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Photodynamic therapy (PDT) has demonstrated broad application prospects in treating gynecological diseases such as human papillomavirus (HPV) infection, cervical intraepithelial neoplasia (CIN), and vulvar lichen sclerosus (VLS), due to its non-invasiveness, targeting capability, and low side effects. However, the bibliometric characteristics of this field remain unexplored. On March 26, 2026, we retrieved literature from the Web of Science Core Collection (WoSCC) database covering publications from January 1, 2010, to December 31, 2025. A total of 748 publications (545 articles, 203 review articles) were included after data cleaning. Visualization analysis was performed using VOSviewer, CiteSpace, Bibliometrix, and Excel 2023. Publication numbers showed a significant upward trend, peaking at 93 articles in 2022, with synchronous citation increases (2227 citations in 2022). China led in publication volume (310 articles), followed by the United States (109 articles). The United States exhibited higher international cooperation intensity (total link strength 48) compared to China (12). Southern Medical University (28 articles) was the most productive institution, and Zeng Kang was the leading author. Keyword clustering revealed "photodynamic therapy" and "human papillomavirus" as core themes. Burst keywords included "human papillomavirus infection" (2010-2017, strength 4.23) and "5-aminolevulinic acid photodynamic therapy" (2021-2025, strength 6.25). Clinical data extraction from burst core literature showed that ALA-PDT achieved a 64.3%-82.5% clearance rate for high-risk HPV in the cervix and a >70% regression rate for cervical lesions. For VLS, the total effective rate was 64%-91%, with good safety and no impact on reproductive function. Research interest in PDT for gynecological diseases continues to rise, with HPV infection and PDT treatment as core directions. The efficient, safe evidence-based data extracted from the literature further consolidates PDT's potential as a preferred non-invasive treatment. Future research should strengthen international cooperation and clinical translation.
This work focuses on the photophysical and photochemical properties of chromene-porphyrin derivatives (containing Zn, Ga and In as central metals) and their use as photosensitizers in photodynamic therapy (PDT) and photodynamic antimicrobial chemotherapy (PACT) in the presence and absence of carbon quantum dots (CQDs). PDT is being developed as an alternative non-invasive treatment option for cancer. PACT has been used to combat the growing challenge of antimicrobial resistance to the currently used anti-biotics. The biological activities were tested against the triple negative breast cancer cells against MDA-MB-231 (using PDT) and Escherichia coli (using PACT). Resazurin assay was used to monitor the toxicity of the complexes. The porphyrins were stacked ontoCQDs in order to enhance their water solubility and also improve their bio-availability. In general, the porphyrins did not show dark toxicity. Zinc tetrakis-(4‑bromo-chromene) porphyrin (ZnTBCP) and indium tetrakis-(4‑bromo-chromene) porphyrin (InTBCP) had good activities in PDT and PACT respectively, with cell viabilities as low as 23.43% (PDT) and 31.38% (PACT) at the highest concentrations. The results suggest that ZnTBCP and InBCTP are good candidates for use as photosensitizers. CQDs reduced the dark toxicity of the porphyrins.
Laser therapy has been proposed as an adjunct to conventional endodontic treatment due to its potential photobiomodulatory and antimicrobial effects on apical periodontitis. This systematic review and meta-analysis aimed to evaluate whether adjunctive laser therapy enhances the healing of periapical lesions. A comprehensive literature search was conducted in PubMed, Embase, Scopus, and Web of Science. Randomized and non-randomized studies assessing periapical lesion healing using the Periapical Index (PAI) and comparing conventional endodontic treatment with and without adjunctive laser therapy were included. Meta-analysis was performed using a random-effects model, risk of bias was assessed with RoB 2.0 and ROBINS-I and the evidence certainty was rated using GRADE. Six studies met the inclusion criteria. All included studies reported significant reductions in PAI in both experimental and control groups. However, meta-analysis demonstrated no significant difference between adjunctive laser therapy and conventional endodontic treatment (mean difference = 0.17; 95% CI: -0.14 to 0.47; p = 0.28), with moderate heterogeneity (I² = 52%). All randomized controlled trials were judged as presenting some concerns of bias, the single non-randomized clinical study was judged to have a critical risk of bias and the certainty of evidence was rated as low CONCLUSIONS: Current evidence does not consistently demonstrate a significant additional benefit of adjunctive laser therapy over conventional endodontic treatment in terms of radiographic healing of periapical lesions assessed by PAI. Conventional endodontic treatment is sufficient for periapical healing, and routine adjunctive laser use may not be justified.
