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.

To investigate the risk factors and treatment methods of portal vein thrombosis (PVT) after liver transplantation (LT) in adult liver cirrhosis recipients.

The clinical data of 596 adult cirrhosis patients undergoing LT in the Organ transplantation Center of Tianjin First Central Hospital from January 2018 to June 2022 were analyzed, and the overall cases were divided into PVT group (32 cases) and non-PVT group (564 cases) according to postoperative PVT. Unvariate and multivariate analysis were used to screen risk factors for PVT formation after LT and to compare survival rates between the two groups.

Out of the 596 LT recipients included in this study, the overall incidence of postoperative PVT was 5.37% (32/596). Multivariate analysis revealed that, the presence of large spontaneous portosystemic shunt (SPSS) (OR=6.716, 95%CI: 2.481-18.180), postoperative presence of portoshunt (OR=5.917, 95%CI: 1.785-19.615), preoperative grade Ⅲ-Ⅳ PVT (OR=8.368, 95%CI: 1.954-35.835) and cold ischemia time ≥10 h (OR=4.002, 95%CI: 1.183-13.537) were independent risk factors for PVT formation after LT(P<0.05). Among 32 recipients with PVT, 4 underwent surgical thrombectomy, 7 received interventional therapy, and 21 were treated with anticoagulant medications. After treatment, PVT resolved in 25 recipients, while 7 had stable PVT without clinical symptoms. A total of 5 deaths unrelated to PVT occurred. Survival analysis revealed that the 1-year, 2-year, and 3-year post-operative graft survival rates of the non-PVT group achieved 98.4%, 95.1%, and 93.6%, compared with 87.3%, 83.6%, and 78.4% in the PVT group. The difference was statistically significant (χ²=11.3, P<0.05).

The presence of large SPSS, grade Ⅲ-Ⅳ PVT, persistence of portosystemic shunt and cold ischemia time ≥10 h are independent risk factors for PVT formation after LT in adult patients with cirrhosis. For recipients of postoperative PVT formation, early diagnosis and treatment can achieve a better survival prognosis.

To investigate the impact of downgrading therapy during liver transplant waiting period on the prognosis of patients with acute-on-chronic liver failure (ACLF).

A retrospective analysis was performed on 344 ACLF patients who were on the liver transplantation waiting list at the Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, from January 2018 to August 2024. The cohort included 102 patients who did not undergo transplantation and 242 patients who completed liver transplantation. Based on the Chinese Group on the Study of Severe Hepatitis B-ACLF guideline, ACLF was classified into grades 1 to 3. For the transplant group, the last examination prior to liver transplantation was used as the endpoint for scoring, while for the non-transplant group, the last examination before discharge or prior to death was used as the scoring endpoint. In addition to assessing changes in ACLF grades, an evaluation method based on "organ failure + organ injury" was incorporated. After downgrading therapy, patients were divided into a successful downgrading group and a failed downgrading group. Normally distributed continuous variables were compared using the independent-samples t-test; non-normally distributed continuous variables were compared using the Mann-Whitney U test. Categorical variables were compared using the chi-square test. Kaplan-Meier survival curves were constructed, and comparisons were made using the log-rank test. A P-value of <0.05 was considered statistically significant.

The differences in γ-glutamyltransferase, serum glucose, prothrombin time, serum creatinine, the proportion of patients with renal failure, international normalized ratio, the proportion of patients with coagulopathy, and the model for end-stage liver disease score between the transplant and non-transplant groups were statistically significant (Z/χ²=-2.315, -2.260, -4.299, -2.434, 4.428, -5.263, 13.021, and -5.282, all P<0.05). At the time of outcome events, 225 patients achieved successful downgrading therapy (successful downgrading group), including 193 in the transplant group and 32 in the non-transplant group. A total of 119 patients experienced failure of downgrading therapy (failed downgrading group), including 49 cases in the transplant group and 70 cases in the non-transplant group. The 1-year cumulative survival rate of ACLF patients in the successful downgrading group (n=225) was higher than that in the failed downgrading group (n=119) (χ²=81.95, P<0.05). Further analysis showed that in the non-transplant group, the 1-year cumulative survival rate of ACLF patients in the successful downgrading group (n=32) was higher than that in the failed downgrading group (n=70) (χ²=4.28, P<0.05). However, in the transplant group, there was no statistically significant difference in the 1-year cumulative survival rate between the successful downgrading group (n=193) and the failed downgrading group (n=49) (χ²=2.62, P>0.05).

