Myopia is a highly prevalent refractive error worldwide, with scleral remodeling accompanying excessive axial elongation being one of its core pathological features. As the crucial outer layer responsible for maintaining eyeball morphology and biomechanical stability, the sclera plays a decisive role in the pathogenesis and progression of myopia through abnormal alterations in its cellular components, extracellular matrix(ECM)metabolism, and regulatory networks. This review systematically summarizes recent research advances in scleral remodeling. It focuses on elucidating, from cellular and molecular perspectives, the mechanisms by which dysfunction of scleral fibroblasts, dysregulation of ECM metabolism(e.g., decreased collagen content, disrupted MMP-2/TIMP-2 balance), and complex regulatory networks involving multiple signaling pathways such as TGF-β, Wnt/β-catenin, and MAPK drive scleral thinning and reduced mechanical strength. Concurrently, the review provides a comprehensive analysis of the potential roles and existing controversies regarding factors like inflammatory responses and novel regulatory axes(e.g., FOXM1/METTL3/APOA1)in scleral remodeling. Furthermore, it discusses the current research status and application prospects of sclera-targeted intervention strategies(e.g., modulating specific pathways, supplementing exogenous factors), aiming to provide a theoretical basis and directional reference for a deeper understanding of myopia pathogenesis and the development of new prevention and treatment approaches.

Myopia is an increasingly prevalent public health concern globally, with a complex pathogenesis involving the interplay of multiple signaling pathways and genes. The Wnt signaling pathway plays a crucial role in biological processes such as cell proliferation, differentiation, apoptosis, and tissue remodeling, and its role in myopia development has garnered significant attention in recent years. Studies have demonstrated that the Wnt signaling pathway influences the occurrence and progression of myopia by regulating the proliferation, differentiation, and apoptosis of retinal cells(including RPE cells and ipRGCs), as well as the proliferation of scleral fibroblasts and the expression of extracellular matrix components(such as type I collagen), thereby affecting scleral remodeling and axial length elongation. This paper summarizes the roles of the Wnt signaling pathway in myopia development within different ocular tissues(retina and sclera)and explores potential myopia prevention and treatment strategies based on this pathway, providing insights for further research and clinical management of myopia.

In recent years, the role of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in the prevention and treatment of ischemic stroke has received widespread attention. Researches have shown that n-3 PUFAs can reduce the risk of stroke and improve stroke outcome through various mechanisms, including anti-inflammatory, antioxidant, improvement of endothelial function, promotion of angiogenesis, and anti-apoptotic effects, demonstrating potential in the prevention and treatment of ischemic stroke. This article reviews the mechanism of action and clinical research of n-3 PUFAs in ischemic stroke.

Objective To compile a comprehension assessment scale of double-conditional phrases for adults and to test its reliability and validity.Methods With reference to the compilation process of local and international word lists,a comprehension assessment scale of double-conditional phrases for adults was developed.The scale was used to assess 40 aphasia patients and 20 ordinary adults as subjects from four hospitals in Shanghai.The internal consistency reliability,split-half reliability,retest reliability and calibration validity of the scale were evaluated and analyzed[the western aphasia battery(WAB)as a calibrated measurcment instrument].Results The scale consists of 30 questions,including five types of phrases:coordinate phrases,verb-object phrases,subject-predicate phrases,endocentric phrases and interface-object phrases.Compared with the ordinary adult group,the total score of the scale and the scores of each dimension in the aphasia group were significantly lower than those in the control group(P＜0.001).The Cronbach's alpha coefficient for the total score was 0.894,the half coefficient was 0.924,and the correlation coefficient for the retest reliability of the total score was 0.923,with retest reliability for each type of word group ranging from 0.731 to 0.903.With the exception of the repetition scores,correlation coefficients be-tween the scale and all other scores of WAB were all＞0.6(P＜0.01).Conclusion The self-developed"Adult Double Conditional Phrases Auditory Comprehension Assessment Scale"demonstrates good reliability and validity.It serves as a scientific and reliable tool for evaluating the auditory comprehension ability of adult patients.

