Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hosp...Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hospital from January 2023 to May 2025 were selected and randomly divided into an observation group and a control group,with 25 cases in each group,using a random number table method.The observation group received intravitreal injection of faricimab,while the control group received intravitreal injection of conbercept.Both groups adopted a loading phase plus maintenance phase treatment regimen.The best-corrected visual acuity(BCVA,expressed in logMAR)and central subfield thickness(CST)of the two groups were compared before treatment and at 1,3,and 6 months after treatment,and the incidence of adverse events during treatment was recorded.Results:The logMAR BCVA in the observation group was lower than that in the control group at 3 and 6 months after treatment(both p<0.05).The CST in the observation group was smaller than that in the control group at 1,3,and 6 months after treatment(all p<0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(χ^(2)=0.189,p=0.663).Conclusion:Both intravitreal injections of faricimab and conbercept are effective in improving visual acuity and reducing macular edema in patients with DME,with good safety profiles.However,faricimab demonstrates superior efficacy in the medium to long term(3 and 6 months)compared to conbercept,making it more suitable for long-term treatment of patients with DME.展开更多
Background:Diabetic macular edema is a prevalent retinal condition and a leading cause of visual impairment among diabetic patients’Early detection of affected areas is beneficial for effective diagnosis and treatmen...Background:Diabetic macular edema is a prevalent retinal condition and a leading cause of visual impairment among diabetic patients’Early detection of affected areas is beneficial for effective diagnosis and treatment.Traditionally,diagnosis relies on optical coherence tomography imaging technology interpreted by ophthalmologists.However,this manual image interpretation is often slow and subjective.Therefore,developing automated segmentation for macular edema images is essential to enhance to improve the diagnosis efficiency and accuracy.Methods:In order to improve clinical diagnostic efficiency and accuracy,we proposed a SegNet network structure integrated with a convolutional block attention module(CBAM).This network introduces a multi-scale input module,the CBAM attention mechanism,and jump connection.The multi-scale input module enhances the network’s perceptual capabilities,while the lightweight CBAM effectively fuses relevant features across channels and spatial dimensions,allowing for better learning of varying information levels.Results:Experimental results demonstrate that the proposed network achieves an IoU of 80.127%and an accuracy of 99.162%.Compared to the traditional segmentation network,this model has fewer parameters,faster training and testing speed,and superior performance on semantic segmentation tasks,indicating its highly practical applicability.Conclusion:The C-SegNet proposed in this study enables accurate segmentation of Diabetic macular edema lesion images,which facilitates quicker diagnosis for healthcare professionals.展开更多
AIM:To analyze the effect of conbercept treatment on different types of macular edema secondary to retinal vein occlusion(RVO-ME)using optical coherence tomography(OCT)images.METHODS:This retrospective study included ...AIM:To analyze the effect of conbercept treatment on different types of macular edema secondary to retinal vein occlusion(RVO-ME)using optical coherence tomography(OCT)images.METHODS:This retrospective study included patients who first received conbercept injections for RVO-ME at Yijishan Hospital of Wannan Medical College from December 1,2017,to March 31,2022.Data on disease duration,age,hypertension,OCT images,central macular thickness(CMT),and best-corrected visual acuity(BCVA)were collected before and at 4-6 wk after treatment.Patients were divided into 4 groups according to different types of macular edema:cystoid macular edema(CME),sponge-like diffuse retinal thickening(SDRT),serous retinal detachment(SRD),and mixed type(FULL).Changes in CMT and visual acuity before and after treatment were compared among the groups to analyze differences in the effect of conbercept treatment on different ME types,and the effect of baseline CMT and visual acuity on post-treatment visual acuity.RESULTS:Totally 139 patients(139 eyes)were classified as having macular edema,including 62 males(44.6%)and 77 females(55.4%),with a mean age of 58.9±10.9 years,and they were divided into 4 groups based on different types of macular edema,including 54 cases(54 eyes)(mean age 59.6±11.1 years)in the CME group,23 cases(23 eyes;mean age 56.6±10.2 years)in the SDRT group,22 cases(22 eyes;mean age 57.8±12.0 years)in the SDR group,and 40 cases(40 eyes;mean age 60.0±10.7 years)in the FULL group.There were no significant differences in the duration of disease or age between groups(P>0.05).There was a significant difference in preoperative CMT between groups(P=0.01,one-way ANOVA),with the CMT in the FULL group being significantly greater than that in the SDRT group(P=0.03).There were no significant differences in pre-treatment visual acuity between the four groups(P=0.26).After conbercept treatment,the macular central recess thickness was reduced and visual acuity was improved in all four groups,among which the CMT in the CME and FULL groups was reduced significantly compared with the other two groups(P<0.05),and the visual acuity in the CME and SRD groups was improved significantly compared with the other two groups(P<0.05).Postoperative visual acuity was negatively correlated with preoperative CMT(P=0.044)and positively correlated with preoperative visual acuity(P<0.01).CONCLUSION:The efficacy of intravitreal conbercept in the treatment of RVO and macular edema may be related to the type of edema observed on OCT images,in which the efficacy is best in patients with CME but poor in patients with SDRT.展开更多
AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabe...AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabetic macular edema(DME)and visually significant cataract.METHODS:This nonrandomized,retrospective analysis included 54 eyes undergoing phacoemulsification with DEX-I(DEX-I group)and 47 eyes receiving anti-VEGF injections(anti-VEGF group).Best-corrected visual acuity(BCVA)and central macular thickness(CMT)were measured preoperatively and postoperatively at 1 and 3mo.RESULTS:The two groups had comparable baseline characteristics,with similar age(DEX-I:66.83±7.27y;anti-VEGF:66.81±6.79y)and gender distribution(51.9%vs 59.6%males).Both groups showed significant BCVA improvement at 1 and 3mo,with no significant intergroup differences.CMT reduction was significantly greater in the DEX-I group at 3mo(25.03%vs 14.07%;P=0.049),particularly in recalcitrant eyes(25.09%vs 11.10%;P=0.007).Postoperative intraocular pressure(IOP)>21 mm Hg was observed in 14.8%of DEX-I eyes and 4.25%of anti-VEGF eyes(P=0.08),normalizing by 3mo.DEX-I required no reinjection,while 29.79%of anti-VEGF eyes needed a fourth dose at 3mo.Complications were minimal,with one posterior capsular injury in the DEX-I group.CONCLUSION:Combined phacoemulsification with intravitreal DEX-I offers superior CMT reduction and comparable visual acuity improvement to anti-VEGF injections in DME,with fewer required treatments.It is an effective strategy for managing cataract with DME,offering benefits,especially for recalcitrant cases.Both therapies have favourable safety profiles,but further long-term studies are needed for clinical guidance.展开更多
Overt and harmful diabetes mellitus(DM)has detrimental effects on individuals and,by extension,the community.Among the microvascular DM complications is diabetic retinopathy(DR).DR may cause irreversible vision deteri...Overt and harmful diabetes mellitus(DM)has detrimental effects on individuals and,by extension,the community.Among the microvascular DM complications is diabetic retinopathy(DR).DR may cause irreversible vision deterioration in cases of poor blood glucose regulation.Changes in vascular permeability are key trigger points for diabetic macular edema(DME),a condition characterized by the accumulation of fluid in the macula.The development of vascular endothelial growth factor(VEGF)pathway inhibitors has provided a pathogenesis-based treatment approach for DME.Optical coherence tomography(OCT)provides highresolution imaging of the anatomy,including the aging of DME and its structural damage,in distinct morphologic subtypes of macular edema,thereby supporting the assessment of macular edema treatment.The availability of repeated OCT monitoring provides clinical reassurance through the treatment.OCT angiography(OCTA)provides retinal blood flow maps with high spatial resolution.The ability promotes an understanding of disease pathogenesis and facilitates the implementation of new therapeutic methods.This review compares the potential of OCT and OCTA in the diagnosis and treatment of DME,as well as their respective therapeutic applications.展开更多
