In the paper, the effects of linear expansion coefficient and basic index of melting slag on the detachability of self shielded flux cored electrode (SSFCE) are investigated. An equation is obtained on the principles ...In the paper, the effects of linear expansion coefficient and basic index of melting slag on the detachability of self shielded flux cored electrode (SSFCE) are investigated. An equation is obtained on the principles of ceramics and mineralography which predict the detachability of basic SSFCE. In addition, stick slag mechanism of SSFCE is analyzed.展开更多
Wound dressing management is critical in healthcare,and frequent dressing changes for full-thickness skin wounds can hinder healing.Nanofiber dressings that resemble the extracellular matrix,have gained popularity in ...Wound dressing management is critical in healthcare,and frequent dressing changes for full-thickness skin wounds can hinder healing.Nanofiber dressings that resemble the extracellular matrix,have gained popularity in wound repair,however,it is challenging to explore how to frequently change it without affecting healing processing and avoiding secondary damage.Here,we developed a self-adhesive and detachable nanofiber dressing inspired by Andrias davidianus.Our asymmetric nanofiber dressing exhibits strong adhesion(26 kPa),to the wound at high temperature(approximately 25°C)to the wound surface and can be easily detached(4 kPa)at low temperature(below 8°C),enabling painless dressing changes that minimize secondary injuries.The dressing comprises an outer layer of polylactic acid which provides mechanical property,support,and pollution resistance,with an inner layer of nanofibrous membrane,composed of gelatin and Andrias davidianus skin secretions,which promotes cellular migration,enhances wound healing and possesses inherent antimicrobial properties.Furthermore,the all-natural nanofiber dressings can be prepared on a large scale and offer favorable biocompatibility to meet the basic requirements of wound dressings.These findings demonstrate the potential applicability of our multilayer nanofiber dressing for advancing wound healing practices.展开更多
AIM:To investigate the effects of shortening the duration of silicone oil tamponade on retinal structure and function in patients undergoing silicone oil removal(SOR)after surgery for primary rhegmatogenous retinal de...AIM:To investigate the effects of shortening the duration of silicone oil tamponade on retinal structure and function in patients undergoing silicone oil removal(SOR)after surgery for primary rhegmatogenous retinal detachment(RRD).METHODS:A total of 58 eligible patients were enrolled and randomly assigned to two groups based on tamponade duration:the short-term group(30-45d)and the conventional group(≥90d).Comprehensive evaluations were performed before and after SOR,including slitlamp examination,best-corrected visual acuity(BCVA)measurement,intraocular pressure(IOP)testing,optical coherence tomography(OCT),optical coherence tomography angiography(OCTA),microperimetry,electroretinography(ERG),and visual evoked potential(VEP)assessment.RESULTS:A total of 33 patients(23 males and 10 females;33 eyes)were enrolled in the short-term SO tamponade group with mean age of 52.45±9.35y,and 25 patients(15 males and 10 females;25 eyes)were enrolled in the conventional SO tamponade group with mean age of 50.80±12.06y.Compared with the conventional group,the short-term silicone oil tamponade group had a significantly lower incidence of silicone oil emulsification and cataract progression,with no significant difference in retinal reattachment success rate.Structurally,short-term tamponade was associated with increased thickness of the retinal ganglion cell layer(RGCL)in the nasal and superior macular regions and improved recovery of superficial retinal vascular density in these areas.Functionally,the shortterm group showed better BCVA and retinal sensitivity both before and 1mo after SOR;additionally,the P100 amplitude in VEP tests was significantly increased in this group.CONCLUSION:Shortening the duration of silicone oil tamponade effectively reduces damage to retinal structure and function without compromising the success rate of retinal reattachment in patients with primary RRD.展开更多
Rhegmatogenous retinal detachment(RRD)is a serious ocular condition marked by the separation of the neuroretina from the retinal pigment epithelium(RPE).The pathogenesis of RRD involves intricate molecular and cellula...Rhegmatogenous retinal detachment(RRD)is a serious ocular condition marked by the separation of the neuroretina from the retinal pigment epithelium(RPE).The pathogenesis of RRD involves intricate molecular and cellular mechanisms,including inflammation,cell migration,and the activation of proliferative signaling pathways.One of the most challenging complications of RRD is proliferative vitreoretinopathy(PVR),which refers to the proliferation and contraction of fibrocellular membranes on the retinal surface and in the vitreous cavity.PVR is a major cause of surgical failure in RRD,as it can lead to recurrent retinal detachment and severe vision loss.However,the pathogenesis of PVR is not yet fully understood,and the treatment options are quite limited.Recent advances in analytical techniques have offered valuable insights into the molecular alterations present in the subretinal fluid(SRF)of patients with RRD.This review seeks to consolidate the current knowledge regarding the SRF profile in RRD and PVR,emphasizing potential biomarkers and therapeutic targets.展开更多
Improvements in surgical techniques have led to 90% success in the surgical repair of rhegmatogenous retinal detachment(RRD).However,anatomical reattachment of the retina does not ensure complete recovery of visual fu...Improvements in surgical techniques have led to 90% success in the surgical repair of rhegmatogenous retinal detachment(RRD).However,anatomical reattachment of the retina does not ensure complete recovery of visual function.The incidence of metamorphopsia remains the most common postoperative complaint,from 24% to 88.6%.Currently,the risk factors of metamorphopsia are categorized into macular involvement,retinal shift,outer retinal folds,subretinal fluid,secondary epiretinal membrane,outer retinal layer damage,and surgical approach.The associations of metamorphopsia with postoperative best-corrected visual acuity and postoperative vision-related quality of life were still controversial.The most popular methods for assessment of metamorphopsia remain the Amsler grid and M-Charts.Most treatments cannot progress beyond the management of negative visual sensations,through methods such as occlusion therapy and aniseikonia-correcting spectacles.The main treatment approach involves RRD prevention and the management of risk factors that can lead to postoperative metamorphopsia after RRD repair.Additional research concerning metamorphopsia treatment,further upgrades of auxiliary inspection methods,and more accurate microstructural assessments are needed to address this common complication.展开更多
AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This...AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This retrospective study involved 65 RVO patients(65 eyes)who received IVR and were followedup for more than 3mo.ME was categorized into cystoid macular edema(CME),diffuse retinal thickening(DRT),and serous retinal detachment(SRD)according to optical coherence tomography(OCT)images.The comparison of best corrected visual acuity(BCVA;logMAR)and central macular thickness(CMT)among different follow-up points and those among 3 groups were performed by Kruskal-Wallis test.The correlation between BCVA and baseline parameters during treatment was analyzed using Spearman correlation analysis.RESULTS:BCVA tended to improve in all groups,with marked improvement in CME and DRT groups.CMT showed the greatest reduction after 1wk,and remained stable over the following 3mo.DRT patients had the worst BCVA and the highest CMT at baseline,but the differences became smaller after IVR treatment.CMT in SRD group was significantly better than in CME and DRT groups 3mo after IVR.Most patients of CME and SRD groups transitioned to a normal pattern at 3mo follow-up.DRT patients were most likely to transform into the other morphological groups,while SRD patients showed minimal transitions.BCVA at baseline was identified as the most important prognostic indicator in all 3 groups.Additionally,DRT patients with a longer clinical course,higher CMT and central retinal vein occlusion(CRVO)tend to exhibit worse BCVA after treatment.In addition,CRVO patients are more likely to have worse BCVA at 2 and 3mo follow-up compared with branch retinal vein occlusion(BRVO)patients in CME group.SRD patients with higher baseline CMT were prone to experiencing worse BCVA after treatment.CONCLUSION:The effectiveness of IVR is strongly correlated with baseline BCVA in all 3 groups.Baseline parameters including clinical course,CMT,and RVO position are also useful in predicting the BCVA at different time points after treatment.展开更多
Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Desc...Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Descemet’s membrane(DM)and the posterior corneal stromal layer can be easily separated with minimal mechanical force.Several risk factors have been associated with the development of DMD including old age,improper intraoperative operation,corneal ectatic disorders,and endothelial disorders and so on[1-4].展开更多
AIM:To report the refractive and surgical outcomes of scleral buckling(SB)with or without pars plana vitrectomy(PPV)in patients with pseudophakic rhegmatogenous retinal detachment(PRRD).METHODS:A consecutive case seri...AIM:To report the refractive and surgical outcomes of scleral buckling(SB)with or without pars plana vitrectomy(PPV)in patients with pseudophakic rhegmatogenous retinal detachment(PRRD).METHODS:A consecutive case series of patients with pseudophakia who underwent retinal detachment(RD)surgery was enrolled.The SB procedures were selected to initially treat primary pseudophakic PRRDs and SB-PPV for more complex cases,according to preoperative findings.Eyes with anterior chamber intraocular lens,proliferative vitreoretinopathy anterior to equator,previous invasive glaucoma surgery,severe degenerative myopia or macular hole,and<6mo follow-up were excluded from outcomes analysis.The primary clinical outcome measures were the single surgery anatomic success(SSAS)and final surgery anatomic success(FSAS)rates.Secondary outcome measures were postoperative visual acuity and refractive error.RESULTS:A total of 81 consecutive patients(81 eyes)were enrolled for analysis,comprising 66(81%)men and 15(19%)women with a mean age of 58y(range,33-86y)and the mean final follow-up period was 21.0±19.6mo.A total of 62 PRRDs(n=62;76.5%)were repaired with an initial SB,and 19 PRRDs(n=19;23.5%)were repaired with a combined SB-PPV.The SSAS and FSAS rates were 92.6%(75/81)and 100%(81/81),respectively.All initial failures had retinal reattachment after the secondary PPV.The mean final postoperative best-corrected visual acuity(BCVA)was 0.42±0.33 logMAR(visual acuity 20/55)and final mean refractive error was-1.48±1.40 diopters.The patients who underwent initially SB-PPV had a significantly longer duration of RD and a higher giant retinal tear rate(P<0.05)preoperatively.SSAS was 56/62(90.3%)and 19/19(100%),and the mean postoperative refractive error was-1.30±1.32 D and-1.53±1.38 D for the patients in the SB and SB-PPV groups,respectively.There was no statistically significant difference for those who had SSAS and postoperative refractive errors between the 2 groups.The postoperative BCVAs of the patients with SSAS were not significantly better in the SB group(median,20/40)than in the SB-PPV group(median 20/50).In the SB group,patients with macula-on had better visual acuity postoperatively than patients with macula-off(P=0.000).CONCLUSION:The initial surgical procedures of SB with or without PPV according to the preoperative findings achieve a high reattachment rate and an acceptable refractive error for primary pseudophakic RRD management.展开更多
Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected fro...Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected from March 2023 to February 2024 in the hospital.Their clinical characteristics and treatment effects were observed and their causes were analyzed.Results:After the operations,the eyes with choroidal detachment after glaucoma surgery had 2 cases of true microphthalmos,6 cases of advanced glaucoma,and 2 cases of glaucoma secondary to vitreoretinal surgery.The postoperative manifestations were persistent shallow anterior chamber,the formation of anterior chamber,and then suddenly became shallow or disappeared.Meanwhile,the intraocular pressure was lower than 6 mmHg.Ultrasound and funduscopic examination showed that the choroid and retina were partially elevated,and the choroidal detachment recovered after treatment.Conclusion:Choroidal detachment is one of the common postoperative complications in glaucoma,especially in some special types of refractory glaucoma.Adequate perioperative management before surgery,cautious and delicate operation during surgery,and close observation and treatment after surgery can obviously decrease the occurrence and damage.展开更多
AIM:To compare the proportion of rhegmatogenous retinal detachment(RRD)associated with choroidal detachment(RRDCD)in the emergency surgery group with the routine inpatient surgery group and determine risk factors for ...AIM:To compare the proportion of rhegmatogenous retinal detachment(RRD)associated with choroidal detachment(RRDCD)in the emergency surgery group with the routine inpatient surgery group and determine risk factors for RRDCD.METHODS:A total of 694 patients(694 eyes)diagnosed with RRD in the emergency surgery(the median duration of RRD was 5d)group were included from the Department of Ophthalmic Emergency,and 692 patients(eyes)in the routine inpatient surgery group(the median duration was 15d)were selected randomly from the Ocular Fundus Department.Demographics,refractive status,macular status,lens status,extent of retinal detachment,number of retinal breaks,duration of symptoms before surgery,and the incidence of RRDCD were compared.A logistic regression analysis was used to determine potential risk factors for RRDCD.RESULTS:Compared to the routine inpatient surgery group,the emergency surgery group had a significant less median time to surgery(P<0.001)and a decreased proportion of RRDCD(2.88%vs 10.84%,P<0.001).Logistic regression analysis revealed that a prolonged duration of RRD[OR 3.51,95%confidence interval(CI)1.98-6.23],pseudophakia/aphakia status[OR 2.74,95%CI(1.50-4.98)],multiple retinal breaks[OR 1.67,95%CI(1.03-2.70)],and a substantial extent of RRD[OR 11.58,95%CI(7.12-18.84)]were independent risk factors for RRDCD.CONCLUSION:Emergency surgical pattern of RRD demonstrates a lower incidence of RRDCD.The adoption of an expedited surgical approach has the potential to reduce the duration of RRD,possibly correlating with a decreased risk of RRDCD development.展开更多
Kinesin is an archetypal microtubule-based molecular motor that can generate force to transport cargo in cells. The load dependence of the detachment rate is an important factor of the kinesin motor, the determination...Kinesin is an archetypal microtubule-based molecular motor that can generate force to transport cargo in cells. The load dependence of the detachment rate is an important factor of the kinesin motor, the determination of which is critically related to the chemomechanical coupling mechanism of the motor. Here, we use three models for the load dependence of the detachment rate of the kinesin motor to study theoretically and numerically the maximal force generated and microtubuleattachment duration of the motor. By comparing the theoretical and numerical results with the available experimental data,we show that only one model can explain well the available experimental data, indicating that only this model can be applicable to the kinesin motor.展开更多
During the EAST radiative divertor experiments,one of the key challenges was how to avoid the occurrence of disruptive events caused by excessive impurity seeding.To estimate the required impurity fraction for diverto...During the EAST radiative divertor experiments,one of the key challenges was how to avoid the occurrence of disruptive events caused by excessive impurity seeding.To estimate the required impurity fraction for divertor detachment,we introduce a reduced edge plasma radiation model.In the model,based on the momentum conservation along the magnetic field line,the upstream pressure is determined by the plasma density and temperature at the divertor target,and then the impurity radiation loss is obtained by the balance of the heat and particle fluxes.It is found that the required impurity fraction shows a non-monotonic variation with divertor electron temperature(T_(d))when 0.1 eV<T_(d)<10 eV.In the range of 0.1 eV<T_(d)<1 e V,the position near the valley of required impurity fraction corresponds to strong plasma recombination.Due to the dependence of the volumetric momentum loss effect on the T_(d)in the range of 1 eV<T_(d)<10 eV,the required impurity fraction peaks and then decreases as T_(d)is increased.Compared to neon,the usage of argon reduces the impurity fraction by about twice.In addition,for the various fitting parameters in the pressure-momentum loss model,it is shown that the tendency of required impurity fraction with T_(d)always increases first and then decreases in the range of 1 eV<T_(d)<10 eV,but the required impurity fraction decreases when the model that characterizes the strong loss in pressure momentum is used.展开更多
