With the younger age of electronic device use and changes in lifestyle, the incidence of dry eye in children has significantly increased, becoming a research hotspot in clinical and scientific fields. Due to the dissociation of symptoms and signs, hidden manifestations, and complex etiology, children with dry eye form a special diagnostic and treatment group. Traditional dry eye detection methods have defects such as low cooperation from children, poor accuracy, and invasiveness, and the lack of a unified diagnostic guideline makes it difficult to accurately assess relevant indicators, urgently requiring scientific diagnostic technologies and standards. In recent years, new detection technologies have brought breakthroughs. The Keratograph 5M can objectively evaluate tear film stability and meibomian gland function; questionnaires such as DEQ-5 enhance the feasibility of subjective symptom feedback in young children; SM Tube test strips, with their rapid and non-invasive advantages, have become efficient tear screening tools; and the application of artificial intelligence(AI)has further revolutionized the diagnostic model, significantly improving diagnostic efficiency and children's compliance. However, existing technologies still face challenges such as difficulty in grassroots popularization, lack of child-specific reference values, and insufficient interdisciplinary data integration. Future efforts should focus on establishing age-stratified diagnostic criteria through multi-center collaboration, integrating AI with multimodal detection technologies, and constructing a diversified evaluation system to support early intervention and precision treatment for childhood dry eye. This paper systematically reviews the progress in detection technologies for childhood dry eye, focuses on the uniqueness of children as a special diagnostic and treatment group, discusses clinical difficulties and challenges, and integrates multimodal and intelligent methods to provide innovative solutions and practical pathways for precise diagnosis, reduction of misdiagnosis rates, and improvement of the diagnostic and treatment system for childhood dry eye.

AIM: To evaluate the pathogenic variants of the SCO2(OMIM 604272)gene in patients with high myopia from Enshi Tujia and Miao Autonomous Prefecture of China.METHODS: A total of 384 patients with high myopia whose spherical refractive error was ≤ -6.00 D and whose axial length was ≥26.00 mm in at least one eye were recruited. DNA was extracted by the phenol-chloroform method from 5 mL of peripheral venous blood. Sanger sequencing was performed to identify pathogenic variants in exon 2 of SCO2. The detected variants were evaluated via in silico prediction software. A total of 288 people from the same district were included as the normal control cohort.RESULTS: Seven variants were detected, namely, four synonymous variants(c.201C>T/p.=, c.576C>T/p.=, c.633A>C/p.=, c.780T>C/p.=.), two missense variants(c.187A>G/p.Ile63Val, c.59G>C/p.Arg20Pro)and one nonsense variant(c.544C>T/p.Gln182*). The two missense variants were not damaging, as predicted by PolyPhen2, SIFT and Provean. The novel nonsense variant(c.544C>T/p.Gln182*)cannot be found in the 1000 Genomes Project and was not identified in 288 normal controls. Variant Taster suggested that the nonsense variant site was conserved.CONCLUSION: The newly identified nonsense mutation may be responsible for high myopia of the patients in our cohort. SCO2 is associated with high myopia, while the incidence of SCO2 variants in high myopia in this cohort was as low as 1/384; the nonsense mutation may be a scarce variant of high myopia in the Enshi Tujia and Miao Autonomous Prefecture of China.

Objective:To explore the effects of body mass index (BMI) on the incidence of nocturnal hypertension in patients with hypertension.Methods:Totally 341 hospitalized hypertensive patients treated at the Affiliated Hospital of Jining Medical University from February to May 2023 were selected by convenience sampling. Patients' general information, clinical data, and 24-hour ambulatory blood pressure results were collected. A binomial Logistic regression analysis was conducted to investigate the factors affecting the occurrence of nocturnal hypertension in these patients. The relationship between BMI and the incidence of nocturnal hypertension was examined using threshold effect tests and smooth curve fitting.Results:The binomial Logistic regression analysis indicated that blood phosphate level was a factor influencing the occurrence of nocturnal hypertension in hypertensive patients ( P<0.05). Smooth curve fitting and threshold effect test results showed that the relationship between BMI and the incidence of nocturnal hypertension was curve-correlated, with a turning point at 24.61 kg/m 2. To the left of the turning point, there was no correlation ( P=0.130) ; to the right, there was a correlation ( P=0.016) . Conclusions:When the BMI of hypertensive patients exceeds 24.61 kg/m 2, the likelihood of nocturnal hypertension increases with rising BMI, providing a precise intervention target for weight management-based patient care in hypertension.