Two types of pisha-sandstones of purple sandstones and gray sandstones,widely distributing in the wind-water erosion crisscross region of China,were selected and used in laboratory experiments for a better understandi...Two types of pisha-sandstones of purple sandstones and gray sandstones,widely distributing in the wind-water erosion crisscross region of China,were selected and used in laboratory experiments for a better understanding of the drying-wetting-freezing weathering process resulting from the apportionment of water or salt solution to rock samples.Weathering experiments were carried out under the conditions of environment control(including temperature,moisture and salt solution).All rock samples were frequently subjected to 140 drying-wetting-freezing cycles.The influences of weathering process were evaluated.It was found that the different treatments of moisture and salt solution applications could affect the nature of the weathering products resulting from drying-wetting-freezing.It was also observed that salt solution could effectively alleviate the weathering of pisha-sandstones.Although not all the observations could be explained,it was apparent that simulated environmental factors had both direct and indirect effects on the weathering of rocks.展开更多
目的探讨双能量CT Bone Marrow Edema(骨髓水肿)定量评估肋骨骨折演变时间节点的价值。方法收集60例双能量CT扫描的胸部外伤患者,利用CT Bone Marrow Edema技术,标准化定量肋骨骨折处骨髓水肿区域及骨折两侧1 cm处正常区域骨髓CT值,得...目的探讨双能量CT Bone Marrow Edema(骨髓水肿)定量评估肋骨骨折演变时间节点的价值。方法收集60例双能量CT扫描的胸部外伤患者,利用CT Bone Marrow Edema技术,标准化定量肋骨骨折处骨髓水肿区域及骨折两侧1 cm处正常区域骨髓CT值,得到三期骨髓水肿标准化CT值增量与VNCa标准化CT值增量。对数值变量行统计学描述,并对三期骨髓水肿标准化CT值增量、VNCa标准化CT值增量进行各自组间比较及两两间比较,对有差异的组别行诊断效能比较,由接受者工作特征(ROC)曲线下面积(AUC)进行评估,并计算Cut-off值。结果三期骨髓水肿标准化CT值增量及VNCa标准化CT值增量组间均有统计学意义(H=10.788,p=0.005;F=115.787,p=0.000),其中,软骨痂期(纤维性骨痂期)与硬骨痂-重塑期骨髓水肿标准化CT值增量有统计学意义(H=54.958,p=0.003),其余两两间无统计学意义(分别为H=-25.603,p=0.183;H=29.354,p=0.113)。而三期VNCa标准化CT值增量两两间均有统计学意义(P均为0.000)。ROC曲线鉴别软骨痂期(纤维性骨痂期)与硬骨痂-重塑期骨髓水肿标准化CT值增量曲线下面积为0.652,Cut-off值为81.575 Hu,鉴别血肿炎症机化期与软骨痂期(纤维性骨痂期)VNCa标准化CT值增量曲线下面积为0.668,Cut-off值为55.700 Hu,鉴别软骨痂期(纤维性骨痂期)与硬骨痂-重塑期VNCa标准化CT值增量曲线下面积为0.905,Cut-off值为37.625 Hu。结论通过双能量CT Bone Marrow Edema可定量评估肋骨骨折演变时间节点,骨折时间演变的标准化CT值增量差异性可为法医鉴定骨折处于不同时间段提供理论依据。通过标准化CT值增量Cut-off值可一定程度上预测骨折所处时间阶段,为法医在鉴定肋骨骨折方面提供定量依据。展开更多
This paper selected the typical wind-water erosion crisscross region Xiliugou watershed for research to reveal the impact of the landscape pattern change of the underlying surface in wind-water erosion crisscross regi...This paper selected the typical wind-water erosion crisscross region Xiliugou watershed for research to reveal the impact of the landscape pattern change of the underlying surface in wind-water erosion crisscross region where soil erosion is most serious on rainfall and runoff as well as erosion and sediment.Based on the Landsat TM image data and measured data of runoff-sediment in that watershed,the paper analyzed the characteristics of watershed landscape pattern change and runoff-sediment and explored the relationship between landscape index and runoff-sediment yield by means of GIS and Fragstats.The results were included as follows.(1)Grassland was the dominant landscape.In terms of the number of patches and area change rate,from 1985 to 2010,cultivated land,forest land and construction land were most stable,followed by unused land.Unused land,grassland and cultivated land experienced the most dramatic conversion and maximally affected by human activities.(2)The inter-annual difference between annual runoff and annual sediment load was significant.Compared with the annual sediment load,the trend of decreasing runoff was more obvious.The correlation coefficient of runoff-sediment was 0.67,representing a significant correlation.(3)There was a significant correlation between the landscape index and runoff-sediment.The runoff was negatively correlated with the largest patch index,patch cohesion index,aggregation index and contagion index,but positively correlated with landscape morphology index and landscape division index.And the sediment was negatively correlated with the contagion index,aggregation index and plaque cohesion index,but positively correlated with other landscape indexes.The results indicate that with the increase of the largest patch index,patch cohesion index and aggregation index,the rainfall infiltration capacity increase obviously and the soil erosion reduce significantly.Therefore,increasing the largest patch index,patch cohesion and aggregation index of the watershed landscape can enhance the function of water storage and soil conservation as well as ecological optimization in the windwater erosion crisscross region.The results can provide theoretical support for the ecological environment construction and comprehensive utilization of water and soil resources.展开更多
All characteristics of vegetation,runoff and sediment from 1960 to 2010 in the Xiliu Gully Watershed,which is a representative watershed in wind-water erosion crisscross region in the upper reaches of the Yellow River...All characteristics of vegetation,runoff and sediment from 1960 to 2010 in the Xiliu Gully Watershed,which is a representative watershed in wind-water erosion crisscross region in the upper reaches of the Yellow River of China,have been analyzed in this study.Based on the remote sensing image data,and used multi-spectral interpretation method,the characteristics of vegetation variation in the Xiliu Gully Watershed have been analyzed.And the rules of precipitation,runoff and sediment's changes have been illuminated by using mathematical statistics method.What′s more,the influence mechanism of vegetation on runoff and sediment has been discussed by using the data obtained from artificial rainfall simulation test.The results showed that the main vegetation type was given priority to low coverage,and the area of the low vegetation coverage type was reducing year by year.On the country,the area of the high vegetation coverage type was gradually increasing.In a word,vegetation conditions had got better improved since 2000 when the watershed management project started.The average annual precipitation of the river basin also got slightly increase in 2000–2010.The average annual runoff reduced by 37.5%,and the average annual sediment reduced by 73.9% in the same period.The results of artificial rainfall simulation tests showed that the improvement of vegetation coverage could increase not only soil infiltration but also vegetation evapotranspiration,and then made the rainfall-induced runoff production decrease.Vegetation root system could increases the resistance ability of soil to erosion,and vegetation aboveground part could reduce raindrop kinetic energy and splash soil erosion.Therefore,with the increase of vegetation coverage,the rainfall-induced sediment could decrease.展开更多
As one of typical areas in the world,northern Chinese Loess Plateau experiences serious wind-water erosion,which leads to widespread land degradation.During the past decades,an ecological engineering was implemented t...As one of typical areas in the world,northern Chinese Loess Plateau experiences serious wind-water erosion,which leads to widespread land degradation.During the past decades,an ecological engineering was implemented to reduce soil erosion and improve soil protection in this area.Thus,it is necessary to recognize the basic characteristics of soil protection for sustainable prevention and wind-water erosion control in the later stage.In this study,national wind erosion survey model and revised universal soil loss equation were used to analyze the spatiotemporal evolution and driving forces of soil protection in the wind-water erosion area of Chinese Loess Plateau during 2000–2020.Results revealed that:(1)during 2000–2020,total amount of soil protection reached up to 15.47×10^(8) t,which was realized mainly through water and soil conservation,accounting for 63.20%of the total;(2)soil protection was improved,with increases in both soil protection amount and soil retention rate.The amounts of wind erosion reduction showed a decrease trend,whereas the retention rate of wind erosion reduction showed an increase trend.Both water erosion reduction amount and retention rate showed increasing trends;and(3)the combined effects of climate change and human activities were responsible for the improvement of soil protection in the wind-water erosion area of Chinese Loess Plateau.The findings revealed the spatiotemporal patterns and driving forces of soil protection,and proposed strategies for future soil protection planning in Chinese Loess Plateau,which might provide valuable references for soil erosion control in other wind-water erosion areas of the world.展开更多