Photodynamic therapy (PDT) using 5-aminolevulinic acid (5-ALA) is a promising treatment for cancer cells. Although cisplatin (CDDP) is a potent anticancer drug, acquired resistance often limits its clinical efficacy. This study aimed to evaluate the effectiveness of 5-ALA-PDT in CDDP-resistant cancer cells and elucidate the underlying mechanisms. We used CDDP-resistant sublines (ACR20 and HCR5) derived from human lung cancer (A549) and cervical epithelioid carcinoma (HeLa) cells, respectively. Intracellular protoporphyrin IX (PpIX) accumulation, mRNA expression of transporters and heme synthesis enzymes, and phototoxicity were analyzed. Both CDDP-resistant sublines exhibited significantly higher sensitivity to 5-ALA-PDT and increased intracellular PpIX accumulation compared to their respective parental cells. The mRNA expression of the 5-ALA transporters, SLC6A6 and SLC36A1, was significantly upregulated in both CDDP-resistant sublines. Treatment with their inhibitors (guanidinoethyl sulfonate for SLC6A6 and tryptophan for SLC36A1) markedly reduced PpIX accumulation and cytotoxic effects of 5-ALA-PDT. Although protoporphyrinogen oxidase expression was elevated in ACR20 cells, 5-ALA-PDT cytotoxicity was not affected by its knockdown. These findings show that the enhanced efficacy of 5-ALA-PDT in CDDP-resistant cells is primarily driven by increased PpIX accumulation through the upregulation of SLC6A6 and SLC36A1. Thus, 5-ALA-PDT has the potential to be a universal and effective treatment for cancers that develop CDDP resistance.
This study aimed to evaluate the efficacy, safety, and fertility-related outcomes of laser pretreatment followed by photodynamic therapy versus LEEP in reproductive-aged women with cervical HSIL. This non-randomized controlled prospective study enrolled 79 eligible patients (January 2022 - June 2025) from Minhang Hospital Affiliated to Fudan University, assigned to PDT after laser pretreatment group (Group 1, n = 38) or LEEP (Group 2, n = 41). One-to-one propensity score matching (PSM) was performed to balance baseline characteristics. The primary efficacy endpoint was histological regression (cure) at 6 and 12 months; HR-HPV clearance was a secondary endpoint. Post-PSM paired analyses used McNemar's test for categorical variables and paired t-test for continuous variables. Safety and fertility-related anxiety were assessed at 1 month. After PSM (32 matched pairs), the 6‑month histological cure rate was 90.63% in Group 1 and 93.75% in Group 2 (P = 0.617). At 12 months, all patients achieved histological cure in both groups (100% vs. 100%, P = 1.000). The 12‑month HR‑HPV clearance rate was 96.88% versus 87.50% (P = 0.134). The incidence of adverse reactions was significantly lower in Group 1 (3.13% vs. 25.00%, P = 0.034), with no cervical adhesions or bleeding observed. Fertility‑related anxiety scores were also lower in Group 1 (1.6 ± 1.1 vs. 4.2 ± 1.2, P < 0.001); these results were obtained using an unvalidated study‑specific scale and should be regarded as preliminary. Laser pretreatment combined with PDT is non-inferior to LEEP in eradicating cervical HSIL and clearing HR-HPV, while offering superior safety profiles. This organ-preserving strategy represents a reliable option for childbearing-aged women with Type I/II transformation zone HSIL.
Chromoblastomycosis(CBM), particularly caused by Fonsecaea monophora, presents significant clinical challenges due to its difficulty in treatment and high recurrence rates, with no established gold standard for therapy. This case report highlights a successful treatment approach that addresses this challenging disease. We report a 65-year-old female patient with a one-year history of a skin lesion on the dorsum of her right hand, diagnosed with CBM through histopathological and mycological examinations. The patient was treated with oral itraconazole at a dosage of 200 mg daily, in conjunction with photodynamic therapy using 5-aminolevulinic acid photodynamic therapy (ALA-PDT), administered biweekly. After one month of ALA-PDT treatment, the patient showed marked improvement. Continued oral itraconazole for three months resulted in complete clinical resolution, with no recurrence observed during a one-year follow-up. The combination of ALA-PDT and antifungal treatment demonstrates an effective strategy for managing skin CBM caused by Fonsecaea monophora.
