To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

The aim of this study is to evaluate the efficacy and safety of VSL scleral lenses in the treatment of irregular astigmatism.

A total of 10 patients (11 eyes) with corneal irregular astigmatism who underwent VSL scleral lens fitting at Peking University Third Hospital from January to December 2024 were included. There were 5 males (5 eyes) and 5 females (6 eyes) with an mean age (22.4±13.9) years (ranging from 6 to 44 years). The VSL scleral lenses were customized by optometrists based on patients′ ocular conditions, with parameters determined by corneal topography, anterior segment optical coherence tomography (AS-OCT), and slit-lamp examination to ensure lens fitting properly. Baseline measurements were recorded after a 2-hour trial period confirmed efficacy and absence of discomfort. Follow-up visits were conducted at 1 week, 1 month, and every 3 months thereafter. The best-corrected visual acuity (BCVA) using a standard logarithmic acuity chart, intraocular pressure measurements, anterior segment photography, AS-OCT, corneal topography, patient-reported comfort, ocular symptoms, and daily artificial tear usage were evaluated. The gender, age, ocular history, lens parameters, objective metrics, and subjective feedback were collected. Visual acuity, intraocular pressure, refractive error, BCVA, and complications were analyzed using frequency and percentage distributions.

The mean follow-up duration of all patients (11 eyes) was (7±2.8) months. The indications for scleral lens fitting included irregular astigmatism after corneal transplantation (4 patients, 4 eyes) and keratoconus (8 patients, 9 eyes), accounting for 36% and 82%, respectively. In keratoconus patients, the mean of K1 values was (45.5±4.8)D (ranging from 39.7 to 57.8 D); the mean of K2 was (50.6±5.9)D (ranging from 46.1 to 67.5 D; and the mean of thinnest corneal thickness was (488.3±72.6)μm (ranging from 301 to 584 μm). The mean of daily wear duration was (10.2±2.5)hours (ranging from 6 to14 hours). During follow-up, the best BCVA achieved with scleral lenses ranged from 0 to 0.3 logarithm of the minimum angle of resolution (logMAR), with a mean value of (0.06±0.11) logMAR and a mean improvement of (0.52±0.39) logMAR. After scleral lens fitting, 8 patients (9 eyes) reported significant subjective visual improvement, and 3 patients (3 eyes) showed reduced artificial tear usage, accounting for 81.8% and 27.3%, respectively. Three pediatric patients (3 eyes) exhibited enhanced visual acuity and comfort during amblyopia training with scleral lenses. The mean comfort score was (8.7±1.49) scores, with 5 patients (5 eyes) rating maximum comfort, accouting for 45.5%. No adverse events were observed.

The VSL scleral lenses significantly improved BCVA, alleviated ocular discomfort, and demonstrated favorable wearing comfort and high safety in patients with corneal irregular astigmatism. The VSL scleral lenses may enhance amblyopia training efficacy in children with corneal irregularities.

The aim of this study is to investigate the effect of extracellular vesicles isolated from T regulatory cells (rEXS) on the inner blood-retinal barrier (IBRB).

BV2 microglial cells were divided into five groups: control (no LPS or rEXS), LPS-stimulated (100 ng/ml LPS), and three rEXS-treated groups (10 μg/ml, 20 μg/ml, and 50 μg/ml rEXS+ 100 ng/ml LPS). A co-culture system of BV2 cells and human umbilical vein endothelial cell (HUVEC) was used to simulate retinal vessels, with groups divided as follows: HUVEC control (no BV2), co-culture (BV2+ HUVEC), co-culture stimulated (BV2+ HUVEC+ 100 ng/ml LPS), and co-culture exosome (BV2+ HUVEC+ 50 μg/ml rEXS). ELISA was used to measure interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and IL-10 levels, while Western blot analyzed zona occludens (ZO)-1 and occludin expression. Data were expressed as ±s and compared by one-way ANOVA and LSD post-hoc test.

