Allergic conjunctivitis is a common ocular inflammatory disease, with intense itching being the most typical and distressing symptom for patients. In recent years, with the in-depth study of the interaction between the nervous and immune systems, significant progress has been made in understanding the mechanism of itching in allergic conjunctivitis. This review elaborates on the neurobiological basis of itching in allergic conjunctivitis, with a focus on the complex dialogue between immune cells and sensory neurons, particularly the core role of the IL-33-ST2-CGRP signaling axis in mediating itching. Additionally, this article introduces new findings in genetic susceptibility research, including the identification of susceptibility genes for allergic conjunctivitis through transcriptome-wide association studies. The sensory nervous system not only transmits itch signals but also actively participates in the formation of antigen channels related to conjunctival goblet cells, thereby regulating the local uptake of allergens and the initiation of the immune response. Moreover, targeted novel therapeutic strategies offer hope for patients with refractory allergic conjunctivitis. Exploring the molecular and cellular mechanisms of itching in allergic conjunctivitis will provide a theoretical basis for the development of more effective treatment methods.

Objective:To apply artificial intelligence（AI）in classifying ovarian tumors on ultrasound images，and compare the diagnostic results of several sonographers with varying seniority levels.Methods:A total of 645 patients diagnosed with adnexal masses via gynecological ultrasound examination at Qilu Hospital of Shandong University from January 2021 to December 2024 were enrolled. Three deep learning architectures，i.e.，Alexnet，Densenet121，and Resnet50 were developed and used to internally test the classification effectiveness of ovarian tumors，while the optimal model was selected for external testing. Two junior sonographers and two senior sonographers were recruited to independently diagnose ovarian tumors in the external test dataset. Subsequently，the benign and malignant results of the model's predictions were disclosed to each sonographer，and their revised diagnoses on the same external test data in combination with the best AI model were recorded.Results:The optimal model achieved an accuracy of 0.941，sensitivity of 0.936，and specificity of 0.944 on the internal test dataset，and maintained robust performance on the external test dataset with accuracy of 0.891，sensitivity of 0.880，and specificity of 0.907. Compared to junior sonographers，the optimal model demonstrated significantly higher sensitivity in discriminating benign from malignant ovarian tumors（0.880 vs. 0.723，0.602；all P<0.05）. No statistically significant difference was observed in diagnostic accuracy between the optimal model and senior sonographer 1（ P=0.05）. With assistance from the optimal model，junior sonographers achieved significant improvements in both sensitivity and specificity（sensitivity：0.723 vs. 0.843，0.602 vs. 0.819；specificity：0.778 vs. 0.833，0.685 vs. 0.741；all P<0.05）. Conclusions:The optimal model achieves comparable performance to that of senior sonographers in ovarian tumor classification. With model assistance，the diagnostic performance of junior sonographers is significantly improved.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To assess the anti-skin photoaging properties of total flavonoids(TFT)extracted from the Chinese herb tulip,a preliminary analysis of its mechanism in combating skin photoaging were conducted.Methods UVB-induced photoaging mouse model was used to assess the anti-skin photoaging effects of TFT.A network pharmacology approach was used to conduct a preliminary analysis of TFT's mechanism of action against skin photoaging.Furthermore,molecular simulation was employed to predict the interactions between the active ingredients and target proteins.Results Treatment with TFT effectively improved skin condition in UVB-induced photoaging mice.The mechanism of action of TFT against skin photoaging likely involved the regulation of transcription factors such as NF-κB and AP-1,modulation of SASPs transcription,and inhibition of MMPs activity.Conclusion TFT is an effective anti-skin photoaging ingredient that deserves further research and development.