BACKGROUND Colonic diverticular bleeding(CDB)is a leading cause of lower gastrointestinal hemorrhage that has a high risk of recurrence.The endoscopic clipping and endoscopic band ligation(EBL)methods are widely used ...BACKGROUND Colonic diverticular bleeding(CDB)is a leading cause of lower gastrointestinal hemorrhage that has a high risk of recurrence.The endoscopic clipping and endoscopic band ligation(EBL)methods are widely used for hemostasis in patients with CDB.Endoscopic detachable snare ligation(EDSL)has also become an increasingly common treatment option.The data remain inconsistent regarding the comparative efficacy of these endoscopic therapies in achieving initial hemostasis and reduction of early and late rebleeding rates.AIM To study the effectiveness and complications of endoscopic clipping,EBL,and EDSL for CDB.METHODS We conducted a systematic search of PubMed/MEDLINE,Scopus,Web of Science,Embase,Google Scholar,and the Cochrane database for clinical trials to find studies that reported CDB and endoscopic clipping,EBL,or EDSL as treatment methods.The pooled estimates of initial hemostasis,early and late rebleeding,and the need for transarterial embolization or surgery between these groups were calculated.RESULTS We analyzed 28 studies with 5224 patients.Of these,4526 had active CDB and required one of the three endoscopic interventions.The pooled prevalence of early rebleeding was 23.5%,10.7%,and 10.6%in the endoscopic clipping,EBL,and EDSL groups,respectively.Patients who underwent endoscopic clipping had a significantly higher rate of early rebleeding compared to those who received EBL[odds ratio(OR)=3.76(95%CI:2.13-6.63)]and EDSL(OR=3.30,95%CI:1.28-8.53).There was no difference in the initial hemostasis between the three groups.The pooled prevalence of late rebleeding was 27.2%in the clipping,followed by 13.8%in the EBL and 2.7%in the EDSL group.Compared to 2.6%in the EBL group,4.0%of patients who received endoscopic clipping subsequently underwent surgery or transarterial embolization.These results were consistent in the network meta-analysis.Based on the ranking of the indirect comparison of modalities,the snare technique was better at achieving initial hemostasis and had a lower late rebleeding rate.CONCLUSION The findings of this direct and indirect pairwise comparison suggest that EDSL is superior to endoscopic clipping and EBL in achieving initial hemostasis and lowering the rate of late rebleeding in patients with CDB.展开更多
The BozdağHigh is a metamorphic core complex located between the Gediz(Alaşehir)and Küçük Menderes grabens in the Western Anatolia Extensional Province.The region is structurally controlled by low-angle...The BozdağHigh is a metamorphic core complex located between the Gediz(Alaşehir)and Küçük Menderes grabens in the Western Anatolia Extensional Province.The region is structurally controlled by low-angle Gediz Detachment Faults(GDF)and high-angle normal faults,which play a fundamental role in its geomorphological evolution.Understanding how these fault systems interact to shape uplift,drainage reorganization,and landscape dynamics remains an open scientific question.This study utilizes GIS-based morphometric analyses of 53 drainage basins and mountain fronts to quantify the spatial variations in uplift and fault activity.By integrating geomorphic indices(e.g.,χ-index,ksn,Smf,Vf)with analytical hierarchy process(AHP)models,we assess relative tectonic activity and investigate the kinematic evolution of fault-bounded blocks.Our findings reveal that the BozdağHigh experienced distinct rotational phases before and after the activation of high-angle faults,transitioning from an initial detachment-dominated extensional system to a segmented fault network.Additionally,BozdağHigh exhibits contrasting tectonic activity between its northern and southern flanks.While the northern flank,facing the Gediz Graben,experiences higher uplift rates and stronger tectonic forcing,the southern flank,adjacent to the Küçük Menderes Graben,exhibits relatively subdued tectonic activity and increased erosional modification.The western section of the eastern flank shows a more rapid uplift trend toward the east,whereas the southern flank displays significant surface tilting.Geomorphic evidence suggests that sequential fault activity and strain partitioning control differential uplift,drainage divide migrations,and basin asymmetry.Asymmetric basins in the southern sector,characterized by high hypsometric integral(HI)and low normalized steepness index(ksn)values,suggest a balance between erosional processes and tectonic uplift.In contrast,regions with ongoing rapid uplift exhibit higher ksn values and active knickpoint formation.These results provide new insights into the interaction between lowand high-angle fault systems and contribute to the broader understanding of tectonic evolution in extensional provinces.These new insights include the identification of spatially variable uplift and rotation patterns caused by sequential activation of low-and high-angle faults,revealing how block tilting and strain partitioning have shaped drainage reorganization and landscape evolution in the BozdağHigh.展开更多
AIM:To establish a risk prediction model for secondary cataract within 2y after pars plana vitrectomy(PPV)in patients with primary rhegmatogenous retinal detachment(RRD).METHODS:Clinical data of patients with primary ...AIM:To establish a risk prediction model for secondary cataract within 2y after pars plana vitrectomy(PPV)in patients with primary rhegmatogenous retinal detachment(RRD).METHODS:Clinical data of patients with primary RRD treated at the Shenzhen Eye Hospital were retrospectively collected.Twenty-four potential influencing factors,including patient characteristics and surgical factors,were selected for analysis.Independent risk factors for secondary cataract were identified through univariate comparisons and multivariate logistic regression analysis.A risk prediction model was constructed and evaluated using receiver operating characteristic(ROC)curves,area under the ROC curve(AUC),calibration plots,and decision curve analysis(DCA)curves.RESULTS:The 386 cases(389 eyes)of patients who underwent PPV and had complete surgical records were ultimately included.Within a 2-year longitudinal observation,41.39%of patients developed cataract secondary to PPV.Logistic regression results identified a history of hypertension[odds ratio(OR)=1.78,95%CI:1.002–3.163,P=0.049],silicone oil tamponade(OR=3.667,95%CI:2.373–5.667,P=0.000),and lens thickness(OR=1.978,95%CI:1.129–3.464,P=0.017)as independent risk factors for cataract secondary to PPV.The constructed nomogram achieved AUC=0.6974.Calibration plots indicated good agreement between predicted and observed outcomes,while DCA curves demonstrated the model’s clinical utility.CONCLUSION:By incorporating a history of hypertension,vitreous substitute type,and lens thickness,this study constructs a prediction model with moderate discriminative ability.This model offers a valuable tool for clinicians to identify high-risk patients early,potentially allowing for more timely interventions and improved patient outcomes.展开更多
Intrinsic decomposition,the process of decomposing an image into reflectance and shading,is widely used in virtual and augmented reality tasks.Reflectance and shading often exhibit large gradients at the object edges,...Intrinsic decomposition,the process of decomposing an image into reflectance and shading,is widely used in virtual and augmented reality tasks.Reflectance and shading often exhibit large gradients at the object edges,and the intrinsic properties on the same object tend to be similar.This spatial coherence is closely related to semantic consistency because objects within the same semantic category often exhibit similar intrinsic properties.Therefore,incorporating semantic segmentation into a deep intrinsic decomposition framework helps the network distinguish between different object instances and understand high-level scene structures.To this end,we design an intrinsic decomposition network jointly trained with a dedicated semantic segmentation module,allowing semantic cues to enhance the decomposition of reflectance and shading.The semantic module provides guidance during training but is removed during inference,improving performance without increasing the inference cost.Additionally,to capture the global contextual dependencies critical for intrinsic decomposition,we adopt a Transformer-based backbone.The proposed backbone enables the model to associate distant regions with similar material properties,thereby maintaining consistency in reflectance and learning smooth illumination patterns across a scene.A convolutional decoder is also designed to output predictions with improved details.Experiments demonstrate that our approach achieves state-of-the-art performance in the quantitative evaluations on the Intrinsic Images in the Wild(IIW)and Shading Annotations in the wild(SAW)datasets.展开更多