Nanoparticle tracking analysis showed that rEXS had a characteristic size range of 50 to 155 nm, with a peak at 106 nm and 155 nm. The rEXS concentration was 4.74×10¹⁰particles/ml. Specific markers were detected in rEXS. Transmission electron microscopy confirmed rEXS particles were approximately 100 nm in diameter. The TNF-αconcentrations in the control group, LPS-stimulated group, 10 μg/ml rEXS groups, 20 μg/ml rEXS groups, 50 μg/ml rEXS groups were (1035.96±32.36)pg/ml, (2965.25±4.08)pg/ml, (2960.41±35.65)pg/ml, (2863.32±30.55)pg/ml, (2586.32±33.25)pg/ml; IL-1βwere (2.60±0.05)pg/ml, (17.18±0.13)pg/ml, (10.98±0.06)pg/ml, (6.39±0.04)pg/ml, (4.05±0.06)pg/ml; IL-10 were (28.24±2.66)pg/ml, (24.55±0.77)pg/ml, (33.96±3.58)pg/ml, (34.29±4.32)pg/ml, and (48.32±1.55)pg/ml, respectively. There were significant differences between them (F=23.01, 1.96, 29.53; P<0.05). In the co-culture system, compared with relative control group, the ZO-1 expression levels in the co-culture group, co-culture stimulated group, co-culture exosome group were (1.28±0.010), (0.8±0.02), and (1.23±0.01); occludin were (1.37±0.04), (0.81±0.02), (1.18±0.03), respectively. There were significant differences between them (F=808.3, 222.2; P<0.05).

The results of the present study revealed that rEXS may have a protective effect on the IBRB by inhibiting the release of TNF-α and IL-1β cytokines, promoting IL-10-mediated anti-inflammatory effects, and alleviating LPS-induced tight junction disruption.

To explore the distribution characteristics and influencing factors of spring immune conjunctivitis patients in Beijing.

13 086 patients with spring immune conjunctivitis who visited the emergency department of Chongwenmen Branch of Beijing Tongren Hospital in March each year from 2021 to 2025 were selected as the research subjects. Among them, there were 6223 males and 6863 females with a median age of 34 (14, 43) years old (ranging from 2 to 90 years old). Patients were divided into three groups based on their age: underage group, young group, middle-aged group, and elderly group. The daily number, age, gender, diagnosis, and medication treatment information of patients with this disease in the Donghua Digital Hospital Information Management System were retrieve and recorded. The pollen concentration, maximum temperature, wind force level, and rainfall or sleet weather monitoring data of the Beijing Meteorological Bureau for the day were reviewed and recorded. The number of patients did not follow a normal distribution according to the Kolmogorov Smirnov test, and was represented by median and interquartile range, and 90% percentile M (Q1, Q3, 90%). The pollen concentration and maximum temperature follow a normal distribution, was represented by ±s. The correlation between the number of patients and pollen concentration, maximum temperature, wind intensity, and rainfall or sleet weather, and draw a logarithmic line graph was evaluated by Spearman correlation coefficient. Single factor generalized linear regression was used to analyze the correlation between the number of patients and climate factors such as pollen concentration, maximum temperature, wind intensity, and rainfall or sleet weather. Further, the variables selected from single factor screening were included in the multi factor generalized linear regression analysis to control for confounding factors and explore the correlation between each factor and the number of patients in depth.

