ObjectiveSpinal cord injury (SCI) directly impairs the regulatory function of the autonomic nervous system, induces intestinal dysfunction, and significantly reduces patients’ quality of life. Preclinical studies have shown that electroacupuncture (EA) therapy can regulate the brain-gut axis and is used to treat central nervous system diseases such as major depressive disorder, Alzheimer’s disease and Parkinson’s disease. Recent research has established that fecal microbiota transplantation (FMT) from EA-treated SCI rats restored intestinal motility and colonic morphology. However, it remains unclear whether the regulation of gut microbiota by EA therapy directly contributes to neural repair after SCI. This study aims to explore whether gut microbiota mediates the neuroprotective effect of EA in the treatment of SCI and its possible mechanism. MethodsThe study employed RNA transcriptome analysis of spinal cord tissue to characterize gene expression profiles and to identify key signaling pathways following EA treatment for SCI. Hematoxylin-Eosin (HE) staining and Nissl staining were used to observe the morphological changes in spinal cord tissue. Western blot (WB) and enzyme-linked immunosorbent assay (ELISA) were applied to detect the effects of EA on the expression of proteins related to nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 (NLRP3) -dependent pyroptosis. Using 16S rDNA sequencing, the study observed alterations in gut microbiota diversity and community composition in SCI rats. Prior to establishing SCI models, rats were pretreated with an antibiotic cocktail to induce gut dysbiosis, and the effects on intestinal function and spinal cord neural repair were evaluated. FMT was performed to investigate the regulatory effects of post-EA FMT on motor function, general status, liver and spleen indices, and NLRP3-mediated pyroptosis in SCI rats. ResultsEA improved motor function and reduced regulated neuronal cell death in SCI rats. Transcriptomic analysis demonstrated the activation of immune- and inflammation-related pathways post-SCI, including NOD-like receptors, nuclear factor-kappa B(NF-κB), and Toll-like receptor (TLR) pathways. EA primarily influenced intestinal inflammation and autoimmune functions. 16S rDNA sequencing illustrated that EA did not alter the diversity of gut microbiota. However, EA altered the gut microbiota composition in SCI rats, increasing Lactobacillus and Akkermansia genera while rebalancing the Firmicutes/Bacteroidetes ratio. Furthermore, depletion of gut microbiota by antibiotics disrupted the intestinal barrier, reduced the expression of intestinal barrier proteins Zonula Occludens-1 (ZO-1) and Occludin, elevated serum lipopolysaccharide-binding protein (LBP) levels, exacerbated spinal cord tissue damage, and hindered motor function recovery in SCI rats. FMT from donors treated with EA reduced LBP levels in the intestine, blood, and spinal cord of rats, inhibited the TLR4 myeloid differentiation primary response protein 88 (MyD88)-NF‑κB pathway and NLRP3-dependent pyroptosis, and improved motor function. On the other hand, FMT treatment resulted in decreased body weight and food intake, whereas FMT using EA-treated donors effectively alleviated these alterations. ConclusionEA effectively alleviated neuroinflammatory responses in rats with SCI, primarily through regulating the gut microbiota and suppressing the NLRP3-dependent pyroptosis signaling pathway.

