Survivin and p53 expression in primary and recurrent pterygium in Chinese patients

AIM: To assess the expression of anti-apoptotic protein survivin and tumor suppressor p53 protein in primary and recurrent pterygium and to investigate the relationship between them. METHODS: Survivin was assessed immunohistochemically using rabbit polyclonal antibody and p53 using mouse monoclonal antibody in a study sample of 20 cases of primary pterygium, 10 cases of recurrent pterygium and 10 cases of normal conjunctiva. RESULTS: In our study, 35% of primary (7 of 20) and 40% of recurrent (4 of 10) pterygium specimens were positive for survivin staining; 45% of primary (9 of 20) and 50% of recurrent (5 of 10) pterygium specimens were positive for p53 expression; and all normal conjunctiva showed no staining of either survivin or p53. The p53 and survivin immunoreactivity in primary and recurrent pterygium groups was greater than those in normal conjunctiva group (P<0. 05). There were no differences in p53 and survivin immunoreactivity between groups of primary and recurrent pterygium (P >0.05). The expression of survivin clearly segregated with p53-positive pterygium as compared with p53-negative cases [8 of 14 cases (57.1%) vs ersus 3 of 16 cases (15.2%)]. The Fisher's exact test analysis confirmed a highly statistically significant correlation between survivin and p53 expression (P <0.05). CONCLUSION: The survivin and p53 are overerpressed with correlation between them in primary and recurrent pterygium.

Detection and comparison of matrix metalloproteinase in primary and recurrent pterygium fibroblasts

AIM: To detect and compare the levels of matrix metalloproteinases (MMPs) secreted by primary and recurrent human pterygium fibroblasts (HPFs). METHODS: Primary and recurrent HPFs as well as human conjunctival fibroblasts (HCF) were cultured in RPMI 1640 medium at the same conditions. The protein levels of MMP-1, MMP-3 and MMP-9 were determined by enzyme-linked immune sorbent assay (ELISA), respectively. RESULTS: 1) The protein level of MMP-1 in serum-free supernatant from cultured primary and recurrent HPFs was higher than that in normal HCFs (P <0.05); similarly, the protein level of MMP-1 in serum-free supernatant from cultured primary HPFs was higher than that in recurrent HCFs (P <0.05). 2) The protein level of MMP-3 in serum-free supernatant from cultured primary HPFs was higher than that in normal HCFs (P<0.05); meanwhile, the protein level of MMP-3 in serum-free supernatant from cultured recurrent HPFs was lower when compared with that in primary HPFs and normal HCFs (P<0.05). 3) MMP-9 was not detected in primary and recurrent HPFs in the conditioned medium. CONCLUSION: The protein levels of MMP-1 and MMP-3 in supernatant secreted by primary HPFs are different from recurrent HPFs. Different pathological mechanisms may exist between primary and recurrent pterygia.

Relationship between angiogenesis and lymphangiogenesis in recurrent pterygium

AIM: To examine the relationship between angiogenesis and lymphangigenesis in recurrent pterygia. METHODS: Tissues from 34 excised recurrent pterygia (including 12 Grade 1, 10 Grade 2, and 12 Grade 3) were involved in the study and tissues from 7 nasal epibulbar conjunctivae segments were used as controls. Sections from each pterygium were immunostained with CD31 and LYVE-1 monoclonal antibodies to evaluate lymphatic microvessel density (LMVD) and blood microvessel density (BMVD), and the relationship between LMVD and BMVD in the pterygium was examined. RESULTS: There was a large number of CD31(+) LYVE-1((-)) blood vessels but only a few CD31 (+)LYVE-1 ((+)) lymphatic vessels in grades 1 and 2 pterygium. However, lymphatic vessels were dramatically increased in grade 3 pterygium. LMVD correlated dosely with BMVD in all pterygia, including grades 1, 2 and 3 peterygium patients (all P values < 0.01). Although both the density of blood and lymphatic vessels increased in recurrent pterygia, lymphatic vessels developed much faster than blood vessels, especially in grade 3 pterygia. CONCLUSION: There is a significant but not parallel relationship between angiogenesis and lymphangiogenesis in recurrent pterygium. The outgrowth of blood and lymphatic vessels provide evidence that immunological mechanism may play a role in the development and recurrence of pterygium.