Successful downgrading can improve the overall short-term prognosis of all patients with ACLF and the survival rate of non-transplanted patients, and extend the liver transplant waiting period.

To explore the latent profiles of lung transplant recipients′ quality of life, as well as the traits and contributing variables of different quality of life categories.

The study included 300 lung transplant recipients who visited Wuxi People′s Hospital for follow-up outpatient visits between January and December 2022. The lung transplant quality of life survey (LT-QOL) and a general information questionnaire were used in the questionnaire surveys. The Kruskal-Wallis H test was used to compare groups for continuous data, while the chi-square test or Fisher′s exact probability test was used for comparison between groups for categorical data. The factor scores for every dimension were determined using the lavaan package. The mclust and tidyLPA programs were used to conduct latent profile analysis (LPA). The nnet software was used to perform logistic regression on factors with P<0.10 in univariate analysis. The threshold for statistical significance was set at P<0.05.

A total of 300 questionnaires were distributed, with 5 invalid responses excluded, yielding a valid response rate of 98.3% (295/300). LPA was conducted based on factor scores across the LT-QOL′s 11 domains, the 295 recipients were categorised into high quality of life-quality of life satisfaction group (n=181), moderate quality of life-prominent diarrhoea symptoms group (n=34), moderate quality of life-prominent sexual function issues group (n=40), low quality of life-poor overall perception group (n=40). Univariate analysis revealed statistically significant differences in age, pathoglycemia, and dyslipidaemia among recipients in the above four groups (H/χ²=10.135, 15.599 and 14.527 respectively, all P<0.05). Multivariate logistic regression analysis revealed that the age, unplanned readmission frequency, pathoglycemia, and dyslipidaemia were statistically significant factors influencing quality of life categories among lung transplant recipients (all P<0.05).

Quality of life among lung transplant recipients exhibits marked heterogeneity. Nursing staff may develop targeted intervention strategies based on the characteristics of their respective quality of life categories to enhance their quality of life and overall health status.

Bibliometric and visualization analyses of the literature in the field of transplant pharmacy were conducted to inform the development of transplant pharmacist teams, advance transplant pharmacy research, and enhance transplant pharmacy service standards in China.

Publications related to transplantation and pharmacy were searched in the Web of Science Core Collection database from the establishment of the database to December 2024. Bibliometric method was used to analyze the annual publication output, citation frequency, as well as the countries, authors, and institutions. CiteSpace software and VOSviewer were used to detect bursts and clusters of keywords and citations, in order to analyze the current status and hotspots of the field.

A total of 3 168 articles were included in this study, with the earliest publication dating back to 1992. The highest number of publications occurred in 2022 (n=273). The total number of citations was 66, 740, with the highest figure in 2024 reaching 6 116. The United States had the most publications (n=1 659) and maintained the strongest collaborations with other countries. A total of 3 077 institutions participated in the publications, with the Pennsylvania Commonwealth System of Higher Education (n=176) ranking first in publication volume. A total of 16 408 authors contributed to the publications, with Taber DJ (n=78) being the most prolific author. The top ten most intense emergent citations sustained their pre-eminence for a period of 3 to 4 years. The most significant emergent citation was "Therapeutic Drug Monitoring of Tacrolimus-Personalized Therapy: Second Consensus Report" by Spanish scholar Brunet M in 2019, with a citation intensity of 37.78. Sixty keywords were subjected to cluster analysis, forming three distinct clusters. These clusters focus on three key areas: assessment of therapeutic efficacy in organ transplantation, immunotherapy in organ transplantation, and the pharmacokinetics and genomics of immunosuppressive agents.

By visualizing and analyzing the research in the field of transplant pharmacy, this study provides guidance for the further development of transplant pharmacy, the improvement of pharmacy services, and the conduct of related research in China in the future.

