AIM: To explore the efficacy of 0.05% cyclosporine A(CsA)eye drops for preventing dry eye after femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK).METHODS: In this prospective randomized controlled study, a total of 80 patients(80 eyes)who underwent FS-LASIK surgery at the Affiliated Hospital of Xuzhou Medical University from January 2025 to September 2025 were enrolled, and only the data from the right eye were included for analysis. Before surgery, these patients were randomly assigned in a 1:1 ratio using a computer-generated sequence to a control group or an experimental group. All patients received standard postoperative treatment starting from postoperative day 1, including 0.5% levofloxacin eye drops, 0.1% fluorometholone eye drops, and 0.1% sodium hyaluronate eye drops(four times daily for 3 mo). The experimental group additionally received 0.05% cyclosporine A eye drops in addition to the standard treatment. The following parameters were compared between the two groups preoperatively and at 1 and 3 mo postoperatively: ocular surface disease index(OSDI)score, numerical rating scale(NRS)for ocular symptoms, lipid layer thickness(LLT), meibomian gland dropout score, Schirmer's Ⅰ test(SⅠt), corneal fluorescein staining(CFS)score, non-invasive tear breakup time(NIBUT), and tear meniscus height(TMH). Confocal microscopy was employed to evaluate corneal nerve parameters, including corneal nerve fiber density(CNFD), corneal nerve branch density(CNBD), corneal nerve fiber length(CNFL), and corneal total branch density(CTBD), and to count Langerhans cell density(DCD). In addition, levels of interferon-gamma(IFN-γ), interleukin(IL)-1β, IL-6, IL-10, and matrix metalloproteinase-9(MMP-9)in the tear were measured using liquid chip technology.RESULTS: A total of 72 patients completed the final follow-up, including 37 patients(15 males, 22 females, mean age 24.05±4.00 y)in the experimental group, 35 patients(16 males, 19 females, mean age 23.77±3.71 y)in the control group. At 1 and 3 mo postoperatively, the experimental group showed significantly lower OSDI scores, NRS eye pain scores, and CFS scores(all P<0.01), and significantly higher NIBUT and TMH values, compared with the control group. Confocal microscopy revealed that DCD was significantly lower in the experimental group at 1 and 3 mo postoperatively, whereas CNFD, CNBD, CNFL, and CTBD were significantly higher at 3 mo postoperatively(all P<0.01). Analysis of tear inflammatory cytokines showed that the levels of IFN-γ, IL-1β, IL-6, and MMP-9 were significantly lower in the experimental group at 1 and 3 mo postoperatively compared with the control group(all P<0.01). Spearman correlation analysis revealed that OSDI and NRS scores were negatively correlated with NIBUT, corneal nerve parameters(CNFD, CNBD, CNFL, CTBD), and corneal sensitivity(all P<0.01), and positively correlated with CFS scores, tear inflammatory cytokines(IFN-γ, IL-10, IL-1β, IL-6, and MMP-9), and DCD(all P<0.01). Tear inflammatory cytokines were negatively correlated with corneal nerve parameters, NIBUT, and corneal sensitivity(all P<0.01), and positively correlated with CFS scores and DCD(all P<0.01). No significant correlations were observed among the remaining parameters(P>0.05).CONCLUSION: Prophylactic use of 0.05% cyclosporine A eye drops significantly improves dry eye symptoms and signs, suppresses ocular surface inflammation, and promotes the restoration of tear film stability in patients after FS-LASIK. Through its dual anti-inflammatory and neuroregenerative effects, cyclosporine A constitutes an effective adjuvant therapy for reestablishing ocular surface microenvironment homeostasis after refractive surgery.

