachments in two cases with DM micro-perforation during deep anterior lamellar keratoplasty(DALK).DM micro-perforation is a common intraoperative complication that occurs during the performance of DM baring in DALK,using methods such as the bigbubble air technique[1].The sequelae of DM micro-perforations include postoperative DM detachments,higher endothelial cell loss,endothelial decompensation,and transplant interface scarring[2].展开更多
Pain is often comorbid with emotional disorders such as anxiety and depression.Hyperexcitability of the anterior cingulate cortex has been implicated in pain and pain-related negative emotions that arise from impairme...Pain is often comorbid with emotional disorders such as anxiety and depression.Hyperexcitability of the anterior cingulate cortex has been implicated in pain and pain-related negative emotions that arise from impairments in inhibitory gamma-aminobutyric acid neurotransmission.This review primarily aims to outline the main circuitry(including the input and output connectivity)of the anterior cingulate cortex and classification and functions of different gamma-aminobutyric acidergic neurons;it also describes the neurotransmitters/neuromodulators affecting these neurons,their intercommunication with other neurons,and their importance in mental comorbidities associated with chronic pain disorders.Improving understanding on their role in pain-related mental comorbidities may facilitate the development of more effective treatments for these conditions.However,the mechanisms that regulate gamma-aminobutyric acidergic systems remain elusive.It is also unclear as to whether the mechanisms are presynaptic or postsynaptic.Further exploration of the complexities of this system may reveal new pathways for research and drug development.展开更多
AIM:To identify topographic determinants of the anterior chamber angle(ACA)in patients with keratoconus(KCN).METHODS:Four hundred and ten eyes of 294 patients with KCN were recruited for this study.First,complete ocul...AIM:To identify topographic determinants of the anterior chamber angle(ACA)in patients with keratoconus(KCN).METHODS:Four hundred and ten eyes of 294 patients with KCN were recruited for this study.First,complete ocular examinations were performed for all patients,including visual acuity measurement,refraction,and slit-lamp biomicroscopy.Then,all participants underwent corneal imaging by the Oculus Pentacam HR.RESULTS:The mean age of the participants was 32.40±8.52y(15-60y)and 69.5%of them were male.The mean ACA was 38.47°±5.75°(range:14.40°to 56.50°)in the whole sample,38.24°±6.00°in males,and 38.98°±5.11°in females(P=0.447).The mean ACA was significantly different among different groups of cone morphology,as patients with nipple cones showed the lowest mean ACA.Moreover,there were statistically significant differences in the mean ACA among different groups of cone locations,with patients having central cones exhibiting the lowest mean ACA(P<0.001).Anterior and posterior Q values were significantly,directly correlated with ACA(anterior Q:r=0.122,P=0.014,posterior Q:r=0.192,P<0.001).CONCLUSION:This study provides critical insights into the risk factors for ACA narrowing in KCN patients,which is essential for planning intraocular surgeries.Patients with nipple and central cones exhibited the most significant ACA narrowing.Additionally,more negative Q-values are associated with increased ACA narrowing,highlighting the need for targeted diagnostic and therapeutic strategies.展开更多
Anterior cruciate ligament(ACL)injuries are frequently caused by sports injuries and trauma.In cases involving complete tears,ACL reconstruction(ACLR)surgery is the only way to restore the ligament’s integrity.When s...Anterior cruciate ligament(ACL)injuries are frequently caused by sports injuries and trauma.In cases involving complete tears,ACL reconstruction(ACLR)surgery is the only way to restore the ligament’s integrity.When selecting a graft,both the potential complications and the mechanical properties and healing efficacies should be considered.Artificial ligaments have been widely applied in clinical ACLR,and most have exhibited satisfactory biocompatibility and short-term follow-up results.Compared with autografts and allografts,however,the lack of bioactivity of currently available artificial ligaments is a major disadvantage.In addition,some long-term follow-up results have revealed other drawbacks of artificial ligaments,such as graft failure and other complications.Here,we summarize attempts to enhance the bioactive performance of artificial ligaments,as such modifications may have good potential for clinical translation and could improve the long-term outcomes of existing products.展开更多
AIM:To analyze the characteristics and correlation of phacoemulsification parameters and anterior segment parameters in cataract patients with different blood glucose levels.METHODS:A total of 45 type 2 diabetic catar...AIM:To analyze the characteristics and correlation of phacoemulsification parameters and anterior segment parameters in cataract patients with different blood glucose levels.METHODS:A total of 45 type 2 diabetic cataract patients(45 eyes)treated in our hospital from March 2023 to April 2024 were stratified into two groups based on glycosylated hemoglobin(HbA1c)levels:group A:HbA1c<7%(n=18)and group B:7%≤HbA1c<8.5%(n=27);a total of 94 age-matched age-related cataract patients(94 eyes)were enrolled as the control group(group C).All underwent phacoemulsification with intraocular lens implantation.Anterior segment parameters,including corneal,lens and anterior chamber measurements,were recorded.Correlations between phacoemulsification parameters and anterior segment parameters were analyzed,and differences among groups were compared.RESULTS:In groups A and B,effective phacoemulsification time(EPT)negatively correlated with corneal endothelial cell density(CECD)(r=-0.315,P=0.035).Average phacoemulsification time(APT)positively correlated with the anterior corneal surface radius of curvature(Rm;r=0.402,P=0.006)and negatively correlated with the flat axis meridian curvature(K 1),steep axis meridian curvature(K 2),mean curvature(Km)of the anterior corneal surface,and lens density at 6 mm zones(PDZ3;all P<0.05).Average phacoemulsification energy(AVE)positively correlated with mean lens density(LD-mean),lens density at 2 mm zones(PDZ1),lens density at 4 mm zones(PDZ2),and PDZ3(all P<0.05),and negatively with pupil diameter(r=-0.385,P=0.009).In the group C,EPT showed a positive correlation with Pentacam nucleus staging(PNS)density grade,PDZ1,PDZ2,and PDZ3(all P<0.05).A positive correlation was observed between AVE and PNS classification(r=0.246,P=0.018).Conversely,AVE