Spinal cord injury (SCI) is a severe traumatic lesion of the central nervous system, in which patients present with sensory, motor and autonomic nerve dysfunction below the level of the injury. Neural stem cells (NSCs) possess robust self-renewal capacity, multi-directional differentiation potential, and unique microenvironment regulatory functions. This article focuses on elaborating the mechanisms of NSCs transplantation for the treatment of SCI. Studies have shown that NSCs can not only differentiate into nerval cells, but also play a crucial role in neuroprotection, axonal regeneration, and neural circuit reconstruction through complex intercellular interactions and microenvironment regulatory mechanisms. However, NSCs transplantation for the treatment of SCI still faces challenges such as low survival rate of transplanted cells, insufficient efficiency of directed differentiation, and obstruction by glial scarring. Future studies may integrate genetic technologies and utilize biomaterials to enhance cell survival capacity and improve the damaged microenvironment, thereby advancing the researches on NSCs transplantation for SCI from basic studies to clinical application and bringing new hope to patients with SCI.

In recent years, contrast-enhanced ultrasound (CEUS) acts as an ultrasound examination technique widely applied in the diagnosis and treatment of vital organ diseases such as pancreas, liver and kidney, providing clinicians with more detailed and comprehensive information to guide subsequent diagnosis and treatment. CEUS is applied in pancreatic diseases, mainly including pancreatitis, pancreatic tumor, pancreatic biopsy and interventional therapy, etc. In this article, research progress in the application of CEUS for pancreatic diseases was reviewed.

Pancreatic ductal adenocarcinoma (PDAC) is a type of digestive tract carcinoma with extremely high degree of malignancy and poor prognosis. At present, relevant research mainly focuses on the core driver gene mutation (such as KRAS/TP53), dense fibrotic microenvironment characterized by abnormal activation and immunosuppression of cancer-associated fibroblasts (CAFs), and the mechanism of chemotherapy resistance. The frontier exploration directions cover targeted therapy (such as KRAS inhibitors), immune microenvironment regulation, metabolic pathway intervention and screening of early diagnostic biomarkers. In this article, biological characteristics of CAFs were illustrated, including cell origin, functional phenotype classification and molecular heterogeneity. The key role of CAFs in the progression of PDAC was unraveled from the perspectives of regulating malignant biological behavior, constructing dynamic microenvironment network and mediating angiogenesis and immunosuppression, etc. Based on the development of spatial transcriptome and multiplex immunofluorescence imaging, analysis of epigenetic regulation mechanism and optimization of combined treatment regimens, this study was designed to provide novel ideas for precise treatment and improve clinical prognosis of PDAC patients.

To investigate the spatiotemporal variation of pressure on the corneal surface under an air puff load among normal, keratoconic, and highly myopic corneas.

From January 2022 to December 2022, two healthy subjects (two eyes), two patients with keratoconus (two eyes), and two patients with high myopia (two eyes) were selected for the study at the Beijing Tongren Ophthalmic Center affiliated to Capital Medical University. Among them, the healthy subjects comprised one male (one eye) and one female (one eye) with an average age of 31 (ranging from 30 to 32 years). The keratoconus patients comprised one male (one eye) and one female (one eye) with an average age of 26 (ranging from 22 to 30 years). The high myopia patients comprised one male (one eye) and one female (one eye) with an average age of 25 years (ranging from 24 to 26 years). The geometric parameters of the anterior and posterior surfaces of the cornea from three groups of subjects: normal cornea, keratoconus, and high myopi using computational fluid dynamics coupled with three dimensional Scheimpflug imaging were performed. A personalized three-dimensional corneal model was constructed. After setting up the computational domain and boundary conditions, simulate and visualize the effects of the air puff from the ocular response analyzer on the cornea, recording the flow field structure and surface pressure distribution.