OBJECTIVE To investigate the intervention effect and potential mechanism of breviscapine on hepatic fibrosis （HF） in rats based on the transforming growth factor-β（1 TGF-β1）/Smad2/extracellular signal-regulated protein kinase 1（ERK1） and Kelch-like epichlorohydrin-associated protein 1（Keap1）/nuclear factor-erythroid 2-related factor 2（Nrf2）/heme oxygenase-1（HO-1） pathways. METHODS Totally 60 rats were randomly divided into normal control group， model group， breviscapine low-dose， medium-dose and high-dose groups （5.4， 10.8， 21.6 mg/kg）， and colchicine group （positive control， 0.45 mg/kg）， with 10 rats in each group， half male and half female. Except for the normal control group， HF model of the other groups was induced by carbon tetrachloride. Subsequently， each drug group was given corresponding medicine by gavage once a day for 28 days. The liver appearance of rats in each group was observed and their liver coefficients were calculated. The levels of alanineaminotransferase （ALT） and aspartate aminotransferase （AST）in serum， those of ALT， AST， superoxide dismutase （SOD），malondialdehyde （MDA） and glutathione peroxidase （GSH- Px） in liver tissue were detected. The liver tissue inflammatory and fibrotic changes were observed. The protein and mRNA expressions of TGF-β1， Smad2， ERK1， Nrf2， Keap1 and HO-in liver tissue were detected. RESULTS Compared with the normal control group， the model group showed large areas of white nodular lesions in the liver， obvious inflammatory cell infiltration and collagen fiber deposition. The body weight， the levels of SOD and GSH-Px in liver tissue， the protein and mRNA expressions of Nrf2 and HO-1 were significantly lowered in the model group （P＜0.05）； the liver coefficient， the percentage of Masson staining positive area， ALT and AST levels of serum and liver tissue， MDA level of liver tissue， the protein and mRNA expressions of TGF-β1， Smad2， ERK1 and Keap1 were significantly increased （P＜0.05）. Compared with the model group， the liver lesions of rats in each drug group were improved， and the above quantitative indexes were generally reversed （P＜0.05）. CONCLUSIONS Breviscapine has a good intervention effect on HF rats， which may be related to inhibiting TGF-β1/Smad2/ERK1 pathway for anti-fibrosis and regulating Keap1/Nrf2/HO-1 pathway to inhibit oxidative stress.

Objective:To explore the application effect of the modified sandwich teaching method based on constructivism theory in clinical teaching of neurology nursing interns.Methods:A total of 29 nursing interns who practiced in the Department of Neurology of the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from June 2020 to May 2021 were selected as the control group, using the conventional clinical nursing teaching method, and 28 nursing interns who practiced from June 2021 to May 2022 were selected as the observation group, using the modified sandwich teaching method based on constructivism theory. Before graduating from the Department of Neurology, nursing interns in the two groups were compared in terms of the teaching effects, such as the score of learning initiative, theoretical examination, operation examination, and nursing round report. SPSS 25.0 was used for t test and chi-square test. Results:The score for each dimension (learning driving force, learning objectives, in-depth learning, controlled learning, and solid learning) and total score in the observation group were significantly higher than those in the control group ( P<0.05). There was no significant difference between the two groups in the scores of theoretical examination and operation examination (89.11±3.58 vs. 88.97±2.74, 93.79±2.48 vs. 93.86±2.20; P>0.05); the scores of nursing rounds in the observation group were significantly higher than those in the control group (88.61±2.60 vs. 83.38±3.97, P<0.05). Conclusions:The modified sandwich teaching method based on constructivism theory can enhance the learning initiative and comprehensive analysis ability of nursing interns in the Department of Neurology. It is suitable for clinical nursing teaching in the Department of Neurology and is worth popularizing.

Objective By exploring the conditional configuration effect of negative defensive medicine behavior,the formation mechanism and causal path of negative defensive medicine are explained,and systematic suggestions are provided for negative defensive medicine behavior,so as to improve the rational utilization of health resources.Methods NCA and fsQCA are used to conduct configuration analysis on factors influencing passive defensive medical behavior,output the conditional configuration,and further analyze the configuration effects among the influencing factors.Results The antecedent conditions of negative defensive medicine include systemic mechanisms,institutional norms,social culture,doctor-patient relationships,and self-efficacy.Ultimately,two paths contributing to passive defensive medical behavior emerge:environment conduction type and efficiency-environment joint conduction type,their consistency is 0.830.Conclusion To reduce the negative defensive medical behavior,it should pay atten-tion to improving the institutional environment and improving doctors'self-efficacy,establish a fair and reasonable external institutional environment,create an honest and harmonious cultural atmosphere,strengthen the training of doctors'professional ability and improve the doctor-patient relationship,so as to improve the rational use of health resources.

