The chronic occlusion of intracranial arteries generally has no or mild clinical symptoms,and the clinical symptoms of acute cerebral artery occlusion are mostly manifested as severe cerebral infarction symptoms,which...The chronic occlusion of intracranial arteries generally has no or mild clinical symptoms,and the clinical symptoms of acute cerebral artery occlusion are mostly manifested as severe cerebral infarction symptoms,which often make early diagnosis difficult,thus losing the best treatment opportunity.Once cerebral infarction occurs,the consequences are difficult to recover.This is also an important reason for the high misdiagnosis rate and mortality of this disease.In this paper,the characteristics of the disease were analyzed to provide clinical reference.展开更多
Central retinal artery occlusion(CRAO)is an acute ophthalmic emergency,characterized by sudden vision loss due to retinal ischemia in areas corresponding to arterial occlusion sites.Diagnosis primarily relies on fundu...Central retinal artery occlusion(CRAO)is an acute ophthalmic emergency,characterized by sudden vision loss due to retinal ischemia in areas corresponding to arterial occlusion sites.Diagnosis primarily relies on fundus fluorescein angiography(FFA)and optical coherence tomography(OCT),which show delayed retinal artery filling time hours to days after occlusion and increased hyperreflectivity of the inner retina.展开更多
Dear Editor,Central retinal artery occlusion(CRAO)is a devastating ocular event caused by obstruction of the central retinal artery,leading to a sudden and significant loss of vision.A hallmark of CRAO on funduscopic ...Dear Editor,Central retinal artery occlusion(CRAO)is a devastating ocular event caused by obstruction of the central retinal artery,leading to a sudden and significant loss of vision.A hallmark of CRAO on funduscopic examination is a characteristic“cherry-red spot”at the fovea surrounded by a pale retina[1].The anterior segment typically appears unremarkable.展开更多
BACKGROUND The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.METHODS All CTO vesse...BACKGROUND The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.METHODS All CTO vessels treated with successful anatomical PCI in patients from PANDA Ⅲ trial were retrospectively measured for postPCI QFR.The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs,composite of target vessel-related cardiac death,target vessel-related myocardial infarction,and ischemia-driven target vessel revascularization).Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs,and all vessels were stratified by this optimal cutoff value.Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI.RESULTS Among 428 CTO vessels treated with PCI,353 vessels (82.5%) were analyzable for post-PCI QFR.31 VOCEs (8.7%) occurred at 2 years.Mean value of post-PCI QFR was 0.92±0.13.Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91.The incidence of 2-year VOCEs in the vessel with post-PCI QFR<0.91 (n=91) was significantly higher compared with the vessels with post-PCI QFR≥0.91 (n=262)(22.0%vs.4.2%,HR=4.98,95%CI:2.32–10.70).CONCLUSIONS Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO.Achieving functionally optimal PCI results (post-PCI QFR value≥0.91) tends to get better prognosis for patients with CTO lesions.展开更多
Background Transcatheter left atrial appendage occlusion(LAAO)has become a suitable alternative to anticoagulation in patients with atrial fibrillation(AF).However,outcomes among patients age>75 years undergoing LA...Background Transcatheter left atrial appendage occlusion(LAAO)has become a suitable alternative to anticoagulation in patients with atrial fibrillation(AF).However,outcomes among patients age>75 years undergoing LAAO are lacking.Methods We included 723 consecutive patients with AF undergoing LAAO from August 2015 to March 2020.Patient data including clinical,laboratory,procedural characteristics,medications and outcomes were collected.The primary composite outcome was major adverse cardiac events(MACE)including mortality,stroke,bleeding and readmissions at 60-days.Results Mean age was 75±8 years and 434(60%)were males.Median CHA2DS2-VASc score was 4(IQR:4,5)points and median HASBLED score was 4(IQR:3,4)points.Composite MACE outcome was significantly higher among patients age>75 years in both unadjusted(17.1%vs.11.5%,P=0.03)and adjusted(Odds Ratio=1.59,95%CI:1.02-2.46,P=0.04)analysis.Composite MACE was primarily driven by higher all-cause mortality(1.3%vs.0,P=0.04)among patients age>75 years.The secondary outcome of procedural success was also lower among patients age>75 years(92.2%vs.96.2%,P=0.02).The occurrence of stroke(P=0.38),major bleeding(P=0.29)and readmissions(P=0.15)did not differ between patients age>75 years and less than 75years.Conclusion Patients age>75 years undergoing LAAO have worse outcomes primarily driven by higher all-cause mortality and are less likely to achieve procedural success.Future prospective studies evaluating these findings are warranted.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
AIM:To assess the relationship between serological parameters and the prognosis of young patients with retinal vein occlusion(RVO)after intravitreal conbercept injection(IVC).METHODS:This study enrolled 100 young pati...AIM:To assess the relationship between serological parameters and the prognosis of young patients with retinal vein occlusion(RVO)after intravitreal conbercept injection(IVC).METHODS:This study enrolled 100 young patients(≤50 years old)diagnosed with RVO-related macular edema(RVO-ME)who had been undergoing IVC at the 474 Hospital in Xinjiang between January 2022 and October 2023.Patients were categorized into two groups:70 eyes in the effective group and 30 eyes in the ineffective group.The effective group comprised patients exhibiting a visual acuity improvement of≥2 lines at the last follow-up,with resolved ME and central macular thickness(CMT)<300μm.Conversely,the ineffective group included patients with visual acuity improvement of<1 line,persistent ME,and CMT≥300μm at the last follow-up.Serological parameters,including white blood cell count,neutrophil count,lymphocyte count,monocyte count,and mean platelet volume were assessed before treatment.The correlation between bestcorrected visual acuity(BCVA)and neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune inflammation index(SII),and systemic immune response index(SIRI)was analyzed.Additionally,the association between these serological parameters and the efficacy of IVC was explored.RESULTS:Three months after treatment,the effective group demonstrated a significant improvement in BCVA from 0.82±0.20 to 0.36±0.10,with a concurrent decrease in CMT from 661.28±163.90 to 200.61±82.45μm(P<0.001).Conversely,the ineffective group exhibited minimal changes in BCVA(0.86±0.25 to 0.82±0.14)and CMT(669.84±164.95 to 492.13±138.67μm,P<0.001).The differences in BCVA and CMT between the two groups were statistically significant(P<0.001).According to subgroup analysis,in patients with central RVO(CRVO),BCVA improved from 0.82±0.23 to 0.49±0.12 in the effective group and from 0.80±0.18 to 0.76±0.22 in the ineffective group(P<0.001).The CMT changes followed a similar pattern.In patients with branch RVO(BRVO),comparable trends in BCVA and CMT changes were observed between the effective and ineffective groups(P<0.001).Additionally,the effective group exhibited higher PLR and SII values than the ineffective group(P<0.05).Further CRVO and BRVO subgroups analysis exhibited consistent PLR and SII value trends.CONCLUSION:Compared to other inflammatory factors,elevated PLR and SII levels before treatment are better predictors of outcomes in young RVO-ME patients undergoing IVC treatment.展开更多