Basal cell carcinoma (BCC) is the most common non-pigmented cutaneous malignancy. Photodynamic diagnosis (PDD) can distinguish tumor tissues from normal tissues by visible fluorescence. Photodynamic therapy (PDT) is widely used in the treatment of non-melanoma skin tumors. This study aims to illustrate the efficacy and safety of PDD-guided tumor excision combined with ALA-PDT in patients with BCC. A retrospective cohort study was conducted on 19 patients diagnosed with high-risk BCC, who were grouped based on the actual treatment they had received in clinical practice: the PDD group (n=9) and the non-PDD group (n=10). Patients were not randomized. The PDD group were treated with PDD-guided tumor excision, and the non-PDD group were treated with wide local excision (WLE). Both groups underwent frozen section analysis, and PDT was performed intraoperatively or postoperatively as an adjunctive therapy to target potential subclinical residual tumor cells. Clinical outcomes were analyzed, including efficacy, aesthetic outcome, patient satisfaction, and quality of life. The negative rate of tumor margins in PDD group was 95.3%, compared to 75.5% in the non-PDD group. PDD group needed fewer times of frozen section analysis and observed better cosmetic outcomes and superior patient satisfaction. PDD can reveal tumor margins in high-risk BCC to guide the extent of surgical resection. The combination of PDD-guided tumor resection with PDT demonstrates high safety and efficacy in the treatment of BCC, particularly in managing potential subclinical residual disease. However, it still needs to be verified in studies with larger sample sizes and longer follow-up periods.
Vascular malformations caused by GNAQ/GNA11 somatic mutations are related to capillary malformations (CM), which include port-wine stains (PWS), and also include capillary malformation-related syndromes, such as Sturge-Weber syndrome (SWS), capillary malformation with overgrowth (CMO), diffuse capillary malformation with overgrowth (DCMO), and phakomatosis pigmentovascularis (PPV). These disorders are known as the GNA-Related Capillary malformation spectrum (GNARCMs). This spectrum presents a therapeutic challenge. This study aimed to evaluate the efficacy and safety of photodynamic therapy (PDT) for treating the GNARCMs of pediatric patients. The clinical manifestations of the pediatric GNARCMs patients were retrospectively analyzed, and the treatment data were assessed after undergoing PDT mediated with a combination of Hemoporfin and 532-nm light. For evaluation of improvement, photographs taken before and after photodynamic therapy were evaluated by three independent assessors blindly. Patient satisfaction was also used as a factor in the efficacy evaluation. Adverse events were recorded after treatment. We identified 25 pediatric patients in the study, including 11 patients of SWS, 8 patients of PPV, 5 patients of CMO, and 1 patient of DCMO. After an average of 1.64 sessions of PDT, based on the overall visual assessment, 72% of patients responded to treatment (with >25% color blanching), 48% of patients showed excellent or good levels of improvement (with >50% color blanching). Most adverse events were transient and self-limiting, except one patient of SWS, on the third day after PDT, the visual acuity of the eye on the non-treated side suddenly decreased, and the patient was diagnosed with retinal detachment, which was considered to be related to primary glaucoma rather than PDT. Focusing on the various clinical manifestations of the GNARCMs, except for patients with contraindications, PDT can be considered for treatment of pediatric patients, and its effectiveness and safety are worthy of affirmation.
High-risk cervical low-grade squamous intraepithelial lesion (LSIL) can progress to invasive cancer if left untreated. This study aims to evaluate the efficacy of 5-aminolevulinic acid mediated photodynamic therapy (ALA PDT) in the treatment of high-risk LSIL. A total of 197 cases (20-69 years old) of high-risk LSIL treated by ALA PDT were retrospectively evaluated. Lesion remission and HPV clearance were evaluated at 6 and 12 months follow-up. The influence of age and number of treatments were analyzed. LSIL lesion remission rates were 87.50% and 92.94% at 6 and 12 months follow-up, respective. HPV negative conversion rates were 64.47% and 80.46% at 6 and 12 months follow-up, respectively. There was no statistical difference between age groups for lesion remission rate and HPV clearance rate (p≥0.4). No statistically significant association between the number of treatment and lesion remission rate or HPV clearance rate. No serious side effects occurred. Topical ALA PDT is effective and safe for the treatment of high-risk LSIL. It is especially suitable for women with fertility requirements and for elderly patients.