AIM:To identify risk factors for postoperative blindness in patients with primary rhegmatogenous retinal detachment(RRD)at their first presentation to a tertiary center,using a large clinical database to improve under...AIM:To identify risk factors for postoperative blindness in patients with primary rhegmatogenous retinal detachment(RRD)at their first presentation to a tertiary center,using a large clinical database to improve understanding of this adverse outcome.METHODS:Electronic health records of patients with primary RRD from the Eye Hospital of Wenzhou Medical University were retrospectively analyzed.Postoperative blindness was defined according to the World Health Organization(WHO)criteria for legal blindness.Potential risk factors included demographic characteristics,preoperative clinical features,and surgical variables.Univariable and multivariable logistic regression analyses were performed to calculate odds ratios(ORs)and 95%confidence intervals(CIs)for each risk factor.RESULTS:A total of 532 patients were included in the cohort,of whom 62(12.0%;28 males,34 females)developed postoperative blindness at the final follow-up.Among these 62 patients,30 had high myopia and 32 did not.The mean age of participants was 49.0±16.4y,with 275 subjects(52%)being male and 133 patients(25%)having the condition in the right eye.In the multivariable model for all patients,the following factors were associated with an increased risk of postoperative blindness:higher preoperative logarithm of the minimum angle of resolution visual acuity(logMAR VA;OR=1.09 per 0.1 logMAR unit increase,95%CI 1.03-1.15);inferior or superior retinal breaks(OR=2.42,95%CI 1.12-5.24);and macular holes or superior retinal breaks(OR=8.46,95%CI 3.45-20.75).In the subgroup of patients with high myopia,risk factors for postoperative blindness included:pseudophakia/aphakia versus phakia(OR=6.33,95%CI 1.41-28.31);macular holes or superior retinal breaks(OR=15.15,95%CI 3.07-74.85);and proliferative vitreoretinopathy(PVR;OR=21.41,95%CI 2.14-214.57).In the subgroup of patients without high myopia,increased risk of postoperative blindness was associated with:higher preoperative logMAR VA(OR=1.11 per 0.1 logMAR unit increase,95%CI 1.04-1.18);and inferior or superior retinal breaks(OR=2.90,95%CI 1.19-7.06).CONCLUSION:Using a large real-world clinical database,we identified distinct risk factors for postoperative blindness in patients with primary RRD-including differences between those with and without high myopia.These findings emphasize the need to target specific risk factors in clinical practice to mitigate and reduce the incidence of postoperative blindness in this patient population.展开更多
AIM:To evaluate the efficacy and safety of combining posterior scleral contraction(PSC)with intravitreal perfluoropropane(C_(3)F_(8))injection in high myopia with macular hole retinal detachment(MHRD).METHODS:A total ...AIM:To evaluate the efficacy and safety of combining posterior scleral contraction(PSC)with intravitreal perfluoropropane(C_(3)F_(8))injection in high myopia with macular hole retinal detachment(MHRD).METHODS:A total of 22 participants(22 eyes)with high myopia[axial length(AL)≥26.5 mm]and MHRD who underwent PSC combined with intravitreal C_(3)F_(8)injection,with at least 6mo of follow-up were retrospectively recruited.Outcome measures included best-corrected visual acuity(BCVA),AL,optical coherence tomography(OCT)findings,and adverse events.Retinal recovery was categorized as type Ⅰ(macular hole bridging with retinal reattachment)or type Ⅱ(reattachment without hole bridging).RESULTS:The mean age of participants was 62.1±8.8y and mean follow-up duration was 9.18±4.21mo.Complete retinal reattachment was observed in 11 eyes(50%)at postoperative day 1,19 eyes(86.3%)at week 1,and all 22 eyes at month 1.Ten eyes(45.5%)achieved type Ⅰ recovery and 12 eyes(54.5%)achieved type Ⅱ.Mean BCVA improved from 1.68±0.84 logMAR before surgery to 1.21±0.65 logMAR after surgery(P<0.001),and AL was significantly reduced compared to baseline(29.07±2.05 vs 30.8±2.2 mm;P<0.001).No serious complications were reported.CONCLUSION:PSC combined with intravitreal C_(3)F_(8)injection is a safe and effective treatment for MHRD in highly myopic eyes,especially for retinal detachment limited within the vascular arcade.展开更多
BACKGROUND Secure transluminal closure remains a fundamental barrier to endoscopic surgery.It has been reported that through-the-scope clips were used to secure the incision of the gallbladder during natural orifice t...BACKGROUND Secure transluminal closure remains a fundamental barrier to endoscopic surgery.It has been reported that through-the-scope clips were used to secure the incision of the gallbladder during natural orifice transluminal endoscopic cholecystolithotomy and were left in the body post-operation.The over-the-scope clip(OTSC)is favored for its rapid deployment and strong anchoring capabilities.Nevertheless,OTSCs are difficult to remove once implanted.The Senscure Biotechnology in China has developed a detachable over-the-scope clip(D-OTSC)for this purpose.Here,we utilized the D-OTSC to successfully close a full-thickness sigmoid defect exceeding 1 cm in diameter.Subsequently,the clip was completely removed postoperatively,yielding favorable clinical outcomes.CASE SUMMARY We present the case of a 51-year-old female patient who underwent natural orifice transluminal endoscopic cholecystolithotomy.The sigmoid incision was closed using a D-OTSC.Postoperative recovery was uneventful,with no abdominal infection or bleeding.The D-OTSC was subsequently removed via enteroscopy in the outpatient department one month later.CONCLUSION The utilization of D-OTSC presents a viable option for closing colonic mucosal incisions ranging from 1 cm to 2 cm.展开更多
Background:Toxic Epidermal Necrolysis(TEN)is a potentially fatal dermatological condition primarily triggered by adverse drug reactions.It is characterized by extensive epidermal necrosis and separation,affecting more...Background:Toxic Epidermal Necrolysis(TEN)is a potentially fatal dermatological condition primarily triggered by adverse drug reactions.It is characterized by extensive epidermal necrosis and separation,affecting more than 30%of the body surface area,and leading to severe complications such as sepsis and multi-organ failure.Common causative agents include antibiotics,anticonvulsants,and NSAIDs.The pathophysiology of TEN in-volves an immune-mediated response,where cytotoxic T lymphocytes(CTLs)and natural killer(NK)cells release cytotoxic proteins such as perforin,granzyme B,and granulysin,leading to widespread keratinocyte apoptosis.This immune response results in massive skin detachment and mucosal damage.Despite its rarity,TEN has a high mortality rate,necessitating early diagnosis and intervention.Case presentation:This paper provides a comprehensive review of TEN,discussing its history,pathophysiology,clinical features,and current understanding of treatment strategies.A case series of 11 patients who developed TEN after exposure to various drugs,including Lamotrigine,Phenytoin,Diclofenac,Ibuprofen,Aceclofenac,Amoxicillin,Sulfadoxine-Pyrimethamine,Amoxiclav,and Gabapentin,is presented.The cases highlight the importance of early drug discontinuation,supportive care,and adjunctive therapies such as intravenous immunoglobulin(IVIG)and corticosteroids.Prognostic factors,such as the extent of skin detachment and sys-temic complications,significantly influenced patient outcomes.All patients recovered with timely intervention and intensive care,except for a few who succumbed to the severity of the condition.Conclusion:This study underscores the need for early intervention,multidisciplinary care,and robust pharma-covigilance systems to reduce the incidence and severity of TEN.Increased awareness of risk factors and early recognition of symptoms associated with high-risk medications are crucial in improving patient outcomes and reducing mortality.展开更多
文摘In the paper, the effects of linear expansion coefficient and basic index of melting slag on the detachability of self shielded flux cored electrode (SSFCE) are investigated. An equation is obtained on the principles of ceramics and mineralography which predict the detachability of basic SSFCE. In addition, stick slag mechanism of SSFCE is analyzed.
