AIM: To evaluate the efficacy of 0.05% cyclosporine eye drops in promoting ocular surface recovery following pterygium excision combined with autologous corneal limbal stem cell transplantation.METHODS:This study is a prospective randomized controlled trial, selecting 104 cases(104 eyes)of primary pterygium with monocular onset admitted to Baoding First Central Hospital from September 2023 to September 2024 as the initial sample. The patients were divided into an experimental group and a control group using a random number table method, with 52 eyes in each group. Both groups underwent pterygium excision and autologous corneal limbal stem cell transplantation performed by the same surgeon. The control group received tobramycin dexamethasone eye drops combined with 0.3% sodium hyaluronate eye drops, while the experimental group was additionally treated with 0.05% cyclosporine eye drops. The corneal epithelial repair status, ocular surface function [corneal fluorescein staining(FL)score, Schirmer I test(SIt), break-up time of tear film(BUT)] at preoperative and postoperative time points(1 and 3 mo), and dry eye symptoms [ocular surface disease index(OSDI), standard patient evaluation of eye dryness(SPEED)scores]. Additionally, the recurrence rate and postoperative complications were recorded.RESULTS: During the follow-up period, there was 1 case of loss to follow-up in both the experimental group and the control group, with lost to follow-up rate of 1.9%. Finally, 51 cases in each group completed all followed-up. No statistically significant difference was observed in preoperative general characteristics of patients between the two groups(P>0.05), and there was no statistically significant difference in corneal epithelial repair time or suture removal time(all P>0.05). At 1 mo postoperatively, the SIt and BUT decreased in both groups compared to preoperative levels, with the experimental group showing higher values than the control group(all P<0.05). FL scores increased compared to preoperative levels but were lower in the experimental group(all P<0.05). By 3 mo, the SIt, BUT and FL score of the control group were not statistically different from preoperative levels(all P>0.05), whereas the experimental group showed increased SIt and BUT, which were higher than the control group, and reduced FL scores, and decreased FL scores, which was lower than the control group(all P<0.05). At 3 mo postoperatively, both groups showed increased SIt and BUT compared to 1-month values, with the experimental group outperforming the control group(all P<0.05). FL scores decreased in both groups compared to 1-month values, with the experimental group maintaining lower scores(P<0.05). At 1 mo postoperatively, OSDI and SPEED scores were higher than preoperative levels, with the experimental group higher than the control group(all P<0.05); at 3 mo postoperatively, the scores returned to preoperative level(all P>0.05), and the OSDI and SPEED scores of the control group increased and higher than those of the experiment group(all P<0.05); at 3 mo postoperatively, the OSDI and SPEED scores decreased when compared with 1-month preoperative level, and the experiment group was lower than the control group(all P<0.05). There was no difference in the total incidence of postoperative complications between the two groups(P>0.05). According to the statistics of 6 mo follow-up after operation, there was no recurrence in the experimental group, and the recurrence rate was 11.8% in the control group(P<0.05).CONCLUSION: Adjunctive use of 0.05% cyclosporine eye drops after pterygium excision with limbal stem cell transplantation enhances ocular surface recovery, reduces dry eye symptoms, and lowers recurrence rates without compromising corneal epithelial healing or safety.