Efficacy of postoperative short-term therapy of topical bevacizumab in recurrent pterygium surgery

Background:The study aimed to evaluate the efficacy of postoperative short-term therapy(for 2 weeks)of topical bevacizumab in recurrent pterygium surgery regarding to corneal vascularization and pterygium recurrence.Methods:This prospective randomized comparative study included two groups of patients with recurrent pterygium,all eyes were subjected to pterygium excision with conjunctiva auto graft,and group A(30 eyes of 30 patients)was treated with postoperative topical tobramycine and dexamethazone for 2 weeks.Group B(30 eyes of 30 patients)was treated also with postoperative topical tobramycine and dexamethazone in addition to topical bevacizumab 5 mg/mL 4 times daily for 2 weeks.Follow-up of cases up to 6 months was performed recording corneal vascularization and pterygium recurrence.Results:The results revealed that after 6 months,group A treated with postoperative tobramycine and dexamethazone reported 5 eyes of recurrence(16.7%)which not significantly(P=0.44726)(P>0.05)different from group B treated with the addition of topical bevacizumab which reported 3 eyes of recurrence(10%).But group B showed significantly different in decreasing corneal neovascularization than group A(P=0.000805)(P<0.05).Conclusions:Postoperative short-term therapy of topical bevacizumab in recurrent pterygium surgery by conjunctiva auto graft showed lower recurrence rate but not statistically significant,But it reduced significantly corneal neovascularization.

A gated recurrent unit model to predict Poisson’s ratio using deep learning

Static Poisson’s ratio(vs)is crucial for determining geomechanical properties in petroleum applications,namely sand production.Some models have been used to predict vs;however,the published models were limited to specific data ranges with an average absolute percentage relative error(AAPRE)of more than 10%.The published gated recurrent unit(GRU)models do not consider trend analysis to show physical behaviors.In this study,we aim to develop a GRU model using trend analysis and three inputs for predicting n s based on a broad range of data,n s(value of 0.1627-0.4492),bulk formation density(RHOB)(0.315-2.994 g/mL),compressional time(DTc)(44.43-186.9 μs/ft),and shear time(DTs)(72.9-341.2μ s/ft).The GRU model was evaluated using different approaches,including statistical error an-alyses.The GRU model showed the proper trends,and the model data ranges were wider than previous ones.The GRU model has the largest correlation coefficient(R)of 0.967 and the lowest AAPRE,average percent relative error(APRE),root mean square error(RMSE),and standard deviation(SD)of 3.228%,1.054%,4.389,and 0.013,respectively,compared to other models.The GRU model has a high accuracy for the different datasets:training,validation,testing,and the whole datasets with R and AAPRE values were 0.981 and 2.601%,0.966 and 3.274%,0.967 and 3.228%,and 0.977 and 2.861%,respectively.The group error analyses of all inputs show that the GRU model has less than 5% AAPRE for all input ranges,which is superior to other models that have different AAPRE values of more than 10% at various ranges of inputs.

Z-shaped incision without epithelial resection in pterygium surgery

AIM:To introduce a novel surgical technique using a Z-shaped incision without epithelial resection in ophthalmic pterygia.METHODS:This was a prospective study.During pterygium surgery,all proliferative tissues were separated from the cornea and conjunctiva without resection of the tissues.The unaffected conjunctiva was incised in a Z-shape.The upper(or lower)conjunctival flap was sutured to the lower(or upper)normal conjunctiva on the limbal sclera,while the proliferative tissue was sutured to the upper conjunctiva(or lower)near the fornix.RESULTS:Ten patients with pterygia were eligible for this study.Eight patients with primary pterygia and 2 with recurrent pterygia were included.The age of patients at surgery ranged from 47 to 90y(average:71.9y).Five patients each showed right and left-sided pterygia.The postoperative follow-up periods were from 8 to 78mo(average:25.0mo).The surgery was successfully conducted and wounds were favorably reconstructed in all patients.The proliferative tissues sutured to the normal conjunctiva showed palor and attenuated neovessles,and never showed re-growth after surgery.Nine patients did not show recerrence.Recerrent pterygium was noted in 1 patient,but additional treatments were not required.CONCLUSION:The procedure involves the reconstruction of pterygial tissue and normal conjunctiva using a Z-shaped incision.The scleral limbal wound can be covered with nonaffected conjunctiva without any excision of conjunctival epithelia in patients with primary or recurrent pterygia.