BACKGROUND Central retinal artery occlusion(CRAO)is a potentially blinding disease,and hyperbaric oxygen therapy(HBOT)is becoming increasingly popular with the support of scientific evidence.Despite the presence of va...BACKGROUND Central retinal artery occlusion(CRAO)is a potentially blinding disease,and hyperbaric oxygen therapy(HBOT)is becoming increasingly popular with the support of scientific evidence.Despite the presence of various acute management measures,there is no clear evidence on the gold standard treatment for CRAO.AIM To identify factors and imaging parameters associated with good visual outcome,which guide ophthalmologists in the triage of CRAO patients for HBOT.METHODS Patients who suffered from CRAO and had a symptom onset≤6 h were recruited for a course of HBOT in a tertiary hospital after failing bedside treatment.Patient demographics,onset time,CRAO eye parameters,and past medical history were prospectively collected.Visual outcomes after HBOT were also analyzed.RESULTS A total of 26 patients were included;the female-to-male ratio was 1:1.6,and the mean age was 67.5 years±13.3 years(range 44–89 years).The mean duration of follow-up and mean visual acuity(VA)improvement were 10.0 mo±5.3 mo and 0.48 logarithm of minimal angle of resolution(logMAR)±0.57 logMAR(approx-imately 9 letters in ETDRS)(P=0.0001,Z=-3.67),respectively.The 1 mm zone of central macular thickness(CMT)on optical coherence tomography was not associated with VA changes(P=0.119);however,the 1-to-3 mm circular rim of CMT was fairly associated(P=0.02,Spearman's coefficient=0.45).Complete retinal perfusion time during fundus fluorescein angiography(FFA)was mode-rately associated(P=0.01,Spearman's coefficient=0.58)with visual outcome.展开更多
BACKGROUND:Resuscitative endovascular balloon occlusion of the aorta(REBOA)is a minimally invasive technique used to control non-compressible torso hemorrhage.However,the optimal degree of partial occlusion that off e...BACKGROUND:Resuscitative endovascular balloon occlusion of the aorta(REBOA)is a minimally invasive technique used to control non-compressible torso hemorrhage.However,the optimal degree of partial occlusion that off ers maximum therapeutic benefi t remains unclear.This study aimed to identify the optimal partial infl ation volume for REBOA.METHODS:In a swine model of hemorrhagic shock,nine healthy female pigs were randomly assigned to three groups based on balloon inflation volume:30%(R30),60%(R60),and 100%(R100)of the volume required to eliminate the contralateral femoral arterial waveform.Hemodynamic variables,fluid and vasopressor requirements,and biochemical markers were evaluated during balloon occlusion and resuscitation following 40%blood volume-controlled hemorrhage.RESULTS:The R30 group showed higher mean arterial pressure during resuscitation and required less fluid and norepinephrine than those of the R100 group.The mean heart rate significantly differed over time among the groups,with more gradual changes in the R30 group.Markers of ischemia-reperfusion injury(lactate,pH,blood urea nitrogen,and creatinine)similarly exhibited significant temporal differences.Post hoc analysis revealed significant pH differences between the groups.The plasma lactate and creatinine levels were significantly lower in the R30 group than those in the other two groups.CONCLUSION:In this swine hemorrhagic shock model,partial REBOA with 30%balloon inflation maintained hemodynamic stability while reducing metabolic derangement compared with higher ballon volumes of 60%and 100%inflation.A strategy involving partial inflation targeting approximately 30%,followed by monitoring the blood pressure trend while using a vasoconstrictor,if necessary,may have potential clinical utility.展开更多
We recently read with interest the article by Chi et al published in the World Journal of Gastroenterology.In this article,the authors reported a novel technique for re-establishing luminal continuity in a completely ...We recently read with interest the article by Chi et al published in the World Journal of Gastroenterology.In this article,the authors reported a novel technique for re-establishing luminal continuity in a completely occluded colorectal anastomosis involving two endoscopes,one for radial electrical incision and the other serving as a guide light.However,this technique can be applied only in selected cases.Given the absence of a standardized guideline-based algorithm for the management of complete anastomotic obstruction,by reviewing the available literature,we provide a brief overview of relevant endoscopic techniques while underlining their importance in the management of this postoperative complication to provide clinicians with the necessary knowledge to improve their daily practice.展开更多
BACKGROUND Abdominal cocoons(ACs)lack characteristic clinical manifestations and are main-ly intestinal obstructions that are difficult to distinguish from intestinal obstruc-tion caused by other causes,resulting in d...BACKGROUND Abdominal cocoons(ACs)lack characteristic clinical manifestations and are main-ly intestinal obstructions that are difficult to distinguish from intestinal obstruc-tion caused by other causes,resulting in difficult preoperative diagnosis and misdiagnosis and mistreatment.There are no reports of enterostomy occlusion caused by ACs in the literature at home and abroad.CASE SUMMARY Here,we report a 16-year-old female patient with intestinal obstruction due to AC.She was treated with abdominal surgery three times.First,she underwent a laparotomy for peritonitis after trauma from a traffic accident.During the pro-cedure,pelvic empyema,severe intestinal adhesions,and damage to the serous layer of the rectum were found,but no significant intestinal rupture and perfo-ration were found.As a precaution,she underwent a prophylactic ileostomy after a flush in her abdomen.The second and third surgeries were for treatment of recurrent stoma obstruction.The patient’s condition was complicated for a long period,but after comprehensive treatment by our department,the patient was successfully discharged from the hospital and is currently recovering well.CONCLUSION Currently,abdominal contrast-enhanced computed tomography is the best imaging modality for pre-operative evaluation of AC,but most patients are diagnosed only after intrao-perative exploration.For the treatment of typical or severe ACs,the primary me-thod of removal and healing of ACs is complete removal of the abdominal fibrous membrane.Finding a breakthrough in the anatomy is the key to the success of the surgery.展开更多