BACKGROUND At present,the conventional methods for diagnosing cerebral edema in clinical practice are computed tomography(CT)and magnetic resonance imaging(MRI),which can evaluate the location and degree of peripheral...BACKGROUND At present,the conventional methods for diagnosing cerebral edema in clinical practice are computed tomography(CT)and magnetic resonance imaging(MRI),which can evaluate the location and degree of peripheral cerebral edema,but cannot realize quantification.When patients have symptoms of diffuse cerebral edema or high cranial pressure,CT or MRI often suggests that cerebral edema is lagging and cannot be dynamically monitored in real time.Intracranial pressure monitoring is the gold standard,but it is an invasive operation with high cost and complications.For clinical purposes,the ideal cerebral edema monitoring should be non-invasive,real-time,bedside,and continuous dynamic monitoring.The dis-turbance coefficient(DC)was used in this study to dynamically monitor the occu-rrence,development,and evolution of cerebral edema in patients with cerebral hemorrhage in real time,and review head CT or MRI to evaluate the development of the disease and guide further treatment,so as to improve the prognosis of patients with cerebral hemorrhage.AIM To offer a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.METHODS A total of 160 patients with hypertensive cerebral hemorrhage admitted to the Department of Neurosurgery,Second Affiliated Hospital of Xi’an Medical University from September 2018 to September 2019 were recruited.The patients were randomly divided into a control group(n=80)and an experimental group(n=80).Patients in the control group received conventional empirical treatment,while those in the experimental group were treated with mannitol dehydration under the guidance of DC.Subsequently,we compared the two groups with regards to the total dosage of mannitol,the total course of treatment,the incidence of complications,and prognosis.RESULTS The mean daily consumption of mannitol,the total course of treatment,and the mean hospitalization days were 362.7±117.7 mL,14.8±5.2 days,and 29.4±7.9 in the control group and 283.1±93.6 mL,11.8±4.2 days,and 23.9±8.3 in the experimental group(P<0.05).In the control group,there were 20 patients with pulmonary infection(25%),30 with electrolyte disturbance(37.5%),20 with renal impairment(25%),and 16 with stress ulcer(20%).In the experimental group,pulmonary infection occurred in 18 patients(22.5%),electrolyte disturbance in 6(7.5%),renal impairment in 2(2.5%),and stress ulcers in 15(18.8%)(P<0.05).According to the Glasgow coma scale score 6 months after discharge,the prognosis of the control group was good in 20 patients(25%),fair in 26(32.5%),and poor in 34(42.5%);the prognosis of the experimental group was good in 32(40%),fair in 36(45%),and poor in 12(15%)(P<0.05).CONCLUSION Using DC for non-invasive dynamic monitoring of cerebral edema demonstrates considerable clinical potential.It reduces mannitol dosage,treatment duration,complication rates,and hospital stays,ultimately lowering hospital-ization costs.Additionally,it improves overall patient prognosis,offering a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.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
Bone marrow edema syndrome (BMES), is a rare and self-limiting condition characterized by localized bone pain and transient marrow edema visible on MRI. BMES has been increasingly associated with specific cutaneous ma...Bone marrow edema syndrome (BMES), is a rare and self-limiting condition characterized by localized bone pain and transient marrow edema visible on MRI. BMES has been increasingly associated with specific cutaneous manifestations that may hold diagnostic and prognostic significance. Patients with BMES have reported localized erythema, dermal thickening, and induration overlying the affected joints, which are hypothesized to reflect microvascular compromise and inflammatory processes within the bone and adjacent soft tissues. Dermatologic signs are likely linked to regional hyperemia, venous stasis, and cytokine-mediated inflammation, paralleling the pathophysiological mechanisms underlying intraosseous edema. Elevated intraosseous pressure in BMES may disrupt local perfusion, resulting in ischemia-reperfusion injury and subsequent vascular leakage, which manifests in visible cutaneous changes. Pro-inflammatory mediators, such as interleukin-1β and vascular endothelial growth factor (VEGF), central to BMES pathogenesis, may exacerbate endothelial activation, and dermal involvement. Histopathologic studies of affected skin have revealed perivascular lymphocytic infiltration and increased dermal vascularity, further supporting the theory of a shared ischemic and inflammatory pathway between bone and skin. Although MRI remains the gold standard for BMES diagnosis, recognition of these cutaneous manifestations could expedite orthopedic referral and intervention, especially in cases where imaging is delayed or symptoms are ambiguous. Current treatment options, including bisphosphonates, prostacyclin analogs, and offloading of weight bearing, may benefit from integration with dermatologic strategies to alleviate localized cutaneous symptoms and improve patient comfort. Evaluating the molecular and vascular links between BMES and its cutaneous manifestations provides an opportunity to refine diagnostic protocols and therapeutic approaches, offering a comprehensive understanding of the systemic interplay between dermal and skeletal pathophysiology, and optimizing clinical outcomes for patients affected by BMES.展开更多
OBJECTIVE:To observe and analysis of the influence of the 12 meridians on edema,the constant value of the detection of the thermal sensitivity was further verified,which provided a basis for the diagnosis and identifi...OBJECTIVE:To observe and analysis of the influence of the 12 meridians on edema,the constant value of the detection of the thermal sensitivity was further verified,which provided a basis for the diagnosis and identification of edema by the thermal sensitivity measurement method.METHODS:A total of 1426 patients who attended Doshisha University in Japan and Xi'an Chengxintang Clinic from March 2019 to March 2023 were selected for observation and analysis and divided into 3 groups according to their diseases;112 patients with edema in Group 1,488 symptomatic patients with non-edema in Group 2,and 826 asymptomatic subjects in Group 3.The Thermal Sensitivity Measurement was conducted in the twelve meridians and compared among the groups.Multivariate analysis was performed to estimate meridians useful for diagnosing edema.RESULTS:In the healthy physiological state,the value of thermal sensitivity is relatively constant,which may be affected by age factors.Through the stepwise analysis,left Taiyin lung,right Jueyin pericardium,left Shaoyang Sanjiao,bilateral Jueyin liver,right Shaoyang gallbladder,right Taiyang bladder,and right Shaoyin kidney were extracted as effective meridians for diagnosing edema.Its accuracy was high,with receiver operating characteristic,area under the curve(ROC AUC)of 96%.These findings were not incompatible with the edema-associated meridians in the Traditional Chinese Medicine.CONCLUSION:The thermal sensitivity measurement is thought to be useful in diagnosing edema and predicting prognosis by combining appropriate meridians.In the future,we will conduct more detailed research on how this method is useful for evaluating medical care and acupuncture treatments.展开更多
Hereditary angioedema (HAE) is a rare,autosomal dominant inherited disorder with an incidence of approximately 1 in 50,000.Among its various tapes,HAE with normal C1 inhibitor levels (HAE-nC1-INH)is exceptionally rare...Hereditary angioedema (HAE) is a rare,autosomal dominant inherited disorder with an incidence of approximately 1 in 50,000.Among its various tapes,HAE with normal C1 inhibitor levels (HAE-nC1-INH)is exceptionally rare.^([1]) HAE symptoms include recurrent episodes of skin and mucosal edema that can occur anywhere in the body.^([1-4]) Laryngeal edema is life-threatening,as it can lead to airway obstruction and potentially fatal suffocation.^([1-3])Edema of the gastrointestinal mucosa may cause abdominal pain,vomiting,and symptoms that are often misdiagnosed as acute abdomen.^([1-4]) This study included four patients,including one with HAE-nC1-INH (genetic testing revealed a heterozygous mutation in the KNG1 gene (c.1404G>C:p.Q468H)) and three with HAE due to C1 inhibitor deficiency (HAE-C1-INH).This case series aims to increase knowledge of HAE by illustrating its diverse clinical presentations and emphasizing features that may prompt clinical suspicion and facilitate timely diagnosis.展开更多
Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who requ...Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who required an emergency cesarean section,posing a significant challenge to the anesthesiologist.The patient had developed Type 1 respiratory failure and needed supplemental oxygen with high-flow nasal oxygen.Due to contraindications for neuraxial anesthesia,the cesarean section was performed under general anesthesia.After induction of anesthesia,the patient’s hypoxemia worsened.Eventually,after treatment with fluid restriction,diuretics,and albumin,oxygenation improved gradually,and the procedure was performed successfully.Both the patient and the newborn had a good prognosis.展开更多
Dear Editor,Diabetic macular edema(DME)is a major cause of visual loss in diabetic patients,which is mainly caused by disruption of the blood-retinal barrier and loss of pericytes and endothelial cells,resulting in th...Dear Editor,Diabetic macular edema(DME)is a major cause of visual loss in diabetic patients,which is mainly caused by disruption of the blood-retinal barrier and loss of pericytes and endothelial cells,resulting in the leakage of plasma and lipids[1].Nowadays,laser photocoagulation,intravitreal injections of anti-vascular endothelial growth factor(anti-VEGF)drugs and dexamethasone implant.展开更多
AIM:To investigate the impact of renal dysfunction on clinical response to intravitreal conbercept injection(IVC)for diabetic macular edema(DME).METHODS:This retrospective study included a total of 100 eyes from 100 p...AIM:To investigate the impact of renal dysfunction on clinical response to intravitreal conbercept injection(IVC)for diabetic macular edema(DME).METHODS:This retrospective study included a total of 100 eyes from 100 patients with DME treated with IVC with 3+PRN regimen.Based on the estimated glomerular filtration rate(eGFR),the patients were divided into normal renal function group(n=37),impaired renal function group(n=27),and renal insufficiency group(n=36).The main outcome measures were best-corrected visual acuity(BCVA)and central subfield macular thickness(CST).Clinical parameters included blood urea nitrogen,serum creatinine,serum uric acid,glycosylated hemoglobin(HbA1c),and hemoglobin.RESULTS:The mean follow-up time was 3.9mo.The mean number of IVCs was 2.07±1.22 in the three groups.Mean BCVA improved significantly from 0.81±0.49 logMAR at baseline to 0.72±0.52 logMAR in the three groups at the final visit(P<0.001).Mean CST decreased significantly from 427.85±148.99μm at baseline to 275.31±108.31μm at final visit(P<0.001).Patients in the normal renal function group had higher baseline hemoglobin levels and thinner baseline CST than those in the impaired renal function and insufficiency renal function group(all P<0.001).Patients in the normal renal function group had higher baseline hemoglobin levels and thinner baseline CST than those in the impaired renal function and insufficiency renal function group(all P<0.001).The three groups had no differences in baseline HbA1c levels(P>0.05).Good baseline BCVA(logMAR,P=0.001)and thicker baseline CST(P=0.041)were associated with visual acuity improvement.Higher eGFR(P<0.001),hemoglobin(P=0.032)and thicker baseline CST(P=0.017)were associated with macular edema retrogression in the conbercept-treated diabetic patients,which showed better anatomical response to IVC.CONCLUSION:Our results indicate that the renal dysfunction is the risk factor associated with the efficacy of IVC for DME.展开更多
AIM:To investigate the change of diabetic macular edema(DME)post vitrectomy and its risk factors.METHODS:This retrospective study included 365 eyes of 330 patients who underwent vitrectomy for proliferative diabetic r...AIM:To investigate the change of diabetic macular edema(DME)post vitrectomy and its risk factors.METHODS:This retrospective study included 365 eyes of 330 patients who underwent vitrectomy for proliferative diabetic retinopathy(PDR)with gradable optical coherence tomography(OCT)imaging from January 2018 to March 2022.The incidence of post vitrectomy DME(PV-DME)was defined as patients with a central retinal thickness(CRT)>300µm by OCT among patients without preoperative DME.RESULTS:The cumulative incidence of PV-DME at 3mo was 40.1%(89/222),with its majority subtype of single diffused retinal thickening(66.2%)followed by single cystoid macular edema(27.0%).Multivariate Cox regression analysis indicated that a thicker preoperative CRT[hazard ratio(HR)=1.01,95%confidence interval(CI)1.00-1.02]and intraoperative internal limiting membrane peeling(HR=3.18,95%CI 1.85-5.47)were associated with the presence of PV-DME,while intraoperative intravitreal injection of triamcinolone acetonide(HR=0.28,95%CI 0.13-0.57)was protective against PV-DME.In eyes with preoperative DME(n=143),the CRT decreased gradually from 468.3±177.7μm preoperatively to 409.5±151.0μm(P=0.027),377.4±141.9μm(P<0.001),and 368.0±157.6μm(P<0.001)at 7d,1 and 3mo postoperatively,respectively.Multivariate linear regression analysis indicated that only a thicker preoperative CRT(β=0.77,95%CI 0.63-0.92)was associated with a decreasing postoperative CRT.CONCLUSION:PV-DME is a very common postoperative complication in patients with PDR.Triamcinolone acetonide could prevent its formation.Attention should be paid to patients with a thicker preoperative CRT and internal limiting membrane peeling.展开更多
AIM:To assess and rank the efficacy of various nonsteroidal anti-inflammatory drugs(NSAIDs)in preventing postoperative macular edema(PME)after cataract surgery.METHODS:A comprehensive search was conducted across PubMe...AIM:To assess and rank the efficacy of various nonsteroidal anti-inflammatory drugs(NSAIDs)in preventing postoperative macular edema(PME)after cataract surgery.METHODS:A comprehensive search was conducted across PubMed,Embase,Cochrane Library,and Web of Science databases.Randomized controlled trials(RCTs)comparing different NSAIDs and control treatments for the prevention of PME were included.Data from the studies were synthesized using the“gemtc”package in R.Risk of bias was assessed with the Cochrane RoB 2 tool,and heterogeneity was evaluated using the global I2 statistic.Surface under the cumulative ranking curve(SUCRA)values were calculated for each treatment.RESULTS:Of 132 identified records,9 RCTs met the inclusion criteria.The Network Meta-analysis indicated that nepafenac had the highest efficacy in preventing PME,followed by artificial tear substitute,ketorolac,diclofenac,and bromfenac.The league table comparisons and rankograms corroborated these findings,with nepafenac consistently ranking highest.Heterogeneity analysis yielded high I2 values,indicating substantial variability across studies.CONCLUSION:This Network Meta-analysis suggests that nepafenac is the most effective NSAID for preventing PME following cataract surgery.Given the substantial heterogeneity observed,further high-quality RCTs are required to confirm these findings and explore the sources of variability.Clinicians should consider these results when selecting NSAIDs for PME prophylaxis in cataract surgery patients.展开更多
文摘Objective:To compare the clinical efficacy and safety of intravitreal injection of faricimab and conbercept in the treatment of diabetic macular edema(DME).Methods:A total of 50 patients diagnosed with DME in our hospital from January 2023 to May 2025 were selected and randomly divided into an observation group and a control group,with 25 cases in each group,using a random number table method.The observation group received intravitreal injection of faricimab,while the control group received intravitreal injection of conbercept.Both groups adopted a loading phase plus maintenance phase treatment regimen.The best-corrected visual acuity(BCVA,expressed in logMAR)and central subfield thickness(CST)of the two groups were compared before treatment and at 1,3,and 6 months after treatment,and the incidence of adverse events during treatment was recorded.Results:The logMAR BCVA in the observation group was lower than that in the control group at 3 and 6 months after treatment(both p<0.05).The CST in the observation group was smaller than that in the control group at 1,3,and 6 months after treatment(all p<0.05).There was no statistically significant difference in the overall incidence of adverse events between the two groups(χ^(2)=0.189,p=0.663).Conclusion:Both intravitreal injections of faricimab and conbercept are effective in improving visual acuity and reducing macular edema in patients with DME,with good safety profiles.However,faricimab demonstrates superior efficacy in the medium to long term(3 and 6 months)compared to conbercept,making it more suitable for long-term treatment of patients with DME.
