Dry eye disease(DED)and depression(DEP), though anatomically and clinically distinct, show significant epidemiological, pathophysiological, and prognostic interplay. Their co-occurrence has risen sharply in recent years, yet the mechanisms driving this comorbidity remain under-investigated. This review systematically synthesizes current evidence, highlighting that pro-inflammatory cytokines, neuro-regulatory imbalance, mitochondrial dysfunction, and gut-microbiota dysbiosis constitute a shared molecular network, while sleep deprivation and antidepressant use further amplify the vicious cycle. By identifying limitations in existing studies, this review proposes future research directions to offer new theoretical and clinical insights for managing DED-DEP comorbidity.

OBJECTIVE To evaluate the cost-effectiveness of cefiderocol versus best available therapy （BAT） or standard-of- care （SOC） for the treatment of confirmed or suspected carbapenem-resistant Gram-negative bacterial （CRGNB） serious infections from the perspective of the Chinese healthcare system， and to explore its reasonable pricing. METHODS A decision tree model was constructed based on data from two phase Ⅲ clinical trials （CREDIBLE-CR and GAME CHANGER） to simulate the cost- effectiveness of cefiderocol in two scenarios： salvage therapy for confirmed CRGNB infection （scenario 1） and empirical therapy for suspected CRGNB infection （scenario 2）. The primary outcome measure was the incremental cost-effectiveness ratio （ICER）. The willingness-to-pay （WTP） was set at 1 to 3 times China’s per capita GDP in 2024. To verify the robustness of the results， one- way and probabilistic sensitivity analyses were conducted， and based on these， a reasonable price range for cefiderocol in the Chinese market was explored. RESULTS The results for scenario 1 showed that the clinical cure rate in the cefiderocol group was higher than that in the BAT group （47.50% vs. 34.21%）， but its ICER was 415 065.03 yuan per cured case， exceeding three times China’s GDP per capita. Scenario 2 revealed that the ICER for cefiderocol relative to SOC was as high as 1 362 446.16 yuan per cured case， far exceeding the WTP. Sensitivity analysis indicated that the treatment duration and price of cefiderocol were key factors affecting its cost-effectiveness. In the two scenarios described above， the unit price of cefiderocol must fall below 683.47 and 242.00 yuan/g， respectively， to be considered cost-effective. CONCLUSIONS Based on the current market price， cefiderocol lacks sufficient cost-effectiveness for treating confirmed or suspected CRGNB serious infections within China’s healthcare system. To improve its accessibility， price negotiations or a tiered medical insurance payment strategy are required.

The therapeutic concept of amblyopia has gradually shifted from improving the visual acuity of the amblyopic eye to restoring binocular visual function.Conventional occlusion therapy and routine visual training have issues such as long treatment cycles, insufficient entertainment value and poor patient compliance, which limits the stability of therapeutic effects. Virtual reality(VR)technology, characterized by immersion, interactivity, and adjustable stimulus parameters, has been increasingly applied to visual training for amblyopia.Current evidence suggests that VR-based training can improve visual acuity and binocular visual function in amblyopia patients to a certain extent.Moreover, its gamified interactions and feedback-driven design may also enhance patient motivation and treatment adherence. This review begins with the mechanisms and theoretical basis of VR training for amblyopia, proceeds to summarizeits advantages over conventional methods, current systems, training modes, clinical efficacy, commonly used outcome measures, as well as safety and acceptability, aiming to provide a reference for its standardization, clinical translation, and widespread adoption.

Objective To explore the principle of antibacterial drug therapy and the strategy of program optimization in elderly patients with Helicobacter pylori（Hp）. Methods The common therapeutic regimen of Hp was summarized, and the better therapeutic regimen of elderly Hp patients was screened ultimately. Results Amoxicillin and cefuroxime were relatively safe compared with other recommended antibacterial drugs. Using other commonly antibiotics for Hp should pay attention to the disease of patients and current drug. Conclusion Elderly patients usually suffered from a variety of diseases and required multiple drugs. The application of therapeutic regimen for elderly patients with Hp should be supposed to fully weigh the risks and benefits.

CD20 is a surface marker protein of B-cell lymphoma, and its extracellular region is the target of specific antibodies and drugs. To obtain a cheap and easily modified specific preparation targeting CD20, we optimized the gene of CD20 extracellular region according to codon degeneracy to facilitate its expression in Escherichia coli. The optimized gene was cloned into pGEX-4T-1 vector, and the recombinant vector was transformed into E. coli BL21(DE3) for expression. The purified protein was identified by SDS-PAGE and Western blotting. Systematic evolution of ligands by exponential enrichment (SELEX) was employed to screen the ssDNA aptamer that specifically binds to the fusion protein, and the affinity of the aptamer to CD20 was detected by flow cytometry. Then, the cytotoxicity test was carried out to examine the inhibitory effect of the aptamer on B lymphoma cells. In this study, we established the prokaryotic expression method of CD20 and obtained the aptamer specifically binding to the extracellular region of CD20, which laid a foundation for the development of therapeutic drugs targeting CD20.
Humans ; Escherichia coli/metabolism* ; SELEX Aptamer Technique/methods* ; Aptamers, Nucleotide/genetics* ; Antigens, CD20/metabolism* ; Ligands

