Assessment of the impact of resting heart rate on the risk of major adverse cardiovascular events after ischemic stroke: a retrospective observational study.

BACKGROUND: Although elevated heart rate is a risk factor for cardiovascular morbidity and mortality in healthy people, the association between resting heart rate and major cardiovascular risk in patients after acute ischemic stroke remains debated. This study evaluated the association between heart rate and major adverse cardiovascular events after ischemic stroke. METHODS: We conducted a retrospective cohort study analyzing data from the Chang Gung Research Database for 21,655 patients with recent ischemic stroke enrolled between January 1, 2010, and September 30, 2018. Initial in-hospital heart rates were averaged and categorized into 10-beats per minute (bpm) increments. The primary outcome was the composite of hospitalization for recurrent ischemic stroke, myocardial infarction, or all-cause mortality. Secondary outcomes were hospitalization for recurrent ischemic stroke, myocardial infarction, and heart failure. Hazard ratios and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, using the heart rate < 60 bpm subgroup as the reference. RESULTS: After a median follow-up of 3.2 years, the adjusted hazard ratios for the primary outcome were 1.13 (95% CI: 1.01 to 1.26) for heart rate 60-69 bpm, 1.35 (95% CI: 1.22 to 1.50) for heart rate 70-79 bpm, 1.64 (95% CI: 1.47 to 1.83) for heart rate 80-89 bpm, and 2.08 (95% CI: 1.85 to 2.34) for heart rate ≥ 90 bpm compared with the reference group. Heart rate ≥ 70 bpm was associated with increased risk of all secondary outcomes compared with the reference group except heart failure.  CONCLUSIONS: Heart rate is a simple measurement with important prognostic implications. In patients with ischemic stroke, initial in-hospital heart rate was associated with major adverse cardiovascular events.

Three novel species of Aquapteridospora (Distoseptisporales, Aquapteridosporaceae) from freshwater habitats in Tibetan Plateau, China.

During an investigation of lignicolous freshwater fungi in the Tibetan Plateau, three Aquapteridospora taxa were collected from freshwater habitats in Xizang, China. The new species possess polyblastic, sympodial, denticles conidiogenous cells and fusiform, septate, with or without sheath conidial, that fit within the generic concept of Aquapteridospora, and multi-gene phylogeny placed these species within Aquapteridospora. Detailed morphological observations clearly demarcate three of these from extant species and are hence described as new taxa. The multi-gene phylogeny of the combined LSU, TEF1-α, and ITS sequence data to infer phylogenetic relationships and discuss phylogenetic affinities with morphologically similar species. Based on morphological characteristics and phylogenetic analyses, three new species viz. A.linzhiensis, A.yadongensis, and A.submersa are introduced. Details of asexual morphs are described, and justifications for establishing these new species are also provided in this study.

Current status and prospects of postoperative adjuvant therapy for hepatocellular carcinoma / 中华消化外科杂志

The high recurrence and metastasis rate of hepatocellular carcinoma (HCC) in patients after hepatectomy significantly impact the prognosis. Exploring effective strategies and indications of postoperative adjuvant therapy for HCC is of great clinical significance in reducing postoperative recurrence rate and improving long-term survival. Traditional local treatment modalities, including transcatheter arterial chemoembolization, hepatic artery infusion chemotherapy, and radiotherapy, continue to play a crucial role in postoperative adjuvant therapy. Recently, the emergence of novel systemic therapy agents, including molecular targeted drugs and immune checkpoint inhibitors, has transformed the landscape of postoperative adjuvant therapy, making the selection of adjuvant therapy more intricate and diverse. The author combines the latest progress in adjuvant therapy to explore the strategies and challenges of postoperative adjuvant therapy for HCC.