exhibited a negative correlation with CECD(r=-0.245,P=0.018).EPT in groups A and B was higher than that in the group C(P<0.05).Both EPT and APT in the group B were higher than those in the group A(P<0.05).In diabetic cataract patients,CECD,corneal density(CD),and posterior corneal surface height positively correlated with diabetes duration(P<0.05).Posterior corneal surface K 1 and Rm positively correlated with 7%≤HbA1c<8.5%(P<0.05).Total corneal astigmatism negatively correlated with HbA1c,2-hour post-breakfast blood glucose(2hPBG),and fasting insulin(FINS;P<0.05).CD and lens thickness(LT)positively correlated with FINS(P<0.05).CONCLUSION:Phacoemulsification parameters and blood glucose-related indices exhibited varying degrees of correlation with anterior segment parameters in cataract patients with different blood glucose levels.EPT in diabetic cataract patients was higher than that in age-related cataract patients,while EPT and APT in diabetic cataract patients with poor glycemic control were higher than those with good glycemic control.展开更多
The current study aimed to evaluate the efficacy and safety of Compound Danshen Dripping Pills(CDDP)in improving cardiac function in patients with acute anterior ST-segment elevation myocardial infarction(AAMI).Betwee...The current study aimed to evaluate the efficacy and safety of Compound Danshen Dripping Pills(CDDP)in improving cardiac function in patients with acute anterior ST-segment elevation myocardial infarction(AAMI).Between February 2021 and February 2023,247 eligible patients with AAMI after primary percutaneous coronary intervention were enrolled and randomly assigned(1∶1)to receive CDDP(n=126)or placebo(n=121),with a follow-up of 48 weeks.Compared with the placebo group,the CDDP group demonstrated a significant increase in left ventricular ejection fraction values after 24 weeks of treatment(least squares mean:3.31;95%confidence interval[CI]:1.72–4.90;P<0.001)and at the 48-week follow-up(least squares mean:4.35;95%CI:2.76–5.94;P<0.001).Significant reductions in N-terminal pro-B-type natriuretic peptide levels were observed in both groups at the 24-and 48-week visits with no significant difference between the two groups(P>0.1 for all).The incidence of major adverse cardiovascular and cerebrovascular events was 6.35%in the CDDP group and 5.79%in the placebo group(P=0.822).Notably,no serious adverse events were attributed to CDDP.These findings suggest that CDDP may be well tolerated and could improve left ventricular ejection fraction in patients with AAMI at 24 and 48 weeks.展开更多
BACKGROUND Orthodontic treatment for open bite and crossbite cases is always challenging.In this paper,we demonstrate a skeletal class III patient with anterior open bite and crossbite whose problem was successfully c...BACKGROUND Orthodontic treatment for open bite and crossbite cases is always challenging.In this paper,we demonstrate a skeletal class III patient with anterior open bite and crossbite whose problem was successfully corrected with improved super-elastic Ti-Ni alloy wire(ISW).CASE SUMMARY A 19 years old male came to our clinic with a chief complaint of anterior open bite and crossbite and not able to chew food well.Clinical examination revealed an angle class III malocclusion with anterior open bite,crossbite and spaced arch.Ra-diographic and clinical examination showed a skeletal class III pattern.We used ISW to level the upper and lower arch and to correct the anterior open bite and crossbite.Intermaxillary elastics were also used to achieve a better interdigitation.Finally,adequate overbite,overjet and a desirable occlusion were achieved.The active treatment time took 2 years and 2 months.CONCLUSION In a case of class III angular malocclusion with open bite and crossbite in the ante-rior teeth,ideal results were achieved using the ISW technique and the patient was satisfied with the outcome.展开更多
Pentadactyl limbs represent a conserved morphological feature among tetrapods,with anterior digits considered more important than posterior digits for refined movement.While posterior digit formation is governed by gr...Pentadactyl limbs represent a conserved morphological feature among tetrapods,with anterior digits considered more important than posterior digits for refined movement.While posterior digit formation is governed by graded expression of the Shh and 5’Hox genes,the regulatory mechanisms underlying anterior digit development,especially digit I(DI),remain poorly defined.This study identified an anterior expression pattern of Zic3 in the limb buds of representative tetrapods,including humans,which exerted an inhibitory effect on skeletal development.Zic3 was highly expressed in the anterior region of limb buds at early developmental stages,with species-specific divergence emerging during later development.Overexpression of Zic3 significantly delayed chondrogenesis and ossification,leading to bone shortening but not loss.Furthermore,RNA sequencing demonstrated that Zic3 down-regulated key genes associated with skeletal development,including Cytl1,Sox9,Ihh,Ptch1,Runx2,and Wnt16.These findings demonstrate that Zic3 acts as a conserved inhibitor of anterior skeletal maturation and contributes to the molecular asymmetry of tetrapod limb development.展开更多
BACKGROUND According to the Global Cancer Statistics Report,the incidence of colorectal cancer ranks third and the mortality rate ranks second worldwide among malignant tumors.AIM To explore the effects of Nursing Out...BACKGROUND According to the Global Cancer Statistics Report,the incidence of colorectal cancer ranks third and the mortality rate ranks second worldwide among malignant tumors.AIM To explore the effects of Nursing Outcomes Classification(NOC)-based multidimensional nursing on self-efficacy and symptom relief in patients with low anterior resection syndrome(LARS)following sphincter-preserving surgery.METHODS This observational study enrolled 120 patients with LARS after sphincterpreserving surgery for low rectal cancer admitted to our hospital between January 2022 and December 2024.The patients were randomly divided into a control group(n=60)that received routine nursing intervention or an observation group(n=60)that received multidimensional nursing intervention.Before and after the intervention,the Chinese version of the Self-Management Efficacy Scale for Cancer Patients(SUPPH),the LARS scoring scale,and the European Organization for Research and Treatment of Cancer Quality of Life Core Scale(EORTC QLQC30)were used to evaluate the self-efficacy,symptom relief,and quality of life of the two patient groups,and the nursing satisfaction was compared between the groups.RESULTS After the intervention,both groups showed increased scores for each item on the SUPPH and EORTC QLQ-C30 scales compared with those before the intervention,whereas the LARS score showed a decreasing trend.Compared with the control group,the scores for each item of the SUPPH and EORTC QLQ-C30 scales in the observation group were significantly higher after the intervention,while the LARS score was significantly lower(all P<0.05).Nursing satisfaction was significantly higher in the observation group than in the control group(83.33%vs 95.00%,P<0.05).CONCLUSION Multidimensional NOC-based nursing improves self-efficacy,symptoms,quality of life,and satisfaction in patients with LARS.However,further research is needed to assess its long-term and comparative effectiveness.展开更多