Objective:To investigate the factors associated with chromosomal abnormalities in embryos of patients with recurrent miscarriage in the in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) population, and to establish a prediction model for chromosomal abnormalities. Methods:This was a retrospective case-control study, aborted tissues were collected from 349 patients who attended the Reproductive and Genetic Laboratory Sports New Town Ward of Dalian Women's and Children's Medical Center (Group) after IVF/ICSI from September 2019 to October 2024, and the samples were examined by copy number variation sequencing (CNV-seq) combined with short tandem repeat (STR) technology. According to the test results, the aborted tissues were divided into chromosome normal and chromosome abnormal groups. Factors affecting the occurrence of chromosomal abnormalities were analyzed by univariate analysis and multifactorial logistic regression.Results:1) By CNV-seq combined with STR method, a total of 252 cases (72.21%, 252/349) of chromosomal abnormalities were detected, while 97 cases had normal chromosomes. 2) The results of univariate analysis showed that the differences in female age, female body mass index (BMI), gestational week, number of miscarriages, progesterone level after 14 d post-transplantation, ovarian reserve function, male age, and male BMI were statistically significant between the chromosome normal group and the chromosome abnormal group (all P<0.05). 3) The results of the multifactorial logistic regression model showed that female age ( OR=1.261, 95% CI: 1.137-1.398, P<0.001), female BMI ( OR=1.121, 95% CI: 1.038-1.227, P=0.004), gestational week ( OR=1.406, 95% CI: 1.155-1.711, P=0.001), progesterone level 14 d after transplantation ( OR=1.016, 95% CI: 1.000-1.031, P=0.043), and BMI of the male partner ( OR=1.132, 95% CI: 1.050-1.220, P=0.001) were the independent risk factors of chromosomal abnormalities. 4) There were statistically significant differences in female age, female BMI, gestational week, progesterone level 14 d after transplantation, and male BMI between patients with normal chromosomes and those with trisomy chromosomes in aborted tissues (all P<0.05).Advanced female age was correlated with the occurrence of trisomy 22 ( P<0.05), and there was a correlation between advanced female age and increased male BMI and the occurrence of trisomy 16 (all P<0.05). Conclusion:The increase in maternal age, BMI, gestational age, progesterone levels 14 d after transplantation, and male BMI can all lead to an increase in the rate of chromosomal abnormalities and an increase in the incidence of trisomy. The advanced age of the female, can lead to the occurrence of trisomy 22. The age of the female and the BMI of the male are positively correlated with the abnormality rate of trisomy 16.

Sarcopenia, characterized by reduced muscle mass, decreased strength, and impaired function, can lead to adverse outcomes, such as frailty, falls, fractures and disability, and subsequently lead to decreased quality of life, increased risk of complications and mortality and elevated healthcare costs. With the accelerating process of global aging, the prevalence of sarcopenia has significantly risen, posing a major public health threat and socioeconomic burden to populations worldwide. To more effectively implement medical nutrition management and exercise intervention for patients with sarcopenia, the Chinese Clinical Nutritionist Center of Chinese Medical Doctor Association and the Nutrition Oncology Branch and Geriatric Nutrition Branch of the Chinese Nutrition Society, in collaboration with the Nutrition and Food Safety Branch of Chinese Geriatrics Society, have developed the Expert Consensus on Medical Nutrition Management and Exercise Intervention for Sarcopenia (2024) based on the latest research evidence, clinical practice experiences and clinical nutrition guidelines. This consensus serves as a reference for clinical diagnosis and treatment of sarcopenia. The consensus emphasizes that the diagnosis and treatment of sarcopenia should focus on elderly population and also encompass patients with related chronic diseases including diabetes, inflammatory bowel disease, cancer, cognitive dysfunction and Parkinson's disease. Multi-modal lifestyle interventions centered on nutrition and exercise remain the preferred strategy for the prevention and treatment of sarcopenia.

Objective:To summarize the applications of machine learning (ML) in sarcopenia research through bibliometric analysis.Methods:Literature on ML applications in sarcopenia research was retrieved on the Web of Science database from its inception to December 2024, along with quality assessment. The CiteSpace software was used to conduct bibliometric analysis of the included literature in terms of publication volume, journals, countries, institutions, authors, co-citations, and keywords.Results:A total of 753 articles were obtained, with 480 being of high quality. There was an overall upward trend in the publication volume from 1999 to 2024. The United States led in total publications (119), with China ranking second (97). At the institutional level, Harvard Medical School led globally (14 publications). Kyung Won Kim had the highest publication count (10), and Alfonso J. Cruz-Jentoft was the most cited author (173 citations). His 2019 paper in Age and Ageing achieved the highest co-citation count. J Cachexia Sarcopenia (with a citation frequency of 208) and Age and Ageing (with a centrality of 0.22) were journals with high impacts in this field. "Body composition" (78 occurrences) was the most frequently occurring keyword apart from the search terms, followed by "computed tomography" (54 occurrences) and "mortality" (47 occurrences). The keyword clustering labels include "prognostic value" (first) and "sarcopenia prediction" (second). Conclusions:Current research hotspots involve applying ML to the diagnosis, risk stratification, prognostic prediction, and health management of sarcopenia. Future trends will focus on its deep integration into comprehensive sarcopenia management and on innovating multimodal data-driven algorithms to improve performance and validation.

