Dry eye disease(DED)is a multifactorial disorder with an unclear pathogenesis. Advances in omics technologies have introduced a novel medical research approach, enabling the identification of global response variables from a single-factor perspective. However, multi-omics methods integrate multiple omics datasets to analyze all potential response variables, generating multidimensional and evidence-supported holistic inferences. These insights help elucidate functional impairments of ocular cells and biomolecular processes during disease progression, thereby revealing correlations between biomolecules and complex diseases. This review summarizes the application of multi-omics technologies in clarifying the pathogenesis and intricate molecular mechanisms of dry eye disease. Distinctive features from genomics, transcriptomics, proteomics, metabolomics, and microbiomics are integrated to deepen the understanding of the pathogenesis and complex molecular mechanisms underlying dry eye disease.

OBJECTIVE To provide a reference for clinical pharmacists to participate in the treatment of rare and complex cases of CTLA-4 haploid deficiency combined with severe malnutrition. METHODS The clinical pharmacist participated in the diagnosis and treatment of a complex case of CTLA-4 haploid deficiency with severe malnutrition， type 1 diabetes， blood coagulation abnormalities with gastrointestinal bleeding and virus infection， assisted the doctor to develop an individualized parenteral nutrition program， and dynamically adjusted the ratio of glucose and insulin （from 3.9∶1 to 15.6∶1）. When patient had severe coagulation abnormalities and gastrointestinal bleeding， the clinical pharmacist recommended discontinuing fat emulsion and switching to glucose amino acid dual energy supply； when the patient had a high fever accompanied by a sudden drop in platelets， the clinical pharmacist recommended to improve the second-generation sequencing of plasma metagenomics. Based on positive results for both EB virus and cytomegalovirus， the clinical pharmacist recommended to discontinue meropenem and switch to ganciclovir for antiviral treatment； when the patient experienced systemic itching and mental excitement， the clinical pharmacist quickly diagnosed as an adverse reaction of ganciclovir and recommended to switch to acyclovir for antiviral treatment. The clinical pharmacist simultaneously carried out parenteral nutrition medication education， and standardized infusion speed， and continuously monitored bleeding-related indicators. RESULTS The physician adopted the advice of the clinical pharmacist. After comprehensive intervention， the patient’s body temperature returned to normal， gastrointestinal bleeding stopped， coagulation indicators significantly improved， blood sugar control reached the standard， and the condition improved and the patient was discharged. CONCLUSIONS Clinical pharmacists rely on comprehensive pharmaceutical services to balance the benefits and risks of treatment for rare and complex cases. They play a key role in individualized nutrition planning， refined blood glucose control， infection identification and anti-infection optimization， and identification and treatment of adverse drug reactions to ensure patient medication safety and efficacy.

Age-related macular degeneration(ARMD)is a common multifactorial disease among the elderly, which may lead to irreversible vision loss; however, the pathogenesis of ARMD is still unclear. Metabolomics is a relatively new “omics” technique that can provide qualitative and quantitative information about low molecular weight metabolites that make up biological systems, thereby revealing the physiological or pathological state of cell or tissue samples at specific time points. In recent years, increasing evidence suggests that metabolic dysfunction plays an important role in the development and progression of ARMD. Metabolic pathway dysregulation involves lipid metabolism, nucleotide metabolism, amino acid metabolism, and energy metabolism, which may play important roles in the occurrence and development of ARMD. The retina is one of the most metabolically active tissues in the human body, so using metabolomics techniques to measure molecular changes in ARMD will further enhance our understanding of the pathogenesis. This will provide important insights for the prevention and treatment of ARMD, This article reviews the application of metabolomics in ARMD.

This article introduces Professor LIU Xing's clinical experience in treatment of peripheral facial paralysis at the recovery and sequelae stages with the combination of acupotomy, cupping and herbal medication. Based on the analysis of etiology and pathogenesis of peripheral facial paralysis, Professor LIU believes that "invasion of pathogenic wind to collaterals and obstruction of qi and blood" is crucial. Therefore, the treatment focuses on "dispelling wind and harmonizing blood". The compound therapeutic mode is proposed, with acupotomy, cupping and herbal decoction involved, in which, "three-step sequential method of acupotomy" is predominated. Firstly, in the prone position, five "feng" (wind) points are stimulated in patient, Fengfu (GV16), Fengchi (GB20), Yifeng (TE17), Bingfeng (SI12) and Fengmen (BL12). Secondly, in the lateral position, three-facial points are stimulated (FaceⅠneedle: Yangbai [GB14]-Yuyao [EX-HN4]; Face Ⅱ needle: Sibai [ST2]-Quanliao [SI18]; Face Ⅲ needle: Jiache [ST6]-Dicang [ST4]) to restore the deviated facial muscles. Finally, in the supine, two Dantian points are stimulated on the forehead and chest, respectively (upper Dantian: Yintang [GV24⁺], middle Dantian: Danzhong [CV17]), to regulate qi and blood. As the adjunctive therapies, cupping is used to remove stasis, and herbal decoction is to harmonize the body interior. In view of holistic regulation, the treatment is administered in accordance with the affected meridians, so as to expel wind, remove obstruction in collaterals and regulate qi and blood.
Humans ; Facial Paralysis/drug therapy* ; Drugs, Chinese Herbal/administration & dosage* ; Acupuncture Therapy ; Male ; Female ; Middle Aged ; Adult ; Combined Modality Therapy ; Acupuncture Points ; Cupping Therapy ; Aged ; Young Adult