The anterior cingulate cortex(ACC)has recently been proposed as a key player in the representation of itch stimuli.However,to date,little is known about the contribution of specific ACC interneuron populations to itch...The anterior cingulate cortex(ACC)has recently been proposed as a key player in the representation of itch stimuli.However,to date,little is known about the contribution of specific ACC interneuron populations to itch processing.Using c-Fos immunolabeling and in vivo Ca2+imaging,we reported that both histamine and chloroquine stimuli-induced acute itch caused a marked enhancement of vasoactive intestinal peptide(VIP)-expressing interneuron activity in the ACC.Behavioral data indicated that optogenetic and chemogenetic activation of these neurons reduced scratching responses related to histaminergic and non-histaminergic acute itch.Similar neural activity and modulatory role of these neurons were seen in mice with chronic itch induced by contact dermatitis.Together,this study highlights the importance of ACC VIP+neurons in modulating itch-related affect and behavior,which may help us to develop novel mechanism-based strategies to treat refractory chronic itch in the clinic.展开更多
AIM:To measure the optimal anterior chamber pressure(ACP)for safe phacoemulsification using a new tube chamber system with internal pressure measurement function in the porcine eye.METHODS:The 20-gauge and 21-gauge st...AIM:To measure the optimal anterior chamber pressure(ACP)for safe phacoemulsification using a new tube chamber system with internal pressure measurement function in the porcine eye.METHODS:The 20-gauge and 21-gauge straight tips with yellow and orange sleeves,respectively,were covered by a test chamber combined with a pressure sensor for measuring ACP.This was measured for 20s from 10s after starting aspiration in the linear mode using vacuum levels of 200 and 150 mm Hg with a 20-gauge tip,and 300 and 250 mm Hg with a 21-gauge tip.Using a porcine eye,a pressure sensor fixed with a 0.9 mm corneal incision measured ACP.For the posterior capsule contact assay,porcine eyes were treated as described above,and the ultrasonic needle tip was held at the height of the iris and aspirated for 30s in linear mode at a vacuum of 200 and 150 mm Hg for the 20-gauge tip,and 300 and 250 mm Hg for the 21-gauge tip.The bottle height at which the posterior capsule accidentally contacted the ultrasonic tip was recorded,and the estimated ACP was calculated.RESULTS:The internal pressure of the new tube chamber system and ACP from the porcine eye closely matched proportional changes at vacuum levels of 200 and 150 mm Hg with 20-gauge tips.Similarly,proportional changes at vacuum levels of 300 and 250 mm Hg with the 21-gauge tip were nearly equal.The bottle height at which the posterior capsule contacted with the tip and estimated ACP were 57.5±12.6 cm(20.2±7.9 mm Hg)at 200 mm Hg with a 20-gauge tip,35.0±10.0 cm(16.6±6.3 mm Hg)at 150 mm Hg with a 20-gauge tip,47.5±12.6 cm(18.7±8.7 mm Hg)at 300 mm Hg with a 21-gauge tip,and 32.5±5.0 cm(15.7±3.5 mm Hg)at 250 mm Hg with a 21-gauge tip.CONCLUSION:A comprehensive understanding of this chamber system’s characteristics and usage can resolve anterior chamber instability caused by changing preoperative settings on the phaco machine.展开更多
AIM:To evaluate changes in corneal light scattering and anterior segment parameters in newly diagnosed rheumatoid arthritis(RA)patients who achieved remission with systemic treatment,compared to healthy controls.METHO...AIM:To evaluate changes in corneal light scattering and anterior segment parameters in newly diagnosed rheumatoid arthritis(RA)patients who achieved remission with systemic treatment,compared to healthy controls.METHODS:A cross-sectional study was conducted at a tertiary care hospital,in ophthalmology,and rheumatology departments.A total of 42 RA patients(13 men and 29 women)and 56 healthy individuals(23 men 33 women)underwent comprehensive ophthalmologic evaluations,including Scheimpflug corneal densitometry and Pentacam HR measurements.Those who initiated systemic treatment for RA were monitored at first,third,and sixth-month follow-ups.Participants who achieved remission at each follow-up assessment were included.RESULTS:Significant differences in corneal densitometry were observed,with higher values in RA patients,particularly in the middle and posterior layers.Anterior segment parameters such as anterior chamber volume and angle were significantly reduced in RA patients compared to other groups(P<0.001).Following systemic treatment and achievement of remission,these parameters showed regression toward normal values.CONCLUSION:The study underscores the potential utility of corneal densitometry and anterior segment analysis as sensitive indicators of subclinical ocular involvement in RA,offering insights into disease progression and treatment efficacy.These findings highlight the importance of early detection and regular monitoring in preventing vision-threatening complications in RA patients.展开更多