AIM:This study aims to investigate the mechanism by which Qingfei-Jiedu-Huatan Formula(QJHF)regulates autophagy in alveolar macrophages through mTOR in the treatment of severe pneumonia(SP)in rats.METHODS:Sixty SPF-grade male rats were randomly assigned to six groups:control,model,QJHF,moxifloxacin(MOX),rapamycin(RAPA),and QJHF+RAPA,with ten rats in each group.An SP rat model was established using Klebsiella pneumoniae.After seven days of treatment,changes in IL-33 and IFN-γ levels in bronchoalveolar lavage fluid(BALF)were measured using ELISA.Histopathological alterations in lung tissue were assessed via HE staining,and the autophagy of alveolar macrophages was detected using immunofluorescence co-localization methods.The expression levels of mTOR,beclin-1,and LC3 mRNA in lung tissue were analyzed using qPCR,while Western blot was employed to assess the protein levels of p-mTOR/mTOR,beclin-1,and LC3-II/LC3-I.RESULTS:Compared to the control group,the model group exhibited a deteriorated condition,characterized by alveolar wall rupture and thickening,significant inflammatory cell infiltration in the alveolar cavity,and extensive lung tissue damage(P<0.01).Elevated levels of IL-33 and IFN-γ in BALF were also observed(P<0.01),along with increased colocalization of CD68 and LC3 in immunofluorescence analy-sis.The mTOR mRNA expression in lung tissue decreased(P<0.01),while LC3 and beclin-1 mRNA expressions in-creased(P<0.01).Additionally,the protein expression ratio of p-mTOR/mTOR decreased(P<0.01),whereas LC3-II/LC3-I and beclin-1 protein levels increased(P<0.01).In comparison to the model group,significant improvements were noted after treatment with QJHF and MOX(P<0.01),while RAPA treatment led to a worsening of these indicators(P<0.05).A slight improvement was observed with the QJHF combined with RAPA intervention,though this was not statisti-cally significant.No significant differences were found between the MOX and QJHF groups.However,the QJHF+RAPA group displayed notable improvements in various indicators compared to the RAPA group(P<0.05).CONCLUSION:The QJHF can mitigate the inflammatory response associated with severe pneumonia,potentially by activating mTOR phos-phorylation activity,which in turn inhibits excessive autophagy in alveolar macrophages.

OBJECTIVES: To explore the correlation of ELFN1 expression level with prognosis of colorectal cancer and its regulatory role in colorectal cancer cell proliferation and metastasis. METHODS: We analyzed the expression levels of ELFN1 across 33 cancer types using publicly available databases and identified differential genes related to ELFN1 in colorectal cancer. Gene function annotation and enrichment analysis were used to identify the involved signaling pathways. Logistic analysis, Kaplan-Meier analysis and Cox regression analysis were performed to evaluate the correlation between ELFN1 expression and clinicopathological parameters and survival of colorectal cancer patients. qPCR and Western blotting were used to validate the expression levels of ELFN1 in different colorectal cancer cell lines and tissues, and Transwell and EDU experiments were carried out to assess the effect of ELFN1 knockdown on biological behaviors of SW480 cells. RESULTS: ELFN1 was highly expressed in 14 cancers, and its expression was significantly higher in colon cancer tissues than in adjacent tissues. A high expression of ELFN1 mRNA was associated with a poorer overall survival of colorectal cancer patients. Cox regression analysis indicated that ELFN1 expression was an independent prognostic factor for overall survival of the patients. ELFN1 was significantly enriched in tumor metastasis and proliferation and participated in several tumor signaling pathways. The colon cancer cell lines showed significantly higher expression levels of ELFN1 than normal cells, ELFN1 knockdown obviously inhibited proliferation and migration of SW480 cells in vitro. CONCLUSIONS ELFN1 is overexpressed in colorectal cancer and is associated with poor clinical prognosis of the patients. A high ELFN1 expression is associated with malignant phenotypes of colorectal cancer and promotes cancer cell proliferation and metastasis, suggesting its potential as a prognostic biomarker for colorectal cancer.
Humans ; Colorectal Neoplasms/diagnosis* ; Cell Proliferation ; Prognosis ; Cell Line, Tumor ; Biomarkers, Tumor/metabolism* ; Neoplasm Metastasis ; Gene Expression Regulation, Neoplastic ; Nerve Tissue Proteins/metabolism* ; Female ; Male