AIM:To observe the effect of cationic nanoemulsion eye drops on the tear film and ocular surface morphology of orthokeratology wearers, and to provide a basis for the clinical selection of eye drops during orthokeratology wear. METHODS:A prospective study was conducted on patients with refractive errors who were fitted with orthokeratology lenses for the first time at Anhui Aier Eye Hospital,from February 2025 to October 2025. Patients were randomly assigned to the experimental group, which received a cationic nanoemulsion eye drops, or the control group, which received a 0.1% sodium hyaluronate eye drops. One drop of the assigned lubricant was instilled in each eye before lens insertion and before lens removal in both groups for 3 consecutive months. Uncorrected visual acuity, spherical equivalent, anterior corneal curvature, tear film break-up time, tear film lipid layer score, and corneal fluorescein staining score were compared between the two groups at baseline and at 1 wk, 1 and 3 mo after lens wear. RESULTS: A total of 64 eyes(all right eyes)from 64 patients with refractive errors were enrolled. Ultimately, 60 patients completed the final follow-up, including 30 in the experimental group(n=30; male/female: 14/16; age: 9.57±1.07 y)and the control group(n=30; male/female: 12/18; age: 9.43±1.01 y). No significant intergroup differences were found in uncorrected visual acuity, spherical equivalent, anterior corneal curvature, or corneal fluorescein staining scores either before or after lens wear(all P>0.05).The tear film break-up time was significantly longer and tear film lipid layer score was significantly better in the experimental group than in the control group at post-wear time point(all P<0.05). Uncorrected visual acuity, spherical equivalent, and anterior corneal curvature improved significantly from baseline at 1 wk, 1 and 3 mo after lens wear in both groups(all P<0.05). Corneal fluorescein staining scores increased significantly from baseline at 1 wk and 1 mo in the control group(both P<0.05), whereas no significant change was observed in the experimental group. No cases of severe corneal injury(score of 3)were found in either group. CONCLUSION: Cationic nanoemulsion eye drops have a similar effect to 0.1% sodium hyaluronate eye drops in improving the visual acuity and corneal morphology of orthokeratology wearers, but have more advantages in stabilizing the tear film and improving the state of the tear film lipid layer, and have good safety, so they can be used as an ideal choice of eye drops for orthokeratology wearers.

This paper systematically summarizes the practical experience of the 2025 Dingri earthquake emergency medical rescue in Tibet. It analyzes the requirements for earthquake medical rescue under conditions of high-altitude hypoxia, low temperature, and low air pressure. The paper provides a detailed discussion on the strategic layout of earthquake medical rescue at the national level, local government level, and through social participation. It covers the construction of rescue organizational systems, technical systems, material support systems, and information systems. The importance of building rescue teams is emphasized. In high-altitude and cold conditions, rapid response, scientific decision-making, and multi-party collaboration are identified as key elements to enhance rescue efficiency. By optimizing rescue organizational structures, strengthening the development of new equipment, and promoting telemedicine technologies, the precision and effectiveness of medical rescue can be significantly improved, providing important references for future similar disaster rescues.