Among all 13 086 patients with spring immune conjunctivitis, there were 3951, 6463, 2187, and 485 patients in the underage group, young group, middle-aged group, and elderly group, respectively, accounting for 30.2%, 49.4%, 16.7%, and 3.7%, respectively. There were 6223 males and 6863 females, accounting for 47.6% and 52.4%, respectively. The number of patients in March 2021, March 2022, March 2023, March 2024, and March 2025 were 2551, 1886, 2180, 2901, and 3568, respectively, accounting for 19.5%, 14.4%, 16.6%, 22.2%, and 27.3%. The range of patient numbers was 3 to 449, 7 to 321, 4 to 208, 5 to 560, and 3 to 521, respectively. The number of patients in the 90^th percentile was 53 (20, 81 206), 35 (21, 60 212), 59 (41, 108 131), 46 (24, 128 173), and 79 (43, 140 308), respectively. The average pollen concentrations were (549.4±611.7) grains/1000 mm^2, (735.7±1175.7) grains/1000 mm^2, (818.7±847.6) grains/1000 mm^2, (835.7±1618.5) grains/1000 mm^2, and (1234.1±2202.6) grains/1000 mm^2, respectively. The average maximum temperatures are (13.9±5.2) ℃, (13.3±4.2) ℃, (16.7±4.5) ℃, (15.3±5.2) ℃, and (15.4±5.9) ℃, respectively. The daily wind speeds were 0 to 4, 1 to 3, 1 to 4, 0 to 4, and 1 to 4, respectively. The types of precipitation are light rain, light rain or sleet, light rain, light rain or sleet, and light rain or sleet. The Spearman correlation analysis results showed that the number of patients was significantly correlated, moderately correlated, moderately correlated, and weakly correlated with pollen concentration, maximum temperature, rainfall or sleet weather, and wind intensity, respectively, with statistical significance (r=0.734, 0.460, 0.452, 0.232; P<0.05). The results of single factor generalized linear regression analysis showed that the number of patients was affected by pollen concentration, maximum temperature, and rainfall or sleet weather, and the correlation analysis had statistical significance (β=0.047, 7.856, 94.316; 95%CI: 0.039 to 0.056, 5.021 to 10.691, 56.621 to 132.012; P<0.05). The number of patients was not affected by wind intensity, and the correlation was not statistically significant (β=14.440, P>0.05). The results of multiple generalized linear regression analysis showed that there was a statistically significant correlation between the number of patients and pollen concentration, maximum temperature, and rainfall or sleet weather (β=0.038, 3.564, 69.460; 95%CI: 0.029 to 0.047, 1.175 to 5.954, 40.754 to 98.166; P<0.05).

The epidemiological characteristics of spring immune conjunctivitis patients in Beijing are slightly higher in females than males. Mainly targeting minors and young people, with a small proportion occurring in middle-aged people, and occasional cases in the elderly population. The number of patients is affected by pollen concentration, maximum temperature, and rainfall or sleet weather, while the effect of wind is not significant.

In recent years, with the advancement of aesthetic concepts and the increasing demand for beauty, aesthetic surgeries related to the eyes have gradually become a popular and emerging topic. Double eyelid surgery, the application of beauty products, and injectable aesthetics are the primary methods of eye-related aesthetic surgeries. Common complications of double eyelid surgery include asymmetry of the double eyelids, disappearance of the double eyelids, hematoma, infection, ptosis, dry eye, and keratitis related to buried sutures. Complications caused by beauty products include infectious ocular surface diseases, immune-related ocular surface diseases, hypopigmentation of the eyelids due to melanocyte reduction, and uveitis. Complications of injectable aesthetics include retinal artery occlusion, tissue edema, characteristic bluish-gray changes in the eyelid injection area, delayed nodules, periorbital swelling, and ptosis. Currently, the research on the pathogenesis of various complications in eye-related aesthetic surgeries is not yet fully understood, and there is room for improvement in their prevention and treatment measures. The methods of eye-related aesthetic surgeries require further development in material selection, surgical innovation, and optimization studies. Additionally, there is a need for the early establishment of expert consensus and standards regarding the techniques of double eyelid surgery, the use of beauty products, and injectable aesthetics. In this paper, the principles of these aesthetic methods and the pathogenesis, treatment methods, and preventive measures for their associated ocular complications was reviewed.

Diabetic retinopathy (DR) is the main cause of visual impairment in working-age adults, with a complex pathogenesis involving structural damage and functional impairment of the retinal neurovascular unit (RNVU). Neurotrophic factor (NTF), as important molecules regulating neuronal survival, differentiation and vascular stability, has shown potential therapeutic value in the neurovascular protection of DR in recent years. The principal pathological alterations of the RNVU associated with DR was delineated, the protective roles and mechanisms of NTFs against RNVU injury, and the advancements in research concerning NTFs in mitigating hyperglycemia-induced RNVU damage alongside their prospective clinical applications were elucidated and emphasized, aiming to provide a theoretical basis for further experimental research and clinical treatment in this paper.