Development and clinical application of automatic recording system for resection of soft tissue tumor based on dense video descriptions / 中华创伤骨科杂志

Objective:To explore the feasibility and application value of an automated method for generation of surgical records for resection of benign soft tissue tumor based on dense video descriptions.Methods:The Transformer deep learning model was used to establish an automated surgical record generation system to analyze the surgical videos of 30 patients with benign soft tissue tumor who had been admitted to Department of Orthopedics, Xijing Hospital, Air Force Military Medical University from September 2021 to August 2023. The patient data were randomly divided into training sets, validation sets, and test sets in a ratio of 8∶1∶1. In the test sets, 7 evaluation indexes, BLEU-1, BLEU-2, BLEU-3, BLEU-4, Meteor, Rouge, and CIDEr, were used to evaluate the text quality of surgical records generated by the model. The text of surgical records was compared with the classical algorithm, dense video captioning with paralled decoding (PDVC) in the field of video-intensive description.Results:The automated surgical record generation system running in the test sets showed the following: BLEU-1, BLEU-2, BLEU-3, BLEU-4, Rouge, Meteor, and CIDEr were 16.80, 15.23, 13.01, 11.68, 16.01, 12.67 and 62.30, respectively. The operation of the classical algorithm PDVC showed the following: BLEU-1, BLEU-2, BLEU-3, BLEU-4, Rouge, Meteor, and CIDEr were 15.63, 14.17, 11.90, 10.45, 12.97, 11.99 and 53.64, respectively. The automated surgical record generation system resulted in significant improvements compared with PDVC in all evaluation indexes. The BLEU-4, Rouge, Meteor, and CIDEr were improved by 1.23, 3.04, 0.68 and 8.66, respectively, demonstrating that the system proposed can better capture the key data in the video to help generate more effective text records.Conclusion:As the automated surgical record generation system shows good performance in generating surgical records for resection of benign soft tissue tumor based on intensive video descriptions, it can be applied in clinical practice.

Treatment of polyethylene sleeve wear in rotating hinge knee joint with femoral component revision surgery / 中华骨科杂志

Objective:To investigate the clinical efficacy of femoral component revision surgery in addressing polyethylene sleeve wear in rotating hinge knee joints.Methods:A retrospective analysis was conducted on 21 patients who underwent treatment for polyethylene sleeve wear in rotating hinge knee joints at the Department of Orthopaedics, the Fourth Medical Center, PLA General Hospital, spanning from August 2008 to April 2023. There were 8 males and 13 females with a median age of 63(38, 76) years. Among them, 11 cases involved the left side, and 10 cases involved the right side. The average body mass index (BMI) was 25.0(22.5, 31.0) kg/m 2, and all cases underwent unilateral knee joint revision. The time interval from receiving the hinge knee joint prosthesis to revision was 10.5(6.0, 17.0) years, with 18 cases undergoing primary revision and 3 cases undergoing revision for the second time. Revision surgery of the femoral component sleeve was performed in all patients due to polyethylene sleeve wear. Visual analogue scale (VAS), range of motion (ROM) of the knee joint, changes in hip-knee-ankle angle (HKA), and Knee Society score (KSS) were collected and recorded to assess the surgical outcomes. Results:All patients were followed up for a median duration of 12.5(11.7, 13.4) months. Preoperatively, the VAS score was 5(3, 7) points, which significantly decreased to 0(0, 1) points at the last follow-up ( Z=5.721, P<0.001). At the last follow-up, the KSS scores decreased from 41.19±13.65 points preoperatively to 79.81±7.80 points, indicating a statistically significant difference ( t=12.560, P<0.001). HKA increased from 174.65°±5.20° preoperatively to 178.71°±2.79°, with a statistically significant difference ( t=5.533, P<0.001). Knee joint ROM increased from 69.05°±34.37° preoperatively to 110.00°±10.12°, also demonstrating a significant improvement ( t=5.960, P<0.001). Notably, patients exhibited knee joint stability with no passive flexion or extension laxity. Conclusion:Femoral component sleeve revision surgery effectively addresses polyethylene sleeve wear in rotating hinge knee joint prostheses, thereby mitigating the substantial loss of bone and soft tissue associated with overall revision procedures. The early postoperative clinical outcomes are promising and indicative of the efficacy of this surgical intervention.