基金supported by the National Natural Science Foundation of China(52273120,21975019,T2222029,and U21A20396)CAS Project for Young Scientists in Basic Research(YSBR-012)+3 种基金Incubation Foundation of Beijing Institute for Stem Cell and Regenerative Medicine(2022FH125,2023FH122)and,the China Scholarship Council(No.202206465017)the Fundamental Research Funds for the Central Universities(FRFTP-20-019A2,FRF-BR-20-03B)the Project was supported by the Science Fund of Shandong Laboratory of Advanced Materials and Green Manufacturing(Yantai)(AMGM2023F04)the Strategic Priority Research Program of the Chinese Academy of Sciences(XDA16020802).
文摘Wound dressing management is critical in healthcare,and frequent dressing changes for full-thickness skin wounds can hinder healing.Nanofiber dressings that resemble the extracellular matrix,have gained popularity in wound repair,however,it is challenging to explore how to frequently change it without affecting healing processing and avoiding secondary damage.Here,we developed a self-adhesive and detachable nanofiber dressing inspired by Andrias davidianus.Our asymmetric nanofiber dressing exhibits strong adhesion(26 kPa),to the wound at high temperature(approximately 25°C)to the wound surface and can be easily detached(4 kPa)at low temperature(below 8°C),enabling painless dressing changes that minimize secondary injuries.The dressing comprises an outer layer of polylactic acid which provides mechanical property,support,and pollution resistance,with an inner layer of nanofibrous membrane,composed of gelatin and Andrias davidianus skin secretions,which promotes cellular migration,enhances wound healing and possesses inherent antimicrobial properties.Furthermore,the all-natural nanofiber dressings can be prepared on a large scale and offer favorable biocompatibility to meet the basic requirements of wound dressings.These findings demonstrate the potential applicability of our multilayer nanofiber dressing for advancing wound healing practices.
基金Supported by the Key Science&Technology Project of Guangzhou(No.202103000045)the National Natural Science Foundation of China(No.82070972,No.82271093).
文摘AIM:To investigate the effects of shortening the duration of silicone oil tamponade on retinal structure and function in patients undergoing silicone oil removal(SOR)after surgery for primary rhegmatogenous retinal detachment(RRD).METHODS:A total of 58 eligible patients were enrolled and randomly assigned to two groups based on tamponade duration:the short-term group(30-45d)and the conventional group(≥90d).Comprehensive evaluations were performed before and after SOR,including slitlamp examination,best-corrected visual acuity(BCVA)measurement,intraocular pressure(IOP)testing,optical coherence tomography(OCT),optical coherence tomography angiography(OCTA),microperimetry,electroretinography(ERG),and visual evoked potential(VEP)assessment.RESULTS:A total of 33 patients(23 males and 10 females;33 eyes)were enrolled in the short-term SO tamponade group with mean age of 52.45±9.35y,and 25 patients(15 males and 10 females;25 eyes)were enrolled in the conventional SO tamponade group with mean age of 50.80±12.06y.Compared with the conventional group,the short-term silicone oil tamponade group had a significantly lower incidence of silicone oil emulsification and cataract progression,with no significant difference in retinal reattachment success rate.Structurally,short-term tamponade was associated with increased thickness of the retinal ganglion cell layer(RGCL)in the nasal and superior macular regions and improved recovery of superficial retinal vascular density in these areas.Functionally,the shortterm group showed better BCVA and retinal sensitivity both before and 1mo after SOR;additionally,the P100 amplitude in VEP tests was significantly increased in this group.CONCLUSION:Shortening the duration of silicone oil tamponade effectively reduces damage to retinal structure and function without compromising the success rate of retinal reattachment in patients with primary RRD.
文摘Rhegmatogenous retinal detachment(RRD)is a serious ocular condition marked by the separation of the neuroretina from the retinal pigment epithelium(RPE).The pathogenesis of RRD involves intricate molecular and cellular mechanisms,including inflammation,cell migration,and the activation of proliferative signaling pathways.One of the most challenging complications of RRD is proliferative vitreoretinopathy(PVR),which refers to the proliferation and contraction of fibrocellular membranes on the retinal surface and in the vitreous cavity.PVR is a major cause of surgical failure in RRD,as it can lead to recurrent retinal detachment and severe vision loss.However,the pathogenesis of PVR is not yet fully understood,and the treatment options are quite limited.Recent advances in analytical techniques have offered valuable insights into the molecular alterations present in the subretinal fluid(SRF)of patients with RRD.This review seeks to consolidate the current knowledge regarding the SRF profile in RRD and PVR,emphasizing potential biomarkers and therapeutic targets.
文摘Improvements in surgical techniques have led to 90% success in the surgical repair of rhegmatogenous retinal detachment(RRD).However,anatomical reattachment of the retina does not ensure complete recovery of visual function.The incidence of metamorphopsia remains the most common postoperative complaint,from 24% to 88.6%.Currently,the risk factors of metamorphopsia are categorized into macular involvement,retinal shift,outer retinal folds,subretinal fluid,secondary epiretinal membrane,outer retinal layer damage,and surgical approach.The associations of metamorphopsia with postoperative best-corrected visual acuity and postoperative vision-related quality of life were still controversial.The most popular methods for assessment of metamorphopsia remain the Amsler grid and M-Charts.Most treatments cannot progress beyond the management of negative visual sensations,through methods such as occlusion therapy and aniseikonia-correcting spectacles.The main treatment approach involves RRD prevention and the management of risk factors that can lead to postoperative metamorphopsia after RRD repair.Additional research concerning metamorphopsia treatment,further upgrades of auxiliary inspection methods,and more accurate microstructural assessments are needed to address this common complication.
基金Supported by the Suzhou Medical Innovation Application Research Project(SZM2023027).
文摘AIM:To explore the morphological and functional parameters to evaluate the effectiveness of intravitreal injections of ranibizumab(IVR)in treating macular edema(ME)secondary to retinal vein occlusion(RVO).METHODS:This retrospective study involved 65 RVO patients(65 eyes)who received IVR and were followedup for more than 3mo.ME was categorized into cystoid macular edema(CME),diffuse retinal thickening(DRT),and serous retinal detachment(SRD)according to optical coherence tomography(OCT)images.The comparison of best corrected visual acuity(BCVA;logMAR)and central macular thickness(CMT)among different follow-up points and those among 3 groups were performed by Kruskal-Wallis test.The correlation between BCVA and baseline parameters during treatment was analyzed using Spearman correlation analysis.RESULTS:BCVA tended to improve in all groups,with marked improvement in CME and DRT groups.CMT showed the greatest reduction after 1wk,and remained stable over the following 3mo.DRT patients had the worst BCVA and the highest CMT at baseline,but the differences became smaller after IVR treatment.CMT in SRD group was significantly better than in CME and DRT groups 3mo after IVR.Most patients of CME and SRD groups transitioned to a normal pattern at 3mo follow-up.DRT patients were most likely to transform into the other morphological groups,while SRD patients showed minimal transitions.BCVA at baseline was identified as the most important prognostic indicator in all 3 groups.Additionally,DRT patients with a longer clinical course,higher CMT and central retinal vein occlusion(CRVO)tend to exhibit worse BCVA after treatment.In addition,CRVO patients are more likely to have worse BCVA at 2 and 3mo follow-up compared with branch retinal vein occlusion(BRVO)patients in CME group.SRD patients with higher baseline CMT were prone to experiencing worse BCVA after treatment.CONCLUSION:The effectiveness of IVR is strongly correlated with baseline BCVA in all 3 groups.Baseline parameters including clinical course,CMT,and RVO position are also useful in predicting the BCVA at different time points after treatment.