基金supported by the Guangdong Pharmaceutical University 2024 Higher Education Research Projects(GKP202403,GMP202402)the Guangdong Pharmaceutical University College Students’Innovation and Entrepreneurship Training Programs(Grant No.202504302033,202504302034,202504302036,and 202504302244).
文摘Background:Diabetic macular edema is a prevalent retinal condition and a leading cause of visual impairment among diabetic patients’Early detection of affected areas is beneficial for effective diagnosis and treatment.Traditionally,diagnosis relies on optical coherence tomography imaging technology interpreted by ophthalmologists.However,this manual image interpretation is often slow and subjective.Therefore,developing automated segmentation for macular edema images is essential to enhance to improve the diagnosis efficiency and accuracy.Methods:In order to improve clinical diagnostic efficiency and accuracy,we proposed a SegNet network structure integrated with a convolutional block attention module(CBAM).This network introduces a multi-scale input module,the CBAM attention mechanism,and jump connection.The multi-scale input module enhances the network’s perceptual capabilities,while the lightweight CBAM effectively fuses relevant features across channels and spatial dimensions,allowing for better learning of varying information levels.Results:Experimental results demonstrate that the proposed network achieves an IoU of 80.127%and an accuracy of 99.162%.Compared to the traditional segmentation network,this model has fewer parameters,faster training and testing speed,and superior performance on semantic segmentation tasks,indicating its highly practical applicability.Conclusion:The C-SegNet proposed in this study enables accurate segmentation of Diabetic macular edema lesion images,which facilitates quicker diagnosis for healthcare professionals.
文摘AIM:To analyze the effect of conbercept treatment on different types of macular edema secondary to retinal vein occlusion(RVO-ME)using optical coherence tomography(OCT)images.METHODS:This retrospective study included patients who first received conbercept injections for RVO-ME at Yijishan Hospital of Wannan Medical College from December 1,2017,to March 31,2022.Data on disease duration,age,hypertension,OCT images,central macular thickness(CMT),and best-corrected visual acuity(BCVA)were collected before and at 4-6 wk after treatment.Patients were divided into 4 groups according to different types of macular edema:cystoid macular edema(CME),sponge-like diffuse retinal thickening(SDRT),serous retinal detachment(SRD),and mixed type(FULL).Changes in CMT and visual acuity before and after treatment were compared among the groups to analyze differences in the effect of conbercept treatment on different ME types,and the effect of baseline CMT and visual acuity on post-treatment visual acuity.RESULTS:Totally 139 patients(139 eyes)were classified as having macular edema,including 62 males(44.6%)and 77 females(55.4%),with a mean age of 58.9±10.9 years,and they were divided into 4 groups based on different types of macular edema,including 54 cases(54 eyes)(mean age 59.6±11.1 years)in the CME group,23 cases(23 eyes;mean age 56.6±10.2 years)in the SDRT group,22 cases(22 eyes;mean age 57.8±12.0 years)in the SDR group,and 40 cases(40 eyes;mean age 60.0±10.7 years)in the FULL group.There were no significant differences in the duration of disease or age between groups(P>0.05).There was a significant difference in preoperative CMT between groups(P=0.01,one-way ANOVA),with the CMT in the FULL group being significantly greater than that in the SDRT group(P=0.03).There were no significant differences in pre-treatment visual acuity between the four groups(P=0.26).After conbercept treatment,the macular central recess thickness was reduced and visual acuity was improved in all four groups,among which the CMT in the CME and FULL groups was reduced significantly compared with the other two groups(P<0.05),and the visual acuity in the CME and SRD groups was improved significantly compared with the other two groups(P<0.05).Postoperative visual acuity was negatively correlated with preoperative CMT(P=0.044)and positively correlated with preoperative visual acuity(P<0.01).CONCLUSION:The efficacy of intravitreal conbercept in the treatment of RVO and macular edema may be related to the type of edema observed on OCT images,in which the efficacy is best in patients with CME but poor in patients with SDRT.
文摘AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabetic macular edema(DME)and visually significant cataract.METHODS:This nonrandomized,retrospective analysis included 54 eyes undergoing phacoemulsification with DEX-I(DEX-I group)and 47 eyes receiving anti-VEGF injections(anti-VEGF group).Best-corrected visual acuity(BCVA)and central macular thickness(CMT)were measured preoperatively and postoperatively at 1 and 3mo.RESULTS:The two groups had comparable baseline characteristics,with similar age(DEX-I:66.83±7.27y;anti-VEGF:66.81±6.79y)and gender distribution(51.9%vs 59.6%males).Both groups showed significant BCVA improvement at 1 and 3mo,with no significant intergroup differences.CMT reduction was significantly greater in the DEX-I group at 3mo(25.03%vs 14.07%;P=0.049),particularly in recalcitrant eyes(25.09%vs 11.10%;P=0.007).Postoperative intraocular pressure(IOP)>21 mm Hg was observed in 14.8%of DEX-I eyes and 4.25%of anti-VEGF eyes(P=0.08),normalizing by 3mo.DEX-I required no reinjection,while 29.79%of anti-VEGF eyes needed a fourth dose at 3mo.Complications were minimal,with one posterior capsular injury in the DEX-I group.CONCLUSION:Combined phacoemulsification with intravitreal DEX-I offers superior CMT reduction and comparable visual acuity improvement to anti-VEGF injections in DME,with fewer required treatments.It is an effective strategy for managing cataract with DME,offering benefits,especially for recalcitrant cases.Both therapies have favourable safety profiles,but further long-term studies are needed for clinical guidance.