Objective:Sheep are commonly used as large animal pre-clinical models for inves-tigating cardiovascular therapies,interventions,anatomy and physiology.Further,novel small diameter vascular grafts are frequently tested...Objective:Sheep are commonly used as large animal pre-clinical models for inves-tigating cardiovascular therapies,interventions,anatomy and physiology.Further,novel small diameter vascular grafts are frequently tested via implantation into sheep carotid arteries(CAs).This is because,unlike humans,acute occlusion of one or both sheep CAs is not associated with morbidity or mortality and thus provides safer experimental testing,with reduced ethical constraints,animal numbers and costs.However,to date there has been no evidence regarding sheep tolerance of femoral artery(FA)occlusion.Methods:In this study,seven sheep underwent CA graft surgery,with digital subtrac-tion angiography(DSA)of the CAs performed every 2 months via femoral access,for a total of 8 months.Four months into the study,the left FA of two sheep became inac-cessible due to a suspected FA occlusion.Thus,femoral angiography was performed,followed by FA dissection,FA histology and retrospective analysis of both veterinar-ian animal monitoring and pain scores.Results:FA angiography and histology confirmed complete left FA occlusion in two sheep.Retrospective animal monitoring demonstrated sheep with occluded FAs did not display increased pain scores or deleterious effects on their gait or wellbeing.Conclusion:Our data shows that sheep tolerate FA occlusion with no symptoms,similar to their cerebral circulation,making them an appropriate model for assessing small diameter femoral graft interposition studies and testing other cardiovascular interventions.展开更多
Placenta abnormalities,which are collectively termed as placenta accreta spec-trum(PAS),are increasing globally in the female population due to the large nu-mber of cesarean sections performed worldwide.PAS represents...Placenta abnormalities,which are collectively termed as placenta accreta spec-trum(PAS),are increasing globally in the female population due to the large nu-mber of cesarean sections performed worldwide.PAS represents a rare but life-threatening occurrence that can lead to an increased risk of postpartum hemorr-hage due to the abnormal infiltration of the chorionic villi in the uterine wall up to the adjacent structures.Performing a prophylactic occlusion of the iliac arteries for a brief amount of time using balloon-occlusion endovascular catheters in patients with PAS can help control unwanted blood losses during cesarean delivery or postpartum demolition surgery.The aim of this narrative minireview was to pro-vide an overview of the aspects about prophylactic occlusion with endovascular balloons in patients with PAS and to analyze current evidence on this topic.In particular,this minireview included an overview of indications,patient selection,type of materials and devices used,technical advice and suggestions,clinical outcomes,and complications to give every interventional radiologist as well as every gynecologist and midwife all the information that is needed to address this particular condition in a safe and prompt manner.展开更多
Directly occluding polymer nanoparticles into growing host crystals provides a versatile pathway for synthe sizing polymer-inorganic composite crystals,where vip nanoparticles are distributed within the crystal matr...Directly occluding polymer nanoparticles into growing host crystals provides a versatile pathway for synthe sizing polymer-inorganic composite crystals,where vip nanoparticles are distributed within the crystal matrix.However,systematically controlling the extent of nanoparticle occlusion within a host crystal remains a significant challenge.In this study,we employ a one-step,soap-free emulsion polymerization method to synthesize polyethyleneimine-functionalized poly(tert-butyl methacrylate)(PtBMA/PEI)nanoparticles.These cationic nanoparticles are subsequently modified using formaldehyde to systematically tune the content of surface amine group via the Eschweiler-Clarke reaction.This approach yields a series of model nanoparticles that allow us to investigate how surface chemistry influences the extent of nanoparticle occlusion within calcite crystals.Our findings reveal that the extent of nanoparticle occlusion within calcite crystals is proportional to the surface amine group content.This study offers a new design rule for creating composite crystals with tailored compositions through a nanoparticle occlusion strategy.展开更多
BACKGROUND Intramural pregnancy is rare,with an unclear etiology and pathophysiology.Surgical,medical,and expectant management options are available for this condition.However,most reported cases are managed surgicall...BACKGROUND Intramural pregnancy is rare,with an unclear etiology and pathophysiology.Surgical,medical,and expectant management options are available for this condition.However,most reported cases are managed surgically.Despite the risks of massive intraoperative bleeding and acute and long-term complications,uterine artery embolization is often selected.Temporary occlusion of the bilateral uterine arteries during surgery is associated with fewer complications.CASE SUMMARY We reported the case of a patient who was diagnosed with intramural pregnancy approximately one month after medical abortion.We performed laparoscopic resection with hysteroscopy.Since the lesion had abundant blood flow,we temporarily blocked the bilateral uterine arteries to prevent massive intraop-erative bleeding.The surgical process went smoothly.The postoperative course was uneventful.CONCLUSION Temporary occlusion of the bilateral uterine arteries in the treatment of intramural pregnancy may prevent excessive uterine bleeding during surgery.展开更多
Object detection in occluded environments remains a core challenge in computer vision(CV),especially in domains such as autonomous driving and robotics.While Convolutional Neural Network(CNN)-based twodimensional(2D)a...Object detection in occluded environments remains a core challenge in computer vision(CV),especially in domains such as autonomous driving and robotics.While Convolutional Neural Network(CNN)-based twodimensional(2D)and three-dimensional(3D)object detection methods havemade significant progress,they often fall short under severe occlusion due to depth ambiguities in 2D imagery and the high cost and deployment limitations of 3D sensors such as Light Detection and Ranging(LiDAR).This paper presents a comparative review of recent 2D and 3D detection models,focusing on their occlusion-handling capabilities and the impact of sensor modalities such as stereo vision,Time-of-Flight(ToF)cameras,and LiDAR.In this context,we introduce FuDensityNet,our multimodal occlusion-aware detection framework that combines Red-Green-Blue(RGB)images and LiDAR data to enhance detection performance.As a forward-looking direction,we propose a monocular depth-estimation extension to FuDensityNet,aimed at replacing expensive 3D sensors with a more scalable CNN-based pipeline.Although this enhancement is not experimentally evaluated in this manuscript,we describe its conceptual design and potential for future implementation.展开更多