Chemical warfare has always been a potential threat to war or armed conflict. Chemical warfare agents act on the whole body or specific organs, causing irreversible damage and corresponding acute or chronic ocular manifestations. The Centers for Disease Control and Prevention in the United States classifies chemical agents into 10 categories: corrosive agents, nerve agents, asphyxiating agents, corrosives, blood agents, disabling agents, metal agents, riot control agents, toxic alcohol, and biotoxins. Corrosive toxins include mustard gas, Louis gas, and phosgene oxime; asphyxiant toxins include phosgene and chloropicrin. The irritation to the ocular surface could be caused after exposure to erosive toxins, and in severe cases, for corneal opacity, corneal ulcers, and corneal edema; the pupil constriction, blurred vision, and increased tear secretion after exposure to nerve agents; the tearing, conjunctival congestion, blepharospasm, photophobia, conjunctivitis, and periorbital edema after exposure to riot control agents. After exposure to chemical warfare agents, emergency treatment mainly involves leaving the toxic environment, and the main treatment methods include detoxification treatment, local eye drops, and ocular surface reconstruction. The ocular manifestations and treatment strategies of chemical warfare agents was reviewed in this paper.

Diabetic macular edema (DME), a severe complication of diabetic retinopathy, exhibits an increasing occurrence rate in parallel with the rising prevalence of diabetes mellitus. It has emerged as a leading cause of vision loss, imposing substantial economic burdens on society and families. It has demonstrated that the conventional treatments, such as intravitreal anti-vascular endothelial growth factor (VEGF) injections and laser photocoagulation, had limited efficacy in certain refractory patient populations. In recent years, significant advancements have been achieved in both mechanistic studies and clinical management of DME: novel anti-VEGF agents featuring dual-target inhibition exhibit superior efficacy in improving retinal morphology with longer intervals of injection and lower complications. Corticosteroid therapy offers a viable alternative for refractory cases, though clinicians must remain vigilant against complications such as elevated intraocular pressure and cataract formation. Combination therapies, integrating anti-VEGF agents with dexamethasone, laser photocoagulation, or adjunctive medications, reduce injection frequency and exert synergistic therapeutic effects. Vitrectomy with internal limiting membrane peeling remains controversial regarding anatomical improvement in refractory DME; however, it holds potential in alleviating mechanical traction and clearing inflammatory mediators. Further refinement via subretinal injection techniques may enhance the clearance of hard exudates. Emerging technologies, including artificial intelligence assisted prediction of anti-VEGF response and gene therapy, present promising avenues for personalized treatment and sustained intervention. Despite these advances, the pathophysiology of DME remains incompletely elucidated. Future research should prioritize the development of long-acting therapeutics, precision medicine strategies, and multicenter clinical validation to optimize visual outcomes for patients.

The aim of this study is to explore the changes in retinal vascular fractal dimension in patients with glaucoma and stroke.

From April 2020 to October 2020, 95 patients (95 eyes) with glaucoma who were treated at Beijing Tongren Hospital affiliated to Capital Medical University, 97 patients (97 eyes) with stroke who were diagnosed in the Neurology Department of Beijing Tongren Hospital, 100 healthy subjects (100 eyes) were recruited in the same period. Among them, there were 51 male patients (51 eyes) and 44 female patients (44 eyes) with an average age of (55.6±7.8) years (ranging from 46 to 69 years) in the glaucoma group; 63 male patients (63 eyes) and 34 female patients (34 eyes) with an average age of (64.7±5.6) years (ranging 58 to 73 years) in the stroke group; 50 male cases (50 eyes) and 50 female cases (50 eyes) with an average age of (52.4±6.4) years (ranging from 40 to 60 years) in the control group. All subjects underwent routine ophthalmic examinations, fundus photography, visual field and optical coherence tomography examinations, and computer-aided image analysis and measurements of retinal vessel diameter width, vessel curvature, and vessel fractal dimension were applied. The measurement values of retinal nerve fiber layer (RNFL) thickness and retinal vascular parameters were tested using Kolmogorov Smirnov method to conform normal distribution, expressed as ±s, and compared between multiple groups using one-way analysis of variance. When the differences were statistically significant, LSD was further used for comparison between two groups. The relationship between retinal vascular parameters and RNFL thickness was analyzed using Pearson correlation analysis.