Objective: To explore the changes of mechanosensitive channels Piezos (Piezo 1 and Piezo 2) in neurogenic bladder (NB) of young rats and their effects，so as to provide reference for clinical search of new therapeutic targets. Methods: A total of 30 female young SD rats were divided into 5 groups based on random number table method：sham operation group (sham)，2-week nerve transection group (NB-2W)，6-week nerve transection group (NB-6W)，2-week nerve transection + Piezos inhibitor group (NB-P-2W) and 6-week nerve transection + Piezos inhibitor group (NB-P-6W)，with 6 rats in each group.The NB models were constructed by transecting the L6 and S1 spinal nerves of young rats.The NB-2W and NB-6W groups were not intervened after modeling，while the NB-P-2W and NB-P-6W groups were intraperitoneally injected with Piezos inhibitor GsMTx4 (10 mg/kg) every 2 days after modeling.Bladder cystometry and ultrasound were performed after 2 and 6 weeks of transection.The expressions of Piezos and fibrosis-related indexes (Collagen Ⅰ and α-smooth muscle actin) were detected in bladder tissues. Results: The results of bladder cystometry showed that the basal bladder pressure in NB-2W group was significantly increased，while it was slightly decreased but was still higher in NB-6W group than in the sham group (P<0.05).Basal bladder pressure was lower in NB-P-2W group than in NB-2W group，but was higher than that in the sham group; basal bladder pressure was lower in NB-P-6W group than in NB-6W group，but higher than that in the sham group (P<0.05).Compared with the sham group，the NB-2W and NB-6W groups had firstly increased and then decreased maximum cystometric capacity (MCC) (P<0.05).Compared with NB-2W group，NB-P-2W group had lower bladder leakage point pressure (BLPP)，but higher MCC and bladder compliance (BC) (P<0.05).Compared with NB-6W group，NB-P-6W group had significantly lower BLPP but higher MCC and BC (P<0.05).HE and MASSON staining and ultrasound results showed that，with the extension of nerve transection time，bladder fibrosis gradually worsened，the bladder wall became rough and thickened，calculi were visible inside，and hydronephrosis gradually appeared; the degree of fibrosis in NB-P-2W and NB-P-6W groups was less than that in NB-2W and NB-6W groups，and no hydronephrosis was observed in the upper urinary tract.In addition，Western blotting and immunohistochemical results showed that NB-2W and NB-6W groups had significantly higher relative expression levels of Piezos，Collagen Ⅰ and α-SMA than the sham group (P<0.01)，while NB-P-2W and NB-P-6W groups had lower relative expression levels of Piezos,Collagen Ⅰ and α-SMA than NB-2W and NB-6W groups (P<0.01). Conclusion: The increased expressions of mechanosensitive channels Piezos in NB young rats may be involved in the progression of bladder fibrosis，but its mechanism needs further study.

Objective: This study aims to investigate the anatomical relationship among the nerve roots, intervertebral space, pedicles, and intradural rootlets of the cervical spine for improving operative outcomes and exploring neuroventral decompression approach in posterior endoscopic cervical discectomy (PECD). Methods: Cervical computed tomography myelography imaging data from January 2021 to May 2023 were collected, and the RadiAnt DICOM Viewer Software was employed to conduct multiplane reconstruction. The following parameters were recorded: width of nerve root (WN), nerve root-superior pedicle distance (NSPD), nerve root-inferior pedicle distance (NIPD), and the relationship between the intervertebral space and the nerve root (shoulder, anterior, and axillary). Additionally, the descending angles between the spinal cord and the ventral (VRA) and dorsal (DRA) rootlets were measured. Results: The WN showed a gradual increase from C4 to C7, with measurements notably larger in men compared to women. The NSPD decreased gradually from the C2–3 to the C5–6 levels. However, the NIPD showed an opposite level-related change, notably larger than the NSPD at the C4–5, C5–6, and C7–T1 levels. Furthermore, significant differences in NIPD were observed between different age groups and genders. The incidence of the anterior type exhibited a gradual decrease from the C2–3 to the C5–6 levels. Conversely, the axillary type exhibited an opposite level-related change. Additionally, the VRA and DRA decreased as the level descended, with measurements significantly larger in females. Conclusion A prediction of the positional relationship between the intervertebral space and the nerve root is essential for the direct neuroventral decompression in PECD to avoid damaging the neural structures. The axillary route of the nerve root offers a safer and more effective pathway for performing direct neuroventral decompression compared to the shoulder approach.

Objective: This study aims to investigate the anatomical relationship among the nerve roots, intervertebral space, pedicles, and intradural rootlets of the cervical spine for improving operative outcomes and exploring neuroventral decompression approach in posterior endoscopic cervical discectomy (PECD). Methods: Cervical computed tomography myelography imaging data from January 2021 to May 2023 were collected, and the RadiAnt DICOM Viewer Software was employed to conduct multiplane reconstruction. The following parameters were recorded: width of nerve root (WN), nerve root-superior pedicle distance (NSPD), nerve root-inferior pedicle distance (NIPD), and the relationship between the intervertebral space and the nerve root (shoulder, anterior, and axillary). Additionally, the descending angles between the spinal cord and the ventral (VRA) and dorsal (DRA) rootlets were measured. Results: The WN showed a gradual increase from C4 to C7, with measurements notably larger in men compared to women. The NSPD decreased gradually from the C2–3 to the C5–6 levels. However, the NIPD showed an opposite level-related change, notably larger than the NSPD at the C4–5, C5–6, and C7–T1 levels. Furthermore, significant differences in NIPD were observed between different age groups and genders. The incidence of the anterior type exhibited a gradual decrease from the C2–3 to the C5–6 levels. Conversely, the axillary type exhibited an opposite level-related change. Additionally, the VRA and DRA decreased as the level descended, with measurements significantly larger in females. Conclusion A prediction of the positional relationship between the intervertebral space and the nerve root is essential for the direct neuroventral decompression in PECD to avoid damaging the neural structures. The axillary route of the nerve root offers a safer and more effective pathway for performing direct neuroventral decompression compared to the shoulder approach.