Background:Postural control deficits and persistent joint stability issues are prevalent in population with anterior cruciate ligament(ACL)injuries or reconstructions.Postural control is typically assessed using the c...Background:Postural control deficits and persistent joint stability issues are prevalent in population with anterior cruciate ligament(ACL)injuries or reconstructions.Postural control is typically assessed using the center of pressure(CoP)parameters during the static single-leg stance with a force plate.However,previous studies have reported unclear definitions and descriptions of the CoP parameters,causing inconsistent results of postural control deficits in a specific population.Objective:To 1)summarize CoP parameters commonly used to evaluate postural control deficits in ACL injured or reconstructed population,and 2)identify the differences in CoP parameters with opened and closed eyes during the single-leg stance between ACL injured or reconstructed and control groups.Methods:PubMed,Embase,Cochrane Library,CINAHL,Scopus,Web of Science,and SPORTDiscus databases were searched up to July 2023.Data were obtained from the selected articles and underwent quality and risk of bias assessment and meta-analysis using random-effect models.Subgroup analysis within ACL injured or reconstructed group were also performed.Results:A total of 14 articles were included in the analysis after screening.The injured knee of the ACL injured or reconstructed group differed insignificantly in sway amplitude,sway area,and sway velocity during static singleleg stance under opened and closed eyes when compared with the control group.In the subgroup analysis,we found that there was only significant difference in sway velocity with open eyes(SMD=0.47,p=0.001)between ACL reconstructed group and control group.Conclusion:This study summarized the common CoP parameters used to evaluate postural control in ACL injured or reconstructed population.The results only showed weak difference in sway velocity between ACL reconstructed population and healthy individuals with opened eyes during the static single-leg stance.展开更多
文摘BACKGROUND Anterior cruciate ligament(ACL)reconstruction using bone-patellar tendon-bone(BPTB)autografts remains the gold standard for young,active individuals due to its superior biomechanical strength and bone-to-bone healing.However,donor site morbidity,particularly anterior knee pain(AKP),limits its utilization despite its advantages.Various techniques have been proposed to reduce AKP,but they show variable outcomes and several limitations.AIM To assess the incidence and severity of AKP following BPTB ACL reconstruction using an autologous bone grafting technique.METHODS We conducted a retrospective observational study of 24 patients aged 20-45 years,who had primary ACL reconstruction with BPTB grafts.During surgery,autologous cancellous bone generated from tunnel drilling was used to fill the patellar and tibial donor site voids after graft fixation.All patients were followed up for at least twelve months.Using the Kujala Anterior Knee Pain Score,clinical outcomes were evaluated,including the pain-specific subcomponent.RESULTS With scores ranging from 86 to 100,the average overall Kujala score was 95.67±4.01.No patient scored below 85.There was no complication such as patellar fracture,tibial tuberosity fracture,or infection.Grouped data showed 20.8%of patients scored 100,whereas 54.2%scored between 95 and 99,and 25%scored between 86 and 94.One patient(4.2%)had an 8/10 pain subcomponent,whereas 23 patients(95.8%)had a 10/10.CONCLUSION This procedure is easy to incorporate into routine surgical practice,cost-effective and reproducible without requiring extra incisions or raising the patient’s surgical expenses.Excellent short-term results back up this technique.
基金The National Natural Science Fund of China(82374561,82174490,81873360)the Research Project of Zhejiang Chinese Medical University(2022JKZKTS44,2022FSYYZZ07)the Zhejiang Medical and Health Science and Technology Program(2021RC098)。
文摘Background:The analgesic effects of multiple electroacupuncture(EA)sessions and single EA sessions differ significantly in pain management.Area 24b(A24b)of the anterior cingulate cortex(ACC)is crucial in pain processing.EA relieves pain by targeting and modulating the neuronal activity within this subregion.However,whether the cumulative effect of EA antinociception is connected to A24b mechanisms has remained unclear.Methods:In our study,we used the Complete Freund's Adjuvant(CFA)model to induce inflammatory pain and the Spared Nerve Injury(SNI)model to induce neuropathic pain,and adult male C57BL/6,FosTRAP,and FosTRAP:Ai9 mice were used as experimental subjects to investigate the cumulative effect of EA antinociception and whether multiple EA sessions and a single EA session regulate different neuronal populations in the A24b.Results:We observed that EA effectively alleviated pain in mice,with three EA sessions yielding superior analgesic effects compared to a single session.Using chemical genetics combined with FosCreER technology to activate EA-TRAPed cells in the A24b,we found that pain relief was more pronounced with three EA sessions.Moreover,chemogenetic inhibition of EA-TRAPed cells in the A24b reversed the analgesic effects of a single EA session but not those of three EA sessions.Fluorescent in situ hybridization results indicated that three EA sessions significantly increased the number of GABAergic neurons in the A24b compared with a single session.Additionally,retrograde tracing revealed that the A24b circuit that monosynaptically innervates EA-TRAPed cells included projections from the central lateral nucleus(CL),lateral mediodorsal thalamic nucleus(MDL),lateral habenula(LHb),dorsal raphe nucleus(DR),caudal linear nucleus of the raphe(CLi),dorsal tuberomamillary nucleus(DTM),periventricular hypothalamic nucleus(Pe)and hippocampal fields CA1,CA2,and CA3.These findings suggest that multiple EA sessions and single EA sessions activated different neuronal populations in the A24b.The enhanced analgesic effect of multiple EA sessions may be attributed to an increase in the proportion of GABAergic neurons within the A24b.Conclusions:Multiple and single EA sessions recruit distinct neuronal populations in A24b,with the stronger analgesic effect of repeated EA linked to a higher proportion of GABAergic neurons in this region.
文摘AIM:To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.METHODS:This study included 74 eyes from 37 patients,comprising 17 males and 20 females,with a mean age of 51.74±7.80 years.Using a coin toss method,one eye per patient was randomly selected for improved anterior capsular polishing,while the other eye received standard irrigation/aspiration(I/A)polishing.The polishing group consisted of 37 eyes,including 21 right and 16 left eyes,while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group.Visual acuity and quality of the patients were evaluated before surgery and at 1 wk,1,6,and 12 mo after surgery.The OPD-Scan III was utilized to assess high-order aberrations,while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff),Strehl ratio(SR),and objective scatter index(OSI)for the purpose of visual quality assessment.Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results,and the SNK-q post hoc test was applied to identify significant differences.RESULTS:The polishing group’s uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05).At 12-months,UDVA,UNVA,and corrected distant visual acuity(CDVA)were better than the control group(P<0.05).The MTF cutoff,SR,OSI,and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.