Objective:To investigate the effects and underlying mechanisms of silent information regulator 1(SIRT1)on the dysfunction of umbilical vein endothelial cells(HUVECs)induced by oxidized low-density lipoprotein(ox-LDL).Methods:The impact of ox-LDL on the viability of HUVEC was assessed using the Cell Counting Kit-8(CCK-8)assay, which also facilitated the determination of the optimal ox-LDL concentration.Subsequent to ox-LDL treatment, several parameters were evaluated, including reactive oxygen species(ROS)production, apoptosis, migration, and angiogenesis, utilizing a ROS detection kit, flow cytometry, a Transwell migration assay, and an angiogenesis assay, respectively.The expression levels of apoptosis-related proteins, namely cleaved caspase-3(c-caspase-3), Bcl-2-associated X protein(Bax), B-cell lymphoma-2(Bcl-2), SIRT1, and peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α), were quantified using Western blot analysis.Adenoviral vectors were employed to either overexpress or silence SIRT1, while the ROS inhibitor N-acetylcysteine(NAC)was applied to assess its effects on cell function.Additionally, PGC-1α acetylation(Ac-Lys)was investigated through co-immunoprecipitation.Results:In the oxidative model of ox-LDL-stimulated HUVECs, compared to controls, we observed a significant increase in ROS-positive cells(35.9±3.1 vs.5.4±0.9), heightened apoptosis(16.3±0.9 vs.7.6±0.7), diminished endothelial cell migration capacity, and reduced angiogenic capacity.Additionally, there was an elevation in the pro-apoptotic protein c-caspase3 and Bax, alongside a decrease in the anti-apoptotic protein bcl-2.Furthermore, SIRT1 expression was increased, as was the expression of PGC-1α.In comparison to the GFP group(28.5±1.9), the reduction in SIRT1 expression resulted in an increase in apoptosis(37.0±1.9).Conversely, overexpression of SIRT1 mitigated ox-LDL-induced apoptosis(25.2±1.6)(all P<0.05).Notably, the expression levels of PGC-1α and SIRT1 exhibited consistent changes: PGC-1α expression increased with SIRT1 overexpression and decreased when SIRT1 expression was reduced(both P<0.05).The administration of NAC to the ox-LDL-treated group led to a reduction in ROS production( t=11.18, P<0.01)and a significant enhancement in cell function.Immunoprecipitation results indicated that SIRT1 overexpression decreased ox-LDL-induced PGC-1α acetylation( t=18.18, P<0.01), whereas silencing of SIRT1 further increased PGC-1α acetylation levels( t=-19.09, P<0.01). Conclusions:SIRT1 is shown to protect against ox-LDL-induced apoptosis and dysfunction in HUVECs by deacetylating and activating PGC-1α, thereby highlighting its therapeutic potential in the context of endothelial cell injury.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective To observe the clinical effect of minimally invasive rotational curettage combined with water-assisted liposuction(WAL)in the treatment of gynecomastia(GYN)patients.Methods The clinical data of 80 GYN patients were retrospectively analyzed.According to different surgical methods,the patients were divided into minimally invasive surgery group(41 cases)and study group(39 cases).The minimally invasive surgery group underwent minimally invasive rotation-al curettage,while the study group underwent minimally invasive rotational curettage combined with WAL.The surgical indicators,pain intensity 24 hours postoperatively,postoperative complications,and subjective satisfaction were observed and compared between the two groups.Results The unilat-eral surgical duration in the study group was shorter than that in the minimally invasive surgery group,with a statistically significant difference(P＜0.05).No statistically significant differences were found in unilateral incision length,intraoperative blood loss,and postoperative hospital stay between the two groups(P＞0.05).No statistically significant difference was found in pain intensity 24 hours postoperatively between the two groups(P＞0.05).The incidence of postoperative complicationsin the study group was 5.13％,which was lower than 21.95％in the minimally invasive surgery group(P＜0.05).The study group had higher satisfaction scores for chest flatness without depression and breast symmetry than the minimally invasive surgery group(P＜0.05).Conclusion Compared with minimally invasive rotational curettage alone,the combination of minimally invasive rotational curet-tage and WAL for GYN patients results in shorter surgical duration,a lower incidence of postoperative complications,and higher patient satisfaction with breast appearance.

Objective:To investigate effect and mechanism of hydroxysafflor yellow A(HSYA)activating neuronal autophagy on cerebral ischemia-reperfusion injury through a combination of in vitro and in vivo experiments.Methods:SD rat MCAO/R model was established by improved suture method.Rats were randomly divided into sham surgery(Sham)group,MCAO/R group and MCAO/R+HSYA group,following indicators were detected to determine extent of cerebral ischemia-reperfusion nerve damage:Z-Longa neu-rological function score was detected,TTC staining to measure cerebral infarction area,and TUNEL staining to measure cell apopto-sis;Western blot was used to detect protein expressions of autophagy related markers LC3,Beclin1,P62 and SIRT1 in rat brain tis-sue;immunofluorescence staining was used to observe expression of LC3 co-localization with neurons.OGD/R injury model of SH-SY5Y cells was established and randomly divided into Normal group,OGD/R group,OGD/R+HSYA group,OGD/R+SIRT1 inhibitor(EX-527)group and OGD/R+EX-527+HSYA group.Western blot was used to detect protein expressions of LC3,Beclin1,P62 and SIRT1.Results:Compared with Sham group,model group rats showed impaired neurological function,significantly increased neu-robehavioral scores,widespread cerebral infarction,significantly increased neuronal cell apoptosis,significantly increased autophagy related protein Beclin1 expression and LC3-Ⅱ/LC3-Ⅰ,significantly decreased P62 expression,significantly increased LC3/NeuN co-stained cells,and decreased SIRT1 expression;compared with model group,HSYA intervention group showed a significant decrease in neurological functional scores,a significant reduction in cerebral infarction area,a significant decrease in neuronal cell apoptosis,a further increase in Beclin1 expression and LC3-Ⅱ/LC3-Ⅰ,a further decrease in P62 expression,number of LC3/NeuN and P62/NeuN co-stained cells also increased,and SIRT1 expression significantly increased.Expression trends of Beclin1,LC3-Ⅱ/LC3-Ⅰ,P62 and SIRT1 of cells between normal group,model group and HSYA intervention group were same as animal experiment;compared with model group,expressions of SIRT1,Beclin1 and LC3-Ⅱ/LC3-Ⅰ in OGD/R+EX-527 group were significantly reduced,while expression of P62 was significantly increased;compared with OGD/R+EX-527 group,there was no significant change in SIRT1 expression in OGD/R+EX-527+HSYA group,LC3-Ⅱ/LC3-Ⅰ and Beclin1 expression were significantly increased,and P62 expres-sion was significantly decreased.Conclusion:HSYA can significantly improve neurological deficits in rats after cerebral ischemia-reperfusion,reduce cerebral infarction area,and decrease neuronal cell apoptosis rate,whose neuroprotective effect may be related to its activation of SIRT1,which significantly enhances neuronal autophagy.