Totally arterialized minimally invasive coronary artery bypass grafting under the guidance of coronary artery function: A case report / 中国胸心血管外科临床杂志

@#We reported a 59-year-old male with exertional angina pectoris, and the coronary angiography showed multiple vessel lesions. The initial strategy was coronary artery bypass grafting (CABG). The measurement of quantitative flow ration (QFR) before operation indicated that the posterior descending branch (PD) did not need to be treated. The left circumflex branch (LCX) was small, and the QFR of the left anterior descending branch (LAD) and the first diagonal branch (D1) was<0.8. Therefore, the LAD and D1 were re-vascularized. The operation strategy was changed to on-pump CABG through a small incision, and the final strategy was LIMA-D1-LAD (sequential), fractional flow reserve (FFR) of distal LAD and D1 after CABG were>0.8 by computed tomography FFR. SYNTAX scores after CABG were 20 and the functional SYNTAX scores after CABG were 3, indicating a good prognosis.

A network pharmacology-based approach to explore mechanism of kaempferol-7 -O -neohesperidoside against prostate cancer / 中国药理学通报

Aim To explore the effect of kaempferol-7- 0-neohesperidoside (K70N) against prostate cancer (PCa) and the underlying mechanism. Methods The effect of K70N on the proliferation of PCa cell lines PC3, DU145, C4-2 and LNCaP was detected using CCK8 assay. The effect of K70N on migration ability of DU145 cells was determined by wound healing assay. The targets of K70N and PCa were screened from SuperPred and other databases. The common targets both related to K70N and PCa were obtained from the Venny online platform, a protein-protein interaction network (PPI) was constructed by the String and Cyto- scape. Meanwhile, the GO and KEGG functional enrichment were analyzed by David database. Then, a "drug-target-disease-pathway" network model was constructed. Cell cycle of PCa cells treated with K70N was analyzed by flow cytometry. The expressions of cycle-associated proteins including Skp2, p27 and p21 protein were detected by Western blot. Molecular docking between Skp2 and K70N was conducted by Sybyl X2. 0. Results K70N significantly inhibited the proliferation and migration of PCa cells. A total number of 34 drug-disease intersection targets were screened. The String results showed that Skp2 and p27, among the common targets, were the key targets of K70N for PCa treatment. Furthermore, GO and KEGG functional en-richment indicated that the mechanism was mainly related to the cell cycle. Flow cytometry showed that K70N treatment induced cell cycle arrest at the S phase. Compared with the control group, the protein expression level of Skp2 was significantly down-regulated, while the protein expression levels of p27 and p21 were up-regulated. The network molecular docking indicated that the ligand K70N had a good binding ability with the receptor Skp2. Conclusions K70N could inhibit the proliferation and migration of PCa cells, block the cell cycle in the S phase, which may be related to the regulation of cell cycle through the Skp2- p27/p21 signaling pathway.

The neuroprotective effects of Haikun Shenxi capsule medicated serum on N2a/APP695 cells based on PINKl-Parkin mitophagy pathway / 中国药理学通报

Aim To research the neuroprotective effect of Haikun Shenxi (HKSX) medicated serum on N2a/ App695 cells and the underlying mechanism. Methods HKSX medicated serum was prepared and carbohydrate components in it was analyzed using high performance thin layer chromatography (HPTLC) . N2a/ App695 cells were intervened with HKSX medicated serum, the cytotoxicity of HKSX medicated serum was measured by MTT; AP[_

Investigating the prognostic and predictive value of the type II cystatin genes in gastric cancer.