基金Task Contract for the 2022 Dongguan Social Development Science and Technology Project,Project Name:Clinical Study on the Protection of Corneal Endothelium by the Anterior Capsular Flap in LenSx Femtosecond Laser-Assisted Cataract Surgery(Project No.:20221800901212)。
文摘Objective: To investigate whether attaching a free lens anterior capsular disc to the corneal endothelial surface during femtosecond laser-assisted cataract surgery (FLACS) can effectively reduce postoperative corneal endothelial cell loss. Methods: This prospective study included 97 cataract patients. Among them, 33 patients served as the experimental group, where a free lens anterior capsular disc was applied for corneal endothelial protection during FLACS. The remaining 64 patients formed the control group and underwent conventional FLACS. Changes in corneal endothelial cell density were compared between the two groups before surgery and one month postoperatively. Results: One month after surgery, corneal endothelial cell counts in both groups were lower than preoperative levels. However, the experimental group exhibited higher corneal endothelial cell counts than the control group, with a smaller reduction in cell counts (p < 0.05). The corneal endothelial cell loss rate in the experimental group was lower than that in the control group one month postoperatively (p < 0.05). At the one-month follow-up, there were no significant differences in LogMAR visual acuity or non-contact intraocular pressure between the two groups compared to preoperative values (p > 0.05). Additionally, no significant differences were observed between the experimental and control groups in terms of LogMAR visual acuity, non-contact intraocular pressure, improvements in LogMAR visual acuity, or changes in non-contact intraocular pressure (p > 0.05). Conclusion: Attaching a free lens anterior capsular disc to the corneal endothelial surface during FLACS can effectively reduce intraoperative corneal endothelial cell loss.
文摘Platelet rich plasma(PRP)is an autologous blood product rich in platelets,showing promise in reducing inflammation and accelerating healing.While extensively utilized in plastic surgery,dermatology,and osteoarthritis treatment,its application in anterior cruciate ligament(ACL)injuries is limited.This article examines PRP's potential in ACL reconstruction(ACLR),exploring its history,current usage,controversies and future directions.PRP has demonstrated significant early benefits in ligamentisation and vascularisation post-ACLR,though its long-term efficacy is inconsistent.Studies suggest that PRP may serve as both an adjunct therapy in ACLR to enhance initial healing and reduce postoperative complications,and as a non-surgical alternative for small ACL tears.Despite these promising findings,outcome variability necessitates further high-quality research to optimize PRP formulations and determine its most effective applications.The exploration of PRP as a treatment modality in ACLR offers promising but varied outcomes.PRP holds considerable promise as both an adjunct and alternative to traditional ACLR.This article underscores the need for targeted research to fully realize PRP's therapeutic potential in ACL treatment,aiming to inform future studies and clinical practices.By understanding PRP's mechanisms of efficacy and identifying the most beneficial patient populations,PRP could significantly impact orthopaedics and sports medicine,improving recovery pathways and patient outcomes.
文摘BACKGROUND Bioabsorbable interference screws are a widely used option for graft fixation in anterior cruciate ligament(ACL)reconstruction.Their ability to degrade over time and avoid secondary hardware removal makes them advantageous.However,complications such as breakage and intra-articular migration of screws can cause significant clinical issues,including joint pain,swelling,and cartilage damage.Early diagnosis and management are critical in such cases.CASE SUMMARY A 26-year-old male presented with knee pain and swelling one year after ACL reconstruction using a hamstring graft and bioabsorbable tibial interference screw.The patient had been engaged in rigorous physical activity as part of military training.Clinical examination revealed mild effusion without instability,and imaging showed screw breakage with intra-articular migration.Therapeutic arthroscopy confirmed intact graft tension,and broken screw fragments were removed successfully.The patient resumed normal activity two weeks after surgery.CONCLUSION This case highlights the potential complications associated with bioabsorbable screws,emphasizing the need for meticulous surgical technique,postoperative monitoring,and timely intervention.A comprehensive review of the literature illustrates the mechanisms,risk factors,and preventive strategies associated with screw-related complications.
文摘BACKGROUND Recovering from anterior cruciate ligament(ACL)reconstruction can be challenging.While standard rehabilitation helps restore knee function,many patients still face a slow or incomplete recovery.Extracorporeal shockwave therapy(ESWT)has recently gained attention as a potential way to speed up healing and improve outcomes when added to traditional rehab.AIM To explore whether combining ESWT with standard postoperative rehabilitation truly leads to better recovery compared with rehab alone.METHODS A systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines,evaluating participant status following ACL reconstruction with standard rehabilitation and without augmented ESWT.This meta-analysis included six studies(five randomized controlled trials,one non-randomized clinical study).The outcome measures were the Lysholm score,International Knee Documentation Committee score,visual analog score,and KT-1000 measurements.To compare the control and intervention groups,the weighted mean differences were calculated along with the 95%confidence intervals.The heterogeneity of the studies and publication bias were analyzed.RESULTS ESWT modestly improved Lysholm scores(weighted mean difference:3.72;95%confidence interval:-0.27 to 7.71)with high heterogeneity(I2:96%,P<0.001)when compared with standard rehabilitation.Focused ESWT showed greater benefits compared with radial ESWT.No significant differences were found in the International Knee Documentation Committee scores,visual analog score,or KT-1000 measurements.Substantial variability and publication bias were noted.CONCLUSION ESWT improved Lysholm scores but did not show other significant benefits.Due to the limited evidence,further standardized,placebo-controlled trials are needed to confirm its effectiveness in ACL reconstruction.
基金Supported by Guangdong Basic Research Center of Excellence for Major Blinding Eye Diseases Prevention and Treatment(No.2024-YXGG-016).
文摘Dear Editor,We report a surgical method for treating repeat Descemet’s membrane(DM)detachments in two cases with DM micro-perforation during deep anterior lamellar keratoplasty(DALK).DM micro-perforation is a common intraoperative complication that occurs during the performance of DM baring in DALK,using methods such as the bigbubble air technique[1].The sequelae of DM micro-perforations include postoperative DM detachments,higher endothelial cell loss,endothelial decompensation,and transplant interface scarring[2].