文摘Overt and harmful diabetes mellitus(DM)has detrimental effects on individuals and,by extension,the community.Among the microvascular DM complications is diabetic retinopathy(DR).DR may cause irreversible vision deterioration in cases of poor blood glucose regulation.Changes in vascular permeability are key trigger points for diabetic macular edema(DME),a condition characterized by the accumulation of fluid in the macula.The development of vascular endothelial growth factor(VEGF)pathway inhibitors has provided a pathogenesis-based treatment approach for DME.Optical coherence tomography(OCT)provides highresolution imaging of the anatomy,including the aging of DME and its structural damage,in distinct morphologic subtypes of macular edema,thereby supporting the assessment of macular edema treatment.The availability of repeated OCT monitoring provides clinical reassurance through the treatment.OCT angiography(OCTA)provides retinal blood flow maps with high spatial resolution.The ability promotes an understanding of disease pathogenesis and facilitates the implementation of new therapeutic methods.This review compares the potential of OCT and OCTA in the diagnosis and treatment of DME,as well as their respective therapeutic applications.
基金supported by the National Natural Science Foundation of China (No.40271071)the Foundation of State Key Laboratory of Soil Erosion and Dryland Farming on the Less Plateau (No.10501-113 10501-165)
文摘Two types of pisha-sandstones of purple sandstones and gray sandstones,widely distributing in the wind-water erosion crisscross region of China,were selected and used in laboratory experiments for a better understanding of the drying-wetting-freezing weathering process resulting from the apportionment of water or salt solution to rock samples.Weathering experiments were carried out under the conditions of environment control(including temperature,moisture and salt solution).All rock samples were frequently subjected to 140 drying-wetting-freezing cycles.The influences of weathering process were evaluated.It was found that the different treatments of moisture and salt solution applications could affect the nature of the weathering products resulting from drying-wetting-freezing.It was also observed that salt solution could effectively alleviate the weathering of pisha-sandstones.Although not all the observations could be explained,it was apparent that simulated environmental factors had both direct and indirect effects on the weathering of rocks.
文摘目的探讨双能量CT Bone Marrow Edema(骨髓水肿)定量评估肋骨骨折演变时间节点的价值。方法收集60例双能量CT扫描的胸部外伤患者,利用CT Bone Marrow Edema技术,标准化定量肋骨骨折处骨髓水肿区域及骨折两侧1 cm处正常区域骨髓CT值,得到三期骨髓水肿标准化CT值增量与VNCa标准化CT值增量。对数值变量行统计学描述,并对三期骨髓水肿标准化CT值增量、VNCa标准化CT值增量进行各自组间比较及两两间比较,对有差异的组别行诊断效能比较,由接受者工作特征(ROC)曲线下面积(AUC)进行评估,并计算Cut-off值。结果三期骨髓水肿标准化CT值增量及VNCa标准化CT值增量组间均有统计学意义(H=10.788,p=0.005;F=115.787,p=0.000),其中,软骨痂期(纤维性骨痂期)与硬骨痂-重塑期骨髓水肿标准化CT值增量有统计学意义(H=54.958,p=0.003),其余两两间无统计学意义(分别为H=-25.603,p=0.183;H=29.354,p=0.113)。而三期VNCa标准化CT值增量两两间均有统计学意义(P均为0.000)。ROC曲线鉴别软骨痂期(纤维性骨痂期)与硬骨痂-重塑期骨髓水肿标准化CT值增量曲线下面积为0.652,Cut-off值为81.575 Hu,鉴别血肿炎症机化期与软骨痂期(纤维性骨痂期)VNCa标准化CT值增量曲线下面积为0.668,Cut-off值为55.700 Hu,鉴别软骨痂期(纤维性骨痂期)与硬骨痂-重塑期VNCa标准化CT值增量曲线下面积为0.905,Cut-off值为37.625 Hu。结论通过双能量CT Bone Marrow Edema可定量评估肋骨骨折演变时间节点,骨折时间演变的标准化CT值增量差异性可为法医鉴定骨折处于不同时间段提供理论依据。通过标准化CT值增量Cut-off值可一定程度上预测骨折所处时间阶段,为法医在鉴定肋骨骨折方面提供定量依据。
基金Sponsored by National Program on Key Basic Research Project(2011CB403303)A Special Fund for Central Public Welfare Research Institutes(HKY-2011-15)
文摘This paper selected the typical wind-water erosion crisscross region Xiliugou watershed for research to reveal the impact of the landscape pattern change of the underlying surface in wind-water erosion crisscross region where soil erosion is most serious on rainfall and runoff as well as erosion and sediment.Based on the Landsat TM image data and measured data of runoff-sediment in that watershed,the paper analyzed the characteristics of watershed landscape pattern change and runoff-sediment and explored the relationship between landscape index and runoff-sediment yield by means of GIS and Fragstats.The results were included as follows.(1)Grassland was the dominant landscape.In terms of the number of patches and area change rate,from 1985 to 2010,cultivated land,forest land and construction land were most stable,followed by unused land.Unused land,grassland and cultivated land experienced the most dramatic conversion and maximally affected by human activities.(2)The inter-annual difference between annual runoff and annual sediment load was significant.Compared with the annual sediment load,the trend of decreasing runoff was more obvious.The correlation coefficient of runoff-sediment was 0.67,representing a significant correlation.(3)There was a significant correlation between the landscape index and runoff-sediment.The runoff was negatively correlated with the largest patch index,patch cohesion index,aggregation index and contagion index,but positively correlated with landscape morphology index and landscape division index.And the sediment was negatively correlated with the contagion index,aggregation index and plaque cohesion index,but positively correlated with other landscape indexes.The results indicate that with the increase of the largest patch index,patch cohesion index and aggregation index,the rainfall infiltration capacity increase obviously and the soil erosion reduce significantly.Therefore,increasing the largest patch index,patch cohesion and aggregation index of the watershed landscape can enhance the function of water storage and soil conservation as well as ecological optimization in the windwater erosion crisscross region.The results can provide theoretical support for the ecological environment construction and comprehensive utilization of water and soil resources.
基金Under the auspices of National Basic Research Program of China(No.2011CB403303)Innovation Scientists and Technicians Troop Construction Projects of Henan Province(No.162101510004)Foundation of Yellow River Institute of Hydraulic Research of China(No.HKY-2011-15)
文摘All characteristics of vegetation,runoff and sediment from 1960 to 2010 in the Xiliu Gully Watershed,which is a representative watershed in wind-water erosion crisscross region in the upper reaches of the Yellow River of China,have been analyzed in this study.Based on the remote sensing image data,and used multi-spectral interpretation method,the characteristics of vegetation variation in the Xiliu Gully Watershed have been analyzed.And the rules of precipitation,runoff and sediment's changes have been illuminated by using mathematical statistics method.What′s more,the influence mechanism of vegetation on runoff and sediment has been discussed by using the data obtained from artificial rainfall simulation test.The results showed that the main vegetation type was given priority to low coverage,and the area of the low vegetation coverage type was reducing year by year.On the country,the area of the high vegetation coverage type was gradually increasing.In a word,vegetation conditions had got better improved since 2000 when the watershed management project started.The average annual precipitation of the river basin also got slightly increase in 2000–2010.The average annual runoff reduced by 37.5%,and the average annual sediment reduced by 73.9% in the same period.The results of artificial rainfall simulation tests showed that the improvement of vegetation coverage could increase not only soil infiltration but also vegetation evapotranspiration,and then made the rainfall-induced runoff production decrease.Vegetation root system could increases the resistance ability of soil to erosion,and vegetation aboveground part could reduce raindrop kinetic energy and splash soil erosion.Therefore,with the increase of vegetation coverage,the rainfall-induced sediment could decrease.
基金funded by the National Key Research and Development Program of China(2023YFF1305304)the National Natural Science Foundation of China(41801007)+3 种基金the Second Tibetan Plateau Scientific Expedition and Research Program(2019QZKK0201)the Science Technology Project of Hebei Academy of Sciences(2024PF11)the Basic Research Program of Shanxi Province(202203021211258,202103021223248)the Science and Technology Strategy Project of Shanxi Province(202304031401073).