AIM:To evaluate the efficacy and safety of concurrent intravitreal ranibizumab(IVR)and extended-release dexamethasone injections(Dex-I)in naïve and refractory patients with retinal vein occlusion macular edema(RV...AIM:To evaluate the efficacy and safety of concurrent intravitreal ranibizumab(IVR)and extended-release dexamethasone injections(Dex-I)in naïve and refractory patients with retinal vein occlusion macular edema(RVO-ME).METHODS:This was a prospective,interventional,and open-label clinical trial.There were two groups:naïve and refractory patients(received≥5 times of previous IVR within one year prior to enrollment)enrolled.Patients received IVR and Dex-I concurrently and re-combination therapy was required if one or more retreatment criteria were met.IVR and Dex-I were given pro re nata(PRN).The mean changes in best-corrected visual acuity(BCVA)and central macular thickness(CMT)were measured as main outcomes.RESULTS:Totally 63 patients(63 eyes)completed the entire follow-up(31 naïve and 32 refractory patients).At month 12,the change in BCVA was greater in the naïve group than in the refractory group[19.67±11.7(95%CI:15.03,24.31)letters vs 11.74±11.18(95%CI:7.32,16.16)letters,P=0.014].There was no difference between the two groups of mean macular thickness reduction[364.26±215.29(95%CI:279.09,449.43)μm vs 410.19±204.34(95%CI:329.35,491.02)μm,P=0.43].The mean co-injection numbers were 2.52±0.58(95%CI:2.29,2.75)and 2.33±0.55(95%CI:2.11,2.55)in both groups(P=0.24),respectively.The retreatment interval was 115.81±13.79 d(95%CI:110.36,121.27)and 122.74±14.06 d(95%CI:119.93,133.56)in both groups(P=0.073).There was no significant difference in the incidence of glaucoma or the progression of cataracts between the two groups.CONCLUSION:In both naïve and refractory RVO-ME patients,IVR combined with Dex-I is effective.The initial combination therapy for naïve patients demonstrates more efficient improvement in BCVA and may reduce total injection numbers compared to refractory patients.展开更多
AIM:To investigate the efficacy and safety of repeated dexamethasone implants with real-life data in eyes with naive retinal vein occlusion(RVO)with macular edema(ME)at a minimum of 60mo follow-up.METHODS:In this retr...AIM:To investigate the efficacy and safety of repeated dexamethasone implants with real-life data in eyes with naive retinal vein occlusion(RVO)with macular edema(ME)at a minimum of 60mo follow-up.METHODS:In this retrospective cohort study,the data about best corrected visual acuity(BCVA),central macular thickness(CMT),serous macular detachment(SMD),hard exudate,hyperreflective foci(HRF),cystoid degeneration,pearl necklace sign,epiretinal membrane(ERM),disorganization of retinal inner layers(DRIL),ellipsoid zone and external limiting membrane(EZ-ELM)integrity,intraocular pressure(IOP)and lens condition were recorded.RESULTS:Thirty-eight eyes of 38 patients were included in the study.Thirteen patients presented with central RVO(CRVO)and 25 with branch RVO(BRVO).The mean follow-up time was 69.9±15.8mo,and the mean number of injections was 7.9±4.0.The mean BCVA gain was 25.0±36 letters,and this difference was statistically significant(P=0.021).The BCVA gain was 19.4±20.4 letters in the CRVO group,and 26.5±38.6 letters in the BRVO group(P=0.763).Besides,21(55.2%)of the patients achieved≥15 letters improvement.At the end of the follow-up period,SMD was not observed in any of the patients(P=0.016).Hard exudate,HRF number were decreased;while DRIL,ERM and EZ-ELM defects were increased but not significantly.CONCLUSION:Intravitreal dexamethasone monotherapy is an effective and safe treatment option for the treatment-naive RVO-ME patients in the long-term follow-up.展开更多
AIM:To analyse the research status and explore global trends in retinal vein occlusion(RVO)studies.METHODS:Publications related to RVO from 2004 to 2023 were extracted from the Web of Science Core Collection(WoSCC).Va...AIM:To analyse the research status and explore global trends in retinal vein occlusion(RVO)studies.METHODS:Publications related to RVO from 2004 to 2023 were extracted from the Web of Science Core Collection(WoSCC).Variables including the number of publications,as well as countries,organizations,authors,journals,references and keywords were analysed using Bibliometrix-BilioShiny.Data visualization was performed using VOSviewer and CiteSpace.RESULTS:A total of 4848 publications were retrieved,and generally,the number of publications showed an overall increasing trend with slight fluctuations over the past 20y.The country with the most publications was the United States.The journal with the most publications was Retina,and the most cited journal was Ophthalmology.The most prolific organization was the University of California,Los Angeles.The most productive author was Noma H,and the most cited author was Campochiaro PA.The top cocited references mainly focused on the prevalence of RVO and the therapies used in clinical trials.According to the co-occurrence analysis,the keywords formed 3 clusters:1)risk factors and pathogenesis of RVO,2)treatments of RVO,and 3)imaging diagnosis of RVO.Anti-vascular endothelial growth factor(VEGF)treatments and artificial intelligence have recently become popular research topics.CONCLUSION:Bibliometric analysis of the research status and trends of RVO could provide researchers and clinicians with valuable insights for further collaboration,future research directions,and clinical practice.展开更多
Anticoagulation has long been the standard of care for preventing embolic events in atrial fibrillation(AF).^([1])The elderly AF generation is more susceptible to thromboembolic incidents.They are also more likely to ...Anticoagulation has long been the standard of care for preventing embolic events in atrial fibrillation(AF).^([1])The elderly AF generation is more susceptible to thromboembolic incidents.They are also more likely to encounter hemorrhagic and other complications when using anticoagulants.Therefore,percutaneous left atrial appendage occlusion(pLAAO)is regarded as an appealing alternative therapy for preventing stroke in patients who are poor candidates for long-term anticoagulation.^([2,3])Contemporary patients undergoing pLAAO are typically older and have more comorbidities than those who were enrolled in pivotal randomized controlled trials.展开更多
基金Supported by the Science and Technology Program of Nantong Health Committee,No.MA2019003 and No.MA2021017Kangda College of Nanjing Medical University,No.KD2021JYYJYB025,No.KD2022KYJJZD019,and No.KD2022KYJJZD022+1 种基金Research Project of Nantong Health and Health Commission,No.MS2023041the Science and Technology Program of Nantong City,No.Key003 and No.JCZ2022040.