The average RNFL thickness in the glaucoma group, stroke group, and control group was (75.3±12.6) μm, (89.5±8.7) μm, and (103.6±6.2) μm, respectively, with statistically significant differences (F=148.516, P<0.05). The average RNFL thickness around the disc decreased in glaucoma group and stroke group, there was statistically significant difference between the glaucoma group and the stroke group compared to the control group (t=-4.362, -3.216; P<0.05). The arterial to venous width ratio in Zone B+ C, arterial to venous width ratio in Zone B, 6 larger arterial widths located in Zone B+ C, 6 larger arterial widths located in Zone B, 6 larger venous widths located in Zone B+ C, 6 larger venous widths located in Zone B, all vessel simple bending, all vessel curvature bending, arterial simple bending, arterial curvature bending, venous simple bending, venous curvature bending, all vessel fractal dimension, arterial fractal dimension, and venous fractal dimension were 0.552±0.216, 0.530±0.137, (8.491±2.039) pixels, (8.804±2.136) pixels, respectively, for the control group, glaucoma group, and stroke group (15.959±2.138) pixels, (15.934±2.962) pixels, 1.057±0.984, 0.033±0.002, 1.083±0.169, 0.027±0.026, 1.069±0.187, 0.042±0.006, 1.527±0.148, 1.295±0.065, 1.344±0.058, 0.558±0.111, 0.567±0.104, (8.852±1.931) pixels, (8.923±1.872) pixels, (16.015±2.787) pixels, (15.891±2.921) pixels, 1.069±0.251, 0.003±0.001 1.044±0.021, 0.003±0.001, 1.068±0.041, 0.044±0.002, 1.529±0.032, 1.286±0.051, 1.342±0.049, 0.609±0.108, 0.774±0.143, (10.082±2.151) pixels, (10.417±2.223) pixels, (16.548±2.885) pixels, (16.739±2.768) pixels, 1.221±1.378, 0.331±0.024, 1.262±1.605, 0.029±0.015, 1.082±0.209, 1.932±0.137 1.544±0.156, 1.331±0.039, and 1.367±0.035, showed statistically significant differences (F=108.973, 117.136, 104.762, 119.531, 113.538, 121.539, 119.968, 134.472, 125.162, 104.167, 76.106, 136.262, 109.421, 116.632, 43.279; P<0.05). Compared between the glaucoma group and the control group, vascular parameters of retinal arteriovenous width ratio (Zone B+ C), arterial width in Zone B+ C, arterial width in Zone B, retinal vein width in Zone B+ C, retinal vein width in Zone B, simple bending of all retinal blood vessels, curvature bending of all retinal blood vessels, simple bending of retinal arteries, curvature bending of retinal veins, fractal dimension of retinal blood vessels, and fractal dimension of retinal arteries, had shown that the differences were statistically significant (t=-3.326, -3.761, -3.964, -2.237, -2.453, -2.447, -3.895, -2.963, -3.871, -2.037, -2.363; P<0.05). The fractal dimension of retinal blood vessels in glaucoma patients was positively correlated with the thickness of RNFL around the disc, and the correlation was statistically significant (r=0.783, P<0.05). Compared between the stroke group and the control group, vascular parameters of retinal arteriovenous width ratio (Zone B+ C), arterial width in Zone B+ C, arterial width in Zone B, retinal vein width in Zone B+ C, retinal vein width in Zone B, simple bending of all retinal blood vessels, curvature bending of all retinal blood vessels, simple bending of retinal arteries, curvature bending of retinal veins, fractal dimension of retinal blood vessels, and fractal dimension of retinal arteries, had shown that the differences were statistically significant (t=-2.741, -3.153, -2.930, -2.041, -2.726, -2.323, -3.881, -3.267, -2.965, -2.024, -2.473; P<0.05). The fractal dimension of retinal blood vessels in stroke patients was positively correlated with the thickness of RNFL around the disc, and the correlation is statistically significant (r=0.645, P<0.05). The lower the fractal dimensionality of retinal vascular analysis in stroke patients, the lower the average RNFL thickness.

Patients with glaucoma and patients with stroke have narrower retinal vessel diameter, decreased retianl vascular bending, and decreased retinal vascular fractal dimension. The parameters of retinal vascular in stroke patients show a trend similar to glaucoma patients. The fractal dimension of retinal vascular in glaucoma is correlated with the severity of glaucoma, lower retinal vascular fractal dimension and RNFL thickness are associated with stroke.