BACKGROUND:Wogonin is a flavonoid extracted from the root of Scutellaria baicalensis.Previous studies have shown that baicalein has protective effects against cerebral ischemia-reperfusion injury,and can also reduce blood sugar and complications in diabetic mice,but its role and mechanism in diabetic cerebral infarction remain unclear. OBJECTIVE:To explore the effect of wogonin on nerve injury in rats with diabetic cerebral infarction and its mechanism. METHODS:Sprague-Dawley rats were randomly divided into six groups:control group,model group,low-dose wogonin group,medium-dose wogonin group,high-dose wogonin group,and high-dose wogonin+Ras homolog gene family member A(RhoA)activator group.Except for the control group,the other rats were established with diabetes and cerebral ischemia models using intraperitoneal injection of streptozotocin and middle cerebral artery occlusion.Low,medium-and high-dose wogonin groups were intragastrically given 10,20,40 mg/kg wogonin,respectively;high-dose wogonin+RhoA activator group was intragastrically given 40 mg/kg wogonin and intraperitoneally injected 10 mg/kg lysophosphatidic acid;control group and model group were given the same amount of normal saline once a day for 7 consecutive days.Rats in each group were evaluated for neurological deficits and their blood glucose levels were measured after the last dose.TTC staining was applied to detect the volume of cerebral infarction.Hematoxylin-eosin staining was applied to observe pathological changes in brain tissue.ELISA kit was applied to detect tumor necrosis factor-α,interleukin-6,malondialdehyde,and superoxide dismutase levels in brain tissue.Western blot was applied to detect the protein expression of RhoA and Rho-associated protein kinase(ROCK)2 in brain tissue. RESULTS AND CONCLUSION:Compared with the control group,the neuronal structure of rats in the model group was severely damaged,with cell necrosis and degeneration,the neurological deficit score,blood glucose level,and infarct volume were significantly elevated(P<0.05),the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue were significantly increased(P<0.05),and the superoxide dismutase level was decreased(P<0.05).Compared with the model group,the low-,medium-,and high-dose wogonin groups showed improved neuronal damage,reduced cell degeneration and necrosis,a significant reduction in neurological deficit score,blood glucose level,infarct volume,and the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue,and an increase in the superoxide dismutase level(P<0.05).Compared with the high-dose wogonin group,the high-dose wogonin+RhoA activator group significantly weakened the improvement in the above indexes of rats with diabetic cerebral infarction(P<0.05).To conclude,wogonin can improve the blood glucose level in rats with diabetic cerebral infarction,reduce cerebral infarction and nerve injury,and its mechanism may be related to the inhibition of RhoA/ROCK signaling pathway.

Objective To observe the value of T2 mapping for quantitatively evaluating the changes of junctional zone and outer myometrium caused by endometrial fibrosis.Methods A total of 73 infertility patients with endometrial fibrosis confirmed by hysteroscopy(disease group)and 33 healthy women of childbearing age(control group)were prospectively enrolled,and MR examinations were performed at the late proliferative phase of endometrium.The thickness and T2 value of junctional zone,T2 value of outer myometrium on anterior,posterior and fundus wall of midsagittal corpus uteri were measured,and the mean value of the above measurements on the three walls were calculated.Receiver operating characteristic curves were constructed,the areas under the curves(AUC)were calculated to explore the efficacy of those with significant difference among the mean thickness and the mean T2 value of junctional zone,the mean T2 value of outer myometrium and their combination for evaluating endometrial fibrosis.Results The thickness and T2 value of anterior wall,posterior wall,fundus wall and the mean junctional zone in disease group were all significantly higher than those in control group(all P＜0.001).No significant difference of T2 value of anterior wall,posterior wall,fundus wall nor the mean outer myometrium was found between groups(all P＞0.05).The mean thickness and the mean T2 value of junctional zone and their combination could be used to effectively evaluate endometrial fibrosis,with AUC of 0.839,0.822 and 0.922,respectively,and their combination had the best performance(both P＜0.01).Conclusion T2 mapping could be used to quantitatively evaluate the injury of junctional zone caused by endometrial fibrosis.

Central hiccup frequently occurs secondary to stroke and is not solely attributed to gastric disharmony with ascending counterflow qi disturbing the diaphragm.It is also associated with post-stroke orifice obstruction with spirit concealment and failure of the spirit to guide qi.In treatment,regulating qi movement and simultaneous brain-diaphragm intervention warrant attention.The foot shaoyang gallbladder meridian interconnects the head,neck,diaphragm,and thorax through its pathway,and as a shaoyang meridian,it plays a pivotal role in coordinating qi dynamics.This study investigates the theoretical and structural foundations for treating central hiccup via the gallbladder meridian,based on meridian-viscera theory and the reflex arc of hiccup.By analyzing the meridian-viscera relationships between the gallbladder meridian and the pathological loci of central hiccup,this study elucidates its etiology and pathogenesis,proposing a gallbladder meridian-oriented therapeutic approach to provide novel clinical insights.