文摘The chronic occlusion of intracranial arteries generally has no or mild clinical symptoms,and the clinical symptoms of acute cerebral artery occlusion are mostly manifested as severe cerebral infarction symptoms,which often make early diagnosis difficult,thus losing the best treatment opportunity.Once cerebral infarction occurs,the consequences are difficult to recover.This is also an important reason for the high misdiagnosis rate and mortality of this disease.In this paper,the characteristics of the disease were analyzed to provide clinical reference.
基金Supported by National Natural Science Foundation of China(No.82070991).
文摘Central retinal artery occlusion(CRAO)is an acute ophthalmic emergency,characterized by sudden vision loss due to retinal ischemia in areas corresponding to arterial occlusion sites.Diagnosis primarily relies on fundus fluorescein angiography(FFA)and optical coherence tomography(OCT),which show delayed retinal artery filling time hours to days after occlusion and increased hyperreflectivity of the inner retina.
文摘Dear Editor,Central retinal artery occlusion(CRAO)is a devastating ocular event caused by obstruction of the central retinal artery,leading to a sudden and significant loss of vision.A hallmark of CRAO on funduscopic examination is a characteristic“cherry-red spot”at the fovea surrounded by a pale retina[1].The anterior segment typically appears unremarkable.
基金supported by the CAMS Innovation Fund for Medical Sciences(No.2021-I2M-1-008)the National High Level Hospital Clinical Research Funding(No.2023-GSP-GG-2&No.2023-GSP-QN-34&No.2023-GSPRC-05).
文摘BACKGROUND The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.METHODS All CTO vessels treated with successful anatomical PCI in patients from PANDA Ⅲ trial were retrospectively measured for postPCI QFR.The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs,composite of target vessel-related cardiac death,target vessel-related myocardial infarction,and ischemia-driven target vessel revascularization).Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs,and all vessels were stratified by this optimal cutoff value.Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI.RESULTS Among 428 CTO vessels treated with PCI,353 vessels (82.5%) were analyzable for post-PCI QFR.31 VOCEs (8.7%) occurred at 2 years.Mean value of post-PCI QFR was 0.92±0.13.Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91.The incidence of 2-year VOCEs in the vessel with post-PCI QFR<0.91 (n=91) was significantly higher compared with the vessels with post-PCI QFR≥0.91 (n=262)(22.0%vs.4.2%,HR=4.98,95%CI:2.32–10.70).CONCLUSIONS Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO.Achieving functionally optimal PCI results (post-PCI QFR value≥0.91) tends to get better prognosis for patients with CTO lesions.
文摘Background Transcatheter left atrial appendage occlusion(LAAO)has become a suitable alternative to anticoagulation in patients with atrial fibrillation(AF).However,outcomes among patients age>75 years undergoing LAAO are lacking.Methods We included 723 consecutive patients with AF undergoing LAAO from August 2015 to March 2020.Patient data including clinical,laboratory,procedural characteristics,medications and outcomes were collected.The primary composite outcome was major adverse cardiac events(MACE)including mortality,stroke,bleeding and readmissions at 60-days.Results Mean age was 75±8 years and 434(60%)were males.Median CHA2DS2-VASc score was 4(IQR:4,5)points and median HASBLED score was 4(IQR:3,4)points.Composite MACE outcome was significantly higher among patients age>75 years in both unadjusted(17.1%vs.11.5%,P=0.03)and adjusted(Odds Ratio=1.59,95%CI:1.02-2.46,P=0.04)analysis.Composite MACE was primarily driven by higher all-cause mortality(1.3%vs.0,P=0.04)among patients age>75 years.The secondary outcome of procedural success was also lower among patients age>75 years(92.2%vs.96.2%,P=0.02).The occurrence of stroke(P=0.38),major bleeding(P=0.29)and readmissions(P=0.15)did not differ between patients age>75 years and less than 75years.Conclusion Patients age>75 years undergoing LAAO have worse outcomes primarily driven by higher all-cause mortality and are less likely to achieve procedural success.Future prospective studies evaluating these findings are warranted.
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 Youth Cultivation Research Program of Beijing Road Medical Area,Xinjiang Military Region General Hospital,Xinjiang,China(No.2022jzbj105)Science and Technology Program of Urumqi Municipal Health and Wellness Commission(No.202360).