文摘As one of typical areas in the world,northern Chinese Loess Plateau experiences serious wind-water erosion,which leads to widespread land degradation.During the past decades,an ecological engineering was implemented to reduce soil erosion and improve soil protection in this area.Thus,it is necessary to recognize the basic characteristics of soil protection for sustainable prevention and wind-water erosion control in the later stage.In this study,national wind erosion survey model and revised universal soil loss equation were used to analyze the spatiotemporal evolution and driving forces of soil protection in the wind-water erosion area of Chinese Loess Plateau during 2000–2020.Results revealed that:(1)during 2000–2020,total amount of soil protection reached up to 15.47×10^(8) t,which was realized mainly through water and soil conservation,accounting for 63.20%of the total;(2)soil protection was improved,with increases in both soil protection amount and soil retention rate.The amounts of wind erosion reduction showed a decrease trend,whereas the retention rate of wind erosion reduction showed an increase trend.Both water erosion reduction amount and retention rate showed increasing trends;and(3)the combined effects of climate change and human activities were responsible for the improvement of soil protection in the wind-water erosion area of Chinese Loess Plateau.The findings revealed the spatiotemporal patterns and driving forces of soil protection,and proposed strategies for future soil protection planning in Chinese Loess Plateau,which might provide valuable references for soil erosion control in other wind-water erosion areas of the world.
基金Supported by the Shaanxi Provincial Key Research and Development Plan Project,No.2020ZDLSF01-02.
文摘BACKGROUND At present,the conventional methods for diagnosing cerebral edema in clinical practice are computed tomography(CT)and magnetic resonance imaging(MRI),which can evaluate the location and degree of peripheral cerebral edema,but cannot realize quantification.When patients have symptoms of diffuse cerebral edema or high cranial pressure,CT or MRI often suggests that cerebral edema is lagging and cannot be dynamically monitored in real time.Intracranial pressure monitoring is the gold standard,but it is an invasive operation with high cost and complications.For clinical purposes,the ideal cerebral edema monitoring should be non-invasive,real-time,bedside,and continuous dynamic monitoring.The dis-turbance coefficient(DC)was used in this study to dynamically monitor the occu-rrence,development,and evolution of cerebral edema in patients with cerebral hemorrhage in real time,and review head CT or MRI to evaluate the development of the disease and guide further treatment,so as to improve the prognosis of patients with cerebral hemorrhage.AIM To offer a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.METHODS A total of 160 patients with hypertensive cerebral hemorrhage admitted to the Department of Neurosurgery,Second Affiliated Hospital of Xi’an Medical University from September 2018 to September 2019 were recruited.The patients were randomly divided into a control group(n=80)and an experimental group(n=80).Patients in the control group received conventional empirical treatment,while those in the experimental group were treated with mannitol dehydration under the guidance of DC.Subsequently,we compared the two groups with regards to the total dosage of mannitol,the total course of treatment,the incidence of complications,and prognosis.RESULTS The mean daily consumption of mannitol,the total course of treatment,and the mean hospitalization days were 362.7±117.7 mL,14.8±5.2 days,and 29.4±7.9 in the control group and 283.1±93.6 mL,11.8±4.2 days,and 23.9±8.3 in the experimental group(P<0.05).In the control group,there were 20 patients with pulmonary infection(25%),30 with electrolyte disturbance(37.5%),20 with renal impairment(25%),and 16 with stress ulcer(20%).In the experimental group,pulmonary infection occurred in 18 patients(22.5%),electrolyte disturbance in 6(7.5%),renal impairment in 2(2.5%),and stress ulcers in 15(18.8%)(P<0.05).According to the Glasgow coma scale score 6 months after discharge,the prognosis of the control group was good in 20 patients(25%),fair in 26(32.5%),and poor in 34(42.5%);the prognosis of the experimental group was good in 32(40%),fair in 36(45%),and poor in 12(15%)(P<0.05).CONCLUSION Using DC for non-invasive dynamic monitoring of cerebral edema demonstrates considerable clinical potential.It reduces mannitol dosage,treatment duration,complication rates,and hospital stays,ultimately lowering hospital-ization costs.Additionally,it improves overall patient prognosis,offering a promising new approach for non-invasive adjuvant therapy in cerebral edema treatment.
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.
文摘Bone marrow edema syndrome (BMES), is a rare and self-limiting condition characterized by localized bone pain and transient marrow edema visible on MRI. BMES has been increasingly associated with specific cutaneous manifestations that may hold diagnostic and prognostic significance. Patients with BMES have reported localized erythema, dermal thickening, and induration overlying the affected joints, which are hypothesized to reflect microvascular compromise and inflammatory processes within the bone and adjacent soft tissues. Dermatologic signs are likely linked to regional hyperemia, venous stasis, and cytokine-mediated inflammation, paralleling the pathophysiological mechanisms underlying intraosseous edema. Elevated intraosseous pressure in BMES may disrupt local perfusion, resulting in ischemia-reperfusion injury and subsequent vascular leakage, which manifests in visible cutaneous changes. Pro-inflammatory mediators, such as interleukin-1β and vascular endothelial growth factor (VEGF), central to BMES pathogenesis, may exacerbate endothelial activation, and dermal involvement. Histopathologic studies of affected skin have revealed perivascular lymphocytic infiltration and increased dermal vascularity, further supporting the theory of a shared ischemic and inflammatory pathway between bone and skin. Although MRI remains the gold standard for BMES diagnosis, recognition of these cutaneous manifestations could expedite orthopedic referral and intervention, especially in cases where imaging is delayed or symptoms are ambiguous. Current treatment options, including bisphosphonates, prostacyclin analogs, and offloading of weight bearing, may benefit from integration with dermatologic strategies to alleviate localized cutaneous symptoms and improve patient comfort. Evaluating the molecular and vascular links between BMES and its cutaneous manifestations provides an opportunity to refine diagnostic protocols and therapeutic approaches, offering a comprehensive understanding of the systemic interplay between dermal and skeletal pathophysiology, and optimizing clinical outcomes for patients affected by BMES.
文摘OBJECTIVE:To observe and analysis of the influence of the 12 meridians on edema,the constant value of the detection of the thermal sensitivity was further verified,which provided a basis for the diagnosis and identification of edema by the thermal sensitivity measurement method.METHODS:A total of 1426 patients who attended Doshisha University in Japan and Xi'an Chengxintang Clinic from March 2019 to March 2023 were selected for observation and analysis and divided into 3 groups according to their diseases;112 patients with edema in Group 1,488 symptomatic patients with non-edema in Group 2,and 826 asymptomatic subjects in Group 3.The Thermal Sensitivity Measurement was conducted in the twelve meridians and compared among the groups.Multivariate analysis was performed to estimate meridians useful for diagnosing edema.RESULTS:In the healthy physiological state,the value of thermal sensitivity is relatively constant,which may be affected by age factors.Through the stepwise analysis,left Taiyin lung,right Jueyin pericardium,left Shaoyang Sanjiao,bilateral Jueyin liver,right Shaoyang gallbladder,right Taiyang bladder,and right Shaoyin kidney were extracted as effective meridians for diagnosing edema.Its accuracy was high,with receiver operating characteristic,area under the curve(ROC AUC)of 96%.These findings were not incompatible with the edema-associated meridians in the Traditional Chinese Medicine.CONCLUSION:The thermal sensitivity measurement is thought to be useful in diagnosing edema and predicting prognosis by combining appropriate meridians.In the future,we will conduct more detailed research on how this method is useful for evaluating medical care and acupuncture treatments.