The rapid advancement of artificial intelligence (AI) has profoundly transformed ophthalmic research, particularly in the diagnosis and management of retinal diseases. This study conducts a comprehensive bibliometric and science mapping analysis to elucidate the intellectual landscape, thematic evolution, and collaborative dynamics of AI applications in eye healthcare. Drawing on data spanning over two decades, we analyze publication trends, citation impact, keyword co-occurrence, and author/institutional networks to address three core research questions: (1) the trajectory of research growth and citation influence in AI-driven retinal diagnostics, (2) the collaborative influence of leading authors and institutions shaping the field, and (3) the conceptual structures and thematic clusters guiding intellectual development. Results reveal exponential growth in research output post-2015, with deep learning, optical coherence tomography (OCT), and diabetic retinopathy emerging as dominant themes. Co-authorship and co-citation networks highlight strong regional and institutional clusters, led by prolific entities such as the University of London and the University of California System. Thematic and factorial analyses uncover a gradual shift from foundational algorithmic studies to multimodal and therapy-focused innovations, with emerging themes including explainable AI, telemedicine, and personalized diagnostics. Despite robust growth, notable gaps persist in real-world clinical integration, regulatory frameworks, and representation from low-resource regions. This study not only maps the current intellectual terrain of AI in ophthalmology but also identifies critical avenues for future research to ensure equitable, interpretable, and clinically translatable AI solutions in eye care.
Pulmonary mucoepidermoid carcinoma (PMEC) is a rare salivary gland-type primary lung malignancy arising from the tracheobronchial submucosal glands. Although surgery remains a standard curative option, carefully selected low-grade localized endobronchial lesions may also be amenable to definitive bronchoscopic local treatment. We report a 40-year-old man with compensated liver cirrhosis (preserved liver function) who presented with a 1-year history of cough. Chest computed tomography revealed an endobronchial lesion (∼10 mm) in the left main bronchus approximately 1 cm distal to the carina. 18F-FDG PET/CT showed no nodal or distant metastasis. Pathology confirmed low-grade PMEC (Ki-67 ∼5%), and MAML2 break-apart fluorescence in situ hybridization (FISH) was positive (split signals in 23% of analyzed nuclei). After multidisciplinary discussion, an initial airway-preserving definitive bronchoscopic strategy was selected because the lesion was small, low-grade, and apparently confined to the bronchial lumen, with surgery reserved as a salvage option if local control could not be achieved. The visible tumor was removed by endoscopic electrosnare resection, followed by one treatment course of photodynamic therapy using a hematoporphyrin derivative photosensitizer (Hiporfin, 2 mg/kg, Chongqing Milelonge Biopharmaceutical Co., Ltd., China) and 630-nm laser irradiation (120 J/cm, 3-cm cylindrical diffuser; Guilin Xingda Photoelectric Medical Instrument Co., Ltd., China) at 48 h and 72 h to treat the implantation base and adjacent at-risk mucosa. Complete endobronchial clearance was achieved with preservation of airway anatomy. Follow-up bronchoscopy and chest imaging at 1, 3, 9, 24, and 36 months demonstrated sustained complete response without recurrence or metastasis; site-directed mucosal biopsies at each visit showed no tumor cells. This case adds to the limited literature supporting bronchoscopic PDT as a potential initial local treatment option in carefully selected patients with localized low-grade endobronchial PMEC, particularly when airway preservation is desirable.