Objective To explore the correlation between neuron specific enolase(NSE)levels and recurrence after percutaneous balloon compression(PBC)in patients with trigeminal neuralgia(TN).Methods 166 TN patients who underwent PBC at the Second People's Hospital of Huai'an City,Jiangsu Province from July 2018 to April 2021 were selected as the study subjects.According to the recurrence rate after 2 years of surgery,patients were divided into a recurrence group(n=22)and a non-recurrence group(n=144).The general information of the two groups of patients was compared,and the serum biomarker levels before and after PBC in TN patients were analyzed,as well as the postoperative efficacy of TN patients with PBC.Compared the difference changes(T2-T1)between various inflammatory markers and nerve injury markers before surgery(T1)and 2 days after surgery(T2),and perform correlation analysis(Spearman correlation and Logistic regression)between the significantly changed difference indicators and prognosis recurrence to explor the predictive value of serum NSE for recurrence after PBC in TN patients.Results The serum NSE level of TN patients on the first day of PBC was 12.39±3.15 ng/ml,were compored with those on the second day after PBC was 16.27±4.03ng/ml,and the difference was statisically significant(t=14.922,P<0.01).The difference in serum NEC levels before and after PBC in the recurrent group was 5.72(5.25,7.58)ng/ml,while the difference in serum NSE levels before and after PBC in the non-recurrent group was 3.01(2.63,3.37)ng/ml,the difference between the two groups was statistically significant(Z=3.925,P<0.001).Logistic regression results showed that the difference in serum NSE levels(T2-T1)before and after PBC was a rish factor for postoperative recurrence in TN patients at two-years(OR=1.602,Wald χ2=12.252,P<0.05).ROC analysis tesults:the predictive power of serum NSE difference(T2-T1)before and after PBC for two-year recurrence in TN patients AUC(95%CI)was 0.777(0.587～0.954),and the prediction threshold was 4ng/ml.The corresponding sensitivity and specificity was 0.727 and 0.806,respectively.Conclusion Serum NSE may become a biomarker for predicting the recurrence of TN patients after PBC treatment.

Objective To explore the correlation between neuron specific enolase(NSE)levels and recurrence after percutaneous balloon compression(PBC)in patients with trigeminal neuralgia(TN).Methods 166 TN patients who underwent PBC at the Second People's Hospital of Huai'an City,Jiangsu Province from July 2018 to April 2021 were selected as the study subjects.According to the recurrence rate after 2 years of surgery,patients were divided into a recurrence group(n=22)and a non-recurrence group(n=144).The general information of the two groups of patients was compared,and the serum biomarker levels before and after PBC in TN patients were analyzed,as well as the postoperative efficacy of TN patients with PBC.Compared the difference changes(T2-T1)between various inflammatory markers and nerve injury markers before surgery(T1)and 2 days after surgery(T2),and perform correlation analysis(Spearman correlation and Logistic regression)between the significantly changed difference indicators and prognosis recurrence to explor the predictive value of serum NSE for recurrence after PBC in TN patients.Results The serum NSE level of TN patients on the first day of PBC was 12.39±3.15 ng/ml,were compored with those on the second day after PBC was 16.27±4.03ng/ml,and the difference was statisically significant(t=14.922,P<0.01).The difference in serum NEC levels before and after PBC in the recurrent group was 5.72(5.25,7.58)ng/ml,while the difference in serum NSE levels before and after PBC in the non-recurrent group was 3.01(2.63,3.37)ng/ml,the difference between the two groups was statistically significant(Z=3.925,P<0.001).Logistic regression results showed that the difference in serum NSE levels(T2-T1)before and after PBC was a rish factor for postoperative recurrence in TN patients at two-years(OR=1.602,Wald χ2=12.252,P<0.05).ROC analysis tesults:the predictive power of serum NSE difference(T2-T1)before and after PBC for two-year recurrence in TN patients AUC(95%CI)was 0.777(0.587～0.954),and the prediction threshold was 4ng/ml.The corresponding sensitivity and specificity was 0.727 and 0.806,respectively.Conclusion Serum NSE may become a biomarker for predicting the recurrence of TN patients after PBC treatment.

Objective To observe the value of T2 mapping for quantitatively evaluating the changes of junctional zone and outer myometrium caused by endometrial fibrosis.Methods A total of 73 infertility patients with endometrial fibrosis confirmed by hysteroscopy(disease group)and 33 healthy women of childbearing age(control group)were prospectively enrolled,and MR examinations were performed at the late proliferative phase of endometrium.The thickness and T2 value of junctional zone,T2 value of outer myometrium on anterior,posterior and fundus wall of midsagittal corpus uteri were measured,and the mean value of the above measurements on the three walls were calculated.Receiver operating characteristic curves were constructed,the areas under the curves(AUC)were calculated to explore the efficacy of those with significant difference among the mean thickness and the mean T2 value of junctional zone,the mean T2 value of outer myometrium and their combination for evaluating endometrial fibrosis.Results The thickness and T2 value of anterior wall,posterior wall,fundus wall and the mean junctional zone in disease group were all significantly higher than those in control group(all P＜0.001).No significant difference of T2 value of anterior wall,posterior wall,fundus wall nor the mean outer myometrium was found between groups(all P＞0.05).The mean thickness and the mean T2 value of junctional zone and their combination could be used to effectively evaluate endometrial fibrosis,with AUC of 0.839,0.822 and 0.922,respectively,and their combination had the best performance(both P＜0.01).Conclusion T2 mapping could be used to quantitatively evaluate the injury of junctional zone caused by endometrial fibrosis.