BACKGROUND: Accumulating evidence indicates that type II cystatin (CST) genes play a pivotal role in several tumor pathological processes, thereby affecting all stages of tumorigenesis and tumor development. However, the prognostic and predictive value of type II CST genes in GC has not yet been investigated. METHODS: The present study evaluated the expression and prognostic value of type II CST genes in GC by using The Cancer Genome Atlas (TCGA) database and the Kaplan-Meier plotter (KM plotter) online database. The type II CST genes related to the prognosis of GC were then screened out. We then validated the expression and prognostic value of these genes by immunohistochemistry. We also used Database for Annotation, Visualization, and Integrated Discovery (DAVID), Gene Multiple Association Network Integration Algorithm (GeneMANIA), Search Tool for the Retrieval of Interacting Genes/Proteins (STRING), nomogram, genome-wide co-expression analysis, and other bioinformatics tools to analyze the value of type II CST genes in GC and the underlying mechanism. RESULTS: The data from the TCGA database and the KM plotter online database showed that high expression of CST2 and CST4 was associated with the overall survival (OS) of patients with GC. The immunohistochemical expression analysis showed that patients with high expression of CST4 in GC tissues have a shorter OS than those with low expression of CST4 (HR = 1.85,95%CI: 1.13-3.03, P = 0.015). Multivariate Cox regression analysis confirmed that the high expression level of CST4 was an independent prognostic risk factor for OS. CONCLUSIONS: Our findings suggest that CST4 could serve as a tumor marker that affects the prognosis of GC and could be considered as a potential therapeutic target for GC.

Determination of bone marrow cell morphology in rat.

The skeletal system of the body is responsible for important functions in the human body. In addition to causing movement, this system also plays a role in the production of blood cells and fat storage. Bone marrow is a spongy or viscous tissue that fills the inside of the body's bones. The basic structure of bone marrow is of two types. Red bone marrow and yellow bone marrow. Red bone marrow contains blood stem cells that can become red blood cells, white blood cells, or platelets. Yellow bone marrow is made mostly of fat and contains stem cells that can turn into cartilage, fat, or bone cells. Human bone marrow mesenchymal stem cells (HBMSCs) are widely used cell sources for clinical bone regeneration. Achieving a therapeutic effect depends on the osteogenic differentiation potential of the stem cells. The purpose of judging the morphology of bone marrow cells is to diagnose leukemia or bone marrow disorders, determine the cause of severe anemia or thrombocytopenia and low platelet count, identify abnormal chromosomes to prevent hereditary diseases, and plan their treatment. In this study, we examined the morphological characteristics of bone marrow cells, mesenchyme cells, and osteoblasts in a laboratory environment. The results of the morphological investigations showed changes such as the change of the position of the nucleus and the rounding of the cytoplasm in the differentiated cells compared to the mesenchyme cells. Therefore, to identify and diagnose as many of these cells as possible, molecular genetic techniques such as network algorithms and fluorescence staining can be used for hematological and cytomorphological investigations.

Functional implications of rs9373441 with FOXP3+Treg and Tr1 for the clinical effectiveness of csDMARDs in rheumatoid arthritis.

Rheumatoid arthritis (RA) is characterized by a deficiency in regulatory T cells (Treg), which play a crucial role in immune regulation. While conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) are widely used, there remains a challenge as efficacy varies among patients. In this genome-wide association study (GWAS) involving 410 RA patients, rs9373441 emerged as the most significantly linked single-nucleotide polymorphism (SNP) to csDMARDs response. This non-coding variant functions as a cis-acting regulatory element within the UTRN gene, which is associated with cortical erosion and osteoporosis. Particularly, individuals with the TT allele at rs9373441 exhibited a more favorable response, characterized by a significant increase in FOXP3 + Treg and Type 1 regulatory T cells (Tr1) (p = 0.04, 0.02) and a decrease in Effector T helper cells (Effector Th) (p = 0.03). The GATA3-GCM2-PTH and GATA3-FOXO1-FOXP3 pathways were implicated. RNA-sequencing (RNA-seq) analysis revealed increased expression levels of UTRN, PTH2R, FOXO1, and FOXO3 in good and moderate responders (p = 0.01, 0.03, 0.0005, and 0.02). Notably, the change in FOXP3 + Treg and Tr1 was positively correlated with UTRN expression (both p = 0.03). These findings underscore the critical link between rs9373441 and the response to csDMARDs, empowering clinicians to tailor treatments for enhanced outcomes in patients with RA.