Objective:To investigate the influencing factors of secondary type 2 diabetes in young obesity patients, and construct and validate a risk prediction model.Methods:The retrospective cohort study was conducted. The clinical data of 847 young obesity patients who were admitted to The First Affiliated Hospital of Nanjing Medical University from January 2022 to July 2024 were collected. There were 382 males and 465 females, aged (29.4±3.8)years. Patients were randomly divided into a training set of 593 cases and a validation set of 254 cases based on a random number table method of 7∶3 ratio. The training set was used to construct the prediction model, and the validation set was used to validate prediction model. Observation indicators: (1) analysis of influencing factors of secondary type 2 diabetes in young obesity patients; (2) construc-tion and validation of a prediction model for secondary type 2 diabetes in young obesity patients. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Univariate analysis was performed using the corresponding statistical methods based on data types. Multivariate analysis was performed using the Logistic regression model, and the area under the curve (AUC) of receiver operating characteristic (ROC) curve, the Hosmer-Lemeshow test, the calibration curve and decision curve were used to evaluate the predictive performance of the model. Results:(1) Analysis of influencing factors of secondary type 2 diabetes in young obesity patients. Of the 847 young obesity patients, there were 238 patients with secondary type 2 diabetes, including 161 cases in the training set and 77 cases in the validation set, 609 patients of simple obesity, including 432 cases in the training set and 177 cases in the validation set. Results of multivariate analysis showed that family history of diabetes, hypertension, high-sugar diet, exercise habits, triglyceride (TG), homeostasis model assessment of insulin resistance (HOMA-IR) and neutrophil-to-lymphocyte ratio (NLR) were independent factors influencing secondary type 2 diabetes in young obesity patients [ odds ratio=9.476, 2.420, 3.219, 0.272, 2.137, 26.759, 41.535, 95% confidence interval ( CI) as 3.242-27.696, 1.159-5.052, 1.525-6.796, 0.117-0.632, 1.019-4.481, 12.907-55.476, 16.085-107.251, P<0.05]. (2) Construction and validation of a prediction model for secondary type 2 diabetes in young obesity patients. A nomogram prediction model for secondary type 2 diabetes in young obesity patients was constructed based on the results of multivariate analysis. Results of ROC curve analysis showed that the AUC of prediction model for the training set was 0.963(95% CI as 0.946-0.980), with sensitivity of 89.6% and specificity of 93.2%, respectively, and the AUC of prediction model for the validation set was 0.966(95% CI as 0.944-0.988), with sensitivity of 92.7% and specificity of 88.3%, respectively. Results of Hosmer-Lemeshow test showed that the P-values for both the training set and validation set were >0.05, indicating good model fit. The calibration curves for both the training set and validation set closely matched the actual curve, demonstrating the prediction model with a good fit. The decision curve analysis showed high practical value of the model. Conclusions:Family history of diabetes, hypertension, high-sugar diet, exercise habits, TG, HOMA-IR and NLR are independent factors influencing secondary type 2 diabetes in young obesity patients. The prediction model constructed based on these factors demons-trates good predictive performance.

Objective To determine the body weights and blood physiological and biochemical indicators in the Macaca mulatta brevicaudus(M.m.brevicaudus),to provide a reference for the breeding of experimental animals.Methods A total of 180 wild M.m.brevicaudus(female and male)from the South Bay Macaque Reserve in Lingshui were selected as the research subjects.Body weights were measured using electronic scales and blood samples were collected.Routine blood indicators(red blood cell count,hemoglobin,white blood cell count,and platelet count)were detected using an automated blood cell analyzer,and biochemical indicators(alanine aminotransferase,aspartate aminotransferase,glucose,blood urea nitrogen)were measured using an automated biochemical analyzer.Data were analyzed using SPSS 18.0 software for descriptive statistics,and differences in body weights and blood indicators between sexes and age groups were compared using t-tests.Results Adult male wild M.m.brevicaudus were significantly heavier than females(P＜0.05);however,there were no significant differences in complete blood cell counts between female and male macaques(P＞0.05).In terms of blood biochemical indicators,lactate dehydrogenase and total bilirubin levels differed significantly between female and male M.m.brevicaudus(P＜0.05),but there were no significant differences in any other biochemical indicators.Conclusions This study established baseline data on the body weights and blood physiological and biochemical indicators of wild M.m.brevicaudus,providing a reference for their future breeding as experimental animals.