基金supported by the National Natural Science Foundation of China,Nos.82374561(to JD),82174490(to JF)the Medical and Health Science and Technology Program of Zhejiang Province,No.2021RC098(to JD)the Research Project of Zhejiang Chinese Medical University,Nos.2022JKZKTS44(to JD),2022FSYYZZ07(to JF).
文摘Pain is often comorbid with emotional disorders such as anxiety and depression.Hyperexcitability of the anterior cingulate cortex has been implicated in pain and pain-related negative emotions that arise from impairments in inhibitory gamma-aminobutyric acid neurotransmission.This review primarily aims to outline the main circuitry(including the input and output connectivity)of the anterior cingulate cortex and classification and functions of different gamma-aminobutyric acidergic neurons;it also describes the neurotransmitters/neuromodulators affecting these neurons,their intercommunication with other neurons,and their importance in mental comorbidities associated with chronic pain disorders.Improving understanding on their role in pain-related mental comorbidities may facilitate the development of more effective treatments for these conditions.However,the mechanisms that regulate gamma-aminobutyric acidergic systems remain elusive.It is also unclear as to whether the mechanisms are presynaptic or postsynaptic.Further exploration of the complexities of this system may reveal new pathways for research and drug development.
基金Supported by Iranian University of Medical Sciences(code:IR.IUMS.REC.1401.371).
文摘AIM:To identify topographic determinants of the anterior chamber angle(ACA)in patients with keratoconus(KCN).METHODS:Four hundred and ten eyes of 294 patients with KCN were recruited for this study.First,complete ocular examinations were performed for all patients,including visual acuity measurement,refraction,and slit-lamp biomicroscopy.Then,all participants underwent corneal imaging by the Oculus Pentacam HR.RESULTS:The mean age of the participants was 32.40±8.52y(15-60y)and 69.5%of them were male.The mean ACA was 38.47°±5.75°(range:14.40°to 56.50°)in the whole sample,38.24°±6.00°in males,and 38.98°±5.11°in females(P=0.447).The mean ACA was significantly different among different groups of cone morphology,as patients with nipple cones showed the lowest mean ACA.Moreover,there were statistically significant differences in the mean ACA among different groups of cone locations,with patients having central cones exhibiting the lowest mean ACA(P<0.001).Anterior and posterior Q values were significantly,directly correlated with ACA(anterior Q:r=0.122,P=0.014,posterior Q:r=0.192,P<0.001).CONCLUSION:This study provides critical insights into the risk factors for ACA narrowing in KCN patients,which is essential for planning intraocular surgeries.Patients with nipple and central cones exhibited the most significant ACA narrowing.Additionally,more negative Q-values are associated with increased ACA narrowing,highlighting the need for targeted diagnostic and therapeutic strategies.
基金supported by the Areas of Excellence Scheme(AoE/M402/20)the Knowledge Transfer Project Fund(KPF24GWP05)+2 种基金the IdeaBooster Fund(IDBF24MED12)the HKSTP Ideation Fund(Ideation 23-0698)the ITC Technology Startup Support Scheme for Universities(TSU24MED05).
文摘Anterior cruciate ligament(ACL)injuries are frequently caused by sports injuries and trauma.In cases involving complete tears,ACL reconstruction(ACLR)surgery is the only way to restore the ligament’s integrity.When selecting a graft,both the potential complications and the mechanical properties and healing efficacies should be considered.Artificial ligaments have been widely applied in clinical ACLR,and most have exhibited satisfactory biocompatibility and short-term follow-up results.Compared with autografts and allografts,however,the lack of bioactivity of currently available artificial ligaments is a major disadvantage.In addition,some long-term follow-up results have revealed other drawbacks of artificial ligaments,such as graft failure and other complications.Here,we summarize attempts to enhance the bioactive performance of artificial ligaments,as such modifications may have good potential for clinical translation and could improve the long-term outcomes of existing products.
文摘AIM:To analyze the characteristics and correlation of phacoemulsification parameters and anterior segment parameters in cataract patients with different blood glucose levels.METHODS:A total of 45 type 2 diabetic cataract patients(45 eyes)treated in our hospital from March 2023 to April 2024 were stratified into two groups based on glycosylated hemoglobin(HbA1c)levels:group A:HbA1c<7%(n=18)and group B:7%≤HbA1c<8.5%(n=27);a total of 94 age-matched age-related cataract patients(94 eyes)were enrolled as the control group(group C).All underwent phacoemulsification with intraocular lens implantation.Anterior segment parameters,including corneal,lens and anterior chamber measurements,were recorded.Correlations between phacoemulsification parameters and anterior segment parameters were analyzed,and differences among groups were compared.RESULTS:In groups A and B,effective phacoemulsification time(EPT)negatively correlated with corneal endothelial cell density(CECD)(r=-0.315,P=0.035).Average phacoemulsification time(APT)positively correlated with the anterior corneal surface radius of curvature(Rm;r=0.402,P=0.006)and negatively correlated with the flat axis meridian curvature(K 1),steep axis meridian curvature(K 2),mean curvature(Km)of the anterior corneal surface,and lens density at 6 mm zones(PDZ3;all P<0.05).Average phacoemulsification energy(AVE)positively correlated with mean lens density(LD-mean),lens density at 2 mm zones(PDZ1),lens density at 4 mm zones(PDZ2),and PDZ3(all P<0.05),and negatively with pupil diameter(r=-0.385,P=0.009).In the group C,EPT showed a positive correlation with Pentacam nucleus staging(PNS)density grade,PDZ1,PDZ2,and PDZ3(all P<0.05).A positive correlation was observed between AVE and PNS classification(r=0.246,P=0.018).Conversely,AVE exhibited a negative correlation with CECD(r=-0.245,P=0.018).EPT in groups A and B was higher than that in the group C(P<0.05).Both EPT and APT in the group B were higher than those in the group A(P<0.05).In diabetic cataract patients,CECD,corneal density(CD),and posterior corneal surface height positively correlated with diabetes duration(P<0.05).Posterior corneal surface K 1 and Rm positively correlated with 7%≤HbA1c<8.5%(P<0.05).Total corneal astigmatism negatively correlated with HbA1c,2-hour post-breakfast blood glucose(2hPBG),and fasting insulin(FINS;P<0.05).CD and lens thickness(LT)positively correlated with FINS(P<0.05).CONCLUSION:Phacoemulsification parameters and blood glucose-related indices exhibited varying degrees of correlation with anterior segment parameters in cataract patients with different blood glucose levels.EPT in diabetic cataract patients was higher than that in age-related cataract patients,while EPT and APT in diabetic cataract patients with poor glycemic control were higher than those with good glycemic control.