Objective To assess the anti-skin photoaging properties of total flavonoids(TFT)extracted from the Chinese herb tulip,a preliminary analysis of its mechanism in combating skin photoaging were conducted.Methods UVB-induced photoaging mouse model was used to assess the anti-skin photoaging effects of TFT.A network pharmacology approach was used to conduct a preliminary analysis of TFT's mechanism of action against skin photoaging.Furthermore,molecular simulation was employed to predict the interactions between the active ingredients and target proteins.Results Treatment with TFT effectively improved skin condition in UVB-induced photoaging mice.The mechanism of action of TFT against skin photoaging likely involved the regulation of transcription factors such as NF-κB and AP-1,modulation of SASPs transcription,and inhibition of MMPs activity.Conclusion TFT is an effective anti-skin photoaging ingredient that deserves further research and development.

Objective To investigate the association between dietary behavior and mild cognitive impairment(MCI)in older adults,and to further analyze the role of cardiometabolic comorbidities in this relationship.Methods A total of 6599 older adults were recruited from 3 communities and 48 villages in Dawu County between 2018 and 2023 as part of the Hubei Elderly Memory Cohort Study.Dietary behaviors were assessed using a food frequency questionnaire and a dietary behavior questionnaire.Latent class analysis was performed to categorize the participants into healthy eat-ing behavior(HEB),sub-healthy eating behavior(SHEB),and unhealthy eating behavior(UEB).Cardiovascular-metabolic diseases were diabetes,hypertension,coronary heart disease,and cere-brovascular disease,which all diagnosed by physicians.MCI was diagnosed by a team of clinical experts according to Peterson's criteria.Multivariable logistic regression model was used to ana-lyze the impact of cardiometabolic comorbidities on the association between dietary behavior and MCI.Results The morbidity rate of MCI was 24.3％,and that of HEB,SHEB and UEB was 16.6％,24.3％and 31.3％,respectively.The incidence of MCI was higher in the participants who were female,over ≥75 years old,unmarried,and lack physical exercise,SHEB and UEB groups,had low educational level,lived in rural areas,had no stable income,had abnormal BMI,and more types of cardiometabolic diseases(P＜0.05,P＜0.01).After adjusting for confounders,multivari-able logistic regression analysis indicated that both UEB(OR=1.220,95％CI:1.004-1.418,P=0.045)and SHEB(OR=1.592,95％CI:1.345-1.883,P=0.001)were positively correlated with MCI risk in older adults.Further stratified analysis by cardiometabolic comorbidities revealed that for the patients in the HEB group,those suffering from hypertension+diabetes+coronary heart disease had the highest risk for MCI(OR=4.220,95％CI:1.913-9.309,P=0.001),while for the SHEB group,the following comorbidities were significantly associated with increased MCI risk:hypertension+diabetes(OR=1.640,95％CI:1.157-2.322,P=0.005),hypertension+cerebro-vascular disease(OR=1.454,95％CI:1.041-2.031,P=0.028),hypertension+diabetes+cere-brovascular disease(OR=2.064,95％CI:1.246-3.419,P=0.005),and hypertension+diabetes+coronary heart disease+cerebrovascular disease(OR=1.974,95％CI:1.036-3.760,P=0.039).Conclusion Older adults with SHEB or UEB have a higher risk of developing MCI,and the pres-ence of cardiometabolic comorbidities further exacerbates this risk.