基金supported by the National Social Science Fund of China (19VJX168)。
文摘Hereditary angioedema (HAE) is a rare,autosomal dominant inherited disorder with an incidence of approximately 1 in 50,000.Among its various tapes,HAE with normal C1 inhibitor levels (HAE-nC1-INH)is exceptionally rare.^([1]) HAE symptoms include recurrent episodes of skin and mucosal edema that can occur anywhere in the body.^([1-4]) Laryngeal edema is life-threatening,as it can lead to airway obstruction and potentially fatal suffocation.^([1-3])Edema of the gastrointestinal mucosa may cause abdominal pain,vomiting,and symptoms that are often misdiagnosed as acute abdomen.^([1-4]) This study included four patients,including one with HAE-nC1-INH (genetic testing revealed a heterozygous mutation in the KNG1 gene (c.1404G>C:p.Q468H)) and three with HAE due to C1 inhibitor deficiency (HAE-C1-INH).This case series aims to increase knowledge of HAE by illustrating its diverse clinical presentations and emphasizing features that may prompt clinical suspicion and facilitate timely diagnosis.
文摘Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who required an emergency cesarean section,posing a significant challenge to the anesthesiologist.The patient had developed Type 1 respiratory failure and needed supplemental oxygen with high-flow nasal oxygen.Due to contraindications for neuraxial anesthesia,the cesarean section was performed under general anesthesia.After induction of anesthesia,the patient’s hypoxemia worsened.Eventually,after treatment with fluid restriction,diuretics,and albumin,oxygenation improved gradually,and the procedure was performed successfully.Both the patient and the newborn had a good prognosis.
基金Supported by National Natural Science Foundation of China(No.82171062No.82301222)Zhejiang Provincial Natural Science Foundation of China(No.LY20H120002).
文摘Dear Editor,Diabetic macular edema(DME)is a major cause of visual loss in diabetic patients,which is mainly caused by disruption of the blood-retinal barrier and loss of pericytes and endothelial cells,resulting in the leakage of plasma and lipids[1].Nowadays,laser photocoagulation,intravitreal injections of anti-vascular endothelial growth factor(anti-VEGF)drugs and dexamethasone implant.
基金Supported by Basic and Applied Basic Research Project of Guangzhou Science and Technology Plan(No.202201020008,No.2023A03J0584).
文摘AIM:To investigate the impact of renal dysfunction on clinical response to intravitreal conbercept injection(IVC)for diabetic macular edema(DME).METHODS:This retrospective study included a total of 100 eyes from 100 patients with DME treated with IVC with 3+PRN regimen.Based on the estimated glomerular filtration rate(eGFR),the patients were divided into normal renal function group(n=37),impaired renal function group(n=27),and renal insufficiency group(n=36).The main outcome measures were best-corrected visual acuity(BCVA)and central subfield macular thickness(CST).Clinical parameters included blood urea nitrogen,serum creatinine,serum uric acid,glycosylated hemoglobin(HbA1c),and hemoglobin.RESULTS:The mean follow-up time was 3.9mo.The mean number of IVCs was 2.07±1.22 in the three groups.Mean BCVA improved significantly from 0.81±0.49 logMAR at baseline to 0.72±0.52 logMAR in the three groups at the final visit(P<0.001).Mean CST decreased significantly from 427.85±148.99μm at baseline to 275.31±108.31μm at final visit(P<0.001).Patients in the normal renal function group had higher baseline hemoglobin levels and thinner baseline CST than those in the impaired renal function and insufficiency renal function group(all P<0.001).Patients in the normal renal function group had higher baseline hemoglobin levels and thinner baseline CST than those in the impaired renal function and insufficiency renal function group(all P<0.001).The three groups had no differences in baseline HbA1c levels(P>0.05).Good baseline BCVA(logMAR,P=0.001)and thicker baseline CST(P=0.041)were associated with visual acuity improvement.Higher eGFR(P<0.001),hemoglobin(P=0.032)and thicker baseline CST(P=0.017)were associated with macular edema retrogression in the conbercept-treated diabetic patients,which showed better anatomical response to IVC.CONCLUSION:Our results indicate that the renal dysfunction is the risk factor associated with the efficacy of IVC for DME.
基金Supported by Zhejiang Provincial Highlevel Health Talents Training Project(No.CZ-RC2022010)Wenzhou Basic Medical and Health Technology Project(No.Y2023173)Innovation Project of School of Ophthalmology and Optometry,Eye Hospital of Wenzhou Medical University(No.YNCX3201905).
文摘AIM:To investigate the change of diabetic macular edema(DME)post vitrectomy and its risk factors.METHODS:This retrospective study included 365 eyes of 330 patients who underwent vitrectomy for proliferative diabetic retinopathy(PDR)with gradable optical coherence tomography(OCT)imaging from January 2018 to March 2022.The incidence of post vitrectomy DME(PV-DME)was defined as patients with a central retinal thickness(CRT)>300µm by OCT among patients without preoperative DME.RESULTS:The cumulative incidence of PV-DME at 3mo was 40.1%(89/222),with its majority subtype of single diffused retinal thickening(66.2%)followed by single cystoid macular edema(27.0%).Multivariate Cox regression analysis indicated that a thicker preoperative CRT[hazard ratio(HR)=1.01,95%confidence interval(CI)1.00-1.02]and intraoperative internal limiting membrane peeling(HR=3.18,95%CI 1.85-5.47)were associated with the presence of PV-DME,while intraoperative intravitreal injection of triamcinolone acetonide(HR=0.28,95%CI 0.13-0.57)was protective against PV-DME.In eyes with preoperative DME(n=143),the CRT decreased gradually from 468.3±177.7μm preoperatively to 409.5±151.0μm(P=0.027),377.4±141.9μm(P<0.001),and 368.0±157.6μm(P<0.001)at 7d,1 and 3mo postoperatively,respectively.Multivariate linear regression analysis indicated that only a thicker preoperative CRT(β=0.77,95%CI 0.63-0.92)was associated with a decreasing postoperative CRT.CONCLUSION:PV-DME is a very common postoperative complication in patients with PDR.Triamcinolone acetonide could prevent its formation.Attention should be paid to patients with a thicker preoperative CRT and internal limiting membrane peeling.
基金Supported by Natural Science Foundation of Chongqing(No.CSTB2024NSCQ-MSX0900No.CSTB2023NSCQ-MSX0593).
文摘AIM:To assess and rank the efficacy of various nonsteroidal anti-inflammatory drugs(NSAIDs)in preventing postoperative macular edema(PME)after cataract surgery.METHODS:A comprehensive search was conducted across PubMed,Embase,Cochrane Library,and Web of Science databases.Randomized controlled trials(RCTs)comparing different NSAIDs and control treatments for the prevention of PME were included.Data from the studies were synthesized using the“gemtc”package in R.Risk of bias was assessed with the Cochrane RoB 2 tool,and heterogeneity was evaluated using the global I2 statistic.Surface under the cumulative ranking curve(SUCRA)values were calculated for each treatment.RESULTS:Of 132 identified records,9 RCTs met the inclusion criteria.The Network Meta-analysis indicated that nepafenac had the highest efficacy in preventing PME,followed by artificial tear substitute,ketorolac,diclofenac,and bromfenac.The league table comparisons and rankograms corroborated these findings,with nepafenac consistently ranking highest.Heterogeneity analysis yielded high I2 values,indicating substantial variability across studies.CONCLUSION:This Network Meta-analysis suggests that nepafenac is the most effective NSAID for preventing PME following cataract surgery.Given the substantial heterogeneity observed,further high-quality RCTs are required to confirm these findings and explore the sources of variability.Clinicians should consider these results when selecting NSAIDs for PME prophylaxis in cataract surgery patients.