基金supported by Tasly Pharmaceutical Group Co.,Ltd.(Grant No.303100031BA20)。
文摘The current study aimed to evaluate the efficacy and safety of Compound Danshen Dripping Pills(CDDP)in improving cardiac function in patients with acute anterior ST-segment elevation myocardial infarction(AAMI).Between February 2021 and February 2023,247 eligible patients with AAMI after primary percutaneous coronary intervention were enrolled and randomly assigned(1∶1)to receive CDDP(n=126)or placebo(n=121),with a follow-up of 48 weeks.Compared with the placebo group,the CDDP group demonstrated a significant increase in left ventricular ejection fraction values after 24 weeks of treatment(least squares mean:3.31;95%confidence interval[CI]:1.72–4.90;P<0.001)and at the 48-week follow-up(least squares mean:4.35;95%CI:2.76–5.94;P<0.001).Significant reductions in N-terminal pro-B-type natriuretic peptide levels were observed in both groups at the 24-and 48-week visits with no significant difference between the two groups(P>0.1 for all).The incidence of major adverse cardiovascular and cerebrovascular events was 6.35%in the CDDP group and 5.79%in the placebo group(P=0.822).Notably,no serious adverse events were attributed to CDDP.These findings suggest that CDDP may be well tolerated and could improve left ventricular ejection fraction in patients with AAMI at 24 and 48 weeks.
文摘BACKGROUND Orthodontic treatment for open bite and crossbite cases is always challenging.In this paper,we demonstrate a skeletal class III patient with anterior open bite and crossbite whose problem was successfully corrected with improved super-elastic Ti-Ni alloy wire(ISW).CASE SUMMARY A 19 years old male came to our clinic with a chief complaint of anterior open bite and crossbite and not able to chew food well.Clinical examination revealed an angle class III malocclusion with anterior open bite,crossbite and spaced arch.Ra-diographic and clinical examination showed a skeletal class III pattern.We used ISW to level the upper and lower arch and to correct the anterior open bite and crossbite.Intermaxillary elastics were also used to achieve a better interdigitation.Finally,adequate overbite,overjet and a desirable occlusion were achieved.The active treatment time took 2 years and 2 months.CONCLUSION In a case of class III angular malocclusion with open bite and crossbite in the ante-rior teeth,ideal results were achieved using the ISW technique and the patient was satisfied with the outcome.
基金supported by the Department of Science&Technology of Liaoning Province(2024-MS-099,2024-BS-093)。
文摘Pentadactyl limbs represent a conserved morphological feature among tetrapods,with anterior digits considered more important than posterior digits for refined movement.While posterior digit formation is governed by graded expression of the Shh and 5’Hox genes,the regulatory mechanisms underlying anterior digit development,especially digit I(DI),remain poorly defined.This study identified an anterior expression pattern of Zic3 in the limb buds of representative tetrapods,including humans,which exerted an inhibitory effect on skeletal development.Zic3 was highly expressed in the anterior region of limb buds at early developmental stages,with species-specific divergence emerging during later development.Overexpression of Zic3 significantly delayed chondrogenesis and ossification,leading to bone shortening but not loss.Furthermore,RNA sequencing demonstrated that Zic3 down-regulated key genes associated with skeletal development,including Cytl1,Sox9,Ihh,Ptch1,Runx2,and Wnt16.These findings demonstrate that Zic3 acts as a conserved inhibitor of anterior skeletal maturation and contributes to the molecular asymmetry of tetrapod limb development.
文摘BACKGROUND According to the Global Cancer Statistics Report,the incidence of colorectal cancer ranks third and the mortality rate ranks second worldwide among malignant tumors.AIM To explore the effects of Nursing Outcomes Classification(NOC)-based multidimensional nursing on self-efficacy and symptom relief in patients with low anterior resection syndrome(LARS)following sphincter-preserving surgery.METHODS This observational study enrolled 120 patients with LARS after sphincterpreserving surgery for low rectal cancer admitted to our hospital between January 2022 and December 2024.The patients were randomly divided into a control group(n=60)that received routine nursing intervention or an observation group(n=60)that received multidimensional nursing intervention.Before and after the intervention,the Chinese version of the Self-Management Efficacy Scale for Cancer Patients(SUPPH),the LARS scoring scale,and the European Organization for Research and Treatment of Cancer Quality of Life Core Scale(EORTC QLQC30)were used to evaluate the self-efficacy,symptom relief,and quality of life of the two patient groups,and the nursing satisfaction was compared between the groups.RESULTS After the intervention,both groups showed increased scores for each item on the SUPPH and EORTC QLQ-C30 scales compared with those before the intervention,whereas the LARS score showed a decreasing trend.Compared with the control group,the scores for each item of the SUPPH and EORTC QLQ-C30 scales in the observation group were significantly higher after the intervention,while the LARS score was significantly lower(all P<0.05).Nursing satisfaction was significantly higher in the observation group than in the control group(83.33%vs 95.00%,P<0.05).CONCLUSION Multidimensional NOC-based nursing improves self-efficacy,symptoms,quality of life,and satisfaction in patients with LARS.However,further research is needed to assess its long-term and comparative effectiveness.