ObjectiveSpinal cord injury (SCI) directly impairs the regulatory function of the autonomic nervous system, induces intestinal dysfunction, and significantly reduces patients’ quality of life. Preclinical studies have shown that electroacupuncture (EA) therapy can regulate the brain-gut axis and is used to treat central nervous system diseases such as major depressive disorder, Alzheimer’s disease and Parkinson’s disease. Recent research has established that fecal microbiota transplantation (FMT) from EA-treated SCI rats restored intestinal motility and colonic morphology. However, it remains unclear whether the regulation of gut microbiota by EA therapy directly contributes to neural repair after SCI. This study aims to explore whether gut microbiota mediates the neuroprotective effect of EA in the treatment of SCI and its possible mechanism. MethodsThe study employed RNA transcriptome analysis of spinal cord tissue to characterize gene expression profiles and to identify key signaling pathways following EA treatment for SCI. Hematoxylin-Eosin (HE) staining and Nissl staining were used to observe the morphological changes in spinal cord tissue. Western blot (WB) and enzyme-linked immunosorbent assay (ELISA) were applied to detect the effects of EA on the expression of proteins related to nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 (NLRP3) -dependent pyroptosis. Using 16S rDNA sequencing, the study observed alterations in gut microbiota diversity and community composition in SCI rats. Prior to establishing SCI models, rats were pretreated with an antibiotic cocktail to induce gut dysbiosis, and the effects on intestinal function and spinal cord neural repair were evaluated. FMT was performed to investigate the regulatory effects of post-EA FMT on motor function, general status, liver and spleen indices, and NLRP3-mediated pyroptosis in SCI rats. ResultsEA improved motor function and reduced regulated neuronal cell death in SCI rats. Transcriptomic analysis demonstrated the activation of immune- and inflammation-related pathways post-SCI, including NOD-like receptors, nuclear factor-kappa B(NF-κB), and Toll-like receptor (TLR) pathways. EA primarily influenced intestinal inflammation and autoimmune functions. 16S rDNA sequencing illustrated that EA did not alter the diversity of gut microbiota. However, EA altered the gut microbiota composition in SCI rats, increasing Lactobacillus and Akkermansia genera while rebalancing the Firmicutes/Bacteroidetes ratio. Furthermore, depletion of gut microbiota by antibiotics disrupted the intestinal barrier, reduced the expression of intestinal barrier proteins Zonula Occludens-1 (ZO-1) and Occludin, elevated serum lipopolysaccharide-binding protein (LBP) levels, exacerbated spinal cord tissue damage, and hindered motor function recovery in SCI rats. FMT from donors treated with EA reduced LBP levels in the intestine, blood, and spinal cord of rats, inhibited the TLR4 myeloid differentiation primary response protein 88 (MyD88)-NF‑κB pathway and NLRP3-dependent pyroptosis, and improved motor function. On the other hand, FMT treatment resulted in decreased body weight and food intake, whereas FMT using EA-treated donors effectively alleviated these alterations. ConclusionEA effectively alleviated neuroinflammatory responses in rats with SCI, primarily through regulating the gut microbiota and suppressing the NLRP3-dependent pyroptosis signaling pathway.

Methods: Fifty patients who underwent UBE-TLIF and 50 patients who underwent W-TLIF, each with >2 years of follow-up, were retrospectively analyzed. Outcomes included operative parameters, time to postoperative mobilization, paravertebral muscle atrophy and fat infiltration rates, clinical scores (Visual Analog Scale [VAS], Oswestry Disability Index [ODI], Japanese Orthopaedic Association [JOA]), modified Macnab criteria, fusion rates, and complications. Results: Compared with W-TLIF, the UBE-TLIF group had significantly less intraoperative blood loss, shorter operative times, and lower postoperative drainage volumes (p <0.05). The UBE-TLIF group showed faster postoperative recovery and shorter hospital stays. At 6 months, 1 year, and 2 years, W-TLIF patients had higher multifidus and erector spinae atrophy, and greater paravertebral muscle fat infiltration (p <0.05). The UBE-TLIF group also had lower VAS and ODI scores at 1 year and 2 years (p <0.05) and fewer surgical complications (6% vs. 10%). Fusion rates (94% vs. 92%) and modified Macnab outcomes (88% vs. 86%) were comparable (p >0.05). Conclusions UBE-TLIF is associated with reduced intraoperative trauma, quicker recovery, and fewer complications. In the long-term, it better preserves paravertebral muscle integrity and provides superior pain and functional outcomes.

AIM:To assess the influence of preoperative lacrimal passage probing and dilation on the therapeutic effectiveness of nasolacrimal silicone intubation in cases of incomplete primary acquired nasolacrimal duct obstruction(PANDO).METHODS: A retrospective case-control clinical study was conducted. The study included patients with incomplete PANDO who underwent nasolacrimal silicone intubation at the hospital between October 2022 and October 2024. Participants were categorized into two groups based on their receipt of nasolacrimal duct probing and dilation prior to intubation. Group A consisted of patients who had undergone one or more sessions of nasolacrimal duct probing and dilation before nasolacrimal silicone intubation, while Group B included patients who did not receive nasolacrimal duct probing and dilation before intubation. All patients had their nasolacrimal silicone tubes removed 3 mo postoperatively and were monitored for 6 mo following tube removal to evaluate surgical success rates.RESULTS: A total of 136 patients(152 eyes)completed the six-month follow-up period. The overall surgical success rate for both groups was 72.4%(110/152 eyes).Group A included 22 males and 36 females, mean age 58.09±11.07 y, and achieved a success rate of 82.8%(53/64 eyes), while Group B included 27 males and 51 females, mean age 59.35±8.84 y and attained a success rate of 64.8%(57/88 eyes). The difference in surgical success rates between the two groups was statistically significant(P=0.014). Furthermore, Group A achieved a complete success rate of 67.2%(43/64 eyes), compared to 47.7%(42/88 eyes)in Group B, with this difference also reaching statistical significance(P=0.017). No serious postoperative complications were observed in either group.CONCLUSION: Nasolacrimal silicone intubation is a safe and effective intervention for incomplete PANDO, with preoperative nasolacrimal duct probing and dilation potentially enhancing therapeutic outcomes.

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.