Intelligent diagnostic model for pterygium by combining attention mechanism and MobileNetV2

AIM:To evaluate the application of an intelligent diagnostic model for pterygium.METHODS:For intelligent diagnosis of pterygium,the attention mechanisms—SENet,ECANet,CBAM,and Self-Attention—were fused with the lightweight MobileNetV2 model structure to construct a tri-classification model.The study used 1220 images of three types of anterior ocular segments of the pterygium provided by the Eye Hospital of Nanjing Medical University.Conventional classification models—VGG16,ResNet50,MobileNetV2,and EfficientNetB7—were trained on the same dataset for comparison.To evaluate model performance in terms of accuracy,Kappa value,test time,sensitivity,specificity,the area under curve(AUC),and visual heat map,470 test images of the anterior segment of the pterygium were used.RESULTS:The accuracy of the MobileNetV2+Self-Attention model with 281 MB in model size was 92.77%,and the Kappa value of the model was 88.92%.The testing time using the model was 9ms/image in the server and 138ms/image in the local computer.The sensitivity,specificity,and AUC for the diagnosis of pterygium using normal anterior segment images were 99.47%,100%,and 100%,respectively;using anterior segment images in the observation period were 88.30%,95.32%,and 96.70%,respectively;and using the anterior segment images in the surgery period were 88.18%,94.44%,and 97.30%,respectively.CONCLUSION:The developed model is lightweight and can be used not only for detection but also for assessing the severity of pterygium.

Role of hsa_circ_0007482 in pterygium development: insights into proliferation, apoptosis, and clinical correlations

AIM:To investigate the impact of hsa_circ_0007482 on the proliferation and apoptosis of human pterygium fibroblasts(HPFs)and its correlation with the severity grades of pterygium.METHODS:Pterygium and normal conjunctival tissues were collected from the superior area of the same patient’s eye(n=33).The correlation between pterygium severity and hsa_circ_0007482 expression using quantitative reversetranscription polymerase chain reaction(RT-qPCR)were analyzed.Three distinct siRNA sequences targeting hsa_circ_0007482,along with a negative control sequence,were transfected into HPFs.Cell proliferation was assessed using the cell counting kit-8.Expression levels of Ki67,proliferating cell nuclear antigen(PCNA),Cyclin D1,Bax,B-cell lymphoma-2(Bcl-2),and Caspase-3 were measured via RT-qPCR.Immunofluorescence staining was employed to detect Ki67 and vimentin expressions.Apoptosis was evaluated using flow cytometry.RESULTS:Hsa_circ_0007482 expression was significantly higher in pterygium tissues compared to normal conjunctival tissues(P<0.001).Positive correlations were observed between hsa_circ_0007482 expression and pterygium severity,thickness,and vascular density.Knockdown of hsa_circ_0007482 inhibited cell proliferation,reducing the mRNA expression of Ki67,PCNA,and Cyclin D1 in HPFs.Hsa_circ_0007482 knockdown induced apoptosis,increasing mRNA expression levels of Bax and Caspase-3,while decreasing Bcl-2 expression in HPFs.Additionally,hsa_circ_0007482 knockdown attenuated vimentin expression in HPFs.CONCLUSION:The downregulation of hsa_circ_0007482 effectively hampers cell proliferation and triggers apoptosis in HPFs.There are discernible positive correlations detected between the expression of hsa_circ_0007482 and the severity of pterygium.

Intermittent sliding-lock-knot suture for limbal conjunctival autograft fixation in pterygium surgery:a technique note

AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed.Primary outcome measures were mean duration of surgery and suture removal,degree of conjunctival hyperemia on postoperative day 1,pain score at suture removal,postoperative symptoms at 6mo,including conjunctival hyperemia,foreign body sensation,and graft stability.RESULTS:Ninety-eight patients underwent monocular surgery and were divided into ISLK(51 eyes)and RI(47 eyes)groups according to the type of conjunctiva autograft fixation method planned.There was no significant difference in mean duration of surgery between the two groups(18.59±2.39min vs 18.15±2.20min,P=0.417);however,compared to the RI group,shorter suture removal times were observed in the ISLK group[0.58min(0.42-0.87)vs 3.00min(2.21-4.15),P<0.001].The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group(P<0.001).Pain scores at suture removal were lower in the ISLK group than in RI group[1(0-3)vs 2(1-4),P<0.001].Postoperative symptoms at 6mo were comparable between the groups(P=0.487),with no recurrence.CONCLUSION:ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision.Compared to RI fixation,ISLK facilitates suture removal and reduces discomfort,with comparable surgery duration and less conjunctival hyperemia.