Objective: This study aims to investigate the anatomical relationship among the nerve roots, intervertebral space, pedicles, and intradural rootlets of the cervical spine for improving operative outcomes and exploring neuroventral decompression approach in posterior endoscopic cervical discectomy (PECD). Methods: Cervical computed tomography myelography imaging data from January 2021 to May 2023 were collected, and the RadiAnt DICOM Viewer Software was employed to conduct multiplane reconstruction. The following parameters were recorded: width of nerve root (WN), nerve root-superior pedicle distance (NSPD), nerve root-inferior pedicle distance (NIPD), and the relationship between the intervertebral space and the nerve root (shoulder, anterior, and axillary). Additionally, the descending angles between the spinal cord and the ventral (VRA) and dorsal (DRA) rootlets were measured. Results: The WN showed a gradual increase from C4 to C7, with measurements notably larger in men compared to women. The NSPD decreased gradually from the C2–3 to the C5–6 levels. However, the NIPD showed an opposite level-related change, notably larger than the NSPD at the C4–5, C5–6, and C7–T1 levels. Furthermore, significant differences in NIPD were observed between different age groups and genders. The incidence of the anterior type exhibited a gradual decrease from the C2–3 to the C5–6 levels. Conversely, the axillary type exhibited an opposite level-related change. Additionally, the VRA and DRA decreased as the level descended, with measurements significantly larger in females. Conclusion A prediction of the positional relationship between the intervertebral space and the nerve root is essential for the direct neuroventral decompression in PECD to avoid damaging the neural structures. The axillary route of the nerve root offers a safer and more effective pathway for performing direct neuroventral decompression compared to the shoulder approach.

Lumbar disc (LD) herniation and aging are prevalent conditions that can result in substantial morbidity. This study aimed to clarify the mechanisms connecting the LD aging and herniation, particularly focusing on cellular senescence and molecular alterations in the nucleus pulposus (NP). We performed a detailed analysis of NP samples from a diverse cohort, including individuals of varying ages and those with diagnosed LD herniation. Our methodology combined histological assessments with single-nucleus RNA sequencing to identify phenotypic and molecular changes related to NP aging and herniation. We discovered that cellular senescence and a decrease in nucleus pulposus progenitor cells (NPPCs) are central to both processes. Additionally, we found an age-related increase in NFAT1 expression that promotes NPPC senescence and contributes to both aging and herniation of LD. This research offers fresh insights into LD aging and its associated pathologies, potentially guiding the development of new therapeutic strategies to target the root causes of LD herniation and aging.
Intervertebral Disc Displacement/metabolism* ; Humans ; Aging/pathology* ; Nucleus Pulposus/pathology* ; Male ; Female ; Transcriptome ; Middle Aged ; Lumbar Vertebrae/pathology* ; Adult ; Cellular Senescence ; Stem Cells/pathology* ; Aged ; Intervertebral Disc Degeneration/metabolism*