Objective To explore the magnetic resonance(MR)imaging characteristics of joint damage caused by Chikungunya virus(CHIKV)and its correlation with pain severity,and analyze the value of T2-Mapping in asse-ssing the severity and prognosis of such damage.Methods A multicenter retrospective study design was adopted,and patients with CHIKV infection accompanied by joint pain were included in analysis.Multi-joint MR scans were performed to assess joint effusion,synovial thickening,bone marrow edema,and cartilage damage.T2-Mapping values were measured.Pain severity was assessed using the Visual Analog Scale(VAS),and imaging findings were independently assessed by two radiologists.Results A total of 131 patients were included in the study.The inci-dence of joint cavity and/or synovial sac effusion was the highest(77.1％,n=101),with knee and ankle joint effu-sion accounting for 81.2％(severe,mild-moderate were 17 and 65 cases,respectively),other joint effusion were mild.78 cases had synovial thickening(14 and 64 were severe and mild-moderate cases,respectively),27 cases had tenosynovitis,21 cases had bone marrow edema(primarily in the knee and ankle joints).19 cases had cartilage damage,114 cases presented muscle soft tissue edema(17 and 97 were severe and mild-moderate cases,respective-ly),28 cases had Kager's fat pad edema.Patients with elevated T2-Mapping values exhibited more pronounced chronic joint pain,with T2-Mapping values in the cartilage damage site increasing by 40％-60％compared with normal cartilage site(19 cases in total).The T2-Mapping value for severely damaged soft tissue was(52.3+6.7)ms,while for mildly to moderately damaged soft tissue was(42.3±5.2)ms,both significantly higher than normal refe-rence values(＜35 ms,both P＜0.05).Among 17 patients with severe soft tissue damage,12 experienced persistent pain for over one month,with statistically significant differences in T2 values compared with those with mild-mode-rate damage(P＜0.05).This further suggested that the degree of elevation in T2-Mapping values was closely related to the duration of pain and the severity of damage.After one-month follow-up,103 patients had pain relief.Among the 28 patients with ongoing pain,17 developed into subacute bone joint pain.Bone marrow edema(81.0％),ele-vation of T2-Mapping value of cartilage(89.5％),and severe synovial thickening(71.4％)were high-risk MR manifestations of subacute bone joint pain.The incidences of subacute joint cavity/sac effusion and subacute tenosy-novitis were 3.0％and 7.4％,respectively.Conclusion MR can clearly display the inflammatory and structural changes in CHIKV joint damage,and T2-Mapping values may serve as a potential imaging measurement parameter for assessing severity and prognosis of damage.

Objective To compile a comprehension assessment scale of double-conditional phrases for adults and to test its reliability and validity.Methods With reference to the compilation process of local and international word lists,a comprehension assessment scale of double-conditional phrases for adults was developed.The scale was used to assess 40 aphasia patients and 20 ordinary adults as subjects from four hospitals in Shanghai.The internal consistency reliability,split-half reliability,retest reliability and calibration validity of the scale were evaluated and analyzed[the western aphasia battery(WAB)as a calibrated measurcment instrument].Results The scale consists of 30 questions,including five types of phrases:coordinate phrases,verb-object phrases,subject-predicate phrases,endocentric phrases and interface-object phrases.Compared with the ordinary adult group,the total score of the scale and the scores of each dimension in the aphasia group were significantly lower than those in the control group(P＜0.001).The Cronbach's alpha coefficient for the total score was 0.894,the half coefficient was 0.924,and the correlation coefficient for the retest reliability of the total score was 0.923,with retest reliability for each type of word group ranging from 0.731 to 0.903.With the exception of the repetition scores,correlation coefficients be-tween the scale and all other scores of WAB were all＞0.6(P＜0.01).Conclusion The self-developed"Adult Double Conditional Phrases Auditory Comprehension Assessment Scale"demonstrates good reliability and validity.It serves as a scientific and reliable tool for evaluating the auditory comprehension ability of adult patients.