When the flow field was 5 ms, a relatively stable shear layer was not formed, and the airflow near the axis was obstructed, decelerated, and pressurized, forming an axial reverse pressure gradient. The airflow away from the axis rolled up and reached the wall at about 7 ms. When the flow field was 10 ms, the shear layer was still unstable, and the pressure waveform was formed and only existed for 7 ms~13 ms during the jet acceleration process. At a flow field of 15 ms, a relatively stable mixing layer was formed after 13 ms, and the pressure fluctuations within the mixing layer weaken and disappear. The jet′s injection effect on the surrounding flow was enhanced, and the pressure decreases. At a flow field of 20 ms, the jet dynamic pressure decreased, the stagnation pressure decreased, the absolute negative pressure outside the shear layer decreases, and the pressure gradient tended to flatten. Unstable shear layer pressure waves appeared in the 25 ms flow field, with pressure hysteresis near the corneal stagnation point. When the velocity of the healthy corneal jet reaches its peak, the radial flow of surface pressure exhibited typical subsonic shock jet flow characteristics. With the corneal center as the stationary point, all dynamic pressure was converted into static pressure, and the velocity stagnates to 0. When the pressure reacheed its peak, the fluid outside the stationary point then turned and flowed downstream along the surface of the detection piece. The maximum stationary pressure on the corneal surface occured between 15 ms and 16 ms. This characteristic was described by Navier-Stokes system of equations. The radial distribution curve of pressure on the surface of keratoconus was lower than that of healthy cornea near the stagnation point, and the pressure distribution curve decreased more slowly than that of healthy cornea. The absolute value of the slope was smaller. When more significant with the degree of disease, and the radial position where the surface pressure exceeded that of healthy cornea was further away. The radial distribution curve of corneal surface pressure in myopic eyes was higher than that of healthy cornea in a considerable ranged except for the corneal edge, and the decrease was slower before the radial dimensionless distance of 0.4.

The air puff reaches the apex of the cornea in approximately 7 ms. The changes in pressure over time and space for normal corneas, keratoconus corneas, and corneas with high myopia exhibit consistent patterns, differing only in numerical distribution. The pressure changes symmetrically around the apex, with a decrease in flow velocity and an increase in pressure near the stagnation point. There was a hysteresis phenomenon during the acceleration and deceleration processes of the jet, and the maximum pressure at the stagnation point closely coincides with the maximum jet velocity, with both time curves exhibiting similar shapes.

To explore the morphological characteristics of cup and plate structures in glaucoma patients and their differences from those in non glaucoma patients.

The 288 patients (288 eyes) who underwent fundus photography examination at the outpatient department of Beijing Tongren Hospital affiliated to Capital Medical University from November 2024 to September 2025 were collected and completed the nipple analysis system detection. Among them, there were 146 males (146 eyes) and 142 females (142 eyes) with an average age of (39.1±15.2) years (ranging from 10 to 71 years old). All patients underwent intraocular pressure, ocular biological measurements, fundus imaging examination, and analysis of the optic disc analysis system. Patients were divided into glaucoma group and non glaucoma group based on their history of glaucoma and clinical manifestations such as enlargement of the optic cup, loss of disc edge, typical atrophic changes in the optic nerve fiber layer, and visual field defects in fundus images. Age, axial length, disc edge area, and vertical width of the optic disc were tested to follow a normal distribution, represented by ±s. Independent sample t-test was used for inter group comparison. The intraocular pressure, central corneal thickness, anterior depth, lens thickness, average corneal curvature radius, pupil diameter, disc edge width in each region, disc edge to disc area ratio, disc edge volume, vertical cup to disc ratio, cup area, cup to disc area ratio, cup volume, average cup depth, maximum cup depth, disc area, disc volume, and likelihood of disc damage scores do not followed a normal distribution and were represented by M (Q1, Q3). Mann Whitney U test was used for inter group comparison.