Objective: This study aims to investigate the anatomical relationship among the nerve roots, intervertebral space, pedicles, and intradural rootlets of the cervical spine for improving operative outcomes and exploring neuroventral decompression approach in posterior endoscopic cervical discectomy (PECD). Methods: Cervical computed tomography myelography imaging data from January 2021 to May 2023 were collected, and the RadiAnt DICOM Viewer Software was employed to conduct multiplane reconstruction. The following parameters were recorded: width of nerve root (WN), nerve root-superior pedicle distance (NSPD), nerve root-inferior pedicle distance (NIPD), and the relationship between the intervertebral space and the nerve root (shoulder, anterior, and axillary). Additionally, the descending angles between the spinal cord and the ventral (VRA) and dorsal (DRA) rootlets were measured. Results: The WN showed a gradual increase from C4 to C7, with measurements notably larger in men compared to women. The NSPD decreased gradually from the C2–3 to the C5–6 levels. However, the NIPD showed an opposite level-related change, notably larger than the NSPD at the C4–5, C5–6, and C7–T1 levels. Furthermore, significant differences in NIPD were observed between different age groups and genders. The incidence of the anterior type exhibited a gradual decrease from the C2–3 to the C5–6 levels. Conversely, the axillary type exhibited an opposite level-related change. Additionally, the VRA and DRA decreased as the level descended, with measurements significantly larger in females. Conclusion A prediction of the positional relationship between the intervertebral space and the nerve root is essential for the direct neuroventral decompression in PECD to avoid damaging the neural structures. The axillary route of the nerve root offers a safer and more effective pathway for performing direct neuroventral decompression compared to the shoulder approach.

BACKGROUND:When exercising in a cold environment,the body's inflammatory response is affected by both low temperature and exercise intervention,and its impact and mechanism remain to be explored.OBJECTIVE:To explore the effects and mechanisms of cold water swimming on inflammatory response of rats based on transcriptome sequencing technology.METHODS:40 male SD rats were randomly divided into room temperature control group,room temperature swimming group,cold water control group,and cold water swimming group,with 10 rats in each group.The room temperature control group had no intervention and was free to eat.The room temperature swimming group received swimming at 30 min/time,6 times/week,for 5 weeks;the water temperature was(28±2)℃,and the water depth was 35 cm.In the cold water control group,the rats were placed in a water tank with a depth of 3 cm;the water temperature was(18±2)℃,and they were free to move.The cold water swimming group received swimming at 30 min/time,6 times/week,for 5 weeks;the water temperature was(18±2)℃,and the water depth was 35 cm.Enzyme-linked immunosorbent assay was used to detect the levels of serum interleukin-6,tumor necrosis factor-α,and high-sensitivity C-reactive protein.Based on the transcriptome sequencing results,differentially expressed genes were screened to draw Venn diagrams and heat maps,and Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were performed.The protein-protein interaction network was used to screen core genes.RT-qPCR was used to detect the mRNA expression of IRF7,OAS2,and OASL in rat spleen tissue.RESULTS AND CONCLUSION:(1)The ELISA results showed that compared with the room temperature control group,the levels of various inflammatory indicators in the room temperature swimming group and the cold water swimming group were significantly increased(P＜0.05),and there was no significant difference in the cold water control group.Compared with the room temperature swimming group,there was no significant difference in the expression of inflammatory indicators in the cold water swimming group.Compared with the cold water control group,the expressions of interleukin-6 and tumor necrosis factor-α in the cold water swimming group showed an upward trend,and high-sensitivity C-reactive protein increased significantly(P＜0.05).(2)Transcriptome analysis:Venn diagram showed that there were 39 differentially expressed genes affected by the dual factors of temperature and exercise intervention.Cluster heat map analysis results showed that the overall gene expression trends of the room temperature swimming group and the cold water swimming group were similar,and the cold water control group showed an opposite trend.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis results showed that differentially expressed genes were enriched in the immune system,locomotion,nucleic acid-binding transcription factor activity,NOD-like receptor signaling pathways and other pathways.The number of genes enriched in the NOD-like receptor signaling pathway was relatively large,and the q value was small,which may be a key pathway.The protein-protein interaction network screened out IRF7,OAS2,OASL,IFIT2,IFIT3 and other core genes.(3)RT-qPCR verification results showed that compared with the room temperature control group,the expressions of IRF7,OAS2 and OASL were significantly increased in the room temperature swimming group and the cold water swimming group(P＜0.01),and there was no significant difference in the cold water control group.Compared with the cold water control group,the expression of each gene was significantly increased in the cold water swimming group(P＜0.01).(4)It is concluded that cold water swimming can promote inflammatory response,and its mechanism may be regulated through the NOD-like receptor signaling pathway.