Objective:To investigate the influencing factors of secondary type 2 diabetes in young obesity patients, and construct and validate a risk prediction model.Methods:The retrospective cohort study was conducted. The clinical data of 847 young obesity patients who were admitted to The First Affiliated Hospital of Nanjing Medical University from January 2022 to July 2024 were collected. There were 382 males and 465 females, aged (29.4±3.8)years. Patients were randomly divided into a training set of 593 cases and a validation set of 254 cases based on a random number table method of 7∶3 ratio. The training set was used to construct the prediction model, and the validation set was used to validate prediction model. Observation indicators: (1) analysis of influencing factors of secondary type 2 diabetes in young obesity patients; (2) construc-tion and validation of a prediction model for secondary type 2 diabetes in young obesity patients. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Univariate analysis was performed using the corresponding statistical methods based on data types. Multivariate analysis was performed using the Logistic regression model, and the area under the curve (AUC) of receiver operating characteristic (ROC) curve, the Hosmer-Lemeshow test, the calibration curve and decision curve were used to evaluate the predictive performance of the model. Results:(1) Analysis of influencing factors of secondary type 2 diabetes in young obesity patients. Of the 847 young obesity patients, there were 238 patients with secondary type 2 diabetes, including 161 cases in the training set and 77 cases in the validation set, 609 patients of simple obesity, including 432 cases in the training set and 177 cases in the validation set. Results of multivariate analysis showed that family history of diabetes, hypertension, high-sugar diet, exercise habits, triglyceride (TG), homeostasis model assessment of insulin resistance (HOMA-IR) and neutrophil-to-lymphocyte ratio (NLR) were independent factors influencing secondary type 2 diabetes in young obesity patients [ odds ratio=9.476, 2.420, 3.219, 0.272, 2.137, 26.759, 41.535, 95% confidence interval ( CI) as 3.242-27.696, 1.159-5.052, 1.525-6.796, 0.117-0.632, 1.019-4.481, 12.907-55.476, 16.085-107.251, P<0.05]. (2) Construction and validation of a prediction model for secondary type 2 diabetes in young obesity patients. A nomogram prediction model for secondary type 2 diabetes in young obesity patients was constructed based on the results of multivariate analysis. Results of ROC curve analysis showed that the AUC of prediction model for the training set was 0.963(95% CI as 0.946-0.980), with sensitivity of 89.6% and specificity of 93.2%, respectively, and the AUC of prediction model for the validation set was 0.966(95% CI as 0.944-0.988), with sensitivity of 92.7% and specificity of 88.3%, respectively. Results of Hosmer-Lemeshow test showed that the P-values for both the training set and validation set were >0.05, indicating good model fit. The calibration curves for both the training set and validation set closely matched the actual curve, demonstrating the prediction model with a good fit. The decision curve analysis showed high practical value of the model. Conclusions:Family history of diabetes, hypertension, high-sugar diet, exercise habits, TG, HOMA-IR and NLR are independent factors influencing secondary type 2 diabetes in young obesity patients. The prediction model constructed based on these factors demons-trates good predictive performance.

Objective To determine the body weights and blood physiological and biochemical indicators in the Macaca mulatta brevicaudus(M.m.brevicaudus),to provide a reference for the breeding of experimental animals.Methods A total of 180 wild M.m.brevicaudus(female and male)from the South Bay Macaque Reserve in Lingshui were selected as the research subjects.Body weights were measured using electronic scales and blood samples were collected.Routine blood indicators(red blood cell count,hemoglobin,white blood cell count,and platelet count)were detected using an automated blood cell analyzer,and biochemical indicators(alanine aminotransferase,aspartate aminotransferase,glucose,blood urea nitrogen)were measured using an automated biochemical analyzer.Data were analyzed using SPSS 18.0 software for descriptive statistics,and differences in body weights and blood indicators between sexes and age groups were compared using t-tests.Results Adult male wild M.m.brevicaudus were significantly heavier than females(P＜0.05);however,there were no significant differences in complete blood cell counts between female and male macaques(P＞0.05).In terms of blood biochemical indicators,lactate dehydrogenase and total bilirubin levels differed significantly between female and male M.m.brevicaudus(P＜0.05),but there were no significant differences in any other biochemical indicators.Conclusions This study established baseline data on the body weights and blood physiological and biochemical indicators of wild M.m.brevicaudus,providing a reference for their future breeding as experimental animals.