基金Supported by the Natural Science Foundation of Fujian Province(No.2024J011318No.2024J011321)Fuzhou Science and Technology Program(No.2023-S-005).
文摘Dear Editor,Descemet’s membrane detachment(DMD)is considered as a potential sight-threatening complication following various intraocular surgeries,particularly cataract surgery[1].The labile adhesion between the Descemet’s membrane(DM)and the posterior corneal stromal layer can be easily separated with minimal mechanical force.Several risk factors have been associated with the development of DMD including old age,improper intraoperative operation,corneal ectatic disorders,and endothelial disorders and so on[1-4].
文摘AIM:To report the refractive and surgical outcomes of scleral buckling(SB)with or without pars plana vitrectomy(PPV)in patients with pseudophakic rhegmatogenous retinal detachment(PRRD).METHODS:A consecutive case series of patients with pseudophakia who underwent retinal detachment(RD)surgery was enrolled.The SB procedures were selected to initially treat primary pseudophakic PRRDs and SB-PPV for more complex cases,according to preoperative findings.Eyes with anterior chamber intraocular lens,proliferative vitreoretinopathy anterior to equator,previous invasive glaucoma surgery,severe degenerative myopia or macular hole,and<6mo follow-up were excluded from outcomes analysis.The primary clinical outcome measures were the single surgery anatomic success(SSAS)and final surgery anatomic success(FSAS)rates.Secondary outcome measures were postoperative visual acuity and refractive error.RESULTS:A total of 81 consecutive patients(81 eyes)were enrolled for analysis,comprising 66(81%)men and 15(19%)women with a mean age of 58y(range,33-86y)and the mean final follow-up period was 21.0±19.6mo.A total of 62 PRRDs(n=62;76.5%)were repaired with an initial SB,and 19 PRRDs(n=19;23.5%)were repaired with a combined SB-PPV.The SSAS and FSAS rates were 92.6%(75/81)and 100%(81/81),respectively.All initial failures had retinal reattachment after the secondary PPV.The mean final postoperative best-corrected visual acuity(BCVA)was 0.42±0.33 logMAR(visual acuity 20/55)and final mean refractive error was-1.48±1.40 diopters.The patients who underwent initially SB-PPV had a significantly longer duration of RD and a higher giant retinal tear rate(P<0.05)preoperatively.SSAS was 56/62(90.3%)and 19/19(100%),and the mean postoperative refractive error was-1.30±1.32 D and-1.53±1.38 D for the patients in the SB and SB-PPV groups,respectively.There was no statistically significant difference for those who had SSAS and postoperative refractive errors between the 2 groups.The postoperative BCVAs of the patients with SSAS were not significantly better in the SB group(median,20/40)than in the SB-PPV group(median 20/50).In the SB group,patients with macula-on had better visual acuity postoperatively than patients with macula-off(P=0.000).CONCLUSION:The initial surgical procedures of SB with or without PPV according to the preoperative findings achieve a high reattachment rate and an acceptable refractive error for primary pseudophakic RRD management.
基金Key Research and Development Program of Hubei Province(Project No.:2021BCA125)。
文摘Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected from March 2023 to February 2024 in the hospital.Their clinical characteristics and treatment effects were observed and their causes were analyzed.Results:After the operations,the eyes with choroidal detachment after glaucoma surgery had 2 cases of true microphthalmos,6 cases of advanced glaucoma,and 2 cases of glaucoma secondary to vitreoretinal surgery.The postoperative manifestations were persistent shallow anterior chamber,the formation of anterior chamber,and then suddenly became shallow or disappeared.Meanwhile,the intraocular pressure was lower than 6 mmHg.Ultrasound and funduscopic examination showed that the choroid and retina were partially elevated,and the choroidal detachment recovered after treatment.Conclusion:Choroidal detachment is one of the common postoperative complications in glaucoma,especially in some special types of refractory glaucoma.Adequate perioperative management before surgery,cautious and delicate operation during surgery,and close observation and treatment after surgery can obviously decrease the occurrence and damage.
基金Supported by the Medical Scientific Research Foundation of Guangdong Province,China(No.C2022060).
文摘AIM:To compare the proportion of rhegmatogenous retinal detachment(RRD)associated with choroidal detachment(RRDCD)in the emergency surgery group with the routine inpatient surgery group and determine risk factors for RRDCD.METHODS:A total of 694 patients(694 eyes)diagnosed with RRD in the emergency surgery(the median duration of RRD was 5d)group were included from the Department of Ophthalmic Emergency,and 692 patients(eyes)in the routine inpatient surgery group(the median duration was 15d)were selected randomly from the Ocular Fundus Department.Demographics,refractive status,macular status,lens status,extent of retinal detachment,number of retinal breaks,duration of symptoms before surgery,and the incidence of RRDCD were compared.A logistic regression analysis was used to determine potential risk factors for RRDCD.RESULTS:Compared to the routine inpatient surgery group,the emergency surgery group had a significant less median time to surgery(P<0.001)and a decreased proportion of RRDCD(2.88%vs 10.84%,P<0.001).Logistic regression analysis revealed that a prolonged duration of RRD[OR 3.51,95%confidence interval(CI)1.98-6.23],pseudophakia/aphakia status[OR 2.74,95%CI(1.50-4.98)],multiple retinal breaks[OR 1.67,95%CI(1.03-2.70)],and a substantial extent of RRD[OR 11.58,95%CI(7.12-18.84)]were independent risk factors for RRDCD.CONCLUSION:Emergency surgical pattern of RRD demonstrates a lower incidence of RRDCD.The adoption of an expedited surgical approach has the potential to reduce the duration of RRD,possibly correlating with a decreased risk of RRDCD development.
基金Project supported by Youth Project of Science and Technology Research Program of Chongqing Education Commission of China (Grant No. KJQN202404522)。
文摘Kinesin is an archetypal microtubule-based molecular motor that can generate force to transport cargo in cells. The load dependence of the detachment rate is an important factor of the kinesin motor, the determination of which is critically related to the chemomechanical coupling mechanism of the motor. Here, we use three models for the load dependence of the detachment rate of the kinesin motor to study theoretically and numerically the maximal force generated and microtubuleattachment duration of the motor. By comparing the theoretical and numerical results with the available experimental data,we show that only one model can explain well the available experimental data, indicating that only this model can be applicable to the kinesin motor.