Among the total 288 patients (288 eyes), there were 241 patients (241 eyes) in the non glaucoma group and 47 patients (47 eyes) in the glaucoma group, accounting for 83.7% and 16.3%, respectively. The intraocular pressure of patients in the non glaucoma group and glaucoma group was 16.7 (14.0, 19.0)mmHg (1 mmHg=0.133 kPa) and 21.9 (17.2, 25.3)mmHg, respectively. The non glaucoma group was lower than the glaucoma group, and the difference was statistically significant (Z=-5.49, P<0.05). The width, area, and ratio of optic disc area from point A to point F in the non glaucoma group were 0.18 (0.14, 0.21)mm, 0.20 (0.15, 0.25)mm, 0.22 (0.16, 0.29)mm, 0.24 (0.17, 0.33)mm, 0.25 (0.18, 0.33)mm, 0.22 (0.16, 0.27)mm, 0.15 (0.11, 0.18)mm, (1.23±0.36)mm^2, and 0.68 (0.54, 0.81)mm, respectively. The glaucoma group had 0.12 (0.09, 0.16)mm, 0.16 (0.09, 0.20)mm, and 0.16 (0.11, 0.24)mm, 0.19 (0.12, 0.24)mm, 0.16 (0.11, 0.24)mm, 0.13 (0.08, 0.20)mm, 0.10 (0.05, 0.14)mm, (0.94±0.34)mm^2, and 0.52 (0.38, 0.67)mm, respectively. Those were all larger in the non glaucoma group than in the glaucoma group, and the differences were statistically significant (Z/t=-4.70, -4.05, -3.33, -3.59, -4.37, -4.55, -4.18, 5.35, -4.32; P<0.05). The vertical cup to disc ratio, cup area, cup to disc area ratio, cup volume, average cup depth, and maximum cup depth in non glaucoma patients were 0.55 (0.44, 0.65), 0.58 (0.30, 1.11)mm^2, 0.32 (0.19, 0.46), 0.08 (0.02, 0.22)mm^3, 0.14 (0.08, 0.22)mm, 0.36 (0.23, 0.52)mm, 2.00 (2.00, 3.00), while the glaucoma patients were 0.69 (0.58, 0.81), 1.05 (0.52, 1.35)mm^2, 0.48 (0.33, 0.62), 0.16 (0.07, 0.33)mm^3, 0.18 (0.11, 0.26)mm, 0.43 (0.33, 0.60)mm, and 3.00 (3.00, 3.00)mm were all lower in the non glaucoma group than those in the glaucoma group, and the differences were statistically significant (Z=-4.47, -2.91, -4.32, -2.88, -2.17, -2.41, -6.36; P<0.05). 159 cases (159 eyes) of non glaucoma patients were distributed near temporal 0° or 360°, accounting for 65.98%; there were 53 cases (53 eyes) distributed near 300° below the temporal lobe and 60° above the temporal lobe, accounting for 21.99%; 29 cases (29 eyes) were distributed in other parts, accounting for 12.03%. 22 cases (22 eyes) of glaucoma patients were distributed near 300° below the temporal lobe and 40° above the temporal lobe, accounting for 46.81%; 25 cases (25 eyes) were distributed in other parts, accounting for 53.19%.

The narrowest part of the optic disc in patients with physiological large optic cups is mainly distributed near the temporal side at 0° or 360°, while in the glaucoma group, nearly half of the affected eyes are concentrated near 300° below and 40° above the temporal side, with scattered distribution in other areas. The rim of glaucoma affected eyes is narrower, with a smaller ratio of rim area to optic disc area. The vertical cup to disc ratio, cup to disc area ratio, cup to disc volume, and cup depth are larger.

The aim of this study is to identify factors influencing the short-term prognosis of patients with proliferative diabetic retinopathy (PDR) after pars plana vitrectomy (PPV) using Lasso-Logistic regression analysis and construct a predictive model.

A total of 179 PDR patients (179 eyes) who underwent PPV in the Ophthalmology Department of Linfen People′s Hospital from January 2021 to February 2024 were selected as the study subjects. There were 83 female (83 eyes) and 96 male (96 eyes) with a mean age of (64.3±8.3) years (ranging from 29 to 81 years). Based on the degree of visual acuity after surgery 6 months decline compared to preoperative levels, patients were divided into the poor prognosis group with 33 cases (33 eyes) and the favorable prognosis group with 146 cases (146 eyes). Data collected included gender, age, eye involved, diabetes duration, medical history, PDR stage, diabetes treatment type, preoperative best-corrected visual acuity (BCVA), disease severity, treatment modality, intraocular pressure (IOP), blood pressure, blood glucose, blood lipids, blood cells, liver and kidney biochemistry, and postoperative complications. The age, diabetes duration, preoperative BCVA, number of retinal laser photocoagulations, preoperative IOP, blood pressure, fasting blood glucose, glycated hemoglobin (HbA1c), four lipid items, complete blood count, liver and kidney function indices. Data conforming to a normal distribution were expressed as ±s and compared between groups using independent samples t-test. Skewed measurement data including the diabetes duration and urinary albumin were expressed as M(P₂₅, P₇₅) and compared between groups using the rank-sum test. The gender, eye involved, medical history, PDR stage, diabetes treatment type, macular detachment, iris neovascularization/rubeosis, vitreous hemorrhage, preretinal hemorrhage, anti-vascular endothelial growth factor (anti-VEGF) treatment, combined cataract surgery, vitreous cavity tamponade, postoperative complications were expressed as number and percentage, and compared between groups using Pearson′s or continuity-adjusted chi-square test. Univariate analysis and Lasso regression were used to screen factors affecting short-term poor prognosis after PPV in PDR patients. Independent influencing factors were identified using multivariate Logistic regression analysis, and a nomogram prediction model was constructed based on these factors. The Hosmer-Lemeshow test was used for goodness-of-fit; the C-index was used to analyze discriminative ability; the accuracy was analyzed using calibration curves; the clinical utility was analyzed using decision curve analysis, and predictive efficacy was analyzed using receiver operating characteristic (ROC) curve analysis.