An Interpretable Light Attention-Convolution-Gate Recurrent Unit Architecture for the Highly Accurate Modeling of Actual Chemical Dynamic Processes

To equip data-driven dynamic chemical process models with strong interpretability,we develop a light attention–convolution–gate recurrent unit(LACG)architecture with three sub-modules—a basic module,a brand-new light attention module,and a residue module—that are specially designed to learn the general dynamic behavior,transient disturbances,and other input factors of chemical processes,respectively.Combined with a hyperparameter optimization framework,Optuna,the effectiveness of the proposed LACG is tested by distributed control system data-driven modeling experiments on the discharge flowrate of an actual deethanization process.The LACG model provides significant advantages in prediction accuracy and model generalization compared with other models,including the feedforward neural network,convolution neural network,long short-term memory(LSTM),and attention-LSTM.Moreover,compared with the simulation results of a deethanization model built using Aspen Plus Dynamics V12.1,the LACG parameters are demonstrated to be interpretable,and more details on the variable interactions can be observed from the model parameters in comparison with the traditional interpretable model attention-LSTM.This contribution enriches interpretable machine learning knowledge and provides a reliable method with high accuracy for actual chemical process modeling,paving a route to intelligent manufacturing.

Aerial target threat assessment based on gated recurrent unit and self-attention mechanism

Aerial threat assessment is a crucial link in modern air combat, whose result counts a great deal for commanders to make decisions. With the consideration that the existing threat assessment methods have difficulties in dealing with high dimensional time series target data, a threat assessment method based on self-attention mechanism and gated recurrent unit(SAGRU) is proposed. Firstly, a threat feature system including air combat situations and capability features is established. Moreover, a data augmentation process based on fractional Fourier transform(FRFT) is applied to extract more valuable information from time series situation features. Furthermore, aiming to capture key characteristics of battlefield evolution, a bidirectional GRU and SA mechanisms are designed for enhanced features.Subsequently, after the concatenation of the processed air combat situation and capability features, the target threat level will be predicted by fully connected neural layers and the softmax classifier. Finally, in order to validate this model, an air combat dataset generated by a combat simulation system is introduced for model training and testing. The comparison experiments show the proposed model has structural rationality and can perform threat assessment faster and more accurately than the other existing models based on deep learning.

Diagnosis and management of benign recurrent intrahepatic cholestasis and psychosocial stressors in an adolescent:A case report

BACKGROUND Benign recurrent intrahepatic cholestasis(BRIC)is a rare autosomal recessive disorder,characterized by episodes of intense pruritus,elevated serum levels of alkaline phosphatase and bilirubin,and near-normal-glutamyl transferase.These episodes may persist for weeks to months before spontaneously resolving,with patients typically remaining asymptomatic between occurrences.Diagnosis entails the evaluation of clinical symptoms and targeted genetic testing.Although BRIC is recognized as a benign genetic disorder,the triggers,particularly psychosocial factors,remain poorly understood.CASE SUMMARY An 18-year-old Chinese man presented with recurrent jaundice and pruritus after a cold,which was exacerbated by self-medication involving vitamin B and paracetamol.Clinical and laboratory evaluations revealed elevated levels of bilirubin and liver enzymes,in the absence of viral or autoimmune liver disease.Imaging excluded biliary and pancreatic abnormalities,and liver biopsy demonstrated centrilobular cholestasis,culminating in a BRIC diagnosis confirmed by the identification of a novel ATP8B1 gene mutation.Psychological assessment of the patient unveiled stress attributable to academic and familial pressures,regarded as potential triggers for BRIC.Initial relief was observed with ursodeoxycholic acid and cetirizine,followed by an adjustment of the treatment regimen in response to elevated liver enzymes.The patient's condition significantly improved following a stress-related episode,thanks to a comprehensive management approach that included psychosocial support and medical treatment.CONCLUSION Our research highlights genetic and psychosocial influences on BRIC,emphasizing integrated diagnostic and management strategies.

Comparison of Two Recurrent Neural Networks for Rainfall-Runoff Modeling in the Zou River Basin at Atchérigbé (Bénin)

Hydrological models are developed to simulate river flows over a watershed for many practical applications in the field of water resource management. The present paper compares the performance of two recurrent neural networks for rainfall-runoff modeling in the Zou River basin at Atchérigbé outlet. To this end, we used daily precipitation data over the period 1988-2010 as input of the models, such as the Long Short-Term Memory (LSTM) and Recurrent Gate Networks (GRU) to simulate river discharge in the study area. The investigated models give good results in calibration (R2 = 0.888, NSE = 0.886, and RMSE = 0.42 for LSTM;R2 = 0.9, NSE = 0.9 and RMSE = 0.397 for GRU) and in validation (R2 = 0.865, NSE = 0.851, and RMSE = 0.329 for LSTM;R2 = 0.9, NSE = 0.865 and RMSE = 0.301 for GRU). This good performance of LSTM and GRU models confirms the importance of models based on machine learning in modeling hydrological phenomena for better decision-making.