[Effect of collagen sponge on the healing process of alveolar fossa after tooth extraction in rats].

PURPOSE: To investigate the effect of collagen sponge on early bone healing process of alveolar fossa after tooth extraction in rats. METHODS: A total of 16 healthy female SD rats were selected. Animal models with tooth extraction were established. The right alveolar fossa inserted with collagen sponge was as the experimental group, and the left alveolar fossa was as the control group with treatment. The rats were sacrificed 1, 2, 4 and 8 weeks after tooth extraction, and the osteogenesis of alveolar fossa was observed. Real-time quantitative PCR (qt-PCR) was used to detect the changes of osteogenesis related gene expression. SPSS 19.0 software package was used for statistical analysis. RESULTS: After surgery, alveolar cavity healing was significantly better in the experimental group than in the control group. Osterix, Runx2 and Vegf genes were expressed in the experimental group and the control group, and the expression levels of related genes in the experimental group were significantly higher than the control group 1, 2, 4 and 8 weeks after surgery(P＜0.05). CONCLUSIONS: Collagen sponge could promote early alveolar bone healing, possibly related to the expression level of osteogenic genes regulated by collagen sponge.

Stratifin Promotes Hepatocellular Carcinoma Progression by Modulating the Wnt/ß-Catenin Pathway.

Abnormal stratifin (SFN) expression is closely related to the progression of several human cancers, but the potential roles of SFN in hepatocellular carcinoma (HCC) remain largely unknown. In this study, we found that SFN was upregulated in HCC cell lines and tissues and was positively associated with tumor size, poor differentiation, Tumor Node Metastasis (TNM) stage, and vascular invasion. In addition, high expression levels of SFN were associated with poor overall survival and disease-free survival. Biologically, downregulation of SFN suppressed tumor cell proliferation, epithelial-mesenchymal transition (EMT), invasion, and migration in vitro and tumor growth in vivo. However, overexpression of SFN promoted cell proliferation, EMT, invasion, and migration in vitro and tumor growth in vivo. Mechanistically, overexpression of SFN activated the Wnt/ß-catenin pathway by promoting Glycogen synthase kinase-3 beta (GSK-3ß) phosphorylation, decreasing ß-catenin phosphorylation, promoting ß-catenin transport into the nucleus, and enhancing the expression of c-Myc, whereas depletion of SFN inhibited the Wnt/ß-catenin pathway. In addition, TOPFlash/FOPFlash reporter assays showed that overexpression or downregulation of SFN obviously increased or decreased, respectively, the activity of the Wnt/ß-catenin pathway. Our results indicated that SFN plays an important role in HCC, possibly providing a prognostic factor and therapeutic target for HCC.

High shear stress attenuated arterial neointimal hyperplasia accompanied by changes in yes-associated protein/jun N-terminal kinase/vascular cell adhesion protein 1 expression.

