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
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
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
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 Fibro-adipogenic progenitors(FAPs)are a group of mesenchymal stem cells that cause fibro-fatty degeneration in skeletal muscle in various chronic disease mode-ls.FAPs also play a role in preventing muscle d...BACKGROUND Fibro-adipogenic progenitors(FAPs)are a group of mesenchymal stem cells that cause fibro-fatty degeneration in skeletal muscle in various chronic disease mode-ls.FAPs also play a role in preventing muscle degeneration at acute stages during disease progression.However,few studies have reported the changes in and function of FAPs in the acute phase after tendon rupture.AIM To clarify the changes in the number of FAPs and their impact on skeletal muscle soon after tendon rupture to facilitate future studies targeting FAPs to treat muscle degeneration.METHODS We utilized Pdgfra-H2B::eGFP mice to trace and quantify FAPs in a tibialis anterior tenotomy(TAT)model at 0 and 3 days,1 week,2 weeks,3 weeks,4 weeks,5 weeks,and 6 weeks post-injury,and the results were further validated using fluorescence-activated cell sorting analysis with C57BL/6 mice at the same post-injury timepoints.We subsequently used PdgfraCreERT::RosaDTA mice,and evaluated the severity of post-TAT skeletal muscle degeneration with or without FAP-depletion.RESULTS The number of FAPs peaked at 1 week post-TAT before gradually declining to a level comparable to that pre-TAT.The change in the number of FAPs was potentially temporally correlated with the progression of skeletal muscle degeneration after TAT.FAP-depletion led to more severe degeneration early after TAT,indicating that FAPs potentially alleviate muscle degeneration after tendon rupture in the early post-injury phase.CONCLUSION FAPs potentially alleviate the degeneration of skeletal muscle in the acute stage after tendon rupture.展开更多
AIM:To examine how three distinct central positioning techniques for anterior capsulotomy-pupil center,limbus center,and lens apex-affect intraocular lens(IOL)placement and visual quality following femtosecond laser-a...AIM:To examine how three distinct central positioning techniques for anterior capsulotomy-pupil center,limbus center,and lens apex-affect intraocular lens(IOL)placement and visual quality following femtosecond laser-assisted cataract surgery(FLACS).METHODS:A total of 36 patients(72 eyes)with age-related cataracts who underwent FLACS and ZCB00 aspherical IOL implantation at Aier Eye Hospital Medical Center,Anhui Medical University between January and December 2023 were included in this prospective study.Patients were divided into three groups based on the central positioning mode for anterior capsulotomy:pupil center,limbus center,and lens apex center groups.IOL alignment and displacement were evaluated using the Casia2 device,and the postoperative visual quality was assessed.RESULTS:At 1 d postoperatively,the IOL tilt for the pupil,limbus,and apex groups were 3.96°±1.51°,4.63°±1.87°,and 3.90°±2.24°,respectively(F=1.07,P=0.35);IOL decentration values were 0.21±0.10 mm,0.23±0.16 mm,and 0.21±0.12 mm,respectively(F=0.14,P=0.87);total higher-order aberrations were 0.32±0.40μm,0.56±0.61μm,and 0.53±0.60μm,respectively(F=1.38,P=0.26);and coma aberrations values were 0.13±0.10μm,0.16±0.15μm,and 0.14±0.15μm,respectively(F=0.3,P=0.74).All results obtained postoperative day 1 did not differ significantly.At 3 mo postoperatively,IOL tilt values were 5.42°±2.00°,3.96°±1.44°,and 3.20°±1.19°,respectively(F=12.40,P<0.001);IOL decentration values were 0.33±0.07 mm,0.23±0.11 mm,and 0.21±0.11 mm,respectively(F=4.99,P=0.008);total higher-order aberrations were 0.67±0.29μm,0.44±0.37μm,and 0.42±0.19μm,respectively(F=5.50,P=0.006);and coma aberrations values were 0.21±0.12μm,0.19±0.12μm,and 0.12±0.11μm,respectively(F=3.87,P=0.03).All results obtained 3 mo postoperatively were statistically significant.CONCLUSION:Using the lens apex as the central positioning mode for anterior capsulotomy in FLACS improves postoperative IOL stability and reduces postoperative IOL tilt and decentration.If the lens apex cannot be determined intraoperatively,the limbus center-positioning mode is recommended.展开更多