In the poor prognosis group with 33 cases (33 eyes), the diabetes duration median and urinary albumin were 11.00 (9.00, 13.50) years and 42.37 (36.41, 48.46) mg/L, respectively; there were 13 with hyperlipidemia, 14 with coronary heart disease, 6 with hypertension, accounting for 39.39%, 42.42% and 18.18%, respectively; 6 cases (6 eyes) with PDR stage Ⅳ, 15 cases (15 eyes) with stage Ⅴ, 12 cases (12 eyes) with stage Ⅵ, accounting for 18.18%, 45.45% and 36.36%, respectively; 6 with oral medications of diabetes treatment type, 17 with insulin injections, 10 with insulin combined with oral medications, accounting for 18.18%, 51.52% and 30.30%, respectively; 14 with macular detachment, 4 with iris rubeosis, 31 with vitreous hemorrhage, 13 with preretinal hemorrhage, accounting for 42.42%, 12.12%, 93.94% and 39.39% respectively; 11 not used anti-VEGF treatment, 18 used preoperativly, 4 used intraoperativly, accounting for 33.33%, 54.55% and 12.12% respectively; 17 combined with cataract surgery, accounting for 51.52%; 2 with C3F8 for vitreous cavity tamponade, 27 with silicone oil, 4 with balanced saline solution, accounting for 6.06%, 81.82% and 12.12% respectively; 18 with postoperative complications accounting for 54.55%. In the good prognosis groups with 146 cases (146 eyes), the diabetes duration median were 9.00 (7.00, 11.00) years; urinary albumin 41.76 (37.10, 46.09) mg/L; 37 with hyperlipidemia, 42 with coronary heart disease, 27 with hypertension, accounting for 25.34%, 28.77% and 18.49% respectively; PDR stage: 44 cases (44 eyes) with Ⅳ stage, 85 cases (85 eyes) with Ⅴ stage, 17 cases (17 eyes) with Ⅵ stage, accounting for 30.14%, 58.22% and 11.64% respectively; diabetes treatment type: 37 used by oral medications, 70 used by insulin injections, 39 used by insulin combined with oral medications, accounting for 25.34%, 47.95% and 26.71% respectively; 16 with macular detachment, 3 with iris rubeosis, 127 with vitreous hemorrhage, 52 with preretinal hemorrhage, accounting for 10.96%, 2.05%, 86.99% and 35.62% respectively; 35 not used anti-VEGF treatment, 94 preoperative, 17 intraoperative, accounting for 23.97%, 64.38% and 11.65% respectively; 58 with combined cataract surgery, accounting for 39.73%; 38 with C3F8 after vitreous cavity tamponade, 90 with silicone oil, 18 with balanced saline solution, accounting for 90.41%, 61.64% and 12.33% respectively; 32 with postoperative complications, accounting for 21.92%. The mean preoperative BCVA, number of retinal laser spots, preoperative IOP, systolic blood pressure, diastolic blood pressure, fasting blood glucose, HbA1c, total cholesterol, triglycerides, high density lipoprotein, low density lipoprotein, neutrophil count, lymphocyte count, platelet count, white blood cell count, alanine aminotransferase, aspartate transaminase, glutamyl transpeptidase, serum creatinine were (1.97±0.60) logarithm of the minimum angle of resolution (logMAR), (652.06±381.20)spots, (19.12±4.30)mmHg (1 mmHg=0.133 kPa), (153.97±20.86)mmHg, (93.85±10.03)mmHg, (10.22±1.41)mmol/L, (7.71±1.72)%, (5.33±0.33)mmol/L, (1.84±0.39)mmol/L, (1.05±0.07)mmol/L, (3.20±0.54)mmol/L, (3.90±1.14) ×10⁹/L, (1.60±0.45) ×10⁹/L, (254.93±54.14) ×10⁹/L, (8.47±2.62) ×10⁹/L, (26.92±8.18)U/L, (24.34±8.70)U/L, (36.60±11.12)U/L, (123.39±16.96)μmol/L, respectively; while those of good prognosis group were (1.62±0.47) logMAR, (1055.26±433.68) spots, (17.40±5.08) mmHg, (149.12±20.14) mmHg, (89.84±11.11) mmHg, (9.71±1.35) mmol/L, (6.99±1.40)%, (5.20±0.51) mmol/L, (1.78±0.34) mmol/L, (1.06±0.13) mmol/L, (3.00±0.55) mmol/L, (3.72±1.26) ×10⁹/L, (1.76±0.59) ×10⁹/L, (254.40±69.00) ×10⁹/L, (8.33±2.49) ×10⁹/L, (24.80±8.82) U/L, (22.52±7.54) U/L, (33.36±10.23) U/L, (119.65±18.23) μmol/L, respectively. There was a statistically significant difference in diabetes duration(Z=-3.316, P<0.05); macular detachment, iris rubeosis, vitreous cavity tamponade, and postoperative complications (χ²=19.102, 4.827, 6.479, 14.234; P<0.05); preoperative BCVA, number of retinal laser spots, and HbA1c (t=3.667, 4.926, 2.573; P<0.05). Lasso regression identified five variables with non-zero features: PDR stage, preoperative BCVA, macular detachment, number of retinal lasers, and postoperative complications. Multivariate logistic regression analysis showed that PDR Ⅴ, Ⅵ stages, preoperative BCVA, macular detachment, and postoperative complications were independent risk factors for short-term poor prognosis in PDR patients after PPV (OR=3.630, 10.296, 3.082, 3.806, 2.920; 95%CI: 1.088 to 12.110, 2.630 to 40.303, 1.074 to 8.845, 1.260 to 11.499, 1.075 to 7.930; P<0.05), while the number of retinal lasers was an independent protective factor (OR=0.784, 95%CI: 0.685~0.897; P<0.05). A column chart prediction model was constructed based on independent influencing factors of short-term poor prognosis in PDR patients undergoing PPV Logit (P)=-3.233+ 1.289×PDR stage Ⅴ+ 2.332×PDR stage Ⅵ+ 1.125×preoperative BCVA+ 1.337×macular detachment -0.002×number of retinal lasers+ 1.071×postoperative complications. The prediction model was well, and C index of 0.885 (95%CI: 0.876 to 0.895, P>0.05). The predicted probability of the column chart prediction model after the calibration curve and decision curve was close to the ideal curve, and the net profit range was relatively large. ROC curve analysis showed that the area under the curve of the line chart prediction model for predicting short-term poor prognosis in PDR patients after PPV was 0.885 (95%CI: 0.828 to 0.927), with a sensitivity of 84.85%, specificity of 78.77%, and a Youden index of 0.6362.