The aim of this study is to investigate the therapeutic efficacy of 0.05% cyclosporine A (CsA) eye drops in diabetes-associated dry eye disease.

A total of 60 patients (60 eyes) with moderate-to-severe dry eye associated with type 2 diabetes who visited the Ophthalmology Clinic of Peking University Third Hospital between October 2021 and August 2023 were selected. They were divided into a control group and an experimental group using a random number table, with 30 patients (30 eyes) in each group. Among them, there were 19 males (19 eyes) and 41 females (41 eyes) with a mean age of (65.5±8.7) years (ranging from 53 to 79 years). The control group received 0.1% sodium hyaluronate eye drops three times daily, while the experimental group received 0.1% sodium hyaluronate eye drops three times daily combined with 0.05% CsA eye drops twice daily. Before treatment, as well as at 1 month and 3 months after treatment, patients underwent slit-lamp examination, tear film breakup time (BUT) measurement, corneal fluorescein staining (CFS) scoring, lissamine green (LG) staining scoring, corneal sensitivity testing, Schirmer′s test Ⅰ (SⅠt), ocular surface disease index (OSDI) questionnaire assessment, and tear inflammatory factor testing. Age, OSDI scores, and SⅠt were expressed as ±s. Comparisons before and after treatment were performed using paired t-test, for intergroup were conducted using independent samples t-test, and within-group and between-group comparisons were analyzed using two-way ANOVA. BUT, CFS scores, mean corneal sensitivity, and LG scores were expressed as median M(Q1, Q3). Comparisons before and after treatment and between groups were performed using rank-sum tests, while within-group and between-group differences were assessed using the Scheirer-Ray-Hare test.

In the experimental group, OSDI scores, BUT, CFS scores, SⅠt, mean corneal sensitivity, and LG scores before treatment, after treatment for 1 month, 3 months were as follows: (35.05±12.45)points, 4.00(2.00, 6.50) s, 0.50(0.00, 3.75)points, (13.70±8.56) mm, 5.45(5.20, 5.80)points, 0.00(0.00, 2.00)points, (26.06±10.87)points, 4.00(3.00, 5.50) s, 1.00(0.00, 3.25)points, (14.03±9.00) mm, 6.00(5.60, 6.00)points, 0.00(0.00, 2.00)points, (10.98±10.61)points, 6.50(4.00, 9.00)s, 0.0(0.00, 2.25)points, (13.61±7.32) mm, 6.00(5.90, 6.00)points, 0.00(0.00, 1.00)points, respectively. In the control group, the corresponding values were (31.43±11.11)points, 3.00(2.75, 6.00)s, 1.00(0.00, 3.00)points, (12.30±7.87) mm, 5.75(5.38, 6.00)points, 0.00(0.00, 2.00)points, (31.33±14.64)points, 3.00(2.00, 7.00)s, 1.00(0.00, 3.00)points, (12.23±8.40) mm, 5.75(5.20, 6.00)points, 0.00(0.00, 1.00)points, and (12.97±13.69)points, 4.00(3.00, 6.25) s, 0.00(0.00, 3.00)points, (11.40±7.97) mm, 6.00(5.80, 6.00)points, 0.00(0.00, 2.00)points, respectively. Two-way ANOVA revealed statistically significant differences in OSDI scores within groups across timepoints (F=63.45, P<0.05), but no significant differences between groups or in interaction effects (F=0.20, 2.59; P>0.05). There were significant differences within groups and in interaction effects in BUT (H= 6.92, 4.09; P<0.05), but not between groups (H= 1.36, P>0.05). No significant differences were found in CFS scores, SⅠt, mean corneal sensitivity, or LG scores between groups, within groups, or in interaction effects (H= 0.04, 1.96, 2.60, 2.05, 0.10, 0.22, 1.85, 1.19, 1.70, 0.16, 0.52, 2.12; P>0.05). After treatment for 1 month, there was no significant difference in BUT between the two groups (Z=0.68, P>0.05). However, after treatment for 3 months, the difference in BUT between the two groups was statistically significant (Z=2.19, P<0.05).