AIM:To compare surgical efficacy based on residual peripheral anterior synechiae(PAS)extent af ter viscogonioplasty(VGP)combined with phacoemulsification and intraocular lens implantation(PEI)in patients with primary ...AIM:To compare surgical efficacy based on residual peripheral anterior synechiae(PAS)extent af ter viscogonioplasty(VGP)combined with phacoemulsification and intraocular lens implantation(PEI)in patients with primary angle-closure disease(PACD)and identify risk factors for extensive postoperative PAS.METHODS:This prospective cohort study included 73 eyes of 61 patients with PACD undergoing PEI with VGP.Patients were divided into Group A(PAS<90°,n=39)and Group B(90°≤PAS≤180°,n=34)based on PAS extent at the end of surgery.PAS progression rates were assessed using a linear mixed-effects model.Logistic regression analyzed risk factors for PAS≥180°at 12mo postoperatively.RESULTS:Both groups showed significant PAS progression at 12mo(P<0.001).Group A had smaller PAS extent than Group B at all time points(P<0.001).PAS progression rates were similar between groups(P=0.335).No significant differences were found in intraocular pressure(IOP),IOP-lowering medications,or surgical success rates(P>0.05).Female[odds ratio(OR)=0.211,P=0.046],preoperative medication number(OR=1.017,P=0.029),and PAS extent at the end of surgery(OR=1.017,P=0.018)were risk factors for PAS≥180°at 12mo.CONCLUSION:Residual PAS extent at the end of surgery predicts postoperative extensive PAS formation but has limited effect on PAS progression rate and IOP control.Female,multiple preoperative IOP-lowering medications,and larger residual PAS extent are independent risk factors for extensive PAS at 12mo postoperatively.展开更多
AIM:To describe the alterations of the vitreous pathology and anterior chamber(AC)angle structures following transscleral cyclophotocoagulation(TSCP)and better understand the mechanism of post-laser intraocular pressu...AIM:To describe the alterations of the vitreous pathology and anterior chamber(AC)angle structures following transscleral cyclophotocoagulation(TSCP)and better understand the mechanism of post-laser intraocular pressure(IOP)reduction in angle-closure glaucoma(ACG).METHODS:Porcine eyes ex vivo and rabbit eyes in vivo were used.In porcine eyes,permeability rates of the anterior vitreous cortex(AVC)and anterior hyaloid membrane(AHM)were assessed using Schirmer’s strips.Permeability rates in the circumlental space were compared with or without TSCP bursts.Fluorescein diffusion times from the vitreous to the AC were compared between eyes with and without TSCP.In rabbit eyes,changes in IOP and AC angle structures under ultrasound biomicroscopy(UBM)were evaluated at intervals of 30min,7d,and 14d after TSCP.Vitreous pathology was examined using scanning electron microscopy(SEM)immediately and 14d after TSCP.RESULTS:In porcine eyes(n=20),the median(range)permeability rates were 10.3(range 9.8–10.8)mm/min for the AVC and 4.3(range 3.9–4.9)mm/min for the AHM(P=0.009).Permeability rates in the circumlental space were 4.2(range 3.8–4.9)mm/min in areas without TSCP,6.2(range 5.7–6.8)mm/min in areas with non-burst TSCP,and 11.3(range 10.9–11.8)mm/min in areas with burst TSCP(P=0.002).The median(range)fluorescein diffusion time was 5(range 3–8)min in eyes undergoing TSCP,whereas it was 40min(range 35–68)in eyes without TSCP(P<0.001).In rabbit eyes(n=20),SEM showed immediate localized damage to the AHM,AVC,and posterior lens zonules in areas subjected to TSCP bursts,and obvious lens zonule loss with cellular infiltration and possible vitreous liquefaction by post-op day 14.Persistent widening of AC angles was noted at postoperative days 7 and 14,although a significant reduction in IOP was only observed at postoperative day 7.CONCLUSION:TSCP-induced damage on the zonules,AHM,and AVC potentially enhances fluid outflow from the vitreous,leading to a widened AC angle and vitreous liquefaction in rabbits.These observations offer insights into mechanisms of TSCP in lowering IOP and pathogenic roles of vitreous in ACG.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
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.