BACKGROUND AND OBJECTIVES: Abnormal neointimal hyperplasia (NIH) is known as the predominant mechanism in the pathogenesis of arterial restenosis after balloon angioplasty. Low shear stress (SS) is known to augment balloon injury-induced NIH. The aim of this study is to study the effect and mechanisms of an increase of shear stress caused by arteriovenous fistula could alleviate arterial NIH caused by balloon injury. METHODS AND RESULTS: Eighteen male rabbits were randomly divided into three groups: BI-the rabbits received a balloon injury to right common carotid artery (CCA). BI+AVF-the rabbits received a balloon injury to right CCA and a carotid-jugular AVF. Control-the animals received no surgery. After 21 days, CCA samples were harvested for histological staining, immunohistochemistry, and western blot analysis. The luminal shear stress of the BI+AVF group increased from 13.8 ± 1.0 dyn/cm2 before surgery to 30.9 ± 1.7 dyn/cm2 right after surgery (p < 0.01). This value was higher than that of the BI or Control groups at any timepoint. The neointimal area and neointima/media area ratio in the BI+AVF group were significantly lower than those in the BI group. In the BI group, the cellular proliferation, the protein levels of yes-associated protein (YAP), connective tissue growth factor (CTGF), phospho-c-Jun N-terminal kinase (pJNK), and vascular cell adhesion protein 1 (VCAM1) increased, whereas the protein levels of SMCs specific genes decreased. In the BI+AVF group, the opposite effect was observed as cellular proliferation and the protein levels of YAP, CTGF, pJNK, and VCAM1 decreased, the protein levels of SMCs specific genes increased. CONCLUSION: The arteriovenous fistula alleviated the balloon injury-induced arterial NIH. It elevated the luminal shear stress and inhibited SMCs phenotypic modulation to the synthetic state, as well as suppressing the over-activation of YAP, JNK, and VCAM1.

Research progress and considerations on non-clinical studies of the drugs administered through the ocular vitreous body / 药学学报

In recent years, with the development of ophthalmic therapeutic drugs, the vitreous body, as a channel for the treatment of ophthalmic diseases, especially fundus diseases, has opened up a new therapeutic approach for various choroidal neovascular diseases, macular edema, uveitis and other diseases associated with fundus diseases, which is represented by wet age-related macular degeneration (wAMD). The drugs administered through the vitreous body mainly include ocular anti-vascular endothelial growth factor (VEGF) injections, microplasmin and hormones. For this kind of ophthalmic products, there are no clear technical guidelines and norms for non-clinical research at home and abroad. This article combines review practices and cases of marketed products to sort out the research progress and considerations on non-clinical studies of ophthalmic drugs dosing through the ocular vitreous body, in order to provide references for the research and evaluation of such drugs.

Impact of diagnosis-related groups point payment on hospitalization costs of parturition among lying-in women / 预防医学

Objective@#To examine the effect of diagnosis-related groups (DRGs) point payment on hospitalization costs of parturition among lying-in women, so as to provide the evidence for alleviating the burdens and saving medical resources among lying-in women.@*Methods@#Lying-in women's age, gestational age, parity, duration of hospital stay, DRGs grouping and hospitalization costs were collected from the Inpatient Medical Record System and DRG Operation Analysis System in a tertiary women and children's hospital in Ningbo City from 2020 to 2021. The changes of hospitalization costs of parturition were compared among lying-in women before and after DRGs point payments, and the association between DRGs point payments and gross hospitalization costs of parturition was examined among lying-in women using a multivariable logistic regression analysis.@*Results@# A total of 11 505 lying-in women after DRGs point payments, including 6 216 women at age of 30 years and below (54.03%), and 10 871 lying-in women before DRGs point payments, including 6 208 women at age of 30 years and below (57.11%), were enrolled. The median (interquartile range) gross hospitalization expenses, material expenses and laboratory testing expenses of parturition were 8 519.19 (2 456.61), 881.38 (816.16) and 939.00 (310.00) Yuan among lying-in women after DRGs point payments, which were significantly lower than those [9 123.13 (2 660.33), 915.57 (825.26), 1 036.00 (385.00) Yuan] among lying-in women before DRGs point payments (Z=-21.971,-16.061 and -27.199, all P<0.001). Multivariable logistic regression analysis showed that DRGs point payment was statistically associated with lower gross hospitalization expenses of parturition among lying-in women after adjustment for age, duration of hospital stay, gestational age, parity, type of delivery and development of complications (OR=0.462, 95%CI: 0.432-0.494).@*Conclusion@#DRGs point payment is beneficial to reduce the hospitalization cost of parturition among lying-in women.