Objective: To analyze the epidemiological characteristics, associated factors, and vaccine effectiveness of two pertussis cluster outbreaks in two primary schools in Yangzhong City in 2025, so as to provide evidence for school based epidemic prevention and control. Methods: From August 26 to 30, 2025, a pertussis questionnaire was administered to the epidemic affected classes of two primary schools (school A and school B) in Yangzhong City. A descriptive epidemiological retrospective analysis was used to characterize the pertussis cluster outbreaks in Yangzhong City from March to July 2025. A 1∶5 matched case control study (79 cases, 395 controls) was performed. Multivariate Logistic regression was used to identify associated factors, and the clinical symptom incidence rates, types of pertussis containing vaccines, and timeliness of vaccination were compared between groups using Fisher s exact test. Results: From March to July 2025, a total of 79 pertussis cases were reported in the two schools, with attack rates of 1.33% and 1.01%, respectively. Cases were predominantly aged 7-8 years (85.37% in school A, 73.68% in school B), and the main clinical manifestation was productive cough (63.29%). The pneumonia incidence rate among hospitalized cases ( 57.14 %) was higher than that among nonhospitalized cases(4.17%)(Fisher s exact test, P <0.01). The interval from the last dose to onset was concentrated at 6 to <7 years (44 cases). Logistic regression showed that children exposed to secondhand smoke in daily life ( OR = 3.86 ), those whose desk mates or front/back desk mates took leave due to cough ( OR =4.67), and those whose dining table mates or front/back table mates took leave due to cough ( OR =3.67) had significantly higher risks of pertussis (all P <0.05). A high proportion of both the case group and the control group received the acellular DTaP vaccine (97.47% and 96.96%, respectively),while a low proportion received the pentavalent vaccine (1.27% and 3.04%, respectively). Additionally, one case received only three doses of the acellular DTaP vaccine.The difference in vaccine type distribution between the two groups was not statistically significant (Fisher s exact test, P =0.31). Conclusions The outbreaks represent breakthrough infections under high vaccine coverage. Close contact and secondhand smoke exposure are the main risk factors. A booster immunization strategy with diphtheria-tetanus-pertussis vaccine should be implemented for school aged children.

Obstructive sleep apnea (OSA) is an increasingly widespread sleep-breathing disordered disease, and is an independent risk factor for many high-risk chronic diseases such as hypertension, coronary heart disease, stroke, arrhythmias and diabetes, which is potentially fatal. The key to the prevention and treatment of OSA is early diagnosis and treatment, so the assessment and diagnostic technologies of OSA have become a research hotspot. This paper reviews the research progresses of severity assessment parameters and diagnostic technologies of OSA, and discusses their future development trends. In terms of severity assessment parameters of OSA, apnea hypopnea index (AHI), as the gold standard, together with the percentage of duration of apnea hypopnea (AH%), lowest oxygen saturation (LSpO₂), heart rate variability (HRV), oxygen desaturation index (ODI) and the emerging biomarkers, constitute a multi-dimensional evaluation system. Specifically, the AHI, which measures the frequency of sleep respiratory events per hour, does not fully reflect the patients’ overall sleep quality or the extent of their daytime functional impairments. To address this limitation, the AH%, which measures the proportion of the entire sleep cycle affected by apneas and hypopneas, deepens our understanding of the impact on sleep quality. The LSpO₂ plays a critical role in highlighting the potential severe hypoxic episodes during sleep, while the HRV offers a different perspective by analyzing the fluctuations in heart rate thereby revealing the activity of the autonomic nervous system. The ODI provides a direct and objective measure of patients’ nocturnal oxygenation stability by calculating the number of desaturation events per hour, and the biomarkers offers novel insights into the diagnosis and management of OSA, and fosters the development of more precise and tailored OSA therapeutic strategies. In terms of diagnostic techniques of OSA, the standardized questionnaire and Epworth sleepiness scale (ESS) is a simple and effective method for preliminary screening of OSA, and the polysomnography (PSG) which is based on recording multiple physiological signals stands for gold standard, but it has limitations of complex operations, high costs and inconvenience. As a convenient alternative, the home sleep apnea testing (HSAT) allows patients to monitor their sleep with simplified equipment in the comfort of their own homes, and the cardiopulmonary coupling (CPC) offers a minimal version that simply analyzes the electrocardiogram (ECG) signals. As an emerging diagnostic technology of OSA, machine learning (ML) and artificial intelligence (AI) adeptly pinpoint respiratory incidents and expose delicate physiological changes, thus casting new light on the diagnostic approach to OSA. In addition, imaging examination utilizes detailed visual representations of the airway’s structure and assists in recognizing structural abnormalities that may result in obstructed airways, while sound monitoring technology records and analyzes snoring and breathing sounds to detect the condition subtly, and thus further expands our medical diagnostic toolkit. As for the future development directions, it can be predicted that interdisciplinary integrated researches, the construction of personalized diagnosis and treatment models, and the popularization of high-tech in clinical applications will become the development trends in the field of OSA evaluation and diagnosis.