基金supported by National Natural Science Foundation of China(No.12375227)Innovation in Fusion Engineering Technology of Institute(No.E35QT1080C)。
文摘During the EAST radiative divertor experiments,one of the key challenges was how to avoid the occurrence of disruptive events caused by excessive impurity seeding.To estimate the required impurity fraction for divertor detachment,we introduce a reduced edge plasma radiation model.In the model,based on the momentum conservation along the magnetic field line,the upstream pressure is determined by the plasma density and temperature at the divertor target,and then the impurity radiation loss is obtained by the balance of the heat and particle fluxes.It is found that the required impurity fraction shows a non-monotonic variation with divertor electron temperature(T_(d))when 0.1 eV<T_(d)<10 eV.In the range of 0.1 eV<T_(d)<1 e V,the position near the valley of required impurity fraction corresponds to strong plasma recombination.Due to the dependence of the volumetric momentum loss effect on the T_(d)in the range of 1 eV<T_(d)<10 eV,the required impurity fraction peaks and then decreases as T_(d)is increased.Compared to neon,the usage of argon reduces the impurity fraction by about twice.In addition,for the various fitting parameters in the pressure-momentum loss model,it is shown that the tendency of required impurity fraction with T_(d)always increases first and then decreases in the range of 1 eV<T_(d)<10 eV,but the required impurity fraction decreases when the model that characterizes the strong loss in pressure momentum is used.
文摘BACKGROUND Colonic diverticular bleeding(CDB)is a leading cause of lower gastrointestinal hemorrhage that has a high risk of recurrence.The endoscopic clipping and endoscopic band ligation(EBL)methods are widely used for hemostasis in patients with CDB.Endoscopic detachable snare ligation(EDSL)has also become an increasingly common treatment option.The data remain inconsistent regarding the comparative efficacy of these endoscopic therapies in achieving initial hemostasis and reduction of early and late rebleeding rates.AIM To study the effectiveness and complications of endoscopic clipping,EBL,and EDSL for CDB.METHODS We conducted a systematic search of PubMed/MEDLINE,Scopus,Web of Science,Embase,Google Scholar,and the Cochrane database for clinical trials to find studies that reported CDB and endoscopic clipping,EBL,or EDSL as treatment methods.The pooled estimates of initial hemostasis,early and late rebleeding,and the need for transarterial embolization or surgery between these groups were calculated.RESULTS We analyzed 28 studies with 5224 patients.Of these,4526 had active CDB and required one of the three endoscopic interventions.The pooled prevalence of early rebleeding was 23.5%,10.7%,and 10.6%in the endoscopic clipping,EBL,and EDSL groups,respectively.Patients who underwent endoscopic clipping had a significantly higher rate of early rebleeding compared to those who received EBL[odds ratio(OR)=3.76(95%CI:2.13-6.63)]and EDSL(OR=3.30,95%CI:1.28-8.53).There was no difference in the initial hemostasis between the three groups.The pooled prevalence of late rebleeding was 27.2%in the clipping,followed by 13.8%in the EBL and 2.7%in the EDSL group.Compared to 2.6%in the EBL group,4.0%of patients who received endoscopic clipping subsequently underwent surgery or transarterial embolization.These results were consistent in the network meta-analysis.Based on the ranking of the indirect comparison of modalities,the snare technique was better at achieving initial hemostasis and had a lower late rebleeding rate.CONCLUSION The findings of this direct and indirect pairwise comparison suggest that EDSL is superior to endoscopic clipping and EBL in achieving initial hemostasis and lowering the rate of late rebleeding in patients with CDB.
文摘The BozdağHigh is a metamorphic core complex located between the Gediz(Alaşehir)and Küçük Menderes grabens in the Western Anatolia Extensional Province.The region is structurally controlled by low-angle Gediz Detachment Faults(GDF)and high-angle normal faults,which play a fundamental role in its geomorphological evolution.Understanding how these fault systems interact to shape uplift,drainage reorganization,and landscape dynamics remains an open scientific question.This study utilizes GIS-based morphometric analyses of 53 drainage basins and mountain fronts to quantify the spatial variations in uplift and fault activity.By integrating geomorphic indices(e.g.,χ-index,ksn,Smf,Vf)with analytical hierarchy process(AHP)models,we assess relative tectonic activity and investigate the kinematic evolution of fault-bounded blocks.Our findings reveal that the BozdağHigh experienced distinct rotational phases before and after the activation of high-angle faults,transitioning from an initial detachment-dominated extensional system to a segmented fault network.Additionally,BozdağHigh exhibits contrasting tectonic activity between its northern and southern flanks.While the northern flank,facing the Gediz Graben,experiences higher uplift rates and stronger tectonic forcing,the southern flank,adjacent to the Küçük Menderes Graben,exhibits relatively subdued tectonic activity and increased erosional modification.The western section of the eastern flank shows a more rapid uplift trend toward the east,whereas the southern flank displays significant surface tilting.Geomorphic evidence suggests that sequential fault activity and strain partitioning control differential uplift,drainage divide migrations,and basin asymmetry.Asymmetric basins in the southern sector,characterized by high hypsometric integral(HI)and low normalized steepness index(ksn)values,suggest a balance between erosional processes and tectonic uplift.In contrast,regions with ongoing rapid uplift exhibit higher ksn values and active knickpoint formation.These results provide new insights into the interaction between lowand high-angle fault systems and contribute to the broader understanding of tectonic evolution in extensional provinces.These new insights include the identification of spatially variable uplift and rotation patterns caused by sequential activation of low-and high-angle faults,revealing how block tilting and strain partitioning have shaped drainage reorganization and landscape evolution in the BozdağHigh.
基金Supported by the Shenzhen Science and Technology Program(No.JCYJ20220818103207015)the SanMing Project of Medicine in Shenzhen(No.SZSM202311012).
文摘AIM:To establish a risk prediction model for secondary cataract within 2y after pars plana vitrectomy(PPV)in patients with primary rhegmatogenous retinal detachment(RRD).METHODS:Clinical data of patients with primary RRD treated at the Shenzhen Eye Hospital were retrospectively collected.Twenty-four potential influencing factors,including patient characteristics and surgical factors,were selected for analysis.Independent risk factors for secondary cataract were identified through univariate comparisons and multivariate logistic regression analysis.A risk prediction model was constructed and evaluated using receiver operating characteristic(ROC)curves,area under the ROC curve(AUC),calibration plots,and decision curve analysis(DCA)curves.RESULTS:The 386 cases(389 eyes)of patients who underwent PPV and had complete surgical records were ultimately included.Within a 2-year longitudinal observation,41.39%of patients developed cataract secondary to PPV.Logistic regression results identified a history of hypertension[odds ratio(OR)=1.78,95%CI:1.002–3.163,P=0.049],silicone oil tamponade(OR=3.667,95%CI:2.373–5.667,P=0.000),and lens thickness(OR=1.978,95%CI:1.129–3.464,P=0.017)as independent risk factors for cataract secondary to PPV.The constructed nomogram achieved AUC=0.6974.Calibration plots indicated good agreement between predicted and observed outcomes,while DCA curves demonstrated the model’s clinical utility.CONCLUSION:By incorporating a history of hypertension,vitreous substitute type,and lens thickness,this study constructs a prediction model with moderate discriminative ability.This model offers a valuable tool for clinicians to identify high-risk patients early,potentially allowing for more timely interventions and improved patient outcomes.
基金Supported by Science and Technology Innovation 2030:Major Project of“New Generation Artificial Intelligence”(No.2022ZD0115901)the National Natural Science Foundation of China(No.62332003).