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.
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 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 National Natural Science Foundation of China,No.82172509.
文摘BACKGROUND Fibro-adipogenic progenitors(FAPs)are a group of mesenchymal stem cells that cause fibro-fatty degeneration in skeletal muscle in various chronic disease mode-ls.FAPs also play a role in preventing muscle degeneration at acute stages during disease progression.However,few studies have reported the changes in and function of FAPs in the acute phase after tendon rupture.AIM To clarify the changes in the number of FAPs and their impact on skeletal muscle soon after tendon rupture to facilitate future studies targeting FAPs to treat muscle degeneration.METHODS We utilized Pdgfra-H2B::eGFP mice to trace and quantify FAPs in a tibialis anterior tenotomy(TAT)model at 0 and 3 days,1 week,2 weeks,3 weeks,4 weeks,5 weeks,and 6 weeks post-injury,and the results were further validated using fluorescence-activated cell sorting analysis with C57BL/6 mice at the same post-injury timepoints.We subsequently used PdgfraCreERT::RosaDTA mice,and evaluated the severity of post-TAT skeletal muscle degeneration with or without FAP-depletion.RESULTS The number of FAPs peaked at 1 week post-TAT before gradually declining to a level comparable to that pre-TAT.The change in the number of FAPs was potentially temporally correlated with the progression of skeletal muscle degeneration after TAT.FAP-depletion led to more severe degeneration early after TAT,indicating that FAPs potentially alleviate muscle degeneration after tendon rupture in the early post-injury phase.CONCLUSION FAPs potentially alleviate the degeneration of skeletal muscle in the acute stage after tendon rupture.
文摘AIM:To examine how three distinct central positioning techniques for anterior capsulotomy-pupil center,limbus center,and lens apex-affect intraocular lens(IOL)placement and visual quality following femtosecond laser-assisted cataract surgery(FLACS).METHODS:A total of 36 patients(72 eyes)with age-related cataracts who underwent FLACS and ZCB00 aspherical IOL implantation at Aier Eye Hospital Medical Center,Anhui Medical University between January and December 2023 were included in this prospective study.Patients were divided into three groups based on the central positioning mode for anterior capsulotomy:pupil center,limbus center,and lens apex center groups.IOL alignment and displacement were evaluated using the Casia2 device,and the postoperative visual quality was assessed.RESULTS:At 1 d postoperatively,the IOL tilt for the pupil,limbus,and apex groups were 3.96°±1.51°,4.63°±1.87°,and 3.90°±2.24°,respectively(F=1.07,P=0.35);IOL decentration values were 0.21±0.10 mm,0.23±0.16 mm,and 0.21±0.12 mm,respectively(F=0.14,P=0.87);total higher-order aberrations were 0.32±0.40μm,0.56±0.61μm,and 0.53±0.60μm,respectively(F=1.38,P=0.26);and coma aberrations values were 0.13±0.10μm,0.16±0.15μm,and 0.14±0.15μm,respectively(F=0.3,P=0.74).All results obtained postoperative day 1 did not differ significantly.At 3 mo postoperatively,IOL tilt values were 5.42°±2.00°,3.96°±1.44°,and 3.20°±1.19°,respectively(F=12.40,P<0.001);IOL decentration values were 0.33±0.07 mm,0.23±0.11 mm,and 0.21±0.11 mm,respectively(F=4.99,P=0.008);total higher-order aberrations were 0.67±0.29μm,0.44±0.37μm,and 0.42±0.19μm,respectively(F=5.50,P=0.006);and coma aberrations values were 0.21±0.12μm,0.19±0.12μm,and 0.12±0.11μm,respectively(F=3.87,P=0.03).All results obtained 3 mo postoperatively were statistically significant.CONCLUSION:Using the lens apex as the central positioning mode for anterior capsulotomy in FLACS improves postoperative IOL stability and reduces postoperative IOL tilt and decentration.If the lens apex cannot be determined intraoperatively,the limbus center-positioning mode is recommended.