A Double-Interactively Recurrent Fuzzy Cerebellar Model Articulation Controller Model Combined with an Improved Particle Swarm Optimization Method for Fall Detection

In many Eastern and Western countries,falling birth rates have led to the gradual aging of society.Older adults are often left alone at home or live in a long-term care center,which results in them being susceptible to unsafe events(such as falls)that can have disastrous consequences.However,automatically detecting falls fromvideo data is challenging,and automatic fall detection methods usually require large volumes of training data,which can be difficult to acquire.To address this problem,video kinematic data can be used as training data,thereby avoiding the requirement of creating a large fall data set.This study integrated an improved particle swarm optimization method into a double interactively recurrent fuzzy cerebellar model articulation controller model to develop a costeffective and accurate fall detection system.First,it obtained an optical flow(OF)trajectory diagram from image sequences by using the OF method,and it solved problems related to focal length and object offset by employing the discrete Fourier transform(DFT)algorithm.Second,this study developed the D-IRFCMAC model,which combines spatial and temporal(recurrent)information.Third,it designed an IPSO(Improved Particle Swarm Optimization)algorithm that effectively strengthens the exploratory capabilities of the proposed D-IRFCMAC(Double-Interactively Recurrent Fuzzy Cerebellar Model Articulation Controller)model in the global search space.The proposed approach outperforms existing state-of-the-art methods in terms of action recognition accuracy on the UR-Fall,UP-Fall,and PRECIS HAR data sets.The UCF11 dataset had an average accuracy of 93.13%,whereas the UCF101 dataset had an average accuracy of 92.19%.The UR-Fall dataset had an accuracy of 100%,the UP-Fall dataset had an accuracy of 99.25%,and the PRECIS HAR dataset had an accuracy of 99.07%.

Study on Ecological Change Remote Sensing Monitoring Method Based on Elman Dynamic Recurrent Neural Network

In this paper, Hailin City of Heilongjiang Province, China is taken as the research area. As an important city in Heilongjiang Province, China, the sustainable development of its ecological environment is related to the opening up, economic prosperity and social stability of Northeast China. In this paper, the remote sensing ecological index (RSEI) of Hailin City in recent 20 years was calculated by using Landsat 5/8/9 series satellite images, and the temporal and spatial changes of the ecological environment in Hailin City were further analyzed and the influencing factors were discussed. From 2003 to 2023, the mean value of RSEI in Hailin City decreased and increased, and the ecological environment decreased slightly as a whole. RSEI declined most significantly from 2003 to 2008, and it increased from 2008 to 2013, decreased from 2013 to 2018, and increased from 2018 to 2023 again, with higher RSEI value in the south and lower RSEI value in the northwest. It is suggested to appropriately increase vegetation coverage in the northwest to improve ecological quality. As a result, the predicted value of Elman dynamic recurrent neural network model is consistent with the change trend of the mean value, and the prediction error converges quickly, which can accurately predict the ecological environment quality in the future study area.

A HybridManufacturing ProcessMonitoringMethod Using Stacked Gated Recurrent Unit and Random Forest

This study proposed a new real-time manufacturing process monitoring method to monitor and detect process shifts in manufacturing operations.Since real-time production process monitoring is critical in today’s smart manufacturing.The more robust the monitoring model,the more reliable a process is to be under control.In the past,many researchers have developed real-time monitoring methods to detect process shifts early.However,thesemethods have limitations in detecting process shifts as quickly as possible and handling various data volumes and varieties.In this paper,a robust monitoring model combining Gated Recurrent Unit(GRU)and Random Forest(RF)with Real-Time Contrast(RTC)called GRU-RF-RTC was proposed to detect process shifts rapidly.The effectiveness of the proposed GRU-RF-RTC model is first evaluated using multivariate normal and nonnormal distribution datasets.Then,to prove the applicability of the proposed model in a realmanufacturing setting,the model was evaluated using real-world normal and non-normal problems.The results demonstrate that the proposed GRU-RF-RTC outperforms other methods in detecting process shifts quickly with the lowest average out-of-control run length(ARL1)in all synthesis and real-world problems under normal and non-normal cases.The experiment results on real-world problems highlight the significance of the proposed GRU-RF-RTC model in modern manufacturing process monitoring applications.The result reveals that the proposed method improves the shift detection capability by 42.14%in normal and 43.64%in gamma distribution problems.