Objective To investigate the risk factors for postoperative numbness syndrome secondary to lumbar disc herniation (LDH) based on propensity score matching (PSM). Methods A retrospective analysis was conducted on the clinical data of 429 LDH patients who underwent surgical treatment. The patients were divided into numbness syndrome group (85 patients) and non-numbness syndrome group (344 patients) according to whether they developed postoperative numbness syndrome. A 1∶1 match was performed between the numbness syndrome group and the non-numbness syndrome group based on PSM, with 67 patients in each group after matching. The clinical data of the two groups before and after matching were compared, and Cox regression analysis was performed on the matched data to screen risk factors for postoperative numbness syndrome secondary to LDH. Results The incidence of postoperative numbness syndrome in LDH patients was 19.81%(85/429). Before matching, the numbness syndrome group had a higher or longer proportion of males, age, body mass index (BMI), duration of disease, proportion of patients with L₃ to L₄ or L₄ to L₅ lesion segments, proportion of patients with grade Ⅳ to Ⅴ disc degeneration, proportion of patients with prolapsed or free-fragment herniation, operation time, proportion of patients with incomplete nucleus pulposus removal during surgery, proportion of patients with annulus fibrosus rupture, proportion of patients with a history of hyperlipidemia, proportion of patients who did not undergo postoperative rehabilitation exercises, and postoperative activity intensity scores compared to the non-numbness syndrome group (P < 0.05). After matching, the numbness syndrome group had higher or longer age, BMI, duration of disease, proportion of patients with grade Ⅳ to Ⅴ disc degeneration, proportion of patients with prolapsed or free-fragment herniation, proportion of patients with incomplete nucleus pulposus removal during surgery, proportion of patients with annulus fibrosus rupture, proportion of patients with a history of diabetes, proportion of patients who did not undergo postoperative rehabilitation exercises, and postoperative activity intensity scores compared to the non-numbness syndrome group (P < 0.05). The results of multivariate Cox regression analysis showed that high BMI, grade Ⅳ to Ⅴ disc degeneration, incomplete nucleus pulposus removal during surgery, annulus fibrosus rupture, history of diabetes, lack of postoperative rehabilitation exercises, and high postoperative activity intensity were independent risk factors for postoperative numbness syndrome secondary to LDH (HR=4.395, 7.183, 4.404, 5.633, 3.521, 4.929, 3.710, P < 0.05). Conclusion After controlling for confounding factors based on PSM, the risk factors for postoperative numbness syndrome secondary to LDH include high BMI, grade Ⅳ to Ⅴ disc degeneration, incomplete nucleus pulposus removal during surgery, annulus fibrosus rupture, a history of diabetes, lack of postoperative rehabilitation exercises, and high postoperative activity intensity, which is helpful for clinical healthcare professionals to early identify high-risk patients with postoperative numbness syndrome secondary to LDH and provide a reference for subsequent patient treatment.

Humans ; Aneurysm, False/etiology* ; Heart Aneurysm/complications* ; Heart Ventricles/surgery*

Humans ; Aneurysm, False/etiology* ; Heart Aneurysm/complications* ; Heart Ventricles/surgery*