Analysis of clinical, imaging and gene mutations in 2 pedigrees with hereditary spastic paraplegia type 7 / 中华神经科杂志

Objective:To analyze the clinical, imaging and genetic characteristics of 2 pedigrees with hereditary spastic paraplegia type 7 (SPG7).Methods:The clinical data of the probands and related members of 2 families hospitalized in the Department of Neurology of Henan Provincial People′s Hospital from December 2018 to December 2021 were collected. The probands and all family members were subjected to cranial MRI imaging and genetic testing, and the clinical characteristics and genetic variation of SPG7 families were compared with those reported in the literature.Results:Four patients from the 2 families were observed with adult-onset age in this group. The main manifestations were wide-base ataxic gait in 4 cases, and spastic gait in 1 case during follow-up. Pyramidal tract involvement mainly in the lower limbs were found in all cases, and dysarthria in 3 cases. MRI of 3 patients showed varying degrees of cerebellar atrophy. Genetic testing revealed compound heterozygous or homozygous variants of the SPG7 gene in the 4 patients, of which c.2062C>T and c.2176C>T were novel mutations. At present, only 5 SPG7 families have been reported in China. Among the 12 patients in all groups, 12 cases of pyramidal tract involvement, 10 cases of cerebellar ataxia, 7 cases of dysarticulation, 3 cases of cognitive impairment, 11 cases of complex hereditary spastic paraplegia, 1 case of simple hereditary spastic paraplegia, and 9 cases of cerebellar atrophy were reported. Six novel mutations have been reported in 5 families. Conclusions:SPG7 family is rarely reported in China, mainly manifested as pyramidal tract involvement combined with cerebellar ataxia, accompanied by cerebellar atrophy. SPG7 mutation is confirmed by genetic detection, and there are many novel mutations in SPG7 family in China.

Analysis of the clinical, pathological and genetic features of patients with myopathy-type very long chain acyl-coenzyme A dehydrogenase deficiency / 中华神经科杂志

Objective:To investigate the clinical, pathological and genetic characteristics of myopathy-type very long chain acyl-coenzyme A dehydrogenase deficiency (VLCADD).Methods:The detailed clinical data, muscle biopsy pathology and molecular results of 4 patients with genetically confirmed myopathy-type VLCADD admitted to Henan Provincial People′s Hospital and Xuanwu Hospital, Capital Medical University from June 2014 to November 2019 were retrospectively analyzed.Results:All of the 4 patients were late-onset myopathy-type VLCADD. The onset age ranged from 13 to 16 years, with a mean age of 14.5 years. The age at diagnosis ranged from 21 to 54 years, with a mean age of 42.5 years. The main clinical manifestation was repeated rhabdomyolysis, including myalgia, weakness and dark urine. Obvious somnolence was observerd in 1 patient. Muscle biopsy pathology revealed mild lipid accumulation, without vacuoles. Six ACADVL variations were detected in the 4 patients, including c.1283G>A (p.R428H), c.1532G>A (p.R511Q), c.833_835delAGA (p.K278del), c.1843C>T (p.R615 *), c.1748C>T (p.S583L) and c.1391C>T (p.T464I),among which c.1391C>T (p.T464I) was a novel variation, predicted to be likely pathogenic. Other 5 variations were reported pathogenic variations. Conclusions:Myopathy-type VLCADD is characterized by paroxysmal rhabdomyolysis and can be associated with somnolence. There is no specificity in muscle pathology. There are ACADVL variations, among which c.1391C>T is a novel variation.