文摘AIM:To assess the relationship between serological parameters and the prognosis of young patients with retinal vein occlusion(RVO)after intravitreal conbercept injection(IVC).METHODS:This study enrolled 100 young patients(≤50 years old)diagnosed with RVO-related macular edema(RVO-ME)who had been undergoing IVC at the 474 Hospital in Xinjiang between January 2022 and October 2023.Patients were categorized into two groups:70 eyes in the effective group and 30 eyes in the ineffective group.The effective group comprised patients exhibiting a visual acuity improvement of≥2 lines at the last follow-up,with resolved ME and central macular thickness(CMT)<300μm.Conversely,the ineffective group included patients with visual acuity improvement of<1 line,persistent ME,and CMT≥300μm at the last follow-up.Serological parameters,including white blood cell count,neutrophil count,lymphocyte count,monocyte count,and mean platelet volume were assessed before treatment.The correlation between bestcorrected visual acuity(BCVA)and neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune inflammation index(SII),and systemic immune response index(SIRI)was analyzed.Additionally,the association between these serological parameters and the efficacy of IVC was explored.RESULTS:Three months after treatment,the effective group demonstrated a significant improvement in BCVA from 0.82±0.20 to 0.36±0.10,with a concurrent decrease in CMT from 661.28±163.90 to 200.61±82.45μm(P<0.001).Conversely,the ineffective group exhibited minimal changes in BCVA(0.86±0.25 to 0.82±0.14)and CMT(669.84±164.95 to 492.13±138.67μm,P<0.001).The differences in BCVA and CMT between the two groups were statistically significant(P<0.001).According to subgroup analysis,in patients with central RVO(CRVO),BCVA improved from 0.82±0.23 to 0.49±0.12 in the effective group and from 0.80±0.18 to 0.76±0.22 in the ineffective group(P<0.001).The CMT changes followed a similar pattern.In patients with branch RVO(BRVO),comparable trends in BCVA and CMT changes were observed between the effective and ineffective groups(P<0.001).Additionally,the effective group exhibited higher PLR and SII values than the ineffective group(P<0.05).Further CRVO and BRVO subgroups analysis exhibited consistent PLR and SII value trends.CONCLUSION:Compared to other inflammatory factors,elevated PLR and SII levels before treatment are better predictors of outcomes in young RVO-ME patients undergoing IVC treatment.
文摘BACKGROUND Central retinal artery occlusion(CRAO)is a potentially blinding disease,and hyperbaric oxygen therapy(HBOT)is becoming increasingly popular with the support of scientific evidence.Despite the presence of various acute management measures,there is no clear evidence on the gold standard treatment for CRAO.AIM To identify factors and imaging parameters associated with good visual outcome,which guide ophthalmologists in the triage of CRAO patients for HBOT.METHODS Patients who suffered from CRAO and had a symptom onset≤6 h were recruited for a course of HBOT in a tertiary hospital after failing bedside treatment.Patient demographics,onset time,CRAO eye parameters,and past medical history were prospectively collected.Visual outcomes after HBOT were also analyzed.RESULTS A total of 26 patients were included;the female-to-male ratio was 1:1.6,and the mean age was 67.5 years±13.3 years(range 44–89 years).The mean duration of follow-up and mean visual acuity(VA)improvement were 10.0 mo±5.3 mo and 0.48 logarithm of minimal angle of resolution(logMAR)±0.57 logMAR(approx-imately 9 letters in ETDRS)(P=0.0001,Z=-3.67),respectively.The 1 mm zone of central macular thickness(CMT)on optical coherence tomography was not associated with VA changes(P=0.119);however,the 1-to-3 mm circular rim of CMT was fairly associated(P=0.02,Spearman's coefficient=0.45).Complete retinal perfusion time during fundus fluorescein angiography(FFA)was mode-rately associated(P=0.01,Spearman's coefficient=0.58)with visual outcome.
基金supported by Seoul National University Hospital(0420210270).
文摘BACKGROUND:Resuscitative endovascular balloon occlusion of the aorta(REBOA)is a minimally invasive technique used to control non-compressible torso hemorrhage.However,the optimal degree of partial occlusion that off ers maximum therapeutic benefi t remains unclear.This study aimed to identify the optimal partial infl ation volume for REBOA.METHODS:In a swine model of hemorrhagic shock,nine healthy female pigs were randomly assigned to three groups based on balloon inflation volume:30%(R30),60%(R60),and 100%(R100)of the volume required to eliminate the contralateral femoral arterial waveform.Hemodynamic variables,fluid and vasopressor requirements,and biochemical markers were evaluated during balloon occlusion and resuscitation following 40%blood volume-controlled hemorrhage.RESULTS:The R30 group showed higher mean arterial pressure during resuscitation and required less fluid and norepinephrine than those of the R100 group.The mean heart rate significantly differed over time among the groups,with more gradual changes in the R30 group.Markers of ischemia-reperfusion injury(lactate,pH,blood urea nitrogen,and creatinine)similarly exhibited significant temporal differences.Post hoc analysis revealed significant pH differences between the groups.The plasma lactate and creatinine levels were significantly lower in the R30 group than those in the other two groups.CONCLUSION:In this swine hemorrhagic shock model,partial REBOA with 30%balloon inflation maintained hemodynamic stability while reducing metabolic derangement compared with higher ballon volumes of 60%and 100%inflation.A strategy involving partial inflation targeting approximately 30%,followed by monitoring the blood pressure trend while using a vasoconstrictor,if necessary,may have potential clinical utility.
文摘We recently read with interest the article by Chi et al published in the World Journal of Gastroenterology.In this article,the authors reported a novel technique for re-establishing luminal continuity in a completely occluded colorectal anastomosis involving two endoscopes,one for radial electrical incision and the other serving as a guide light.However,this technique can be applied only in selected cases.Given the absence of a standardized guideline-based algorithm for the management of complete anastomotic obstruction,by reviewing the available literature,we provide a brief overview of relevant endoscopic techniques while underlining their importance in the management of this postoperative complication to provide clinicians with the necessary knowledge to improve their daily practice.