Mapping Network-Coordinated Stacked Gated Recurrent Units for Turbulence Prediction

Accurately predicting fluid forces acting on the sur-face of a structure is crucial in engineering design.However,this task becomes particularly challenging in turbulent flow,due to the complex and irregular changes in the flow field.In this study,we propose a novel deep learning method,named mapping net-work-coordinated stacked gated recurrent units(MSU),for pre-dicting pressure on a circular cylinder from velocity data.Specifi-cally,our coordinated learning strategy is designed to extract the most critical velocity point for prediction,a process that has not been explored before.In our experiments,MSU extracts one point from a velocity field containing 121 points and utilizes this point to accurately predict 100 pressure points on the cylinder.This method significantly reduces the workload of data measure-ment in practical engineering applications.Our experimental results demonstrate that MSU predictions are highly similar to the real turbulent data in both spatio-temporal and individual aspects.Furthermore,the comparison results show that MSU predicts more precise results,even outperforming models that use all velocity field points.Compared with state-of-the-art methods,MSU has an average improvement of more than 45%in various indicators such as root mean square error(RMSE).Through comprehensive and authoritative physical verification,we estab-lished that MSU’s prediction results closely align with pressure field data obtained in real turbulence fields.This confirmation underscores the considerable potential of MSU for practical applications in real engineering scenarios.The code is available at https://github.com/zhangzm0128/MSU.

Increased retinal venule diameter as a prognostic indicator for recurrent cerebrovascular events:a prospective observational study

Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.

Radiofrequency ablation combined with transcatheter arterial chemoembolization for recurrent liver cancer

BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its efficacy in recurrent liver cancer remains unclear.AIM To investigate the clinical effect of TACE combined with RFA in the treatment of recurrent liver cancer.METHODS Ninety patients with recurrent liver cancer were divided into 2 groups according to treatment plan:Control(RFA alone);and experimental[TACE combined with RFA(TACE+RFA)].The incidence of increased alanine aminotransferase levels,complications,and other indices were compared between the two groups before and after the procedures.RESULTS One month after the procedures,the short-term efficacy rate and Karnofsky Performance Status scores of the experimental group were significantly higher than those of the control group(P<0.05).Alpha-fetoprotein(AFP)and total bilirubin levels were lower than those in the control group(P<0.05);The overall response rate was 82.22%and 66.67%in the experimental and control groups,respectively;The disease control rate was 93.33%and 82.22%in the experimental and control groups,respectively,the differences are statistically significant(P<0.05).And there were no statistical differences in complications between the two groups(P>0.05).CONCLUSION TACE+RFA was effective for the treatment of recurrent liver cancer and significantly reduced AFP levels and improved various indices of liver function.

Rationale of a Cross Sectional Analytic Study on Determinants of Recurrent Preeclampsia at University Clinics of Kinshasa (Democratic Republic of Congo) and at Victor Dupouy Hospital Center (France)

Research Background: Pre-eclampsia is one of main causes of materno-foetal mortality and morbidity worldwide, with a prevalence of 3% - 7%. Although considered a primiparous condition, it can nevertheless recur. Several factors appear to be associated with risk of recurrence of pre-eclampsia, such as the term of delivery of previous pregnancy, severity of disease, the existence of co-morbidities and the inter-genital space. Purpose: The aim of our study will be to analyse and identify in a population of pregnant women with a history of preeclampsia risk factors associated with occurrence of recurrent preeclampsia at University clinics of Kinshasa (Democratic Republic of Congo) and at Victor Dupouy Hospital Center (France). Methods: In this study, pregnant women with an history of preeclampsia who will give birth between November 2018 and October 2024 at University Clinics of Kinshasa (UCK) and Victor Dupouy Hospital Center (VDHC) will be included. This will be a cross-sectional analytical study, data from previous and subsequent pregnancies will be studied. Expected Result: The prevalence of recurrent preeclampsia in the study population will be determined. And we will highlight the factors that will determine the recurrence of preeclampsia by analysing the risk factors. Conclusion: Knowledge of the factors associated with recurrent preeclampsia could be an excellent tool for predicting and preventing the disease.