Cholelithiasis is a common biliary system disease with a high incidence worldwide. Abnormal lipid metabolism has been shown to play a key role in the mechanism of gallstones. Therefore, recent research literature on the genes, proteins, and molecular substances involved in lipid metabolism during the pathogenesis of gallstones has been conducted. This study aimed to determine the role of lipid metabolism in the pathogenesis of gallstones and provide insights for future studies using previous research in genomics, metabolomics, transcriptomics, and other fields.

Nasojejunal feeding tubes are widely used in surgical,intensive care,and older patients.Manual blind insertion of nasojejunal feeding tubes is technically challenging,associated with a high failure rate,and prone to complications.The primary causes of suboptimal placement outcomes are the uncertainty and weak controllability of the interaction forces during the coordination between manual posterior advancement and the patient's physiological state.While current auxiliary techniques such as X-ray,ultrasound,and endoscopy can improve the success rate of nasojejunal tube placement and reduce complications to some extent,the accuracy and safety of placement remain constrained by challenges in controlling insertion forces and achieving precise positional localization.Robotic technology holds promise for addressing the uncertainties and controllability issues inherent in the placement process.By leveraging precise sensing,real-time navigation,and efficient control,robots can achieve intelligent positioning and precise control over the direction and location of the catheter tip during nasojejunal intubation.However,current research on robotic applications for nasojejunal feeding tube placement is still in an early stage,facing challenges such as high costs,operational complexity,and concerns over safety and reliability.Herein,we analyzed the limitations and causes of failure in existing placement methods and explored the application prospects of robotic technologies for precise control and intelligent positioning in nasojejunal feeding tube placement.The paper provides new insights for developing nursing techniques that enable safer and more effective,comfortable,and rapid intubation.Future efforts should focus on deepening the integration of artificial intelligence and robotics,optimizing drive technologies,and accelerating the translation of these technologies from the laboratory to clinical practice.This will drive the advancement of nasojejunal feeding tube placement techniques towards intelligent,precise,and accessible solutions.

Objective To investigate the effects of transcutaneous auricular vagus nerve stimula-tion(taVNS)on preoperative anxiety and sleep quality in patients undergoing laparoscopic myomecto-my.Methods A total of 106 patients scheduled for elective laparoscopic myomectomy were randomly divided into active stimulation group(a-taVNS group,n=53)and sham stimulation group(s-taVNS group,n=53).Trait Anxiety Inventory(TAI)scores,State Anxiety Inventory(SAI)scores,Hos-pital Anxiety and Depression Scale-anxiety(HADS-A)scores,Amsterdam Preoperative Anxiety and Information Scale-anxiety(APAISa)scores,Athens Insomnia Scale(AIS)scores,hemodynamic parameters,and adverse reactions were evaluated before intervention(T0),30 min after interven-tion(T1),and the next morning(T2).The degrees of anxiety improvement(△SAI=SAIT0-SAIT1;△HADS-A=HADS-AT0-HADS-AT1;△APAISa=APAISaT0-APAISaT1)and sleep improvement(△AIS=AIST0-AIST2)were calculated,and their correlations were assessed.Results At T0,there were no significant differences in SAI,HADS-A,and APAISa scores between the two groups(P=0.376,0.682,0.144).At T1,there were significant differences in SAI and HADS-A scores between the two groups(adjusted P＜0.05),while there was no significant difference in APAISa scores(P=0.141).Compared with the s-taVNS group,the a-taVNS group had higher improvement values of △SAI,△HADS-A,and △APAISa(P＜0.001).Compared with T0,the AIS score de-creased and the incidence of sleep disorders decreased at T2 in the a-taVNS group(P＜0.05).Compared with the s-taVNS group,the AIS score and the proportion of patients with sleep disorders decreased at T2 in the a-taVNS group(P＜0.05).There was a positive correlation between the de-gree of anxiety improvement and the degree of sleep improvement in the a-taVNS group(P＜0.05),while there was no significant correlation in the s-taVNS group(P＞0.05).Compared with T0,sys-tolic blood pressure,diastolic blood pressure,and heart rate decreased at T1 in both groups,but there were no significant differences in these parameters between the two groups(P＞0.05).During the study period,no adverse events such as tinnitus,dizziness,headache,nausea,vomiting,or fa-cial flushing occurred in either group.Conclusion The method taVNS can improve preoperative anxiety and reduce the incidence of sleep disorders in patients undergoing laparoscopic myomectomy.