基金Supported by Suqian Science and Technology Project Contract,No.S201910。
文摘BACKGROUND Abdominal cocoons(ACs)lack characteristic clinical manifestations and are main-ly intestinal obstructions that are difficult to distinguish from intestinal obstruc-tion caused by other causes,resulting in difficult preoperative diagnosis and misdiagnosis and mistreatment.There are no reports of enterostomy occlusion caused by ACs in the literature at home and abroad.CASE SUMMARY Here,we report a 16-year-old female patient with intestinal obstruction due to AC.She was treated with abdominal surgery three times.First,she underwent a laparotomy for peritonitis after trauma from a traffic accident.During the pro-cedure,pelvic empyema,severe intestinal adhesions,and damage to the serous layer of the rectum were found,but no significant intestinal rupture and perfo-ration were found.As a precaution,she underwent a prophylactic ileostomy after a flush in her abdomen.The second and third surgeries were for treatment of recurrent stoma obstruction.The patient’s condition was complicated for a long period,but after comprehensive treatment by our department,the patient was successfully discharged from the hospital and is currently recovering well.CONCLUSION Currently,abdominal contrast-enhanced computed tomography is the best imaging modality for pre-operative evaluation of AC,but most patients are diagnosed only after intrao-perative exploration.For the treatment of typical or severe ACs,the primary me-thod of removal and healing of ACs is complete removal of the abdominal fibrous membrane.Finding a breakthrough in the anatomy is the key to the success of the surgery.
基金funded by R.D.H.,P.B.,A.S.W. and Z.W,Heart Foundation Vanguard Grant#107321funded by contributions from The Baird Institute for applied Heart and Lung Research.
文摘Objective:Sheep are commonly used as large animal pre-clinical models for inves-tigating cardiovascular therapies,interventions,anatomy and physiology.Further,novel small diameter vascular grafts are frequently tested via implantation into sheep carotid arteries(CAs).This is because,unlike humans,acute occlusion of one or both sheep CAs is not associated with morbidity or mortality and thus provides safer experimental testing,with reduced ethical constraints,animal numbers and costs.However,to date there has been no evidence regarding sheep tolerance of femoral artery(FA)occlusion.Methods:In this study,seven sheep underwent CA graft surgery,with digital subtrac-tion angiography(DSA)of the CAs performed every 2 months via femoral access,for a total of 8 months.Four months into the study,the left FA of two sheep became inac-cessible due to a suspected FA occlusion.Thus,femoral angiography was performed,followed by FA dissection,FA histology and retrospective analysis of both veterinar-ian animal monitoring and pain scores.Results:FA angiography and histology confirmed complete left FA occlusion in two sheep.Retrospective animal monitoring demonstrated sheep with occluded FAs did not display increased pain scores or deleterious effects on their gait or wellbeing.Conclusion:Our data shows that sheep tolerate FA occlusion with no symptoms,similar to their cerebral circulation,making them an appropriate model for assessing small diameter femoral graft interposition studies and testing other cardiovascular interventions.
文摘Placenta abnormalities,which are collectively termed as placenta accreta spec-trum(PAS),are increasing globally in the female population due to the large nu-mber of cesarean sections performed worldwide.PAS represents a rare but life-threatening occurrence that can lead to an increased risk of postpartum hemorr-hage due to the abnormal infiltration of the chorionic villi in the uterine wall up to the adjacent structures.Performing a prophylactic occlusion of the iliac arteries for a brief amount of time using balloon-occlusion endovascular catheters in patients with PAS can help control unwanted blood losses during cesarean delivery or postpartum demolition surgery.The aim of this narrative minireview was to pro-vide an overview of the aspects about prophylactic occlusion with endovascular balloons in patients with PAS and to analyze current evidence on this topic.In particular,this minireview included an overview of indications,patient selection,type of materials and devices used,technical advice and suggestions,clinical outcomes,and complications to give every interventional radiologist as well as every gynecologist and midwife all the information that is needed to address this particular condition in a safe and prompt manner.
基金financial supports from the National Natural Science Foundation of China(Nos.22475084 and 22101100)Guangdong Basic and Applied Basic Research Foundation(Nos.2024A1515012114 and 2025A1515012931)College Students’Innovation and Entrepreneurship Training Program.
文摘Directly occluding polymer nanoparticles into growing host crystals provides a versatile pathway for synthe sizing polymer-inorganic composite crystals,where vip nanoparticles are distributed within the crystal matrix.However,systematically controlling the extent of nanoparticle occlusion within a host crystal remains a significant challenge.In this study,we employ a one-step,soap-free emulsion polymerization method to synthesize polyethyleneimine-functionalized poly(tert-butyl methacrylate)(PtBMA/PEI)nanoparticles.These cationic nanoparticles are subsequently modified using formaldehyde to systematically tune the content of surface amine group via the Eschweiler-Clarke reaction.This approach yields a series of model nanoparticles that allow us to investigate how surface chemistry influences the extent of nanoparticle occlusion within calcite crystals.Our findings reveal that the extent of nanoparticle occlusion within calcite crystals is proportional to the surface amine group content.This study offers a new design rule for creating composite crystals with tailored compositions through a nanoparticle occlusion strategy.
文摘BACKGROUND Intramural pregnancy is rare,with an unclear etiology and pathophysiology.Surgical,medical,and expectant management options are available for this condition.However,most reported cases are managed surgically.Despite the risks of massive intraoperative bleeding and acute and long-term complications,uterine artery embolization is often selected.Temporary occlusion of the bilateral uterine arteries during surgery is associated with fewer complications.CASE SUMMARY We reported the case of a patient who was diagnosed with intramural pregnancy approximately one month after medical abortion.We performed laparoscopic resection with hysteroscopy.Since the lesion had abundant blood flow,we temporarily blocked the bilateral uterine arteries to prevent massive intraop-erative bleeding.The surgical process went smoothly.The postoperative course was uneventful.CONCLUSION Temporary occlusion of the bilateral uterine arteries in the treatment of intramural pregnancy may prevent excessive uterine bleeding during surgery.