Despite the growing use of repeated low-level red light (RLRL) therapy for myopic children, its safety remains controversial. This study aimed to analyze macular cone morphology and retinal microvascular hemodynamics using adaptive optics scanning laser ophthalmoscopy (AOSLO) to evaluate retinal microstructural impacts. Cross-sectional study. Three groups were recruited: Myopia-RLRL (20 eyes; ≥8 months treatment), Myopia-Untreated (32 eyes), and Non-Myopic (14 eyes). RLRL therapy was administered using a 650 nm laser at 0.29 mW, twice daily for 3 minutes per session. AOSLO was used to assess cone morphology (density, spacing, regularity, dispersion) and retinal microvasculature parameters (vessel diameter, lumen diameter, blood flow velocity). Cone density was higher in the Non-Myopic group (45,649 ± 5,092/mm²) compared to the Myopia-Untreated group (40,202 ± 7,365/mm², P=0.013), with no significant difference versus the Myopia-RLRL group (41,274 ± 6,228/mm², P=0.627). Cone spacing was enlarged in myopic groups relative to non-myopic (P<0.05). Cone dispersion was lower in the Myopia-RLRL group (16.47 ± 2.43%) than in the Myopia-Untreated (17.36 ± 2.14%, P=0.030) and Non-Myopic (17.80 ± 2.25%, P=0.024) groups. No significant intergroup differences were found in cone regularity or microvasculature. Cone density positively correlated with spherical equivalent refraction (r=0.541) and negatively with axial length (r=-0.594; both P<0.001). After 8 months of RLRL therapy, there was no significant loss of cone density or issues with retinal microvasculature. Assessment of retinal arteriole and venule diameters and flow velocity also showed no significant differences. The reduced cone dispersion in the RLRL group suggests potential photobiomodulation effects on photoreceptor organization, indicating the therapy's safety and potential benefits.
High-grade squamous intraepithelial lesions (HSIL) are key cervical cancer precursors. While effective, traditional treatments may impair fertility. 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) offers a minimally invasive alternative, yet prognostic factors remain unclear. This study evaluated 12-month cure rates and identified predictors of response. This retrospective cohort included 174 HSIL patients treated with ALA-PDT and followed for ≥12 months. Data on age, lesion type (CIN2 vs. CIN3), HPV status, prior treatments (including CO₂ laser pretreatment), and concomitant vaginitis were collected. Cure was defined as normal ThinPrep cytology, negative HPV, and histologic regression. Logistic regression and ROC analysis identified predictors. ALA-PDT achieved 88.5% cure rate. CIN3 lesions (OR=0.175, P = 0.012) and prior CO₂ laser ablation (OR=19.024, P = 0.005) were independent predictors. CIN3 patients showed lower HPV clearance. The positive prognostic value of CO₂ laser pretreatment is likely attributable to enhanced drug penetration after lesion debulking, while standardized management of concomitant vaginitis may optimize therapeutic outcomes by reducing local inflammation. Combining lesion type and treatment history improved predictive accuracy (AUC=0.772). ALA-PDT is effective for HSIL. CIN3 and prior CO₂ laser ablation are key prognostic factors. Optimizing pretreatment strategies and managing vaginitis may further improve cure rates.
To compare axial length (AL) elongation and relative corneal refractive power (RCRP) changes in children wearing corneal refractive therapy (CRT) and vision shaping treatment (VST) lenses with smaller back optical zone diameters (BOZD). This retrospective study of 136 eyes from children aged 8-11 years, having myopia of -0.50 to -3.00 D, were included and fitted with two types of orthokeratology (OK) lenses: 5.0 mm-BOZD CRT and 5.6 mm-BOZD VST. The analysis detected AL at baseline, 6, and 12 months. The treatment zone size (TZS), treatment zone decentration (TZD) and RCRP parameters were obtained through analyzing the corneal topography maps obtained at baseline and after 1 year. The AL increase in the 5.6 mm-BOZD VST group was significantly slower than the 5.0 mm-BOZD CRT group (6 months: 0.09 ± 0.08 mm vs. 0.15 ± 0.10 mm; 12 months: 0.16 ± 0.14 mm vs. 0.31 ± 0.18 mm; both P < 0.001). The 5.6 mm-BOZD VST group showed a smaller 3/4X value (indicating the distance from which the RCRP profile first reaches its three-quarter peak) and a higher summed RCRP value within the pupillary region compared to the 5.0 mm-BOZD CRT group (both P < 0.05). However, the maximum RCRP value, TZS, and TZD were similar between the two groups. 5.6 mm-BOZD VST lenses provided superior myopia control efficacy compared to 5.0 mm-BOZD CRT lenses in 8-11-year-old children with low myopia, mainly through inducing a steeper RCRP profile and a greater RCRP sum value within the pupillary area.