Short-term visual quality observation of femtosecond laser small incision lenticule extraction and evolution implantable collamer lens implantation in the correction of moderate myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the short-term visual quality outcomes after femtosecond laser small incision lenticule extraction(SMILE)and evolution implantable collamer lens(EVO-ICL)implantation for the correction of moderate myopia.METHODS: Prospective control study. A total of 51 cases(51 eyes)with moderate myopia who underwent SMILE or EVO-ICL implantation surgery at Weifang Eye Hospital from April 2021 to February 2022 were selected. They were divided into SMILE group(30 patients, 30 eyes)and EVO-ICL group(21 patients, 21 eyes)according to the surgical methods. The changes of visual acuity [uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA)], diopter [spherical equivalent(SE)] and related parameters of optical quality analysis system(OQAS Ⅱ)were observed before surgery and at 1wk, 1 and 3mo after surgery, and the quality of vision(QoV)questionnaire was completed.RESULTS: At 3mo after surgery, the safety index(postoperative CDVA/preoperative CDVA)of SMILE gruop and EVO-ICL group were 1.20(1.00, 1.20)and 1.20(1.00, 1.38), respectively, the efficacy index(postoperative UDVA/preoperative CDVA)were 1.00(1.00, 1.20)and 1.00(1.00, 1.20), respectively, and the percentage of SE within ±0.50D was 87% and 100%, respectively. In SMILE group, the objective scattering index(OSI)was increased after surgery, while modulation transfer function cutoff frequency(MTF cutoff), contrast visual acuity(VA)100%, and VA20% at 1wk and 1mo after surgery, and Strehl ratio(SR)and VA9% at each time point after surgery were all decreased compared with those before surgery(all P&#x0026;#x003C;0.05). The OSI, MTF cutoff, SR and VA of EVO-ICL group showed no difference at each time point after surgery compared with those before surgery(all P&#x0026;#x003E;0.05). The most common visual symptoms after SMILE and EVO-ICL implantation were visual haze and halos, respectively.CONCLUSION: Both SMILE and EVO-ICL implantation have good safety, efficacy and predictability in the short term after the correction of moderate myopia. Both groups had visual symptoms after surgery, but the overall satisfaction of patients was high. Furthermore, EVO-ICL implantation has better objective visual quality performance.

Visual quality observation of transepithelial photorefractive keratectomy and femtosecond small incision lenticule extraction for the correction of low myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the changes in corneal aberrations and the characteristics of visual quality after transepithelial photorefractive keratectomy(T-PRK)and femtosecond small incision lenticule extraction(SMILE)in the correction of low myopia.METHODS: Prospective cohort study. A total of 32 cases(32 eyes)with low myopia who underwent T-PRK surgery and 45 cases(45 eyes)of SMILE surgery at Weifang Eye Hospital from April 2021 to April 2022 were selected. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), spherical equivalent(SE), corneal higher-order aberrations(HOAs)and objective visual quality were compared between the two groups.RESULTS:All patients completed the surgery successfully without complications such as infection. At 3mo postoperatively, the safety index was 1.13±0.16 and 1.16±0.17(P=0.48)and the efficacy index was 1.10±0.20 and 1.15±0.18(P=0.27)in the T-PRK and SMILE groups, respectively. The percentage of UCVA(LogMAR)≤0 in the T-PRK and SMILE groups was 94% and 98%, respectively. The percentage of the residual SE within ±0.5D was 88% and 87% in the two groups, respectively. The HOAs and spherical aberration in both groups were significantly increased(P≤0.01), and the increase was not statistically significant between the two groups(P=0.31, 0.89). There was no significant change in horizontal coma, horizontal trefoil and vertical trefoil in both groups(P&#x0026;#x003E;0.05). The vertical coma in SMILE group was significantly increased(P&#x0026;#x003C;0.001), while there was no significant change in T-PRK group(P&#x0026;#x003E;0.05), and the increase was significantly greater in SMILE group than in T-PRK group(P&#x0026;#x003C;0.001). There was no significant difference in objective scattering index(OSI), modulation transfer function cut off frequency(MTFcut off), Strehl ratio(SR), visual acuity(VA)100%, VA20% and VA9% between the two groups(P&#x0026;#x003E;0.05).CONCLUSION:Both T-PRK and SMILE showed good safety, efficacy, and visual quality in correcting low myopia, while SMILE induced more vertical coma than T-PRK.