文摘Object detection in occluded environments remains a core challenge in computer vision(CV),especially in domains such as autonomous driving and robotics.While Convolutional Neural Network(CNN)-based twodimensional(2D)and three-dimensional(3D)object detection methods havemade significant progress,they often fall short under severe occlusion due to depth ambiguities in 2D imagery and the high cost and deployment limitations of 3D sensors such as Light Detection and Ranging(LiDAR).This paper presents a comparative review of recent 2D and 3D detection models,focusing on their occlusion-handling capabilities and the impact of sensor modalities such as stereo vision,Time-of-Flight(ToF)cameras,and LiDAR.In this context,we introduce FuDensityNet,our multimodal occlusion-aware detection framework that combines Red-Green-Blue(RGB)images and LiDAR data to enhance detection performance.As a forward-looking direction,we propose a monocular depth-estimation extension to FuDensityNet,aimed at replacing expensive 3D sensors with a more scalable CNN-based pipeline.Although this enhancement is not experimentally evaluated in this manuscript,we describe its conceptual design and potential for future implementation.
基金Supported by the National Nature Science Foundation of China(No.82301211)Beijing Natural Science Foundation(No.J230028).
文摘AIM:To evaluate the efficacy and safety of concurrent intravitreal ranibizumab(IVR)and extended-release dexamethasone injections(Dex-I)in naïve and refractory patients with retinal vein occlusion macular edema(RVO-ME).METHODS:This was a prospective,interventional,and open-label clinical trial.There were two groups:naïve and refractory patients(received≥5 times of previous IVR within one year prior to enrollment)enrolled.Patients received IVR and Dex-I concurrently and re-combination therapy was required if one or more retreatment criteria were met.IVR and Dex-I were given pro re nata(PRN).The mean changes in best-corrected visual acuity(BCVA)and central macular thickness(CMT)were measured as main outcomes.RESULTS:Totally 63 patients(63 eyes)completed the entire follow-up(31 naïve and 32 refractory patients).At month 12,the change in BCVA was greater in the naïve group than in the refractory group[19.67±11.7(95%CI:15.03,24.31)letters vs 11.74±11.18(95%CI:7.32,16.16)letters,P=0.014].There was no difference between the two groups of mean macular thickness reduction[364.26±215.29(95%CI:279.09,449.43)μm vs 410.19±204.34(95%CI:329.35,491.02)μm,P=0.43].The mean co-injection numbers were 2.52±0.58(95%CI:2.29,2.75)and 2.33±0.55(95%CI:2.11,2.55)in both groups(P=0.24),respectively.The retreatment interval was 115.81±13.79 d(95%CI:110.36,121.27)and 122.74±14.06 d(95%CI:119.93,133.56)in both groups(P=0.073).There was no significant difference in the incidence of glaucoma or the progression of cataracts between the two groups.CONCLUSION:In both naïve and refractory RVO-ME patients,IVR combined with Dex-I is effective.The initial combination therapy for naïve patients demonstrates more efficient improvement in BCVA and may reduce total injection numbers compared to refractory patients.
文摘AIM:To investigate the efficacy and safety of repeated dexamethasone implants with real-life data in eyes with naive retinal vein occlusion(RVO)with macular edema(ME)at a minimum of 60mo follow-up.METHODS:In this retrospective cohort study,the data about best corrected visual acuity(BCVA),central macular thickness(CMT),serous macular detachment(SMD),hard exudate,hyperreflective foci(HRF),cystoid degeneration,pearl necklace sign,epiretinal membrane(ERM),disorganization of retinal inner layers(DRIL),ellipsoid zone and external limiting membrane(EZ-ELM)integrity,intraocular pressure(IOP)and lens condition were recorded.RESULTS:Thirty-eight eyes of 38 patients were included in the study.Thirteen patients presented with central RVO(CRVO)and 25 with branch RVO(BRVO).The mean follow-up time was 69.9±15.8mo,and the mean number of injections was 7.9±4.0.The mean BCVA gain was 25.0±36 letters,and this difference was statistically significant(P=0.021).The BCVA gain was 19.4±20.4 letters in the CRVO group,and 26.5±38.6 letters in the BRVO group(P=0.763).Besides,21(55.2%)of the patients achieved≥15 letters improvement.At the end of the follow-up period,SMD was not observed in any of the patients(P=0.016).Hard exudate,HRF number were decreased;while DRIL,ERM and EZ-ELM defects were increased but not significantly.CONCLUSION:Intravitreal dexamethasone monotherapy is an effective and safe treatment option for the treatment-naive RVO-ME patients in the long-term follow-up.
文摘AIM:To analyse the research status and explore global trends in retinal vein occlusion(RVO)studies.METHODS:Publications related to RVO from 2004 to 2023 were extracted from the Web of Science Core Collection(WoSCC).Variables including the number of publications,as well as countries,organizations,authors,journals,references and keywords were analysed using Bibliometrix-BilioShiny.Data visualization was performed using VOSviewer and CiteSpace.RESULTS:A total of 4848 publications were retrieved,and generally,the number of publications showed an overall increasing trend with slight fluctuations over the past 20y.The country with the most publications was the United States.The journal with the most publications was Retina,and the most cited journal was Ophthalmology.The most prolific organization was the University of California,Los Angeles.The most productive author was Noma H,and the most cited author was Campochiaro PA.The top cocited references mainly focused on the prevalence of RVO and the therapies used in clinical trials.According to the co-occurrence analysis,the keywords formed 3 clusters:1)risk factors and pathogenesis of RVO,2)treatments of RVO,and 3)imaging diagnosis of RVO.Anti-vascular endothelial growth factor(VEGF)treatments and artificial intelligence have recently become popular research topics.CONCLUSION:Bibliometric analysis of the research status and trends of RVO could provide researchers and clinicians with valuable insights for further collaboration,future research directions,and clinical practice.
文摘Anticoagulation has long been the standard of care for preventing embolic events in atrial fibrillation(AF).^([1])The elderly AF generation is more susceptible to thromboembolic incidents.They are also more likely to encounter hemorrhagic and other complications when using anticoagulants.Therefore,percutaneous left atrial appendage occlusion(pLAAO)is regarded as an appealing alternative therapy for preventing stroke in patients who are poor candidates for long-term anticoagulation.^([2,3])Contemporary patients undergoing pLAAO are typically older and have more comorbidities than those who were enrolled in pivotal randomized controlled trials.