OBJECTIVE: To detect the expression of plasma exosomal microRNA (miRNA) in systemic sclerosis (SSc), and to investigate its clinical significance. METHODS: A total of 20 patients who were initially diagnosed with SSc and did not receive medication in Department of Rheumatology and Immunology of Meizhou People' s Hospital from January 2020 to January 2022 were recruited, as well as 15 healthy individuals whose gender and age matched with those of the SSc patients. Plasma exosomes were isolated using ultracentrifugation method. The expression levels of exosomal miR-34-5p, miR-92-3p and miR-142-3p were detected by quantative real-time polymerase chain reaction (qRT-PCR). Correlations between the expression levels of exosomal miRNAs and clinical characteristic were analyzed by Spearman's rank correlation coefficient test. RESULTS: The mean age of 20 patients with SSc was (52.6±12.6) years, including 7 males and 13 females. Among the 20 SSc patients, 13 cases were diagnosed as limited cutaneous systemic sclerosis (lcSSc) and 7 cases were diagnosed as diffuse cutaneous systemic sclerosis (dcSSc) according to the extent of skin involvement. According to the findings of high resolution chest CT, 7 of 20 SSc patients were diagnosed with interstitial lung disease (ILD) and 13 SSc patients were diagnosed with non-ILD. The expression levels of exosomal miR-34-5p, miR-92-3p and miR-142-3p were significantly elevated in the SSc patients compared with those in the healthy controls group (P=0.003, P=0.000 1, and P=0.016, respectively). Compared with the SSc patients without ILD, the expression levels of miR-34-5p and miR-142-3p were significantly lower in the SSc patients with ILD (P=0.037 and P=0.015, respectively). The expression levels of exosomal miR-34-5p and miR-142-3p showed negative correlation with ILD (r=-0.48, P=0.031 and r=-0.55, P=0.011, respectively), and arthritis (r=-0.46, P=0.040 and r=-0.48, P=0.032, respectively). The expression levels of exosomal miR-142-3p showed a negative correlation with erythrocyte sedimentation rate (ESR) (r=-0.55, P=0.012). CONCLUSION Plasma exosomal miR-34-5p, miR-92-3p and miR-142-3p were dysregulated in SSc. The dyregulation of exosomal miR-34-5p and miR-142-3p showed correlation with SSc associated ILD (SSc-ILD).
Male ; Female ; Humans ; Young Adult ; Adult ; Clinical Relevance ; MicroRNAs/genetics* ; Scleroderma, Systemic/genetics* ; Lung Diseases, Interstitial

Objective : To investigate equity of resource allocation in ophthalmology departments of medical institutions in Shenzhen City, so as to provide insights into the optimization of resource allocation in ophthalmology departments in Shenzhen City. Methods : The numbers of beds and ophthalmologists in ophthalmology departments of medical institutions in Shenzhen City were collected through the Shenzhen Health Statistical Yearbook 2019. The distribution of resources and equity of resource allocation were evaluated in ophthalmology departments of Shenzhen City using Lorenz curve and Gini coefficient. Results : There were 5.95 beds and 4.62 ophthalmologists in ophthalmology departments per 100 000 permanent residents in Shenzhen City in 2019. There were 13.35 beds and 9.51 ophthalmologists in ophthalmology departments per 100 000 permanent residents within the former special zone (Luohu, Futian, Nanshan and Yantian districts), and 2.17 beds and 2.13 ophthalmologists in ophthalmology departments per 100 000 permanent residents outside the former special zone (Guangming, Baoan, Longhua, Longgang, Pingshan districts and Dapeng New Area). The Gini coefficients of beds and ophthalmologists in ophthalmology departments were 0.348 and 0.243 by permanent residents in Shenzhen City, 0.386 and 0.386 within the former special zone and 0.086 and 0.012 outside the former special zone, respectively. The Lorenz curves of beds and ophthalmologists in ophthalmology departments were closer to the equity line outside the former special zone in relative to within the former special zone. Conclusion The gross number of beds and ophthalmologists remains to be increased in ophthalmology departments of medical institutions in Shenzhen City, and the equity of regional resource allocation is poor, which is mainly characterized by resource scarcity in ophthalmology departments outside the former special zone.

Objective : To investigate the influence and molecular mechanism of hypoxia-inducing factor-1 α( HIF- 1 α) gene silencing combined with methyl selenenic acid (MSA) on cervical cancer cell proliferation，apoptosis and cell migration． Methods : HeLa cells were transfected with HIF-1 interference RNA and negative control RNA．Af- ter transfection for 48 h，cells were stimulated with MSA for 24 h，and cell proliferation was determined by CCK-8 assay and colony formation．Apoptosis was determined by flow cytometry combined with Annexin V-FITC / PI．The expression levels of HIF-1α , Bcl-2 ，and E-cadherin were detected by Western blot assay． Cell migration ability was determined by Transwell assay. RNA-seq analysis was used to investigate the differentially expressed genes and differential signaling pathways. Results : Compared with the control group，interfering with HIF-1α combined with MSA significantly inhibited cell proliferation (P ＜0．01) ．Flow cytometry results showed that the combined drug group significantly induced apoptosis．Transwell results showed that interfering with HIF-1α combined with MSA inhibited HeLa cell migration．Compared with the control group，interfering with HIF-1α combined with MSA down- regulated the expression of Bcl-2 and up-regulated the expression of E-cadherin. RNA-sequencing combined with signal pathway enrichment results showed that the expression of apoptotic signal pathway and downstream genes was inhibited． Conclusion HIF-1α gene silencing combined with MSA can synergically inhibit the proliferation and induce apoptosis of cervical cancer cells，and its regulatory mechanism may be related to the expression of Bcl-2 family proteins and the inhibition of p53 signaling pathway.