基金Supported by the National Natural Science Foundation of China(No.62020106015)the Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(No.PWD&RPP-MRI,JYY2023-6).
文摘AIM:To compare surgical efficacy based on residual peripheral anterior synechiae(PAS)extent af ter viscogonioplasty(VGP)combined with phacoemulsification and intraocular lens implantation(PEI)in patients with primary angle-closure disease(PACD)and identify risk factors for extensive postoperative PAS.METHODS:This prospective cohort study included 73 eyes of 61 patients with PACD undergoing PEI with VGP.Patients were divided into Group A(PAS<90°,n=39)and Group B(90°≤PAS≤180°,n=34)based on PAS extent at the end of surgery.PAS progression rates were assessed using a linear mixed-effects model.Logistic regression analyzed risk factors for PAS≥180°at 12mo postoperatively.RESULTS:Both groups showed significant PAS progression at 12mo(P<0.001).Group A had smaller PAS extent than Group B at all time points(P<0.001).PAS progression rates were similar between groups(P=0.335).No significant differences were found in intraocular pressure(IOP),IOP-lowering medications,or surgical success rates(P>0.05).Female[odds ratio(OR)=0.211,P=0.046],preoperative medication number(OR=1.017,P=0.029),and PAS extent at the end of surgery(OR=1.017,P=0.018)were risk factors for PAS≥180°at 12mo.CONCLUSION:Residual PAS extent at the end of surgery predicts postoperative extensive PAS formation but has limited effect on PAS progression rate and IOP control.Female,multiple preoperative IOP-lowering medications,and larger residual PAS extent are independent risk factors for extensive PAS at 12mo postoperatively.
基金Supported by National Natural Science Foundation of China(No.82201171,No.82171050,No.82471072).
文摘AIM:To describe the alterations of the vitreous pathology and anterior chamber(AC)angle structures following transscleral cyclophotocoagulation(TSCP)and better understand the mechanism of post-laser intraocular pressure(IOP)reduction in angle-closure glaucoma(ACG).METHODS:Porcine eyes ex vivo and rabbit eyes in vivo were used.In porcine eyes,permeability rates of the anterior vitreous cortex(AVC)and anterior hyaloid membrane(AHM)were assessed using Schirmer’s strips.Permeability rates in the circumlental space were compared with or without TSCP bursts.Fluorescein diffusion times from the vitreous to the AC were compared between eyes with and without TSCP.In rabbit eyes,changes in IOP and AC angle structures under ultrasound biomicroscopy(UBM)were evaluated at intervals of 30min,7d,and 14d after TSCP.Vitreous pathology was examined using scanning electron microscopy(SEM)immediately and 14d after TSCP.RESULTS:In porcine eyes(n=20),the median(range)permeability rates were 10.3(range 9.8–10.8)mm/min for the AVC and 4.3(range 3.9–4.9)mm/min for the AHM(P=0.009).Permeability rates in the circumlental space were 4.2(range 3.8–4.9)mm/min in areas without TSCP,6.2(range 5.7–6.8)mm/min in areas with non-burst TSCP,and 11.3(range 10.9–11.8)mm/min in areas with burst TSCP(P=0.002).The median(range)fluorescein diffusion time was 5(range 3–8)min in eyes undergoing TSCP,whereas it was 40min(range 35–68)in eyes without TSCP(P<0.001).In rabbit eyes(n=20),SEM showed immediate localized damage to the AHM,AVC,and posterior lens zonules in areas subjected to TSCP bursts,and obvious lens zonule loss with cellular infiltration and possible vitreous liquefaction by post-op day 14.Persistent widening of AC angles was noted at postoperative days 7 and 14,although a significant reduction in IOP was only observed at postoperative day 7.CONCLUSION:TSCP-induced damage on the zonules,AHM,and AVC potentially enhances fluid outflow from the vitreous,leading to a widened AC angle and vitreous liquefaction in rabbits.These observations offer insights into mechanisms of TSCP in lowering IOP and pathogenic roles of vitreous in ACG.
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.