To develop and evaluate a transformer-enabled multi-task framework for automated diabetic retinopathy (DR) analysis, including lesion-level segmentation and detection, and to compare end-to-end vision transformers with radiomics-based classification for DR severity grading across multi-center datasets. A total of 987 fundus images from two clinical centers were used for lesion segmentation and detection, and 6,852 images were used for four-class DR severity classification, with rigorous inclusion criteria and expert-verified annotations. Preprocessing included CLAHE normalization, artifact filtering, and standardized retinal masking. Four segmentation models (UNet++, CE-Net, Swin-UNet, SegFormer) and four detection models (RetinaNet, YOLOv11, DETR, Deformable DETR) were trained under harmonized settings. Classification was performed using two strategies: (1) an end-to-end Vision Transformer (ViT), and (2) a radiomics-based pipeline incorporating 971 IBSI-compliant radiomic features, ComBat harmonization, and three feature-selection methods (SGR, TES, mRMR) paired with six classifiers (CatBoost, LightGBM, TabPFN, SVM, RF, LR). All models underwent internal cross-validation and external multi-center testing. SegFormer achieved the highest segmentation performance, with Dice scores of 0.871-0.963 across lesions and strong external generalization. Deformable DETR achieved the best detection performance, reaching external mAP values up to 0.895. For severity classification, the radiomics-based TES + TabPFN pipeline achieved the best results, reaching an external accuracy of 0.883 and an AUC of 0.947, outperforming the ViT classifier (accuracy 0.838, AUC 0.902). Radiomics models demonstrated superior robustness under domain shift and reduced sensitivity to training-set size compared with end-to-end transformers. Transformer-based lesion analysis combined with radiomics-driven classification provides a robust, generalizable, and clinically meaningful solution for automated DR screening and severity assessment.
This study quantified retinal color parameters from fundus photography and integrated microcirculatory metrics from retinal oximetry, optical coherence tomography angiography (OCTA), and color doppler imaging (CDI) to investigate the specific application of fundus color in assessing microcirculation in type 2 diabetic Mellitus (T2DM) patients. Participants underwent fundus photography, retinal oximetry, OCTA, and CDI. Fundus color features were extracted using Photoshop and Python based on Red-Green-Blue (RGB), Commission Internationale de l'Éclairage Color Space (Lab), and Hue-Saturation-Value (HSV) models. Microvascular parameters were assessed via oximetry, OCTA, and CDI. Data were analyzed with SPSS 24.0. Fundus color parameter RGB-B correlated positively with age (r = 0.221, P = 0.033, Q = 0.297), venous oxygen saturation (SvO2) (r = 0.404, P = 0.000, Q = 0.000), diameter of vein (D-V) (r = 0.246, P = 0.018, Q = 0.197), and negatively with arteriovenous difference (A-V) (r=-0.385, P=0.000, Q=0.000). Lab-a correlated positively with age (r = 0.392, P= 0.000, Q = 0.000) and disease duration (r = 0.357, P= 0.000, Q = 0.000), and negatively with end diastolic velocity of the central retinal artery (r=-0.206, P = 0.047, Q = 0.378). Lab-b correlated positively with foveal density-300 (FD-300) (r = 0.285, P = 0.006, Q = 0.092). HSV-H correlated positively with age (r = 0.513, P= 0.000, Q = 0.000), A-V (r = 0.313, P = 0.002, Q = 0.034) and FD-300 (r = 0.237, P = 0.022, Q = 0.224), and negatively with disease duration (r=-0.409, P= 0.000, Q = 0.000), Glycated Hemoglobin A1c (HbA1c) (r=-0.252, P = 0.015, Q = 0.177), and SvO2 (r=-0.297, P = 0.007, Q = 0.097). HSV-S correlated negatively with age (r=-0.229, P = 0.027, Q = 0.258), SvO2 (r=-0.412, P= 0.000, Q = 0.000), and d-V (r=-0.215, P = 0.038, Q = 0.323), and positively with A-V (r = 0.387, P= 0.000, Q = 0.000) and FD-300 (r = 0.270, P = 0.009, Q = 0.115). Quantitative fundus color may serve as a non-invasive potential surrogate marker for systemic state and retinal microcirculatory status of T2DM.