PDR staging, preoperative BCVA, macular detachment, number of retinal lasers, and postoperative complications are independent factors affecting the short-term poor prognosis of PDR patients after PPV. The column chart prediction model constructed based on these factors has high predictive efficiency for the short-term poor prognosis of PDR patients after PPV.

The aim of this study is to investigate the influencing factors in the treatment of retinal vein occlusion (RVO) complicated with macular edema.

A total of 30 patients (32 eyes) diagnosed with RVO complicated with macular edema in the Department of Ophthalmology, the Fourth Affiliated Hospital of Anhui Medical University from October 2023 to March 2025 received anti-vascular endothelial growth factor (anti-VEGF) treatment for 3 months, were selected as the research subjects. There were 20 males (21 eyes) and 10 females (11 eyes) with an average age of (58.2±11.4) years (ranging from 35 to 85 years) of the 30 patients (32 eyes). Swept-source optical coherence tomography angiography (SS-OCTA) was used to measure choroidal thickness (CT), choroidal vascular index (CVI), and choroidal capillary layer vessel density (CCVD) before and after treatment. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT), CT, CVI, and CCVD before treatment, after treatment for 1 month and 3 months conformed to a normal distribution and were expressed as ±s. Comparisons among different time points were performed using ANOVA, and pairwise comparisons were conducted using LSD method. Univariate linear regression analysis and multivariate linear regression analysis was performed with changes in BCVA and CMT as dependent variables and basic data as independent variables.