OBJECTIVE To study the sedative and hypnotic effects of zolpidem and the content of amino acid neurotransmitters in the thalamus and hypothalamus after treatment with zolpidem.METHODS Experiments on the loss of righting reflex(LORR)induced by the upper-threshold dose pentobarbital sodium(50 mg·kg-1,ip)were conducted to establish a hypoxic insomnia model in mice by simulating an altitude of 5500 m.Based on this model,the synergistic effect of zolpidem(0.33,1,3,9 and 27 mg·kg-1,ip)and the subthreshold(20 mg·kg-1,ip)and upper-threshold pentobarbital sodium,as well as the sedative hypnotic effect of zolpidem(10,13,17,20,23,30 and 40 mg·kg-1,ip)were evaluated via the LORR in normoxic and hypoxic environments.One hour after ip given zolpidem,the levels of glutamic acid(Glu)and γ-aminobutyric acid(GABA)in the thalamus and hypothalamus of mice in either environment were determined by the high-performance liquid chromatography(HPLC)with fluorescence detection.RESULTS One-day treatment with hypoxia significantly shortened the duration of LORR induced by the upper-threshold dose pentobarbital sodium.Compared with normoxia vehicle and hypoxia induced insomnia vehicle groups,zolpidem 9 and 27 mg·kg-1 significantly shortened the latency to LORR(P<0.01,P<0.05)and prolonged duration of LORR induced by subthreshold and upper-threshold pentobarbital sodi-um(P<0.01,P<0.05).The median effective dose(ED50)of LORR induced by zolpidem was 16.21 and 20.55 mg·kg-1 in normoxic and hypoxic environments,respectively.The results of neurotransmitter level detection showed that Glu contents in the thalamus and hypothalamus and the ratio of Glu/GABA in the hypothalamus were decreased after treatment with zolpidem 40 mg·kg-1 in a normoxic environment(P<0.01,P<0.05).Compared with the normoxia control group,Glu content and the ratio of Glu/GABA in the hypothalamus were significantly increased after treatment with hypoxia(P<0.01,P<0.05),and zolpidem 40 mg·kg-1 could reverse their elevation.CONCLUSION The sedative-hypnotic effect of zolpidem is weakened in a hypoxic environment,and the effect of zolpidem on the levels of Glu and GABA in the hypothalamus may play an important role in the sedative-hypnotic effect of zolpidem.

Objective To investigate the correlation between genetic polymorphisms and the risk of rivaroxaban bleeding events in elderly patients with nonvalvular atrial fibrillation(NVAF).Meth-ods A total of 180 elderly NVAF patients treated with rivaroxaban in our department from June 2019 to June 2022 were enrolled,and after 1 year of follow-up,finally,167 patients were included,according to whether bleeding events occurred,they were divided into hemorrhage group(n=31)and control group(n=136).The clinical data and genetic polymorphism were compared between the two groups.Multivariate logistic regression was used to analyze the association between genet-ic polymorphisms and bleeding events in the patients after rivaroxaban treatment.Results Higher frequencies of CYP2C9*1,CYP2C9*3 and VKORC1-GG,but lower frequencies of CYP2C9*2,VKORC1-AA and VKORC1-AG were observed in the bleeding group than the control group(all P＜0.01).Multivariate logistic regression analysis showed that CYP2C9*1,CYP2C9*3 and VKORC1-GG were independent risk factors for bleeding events in elderly NVAF patients taking rivaroxaban(OR=1.880,95％CI:1.126-1.997,P=0.030;OR=1.432,95％CI:1.044-1.964,P=0.026;OR=2.176,95％CI:1.173-4.037,P=0.014),while,CYP2C9*2,VKORC1-AA and VKORC1-AG were protective factors for bleeding events in elderly NVAF patients taking rivar-oxaban.Conclusion Genetic polymorphisms of CYP2C9 and VKORC1 are significantly correlated with the risk of bleeding events in elderly NVAF patients taking rivaroxaban.And CYP2C9*1,CYP2C9*3 and VKORC1-GG genotypes are independent risk factors,while CYP2C9*2,VKORC1-AA and VKORC1-AG genotypes are protective factors.

Objective To analyze the level of self-management and its influencing factors among patients with nonalcoholic fatty liver disease (NAFLD). Methods A total of 129 patients with NAFLD were recruited using convenience sampling method as study participants. A questionnaire survey was conducted among these patients using general information questionnaire, self-management scale, and health behavior competence scale. Multivariate linear regression analysis was employed to identify the factors influencing the level of self-management among NAFLD patients. Results The overall score of the self-management scale among NAFLD patients was (77.60±21.68). A positive correlation was observed between various dimensions of health behavior score and self-management score (P < 0.05). Monthly income, exercise frequency, dietary habits and mental health status were identified as significant influencing factors of self-management level among NAFLD patients (P < 0.05). Conclusion The self-management level of NAFLD patients is moderate and is influenced by their monthly income, exercise habits, dietary habits and mental health status. Healthcare professionals should develop targeted intervention programs addressing these factors to enhance patients' self-management capabilities.