0.05% CsA eye drops can improve clinical symptoms, enhance tear film stability, and promote tear secretion repair in diabetes-associated dry eye. The mechanism may be related to reducing ocular surface inflammation, and long-term treatment can enhance therapeutic efficacy.

To explore the prenatal ultrasonographic and genetic characteristics of fetus with Williams-Beuren syndrome (WBS) and provide basis for prenatal diagnosis.

A total of 25 pregnant women (one of them was a twin pregnancy) underwent prenatal examination and 25 fetuses (fetus 1 to 25, one of them was one of twins) diagnosed with WBS by chromosomal microarray analysis (CMA) at West China Second University Hospital, Sichuan University, from October 2018 to June 2023 were included in this study, and the clinical case data were retrospectively analyzed. A literature review was conducted by searching domestic and foreign databases for clinical studies related to the prenatal diagnosis of WBS. Prenatal sonographic findings, genetic test results, and pregnancy outcomes of WBS fetuses were summarized. The study procedures complied with the ethical standards of the World Medical Association Declaration of Helsinki revised in 2013.

① Among the 25 WBS fetuses in this study, 18 cases (72.0%, 18/25) had prenatal ultrasound findings, with cardiovascular abnormalities (55.6%, 10/18) being the most common, primarily including intracardiac echogenic foci and ventricular septal defects (VSD); followed by fetal growth restriction (FGR) (38.9%, 7/18). The length of the chromosomal deletion in the 25 WBS fetuses ranged from 1.39 to 23.41 Mb, of which 23 (92.0%) exhibiting deletions of 1.39 to 1.50 Mb. Parental verification in 7 cases of WBS fetuses revealed that the genovariation of 4 cases were de novo, 2 were maternally inherited, and one was paternally inherited. ② Literature retrieval results: According to the retrieval strategy set in this study, a total of 48 clinical studies about prenatal diagnosis of WBS fetus at home and abroad were retrieved, involving 173 WBS fetuses. Among these, 166 cases (93.8%) had prenatal phenotypes, mainly including FGR (49.4%, 82/166) and cardiovascular abnormalities (44.6%, 74/166, predominantly VSD and aortic stenosis). In 157 fetuses, 158 chromosomal deletions were identified, and the length of deletion was mainly 1.06-1.54 Mb (74.7%, 118/158). Among 90 fetuses underwent family validation, 74 cases (82.2%) were de novo, 13 cases (14.4%) were maternally inherited, and 3 cases (3.3%) were paternally inherited. ③ A comprehensive analysis of 166 cases of literature retrieval and 25 cases of this study, a total of 191 WBS fetuses were confirmed the diagnosis with the main genetic testing methods of CMA (85.3%, 163/191), fluorescence in situ hybridization (FISH) (22.0%, 42/191), and quantitative fluorescent-polymerase chain reaction (QF-PCR) (12.0%, 23/191), etc.. ④ Among the 184 WBS fetuses (18 cases of this study and 166 cases of literature retrieval) with available prenatal ultrasound results, the incidence rates of left ventricular outflow tract obstruction was 16.9% (31/184), VSD was 9.8% (18/184), and intracardiac echogenic foci was 9.2% (17/184).

Left ventricular outflow tract obstruction, including aortic stenosis, coarctation of aorta, etc., may be a prenatal sonographic feature of WBS fetus, while FGR is the most common nonspecific prenatal manifestation of WBS fetus.

To evaluate the auxiliary diagnostic value of an artificial intelligence (AI)-based automatic recognition model for cystocele in pelvic floor ultrasound examination.

A total of 200 female outpatients who underwent pelvic floor ultrasound examination at Shengjing Hospital of China Medical University between July and December 2024 were included. Among them, 103 cases were diagnosed with cystocele and 97 had normal anterior pelvic compartment structures. The subjects were randomly divided into a training set (n=140) and a testing set (n=60) in a 7∶3 ratio. In the training set, 73 had cystocele and 67 were normal; in the testing set, both groups included 30 cases. Dynamic pelvic floor ultrasound images at rest and during maximal Valsalva maneuver were collected. Urethral contours were manually delineated, and 13 urethral mobility parameters were extracted. Based on these features, support vector machine (SVM) and random forest (RF) models were trained using five-fold cross-validation, and the resulting five sets of weights were used to evaluate diagnostic performance in the testing set. The study was approved by the Ethics Committee of Shengjing Hospital, China Medical University (Approval No. 2024PS1218K), and all participants provided written informed consent.