There were 18 patients (20 eyes) with hypertension, and 12 patients (12 eyes) with no hypertension, accouting for 62.50% and 37.50%, respectively. The BCVA of patients before treatment, after treatment for 1 month and 3 months after treatment was (0.813±0.456) logarithmus of the minimal angle of resolution (logMAR), (0.666±0.386) logMAR, and (0.484±0.401) logMAR, respectively; the IOP was (16.219±2.366)mmHg (1 mmHg=0.133 kPa), (15.969±1.732)mmHg, and (16.500±2.514)mmHg, respectively; the CMT was (474.625±191.370)μm, (397.094±155.446)μm, and (360.219±173.240)μm, respectively; the CT was (244.813±86.086)μm, (234.563±86.853)μm, and (229.063±88.710)μm, respectively; the CVI was (39.938±4.683)%, (39.375±5.552)%, and (39.625±5.950)%, respectively; the CCVD was (46.188±3.788)%, (46.813±2.361)%, and (47.125±1.755)%, respectively. Comparisons of BCVA, CMT, and CT among different time points showed statistically significant differences (F=34.556, 14.373, 11.955; P<0.05), while no statistically significant differences were observed in IOP, CVI, and CCVD (F=0.959, 0.979, 1.610; P> 0.05). Further pairwise comparisons revealed that after treatment for 1 month, BCVA, CMT, and CT of patients showed statistically significant differences compared with those before treatment (t= 4.027, 3.645, 3.452; P<0.05), whereas IOP, CVI, and CCVD exhibited no statistically significant differences (t=0.701, 1.605, -1.177; P> 0.05). After treatment for 3 months, BCVA, CMT, and CT were significantly different from those before treatment (t= 6.837, 3.990, 3.549; P<0.05), while no significant differences were found in IOP, CVI, and CCVD (t= -0.722, 0.583, -1.368; P> 0.05). After treatment for 3 months, the BCVA of all patients increased by 0.329 logMAR compared with that before treatment, and the CMT decreased by 24.1% relative to the pre-treatment level. Univariate linear regression analysis indicated that hypertension, pre-treatment CMT, and pre-treatment CCVD were influencing factors for the change in BCVA after anti-VEGF treatment for 3 months (β= 0.328, -0.001, 0.027; 95% confidence interval (CI): 0.173 to 0.484, -0.001 to 0.000, 0.003 to 0.050; P<0.05); hypertension, pre-treatment BCVA, and pre-treatment CCVD were influencing factors for the change in CMT after treatment for 3 months (β= -0.226, 0.235, -0.036; 95%CI: -0.359 to -0.092, 0.095 to 0.376, -0.053 to -0.019; P<0.05). Multivariate linear regression analysis showed that hypertension was an independent risk factor for the change in BCVA after anti-VEGF treatment in RVO patients (β= 0.269, 95%CI: 0.102 to 0.436; P<0.05); pre-treatment BCVA and pre-treatment CCVD were influencing factors for the change in CMT after treatment (β=0.155, -0.024; 95%CI: 0.029 to 0.280, -0.043 to -0.006; P<0.05).

Hypertension is an independent risk factor for the change in BCVA after anti-VEGF treatment in RVO patients. Pre-treatment BCVA is an independent protective factor for the change in CMT, and pre-treatment CCVD is an independent risk factor for the change in CMT.

Early screening for Marfan syndrome (MFS) is crucial in reducing related mortality rates. The current clinical diagnosis of MFS is mainly based on the Ghent criteria revised in 2010, with core features of lens ectopia (EL) and aortic root dilation. Modern ophthalmic imaging technology can help discover deep biomarker spectra beyond EL in MFS, such as axial elongation and reduced total corneal refractive power; the corneal curvature value decreases, the central corneal thickness becomes thinner, and the corneal hardness increases; thinning of the ciliary body, decreased thickness of the sclera, and increased asymmetry; decreased retinal microvascular density, thinning of retinal nerve fiber layer, and increased risk of retinal detachment; changes in choroidal structure and function abnormalities, as well as facial features. The ophthalmic imaging omics model based on artificial intelligence integrates multimodal imaging data such as eye images and biometric measurements to construct high-precision prediction tools, could significantly improve sensitivity and accuracy in MFS screening. This strategy not only facilitates early screening of MFS, but also enables dynamic monitoring of disease progression, assists in guiding personalized interventions for cardiovascular disease, and ultimately optimizes patient lifecycle management.