Microsatellite stable (MSS) rectal cancer generally shows limited response to immunotherapy because of its low tumor mutational burden and immunosuppressive tumor microenvironment. Meanwhile, locally advanced low rectal cancer presents a major clinical challenge, as radical surgery often compromises anal sphincter function and postoperative quality of life. Emerging evidence suggests that photodynamic therapy (PDT) and radiofrequency ablation (RFA) can induce immunogenic cell death, promoting the release of tumor-associated antigens and damage-associated molecular patterns, thereby enhancing antitumor immune responses. Here, we report a case of locally advanced MSS low rectal cancer treated with a multimodal neoadjuvant regimen integrating sequential PDT and RFA with systemic therapy including immune checkpoint inhibitors, chemotherapy, and targeted therapy. This strategy achieved a near-complete pathological response (Tumor Regression Grade 1) and enabled successful sphincter-preserving radical surgery despite the tumor being located <5 cm from the anal verge. The treatment was well tolerated, with no severe treatment-related adverse events observed. This case suggests that combining local tumor ablation with systemic immunomodulatory therapy may represent a promising strategy to enhance immunotherapy responsiveness and facilitate organ-preserving treatment in selected patients with MSS rectal cancer.
This study aimed to investigate the association between systemic inflammation and the comorbidity of obesity and myopia among adolescents, focusing on the Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI) as markers of inflammation. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2008. The associations between SII and SIRI and obesity-myopia comorbidity were evaluated using multivariable logistic regression, restricted cubic spline (RCS) modeling, and subgroup analyses. A total of 8,043 adolescents were included in this study. Multivariable logistic regression analysis indicated a significant positive association between both SII and SIRI, analyzed as continuous and quartile-based variables, and the likelihood of obesity-myopia comorbidity (p < 0.05). A dose-response relationship was observed, with the highest quartile of SII (Q4) associated with an odds ratio (OR) of 2.78 and the highest quartile of SIRI associated with an OR of 2.12. RCS analysis indicated significant nonlinear associations (SII: pnonlinear < 0.001; SIRI: pnonlinear = 0.001), suggesting that inflammation is positively associated with myopia after exceeding a critical threshold. Subgroup analysis demonstrated that these associations were statistically significant among adolescents with mild to moderate myopia, but not among those with high myopia. However, due to the non‑significant interaction term, these subgroup results should be considered exploratory analyses of this study. The findings of this study indicate a nonlinear dose-dependent association between systemic inflammatory markers (SII and SIRI) and the comorbidity of obesity and myopia in adolescents. This association was particularly evident in adolescents with mild to moderate myopia. However, due to the cross‑sectional design and the exploratory nature of the subgroup analyses, causality cannot be established, and further research is needed for validation.
To investigate the impact of sex and age on macular ganglion cell complex (mGCC) and retinal nerve fiber layer (RNFL) thickness, and to identify associated determinants. In the population-based Beichen Eye Study involving 5,840 participants aged 50 years and older, mGCC, macular RNFL (mRNFL), and peripapillary RNFL (pRNFL) thickness were measured using swept-source optical coherence tomography. Sex- and age-related variations in these thickness parameters were analyzed. Generalized estimating equation (GEE) models were applied to assess the influence of demographic, ocular, and systemic factors on the thickness parameters (mGCC, mRNFL, and pRNFL). This study included 4,703 eyes from 2,670 participants (mean age 61.9 ± 6.4 years). No significant sex differences were found in average mGCC or mRNFL thickness, but regional variations were present. Males exhibited greater thickness in inner subfields, while females showed thicker outer subfields. In terms of pRNFL, females had a significantly thicker average thickness, as well as in the temporal, superior, and inferior quadrants compared to males. All layers experienced significant age-related thinning. GEE analysis indicated that average mGCC thickness was associated with age (β = -0.30) and pseudophakia (β = 2.55). The mRNFL thickness was associated with age (β = -0.08), pseudophakia (β = 2.20), and axial length (AL) (β = 1.07). The pRNFL thickness was associated with age (β = -0.20), cardiovascular disease (CVD) (β = -1.39), intraocular pressure (IOP) (β = -0.22), and AL (β = -1.92). All associations were statistically significant (p < 0.05). Regional sex-related differences were observed in mGCC and mRNFL thickness, while pRNFL thickness showed significant sex differences globally and across most quadrants. Increasing age was consistently associated with thinning of all three retinal parameters. Additionally, these thickness parameters were also associated with other ocular and systemic factors, including AL, lens status, IOP, and CVD.