Objective By exploring the conditional configuration effect of negative defensive medicine behavior,the formation mechanism and causal path of negative defensive medicine are explained,and systematic suggestions are provided for negative defensive medicine behavior,so as to improve the rational utilization of health resources.Methods NCA and fsQCA are used to conduct configuration analysis on factors influencing passive defensive medical behavior,output the conditional configuration,and further analyze the configuration effects among the influencing factors.Results The antecedent conditions of negative defensive medicine include systemic mechanisms,institutional norms,social culture,doctor-patient relationships,and self-efficacy.Ultimately,two paths contributing to passive defensive medical behavior emerge:environment conduction type and efficiency-environment joint conduction type,their consistency is 0.830.Conclusion To reduce the negative defensive medical behavior,it should pay atten-tion to improving the institutional environment and improving doctors'self-efficacy,establish a fair and reasonable external institutional environment,create an honest and harmonious cultural atmosphere,strengthen the training of doctors'professional ability and improve the doctor-patient relationship,so as to improve the rational use of health resources.

Objective By exploring the conditional configuration effect of negative defensive medicine behavior,the formation mechanism and causal path of negative defensive medicine are explained,and systematic suggestions are provided for negative defensive medicine behavior,so as to improve the rational utilization of health resources.Methods NCA and fsQCA are used to conduct configuration analysis on factors influencing passive defensive medical behavior,output the conditional configuration,and further analyze the configuration effects among the influencing factors.Results The antecedent conditions of negative defensive medicine include systemic mechanisms,institutional norms,social culture,doctor-patient relationships,and self-efficacy.Ultimately,two paths contributing to passive defensive medical behavior emerge:environment conduction type and efficiency-environment joint conduction type,their consistency is 0.830.Conclusion To reduce the negative defensive medical behavior,it should pay atten-tion to improving the institutional environment and improving doctors'self-efficacy,establish a fair and reasonable external institutional environment,create an honest and harmonious cultural atmosphere,strengthen the training of doctors'professional ability and improve the doctor-patient relationship,so as to improve the rational use of health resources.

Objective By exploring the conditional configuration effect of negative defensive medicine behavior,the formation mechanism and causal path of negative defensive medicine are explained,and systematic suggestions are provided for negative defensive medicine behavior,so as to improve the rational utilization of health resources.Methods NCA and fsQCA are used to conduct configuration analysis on factors influencing passive defensive medical behavior,output the conditional configuration,and further analyze the configuration effects among the influencing factors.Results The antecedent conditions of negative defensive medicine include systemic mechanisms,institutional norms,social culture,doctor-patient relationships,and self-efficacy.Ultimately,two paths contributing to passive defensive medical behavior emerge:environment conduction type and efficiency-environment joint conduction type,their consistency is 0.830.Conclusion To reduce the negative defensive medical behavior,it should pay atten-tion to improving the institutional environment and improving doctors'self-efficacy,establish a fair and reasonable external institutional environment,create an honest and harmonious cultural atmosphere,strengthen the training of doctors'professional ability and improve the doctor-patient relationship,so as to improve the rational use of health resources.

Objective By exploring the conditional configuration effect of negative defensive medicine behavior,the formation mechanism and causal path of negative defensive medicine are explained,and systematic suggestions are provided for negative defensive medicine behavior,so as to improve the rational utilization of health resources.Methods NCA and fsQCA are used to conduct configuration analysis on factors influencing passive defensive medical behavior,output the conditional configuration,and further analyze the configuration effects among the influencing factors.Results The antecedent conditions of negative defensive medicine include systemic mechanisms,institutional norms,social culture,doctor-patient relationships,and self-efficacy.Ultimately,two paths contributing to passive defensive medical behavior emerge:environment conduction type and efficiency-environment joint conduction type,their consistency is 0.830.Conclusion To reduce the negative defensive medical behavior,it should pay atten-tion to improving the institutional environment and improving doctors'self-efficacy,establish a fair and reasonable external institutional environment,create an honest and harmonious cultural atmosphere,strengthen the training of doctors'professional ability and improve the doctor-patient relationship,so as to improve the rational use of health resources.