①There were no statistically significant differences in age, body mass index (BMI), height, weight, gravidity, parity, ethnicity, or occupational composition between the training and testing sets (P>0.05). ②In the testing set, the SVM model demonstrated an accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (ROC-AUC) of 0.783, 0.718, 0.933, 0.811, and 0.893, respectively, all superior to those of the RF model (0.733, 0.659, 0.966, 0.783, and 0.876). Among the five SVM model, the first fold performed best with a ROC-AUC of 0.904. ③Confusion matrix analysis showed that the correct identification rates of cystocele by the SVM and RF models were 93.3% (28/30) and 96.7% (29/30), respectively; for normal anterior compartment structures, the rates were 63.3% (19/30) and 50.0% (15/30), respectively.

The AI-based automatic recognition model using full-length urethral dynamic parameters demonstrates favorable diagnostic performance in identifying cystocele and may serve as an objective auxiliary tool to conventional pelvic floor ultrasound. It holds promise for early screening, subtype classification, and postoperative follow-up of cystocele. However, further studies with larger sample sizes and multi-center validation are required to optimize the algorithm and facilitate clinical translation.

To explore the impact of antenatal antipsychotic drug (APD) treatment on pregnancy outcomes in pregnant women with severe mental illness (SMI).

A total of 51 pregnant women with SMI admitted to Sichuan Mental Health Center and Guangyuan Mental Health Center from January 2021 to December 2023 were selected as research subjects. They were divided into observation group 1 (n=22, receiving continuous APD treatment during pregnancy) and observation group 2 (n=29, receiving APD treatment only when SMI symptoms worsened) based on clinical treatment regimens. A total of 68 healthy pregnant women who underwent prenatal examinations and delivered in the same two hospitals during the same period were included into control group. The Positive and Negative Syndrome Scale (PANSS), Social Disability Screening Schedule (SDSS), Suicide Risk Assessment Scale, and Risk Assessment Scale for Endangering Behavior were used to evaluate the disease symptoms of SMI pregnant women after delivery, and the aggravation/recurrence of SMI was recorded. The scores of disease symptoms and SMI aggravation/recurrence rates between observation group 1 and 2 were compared by independent-samples t test and chi-square test. Statistical analyses were performed on pregnancy complications, pregnancy outcomes, and neonatal outcomes, among the three groups. There were no statistically significant differences in general clinical data, such as age, educational level, residence, and parity between observation groups 1, 2 and the control group (P>0.05). Additionally, no significant differences were found in the course and type of SMI between observation group 1 and 2 (P>0.05). This study complied with the standards formulated by the Ethics Committees of Sichuan Mental Health Center and Guangyuan Mental Health Center, and was approved by the Ethics Committee of Sichuan Mental Health Center (Ethics No. 2021-1).

①There was a statistically significant difference in the overall incidence of gestational diabetes mellitus (GDM) among the three groups (χ²=13.08, P=0.003). Further pairwise comparisons showed that the incidence of GDM in observation group 1 was significantly higher than that in observation group 2 (χ²=6.30, P=0.012) and the control group (χ²=9.78, P=0.002). ②After delivery, the aggravation/recurrence rate of SMI, PANSS score, SDSS score, suicide risk score, and risk score for endangering behavior in observation group 1 were significantly lower than those in observation group 2 (P<0.05). ③There was a statistically significant difference in the proportion of newborns transferred to the neonatal intensive care unit (NICU) among the three groups (P<0.05). Further pairwise comparisons revealed that the proportion in observation group 1 was significantly higher than that in the control group (P=0.008), while no significant differences were found in other pairwise comparisons (P>0.05). No significant differences were observed in neonatal outcomes, such as birth weight, birth length, 5-minute Apgar score, and incidence of preterm birth and congenital malformation between observation group 1 and 2 (P>0.05).

APD treatment for pregnant women with SMI can improve their mental status, reduce the risk of SMI aggravation/recurrence during pregnancy, and does not significantly increase the risk of adverse maternal and neonatal outcomes.