基金supported by grants from the National Natural Science Foundation of China(82271243 and 82101318)Shaanxi Province Key Research and Development Plan(2024SF-ZDCYL-01-13)+1 种基金the support funding from Fourth Military Medical University(2024JC005,2020AXJHHJ,and XJZT24JC27)Liaoning Provincial Joint Science and Technology Program(2023-MSLH-345).
文摘The anterior cingulate cortex(ACC)has recently been proposed as a key player in the representation of itch stimuli.However,to date,little is known about the contribution of specific ACC interneuron populations to itch processing.Using c-Fos immunolabeling and in vivo Ca2+imaging,we reported that both histamine and chloroquine stimuli-induced acute itch caused a marked enhancement of vasoactive intestinal peptide(VIP)-expressing interneuron activity in the ACC.Behavioral data indicated that optogenetic and chemogenetic activation of these neurons reduced scratching responses related to histaminergic and non-histaminergic acute itch.Similar neural activity and modulatory role of these neurons were seen in mice with chronic itch induced by contact dermatitis.Together,this study highlights the importance of ACC VIP+neurons in modulating itch-related affect and behavior,which may help us to develop novel mechanism-based strategies to treat refractory chronic itch in the clinic.
文摘AIM:To measure the optimal anterior chamber pressure(ACP)for safe phacoemulsification using a new tube chamber system with internal pressure measurement function in the porcine eye.METHODS:The 20-gauge and 21-gauge straight tips with yellow and orange sleeves,respectively,were covered by a test chamber combined with a pressure sensor for measuring ACP.This was measured for 20s from 10s after starting aspiration in the linear mode using vacuum levels of 200 and 150 mm Hg with a 20-gauge tip,and 300 and 250 mm Hg with a 21-gauge tip.Using a porcine eye,a pressure sensor fixed with a 0.9 mm corneal incision measured ACP.For the posterior capsule contact assay,porcine eyes were treated as described above,and the ultrasonic needle tip was held at the height of the iris and aspirated for 30s in linear mode at a vacuum of 200 and 150 mm Hg for the 20-gauge tip,and 300 and 250 mm Hg for the 21-gauge tip.The bottle height at which the posterior capsule accidentally contacted the ultrasonic tip was recorded,and the estimated ACP was calculated.RESULTS:The internal pressure of the new tube chamber system and ACP from the porcine eye closely matched proportional changes at vacuum levels of 200 and 150 mm Hg with 20-gauge tips.Similarly,proportional changes at vacuum levels of 300 and 250 mm Hg with the 21-gauge tip were nearly equal.The bottle height at which the posterior capsule contacted with the tip and estimated ACP were 57.5±12.6 cm(20.2±7.9 mm Hg)at 200 mm Hg with a 20-gauge tip,35.0±10.0 cm(16.6±6.3 mm Hg)at 150 mm Hg with a 20-gauge tip,47.5±12.6 cm(18.7±8.7 mm Hg)at 300 mm Hg with a 21-gauge tip,and 32.5±5.0 cm(15.7±3.5 mm Hg)at 250 mm Hg with a 21-gauge tip.CONCLUSION:A comprehensive understanding of this chamber system’s characteristics and usage can resolve anterior chamber instability caused by changing preoperative settings on the phaco machine.
文摘AIM:To evaluate changes in corneal light scattering and anterior segment parameters in newly diagnosed rheumatoid arthritis(RA)patients who achieved remission with systemic treatment,compared to healthy controls.METHODS:A cross-sectional study was conducted at a tertiary care hospital,in ophthalmology,and rheumatology departments.A total of 42 RA patients(13 men and 29 women)and 56 healthy individuals(23 men 33 women)underwent comprehensive ophthalmologic evaluations,including Scheimpflug corneal densitometry and Pentacam HR measurements.Those who initiated systemic treatment for RA were monitored at first,third,and sixth-month follow-ups.Participants who achieved remission at each follow-up assessment were included.RESULTS:Significant differences in corneal densitometry were observed,with higher values in RA patients,particularly in the middle and posterior layers.Anterior segment parameters such as anterior chamber volume and angle were significantly reduced in RA patients compared to other groups(P<0.001).Following systemic treatment and achievement of remission,these parameters showed regression toward normal values.CONCLUSION:The study underscores the potential utility of corneal densitometry and anterior segment analysis as sensitive indicators of subclinical ocular involvement in RA,offering insights into disease progression and treatment efficacy.These findings highlight the importance of early detection and regular monitoring in preventing vision-threatening complications in RA patients.
基金supported by the National Natural Science Foundation of China[No.81871823,8207090113]the Shanghai Science and Technology Committee[No.22dz1204700].
文摘Background:Postural control deficits and persistent joint stability issues are prevalent in population with anterior cruciate ligament(ACL)injuries or reconstructions.Postural control is typically assessed using the center of pressure(CoP)parameters during the static single-leg stance with a force plate.However,previous studies have reported unclear definitions and descriptions of the CoP parameters,causing inconsistent results of postural control deficits in a specific population.Objective:To 1)summarize CoP parameters commonly used to evaluate postural control deficits in ACL injured or reconstructed population,and 2)identify the differences in CoP parameters with opened and closed eyes during the single-leg stance between ACL injured or reconstructed and control groups.Methods:PubMed,Embase,Cochrane Library,CINAHL,Scopus,Web of Science,and SPORTDiscus databases were searched up to July 2023.Data were obtained from the selected articles and underwent quality and risk of bias assessment and meta-analysis using random-effect models.Subgroup analysis within ACL injured or reconstructed group were also performed.Results:A total of 14 articles were included in the analysis after screening.The injured knee of the ACL injured or reconstructed group differed insignificantly in sway amplitude,sway area,and sway velocity during static singleleg stance under opened and closed eyes when compared with the control group.In the subgroup analysis,we found that there was only significant difference in sway velocity with open eyes(SMD=0.47,p=0.001)between ACL reconstructed group and control group.Conclusion:This study summarized the common CoP parameters used to evaluate postural control in ACL injured or reconstructed population.The results only showed weak difference in sway velocity between ACL reconstructed population and healthy individuals with opened eyes during the static single-leg stance.