文摘Intrinsic decomposition,the process of decomposing an image into reflectance and shading,is widely used in virtual and augmented reality tasks.Reflectance and shading often exhibit large gradients at the object edges,and the intrinsic properties on the same object tend to be similar.This spatial coherence is closely related to semantic consistency because objects within the same semantic category often exhibit similar intrinsic properties.Therefore,incorporating semantic segmentation into a deep intrinsic decomposition framework helps the network distinguish between different object instances and understand high-level scene structures.To this end,we design an intrinsic decomposition network jointly trained with a dedicated semantic segmentation module,allowing semantic cues to enhance the decomposition of reflectance and shading.The semantic module provides guidance during training but is removed during inference,improving performance without increasing the inference cost.Additionally,to capture the global contextual dependencies critical for intrinsic decomposition,we adopt a Transformer-based backbone.The proposed backbone enables the model to associate distant regions with similar material properties,thereby maintaining consistency in reflectance and learning smooth illumination patterns across a scene.A convolutional decoder is also designed to output predictions with improved details.Experiments demonstrate that our approach achieves state-of-the-art performance in the quantitative evaluations on the Intrinsic Images in the Wild(IIW)and Shading Annotations in the wild(SAW)datasets.
文摘AIM:To identify risk factors for postoperative blindness in patients with primary rhegmatogenous retinal detachment(RRD)at their first presentation to a tertiary center,using a large clinical database to improve understanding of this adverse outcome.METHODS:Electronic health records of patients with primary RRD from the Eye Hospital of Wenzhou Medical University were retrospectively analyzed.Postoperative blindness was defined according to the World Health Organization(WHO)criteria for legal blindness.Potential risk factors included demographic characteristics,preoperative clinical features,and surgical variables.Univariable and multivariable logistic regression analyses were performed to calculate odds ratios(ORs)and 95%confidence intervals(CIs)for each risk factor.RESULTS:A total of 532 patients were included in the cohort,of whom 62(12.0%;28 males,34 females)developed postoperative blindness at the final follow-up.Among these 62 patients,30 had high myopia and 32 did not.The mean age of participants was 49.0±16.4y,with 275 subjects(52%)being male and 133 patients(25%)having the condition in the right eye.In the multivariable model for all patients,the following factors were associated with an increased risk of postoperative blindness:higher preoperative logarithm of the minimum angle of resolution visual acuity(logMAR VA;OR=1.09 per 0.1 logMAR unit increase,95%CI 1.03-1.15);inferior or superior retinal breaks(OR=2.42,95%CI 1.12-5.24);and macular holes or superior retinal breaks(OR=8.46,95%CI 3.45-20.75).In the subgroup of patients with high myopia,risk factors for postoperative blindness included:pseudophakia/aphakia versus phakia(OR=6.33,95%CI 1.41-28.31);macular holes or superior retinal breaks(OR=15.15,95%CI 3.07-74.85);and proliferative vitreoretinopathy(PVR;OR=21.41,95%CI 2.14-214.57).In the subgroup of patients without high myopia,increased risk of postoperative blindness was associated with:higher preoperative logMAR VA(OR=1.11 per 0.1 logMAR unit increase,95%CI 1.04-1.18);and inferior or superior retinal breaks(OR=2.90,95%CI 1.19-7.06).CONCLUSION:Using a large real-world clinical database,we identified distinct risk factors for postoperative blindness in patients with primary RRD-including differences between those with and without high myopia.These findings emphasize the need to target specific risk factors in clinical practice to mitigate and reduce the incidence of postoperative blindness in this patient population.
文摘AIM:To evaluate the efficacy and safety of combining posterior scleral contraction(PSC)with intravitreal perfluoropropane(C_(3)F_(8))injection in high myopia with macular hole retinal detachment(MHRD).METHODS:A total of 22 participants(22 eyes)with high myopia[axial length(AL)≥26.5 mm]and MHRD who underwent PSC combined with intravitreal C_(3)F_(8)injection,with at least 6mo of follow-up were retrospectively recruited.Outcome measures included best-corrected visual acuity(BCVA),AL,optical coherence tomography(OCT)findings,and adverse events.Retinal recovery was categorized as type Ⅰ(macular hole bridging with retinal reattachment)or type Ⅱ(reattachment without hole bridging).RESULTS:The mean age of participants was 62.1±8.8y and mean follow-up duration was 9.18±4.21mo.Complete retinal reattachment was observed in 11 eyes(50%)at postoperative day 1,19 eyes(86.3%)at week 1,and all 22 eyes at month 1.Ten eyes(45.5%)achieved type Ⅰ recovery and 12 eyes(54.5%)achieved type Ⅱ.Mean BCVA improved from 1.68±0.84 logMAR before surgery to 1.21±0.65 logMAR after surgery(P<0.001),and AL was significantly reduced compared to baseline(29.07±2.05 vs 30.8±2.2 mm;P<0.001).No serious complications were reported.CONCLUSION:PSC combined with intravitreal C_(3)F_(8)injection is a safe and effective treatment for MHRD in highly myopic eyes,especially for retinal detachment limited within the vascular arcade.
基金Supported by Natural Science Foundation of Fujian Province,China,No.2021J01545.
文摘BACKGROUND Secure transluminal closure remains a fundamental barrier to endoscopic surgery.It has been reported that through-the-scope clips were used to secure the incision of the gallbladder during natural orifice transluminal endoscopic cholecystolithotomy and were left in the body post-operation.The over-the-scope clip(OTSC)is favored for its rapid deployment and strong anchoring capabilities.Nevertheless,OTSCs are difficult to remove once implanted.The Senscure Biotechnology in China has developed a detachable over-the-scope clip(D-OTSC)for this purpose.Here,we utilized the D-OTSC to successfully close a full-thickness sigmoid defect exceeding 1 cm in diameter.Subsequently,the clip was completely removed postoperatively,yielding favorable clinical outcomes.CASE SUMMARY We present the case of a 51-year-old female patient who underwent natural orifice transluminal endoscopic cholecystolithotomy.The sigmoid incision was closed using a D-OTSC.Postoperative recovery was uneventful,with no abdominal infection or bleeding.The D-OTSC was subsequently removed via enteroscopy in the outpatient department one month later.CONCLUSION The utilization of D-OTSC presents a viable option for closing colonic mucosal incisions ranging from 1 cm to 2 cm.
文摘Background:Toxic Epidermal Necrolysis(TEN)is a potentially fatal dermatological condition primarily triggered by adverse drug reactions.It is characterized by extensive epidermal necrosis and separation,affecting more than 30%of the body surface area,and leading to severe complications such as sepsis and multi-organ failure.Common causative agents include antibiotics,anticonvulsants,and NSAIDs.The pathophysiology of TEN in-volves an immune-mediated response,where cytotoxic T lymphocytes(CTLs)and natural killer(NK)cells release cytotoxic proteins such as perforin,granzyme B,and granulysin,leading to widespread keratinocyte apoptosis.This immune response results in massive skin detachment and mucosal damage.Despite its rarity,TEN has a high mortality rate,necessitating early diagnosis and intervention.Case presentation:This paper provides a comprehensive review of TEN,discussing its history,pathophysiology,clinical features,and current understanding of treatment strategies.A case series of 11 patients who developed TEN after exposure to various drugs,including Lamotrigine,Phenytoin,Diclofenac,Ibuprofen,Aceclofenac,Amoxicillin,Sulfadoxine-Pyrimethamine,Amoxiclav,and Gabapentin,is presented.The cases highlight the importance of early drug discontinuation,supportive care,and adjunctive therapies such as intravenous immunoglobulin(IVIG)and corticosteroids.Prognostic factors,such as the extent of skin detachment and sys-temic complications,significantly influenced patient outcomes.All patients recovered with timely intervention and intensive care,except for a few who succumbed to the severity of the condition.Conclusion:This study underscores the need for early intervention,multidisciplinary care,and robust pharma-covigilance systems to reduce the incidence and severity of TEN.Increased awareness of risk factors and early recognition of symptoms associated with high-risk medications are crucial in improving patient outcomes and reducing mortality.