OBJECTIVES: To investigate the effect of hypaphorine (HYP) on Crohn's disease (CD)‑like colitis in mice and its molecular mechanism. METHODS: Thirty male C57BL/6J mice were equally randomized into WT, TNBS, and HYP groups, and in the latter two groups, mouse models of CD-like colitis were established using TNBS with daily gavage of 15 mg/kg HYP or an equivalent volume of saline. The treatment efficacy was evaluated by assessing the disease activity index (DAI), body weight changes, colon length and histopathology. The effect of HYP was also tested in a LPS-stimulated Caco-2 cell model mimicking intestinal inflammation by evaluating inflammatory responses and barrier function of the cells using qRT-PCR and immunofluorescence staining. GO and KEGG analyses were conducted to explore the therapeutic mechanism of HYP, which was validated in both the cell and mouse models using Western blotting. RESULTS: In the mouse models of CD-like colitis, HYP intervention obviously alleviated colitis as shown by significantly reduced body weight loss, colon shortening, DAI and inflammation scores, and expressions of pro-inflammatory factors in the colon tissues. HYP treatment also significantly increased the TEER values, reduced bacterial translocation to the mesenteric lymph nodes, liver, and spleen, lowered serum levels of I-FABP and FITC-dextran, increased the number of colonic tissue cup cells, and upregulated colonic expressions of MUC2 and tight junction proteins (claudin-1 and ZO-1) in the mouse models. In LPS-stimulated Caco-2 cells, HYP treatment significantly inhibited the expressions of pro-inflammatory factors and increased the expressions of tight junction proteins. Western blotting showed that HYP downregulated the expressions of the key proteins in the TLR4/MyD88 signaling pathway in both the in vitro and in vivo models. CONCLUSIONS HYP alleviates CD-like colitis in mice possibly by suppressing intestinal epithelial inflammation and improving gut barrier function.
Animals ; Male ; Mice, Inbred C57BL ; Crohn Disease/drug therapy* ; Mice ; Humans ; Caco-2 Cells ; Intestinal Mucosa/metabolism* ; Colitis/drug therapy* ; Disease Models, Animal ; Inflammation ; Toll-Like Receptor 4/metabolism* ; Myeloid Differentiation Factor 88/metabolism* ; Intestinal Barrier Function

OBJECTIVE To investigate the clinical efficacy of integrating pharmacists into family health teams （FHTs） for long-term medication therapeutical management （MTM） in stroke patients， and empirically evaluate the service model. METHODS A pharmacist team， jointly established by clinical and community pharmacists from the Affiliated Suzhou Hospital of Nanjing Medical University （hereinafter referred to as “our hospital”）， developed a pharmacist-supported MTM model integrated into FHTs. Using a prospective randomized controlled design， 170 stroke patients discharged from our hospital （July 2022-December 2023） and enrolled in FHTs at Suzhou Runda Community Hospital were randomly divided into trial group （88 cases） and control group （82 cases） according to random number table. The control group received routine FHTs care （without pharmacist involvement in the team collaboration）， while the trial group xhz8405@126.com received 12-month MTM services supported by pharmacists via an information platform. These services specifically included innovative interventions such as personalized medication regimen optimization based on the MTM framework， dynamic medication adherence management， medication safety monitoring， a home medication assessment system， and distinctive service offerings. Outcomes of the 2 grousp were compared before and after intervention， involving medication adherence （adherence rate， adherence score）， compliance rates for stroke recurrence risk factors [blood pressure， low-density lipoprotein cholesterol （LDL-C）]， and incidence of adverse drug reactions （ADR）. RESULTS After 12 months， the trial group exhibited significantly higher medication adherence rates， improved adherence scores， higher compliance rates for blood pressure and LDL-C targets compared to the control group （P＜0.05）. The incidence of ADR in the trial group （4.55%） was significantly lower than that in the control group （8.11%）， though the difference was not statistically significant （P＞ 0.05）. CONCLUSIONS Pharmacist involvement in FHTs to deliver MTM services significantly enhances medication adherence and optimizes risk factor for stroke recurrence， offering practical evidence for advancing pharmaceutical care in chronic disease management under the family doctor system.

Objective:To evaluate the diagnostic value of intestinal tissue metagenomic next-generation sequencing (mNGS) in severe diarrhea following haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Methods:Sixteen patients who developed severe diarrhea or hematochezia after haploidentical allo-HSCT at the First Affiliated Hospital of Fujian Medical University (June 2023–August 2024) were enrolled. All underwent gastrointestinal endoscopy and mNGS for microbial detection. Clinical, endoscopic, pathological, and microbiological data were analyzed to evaluate the diagnostic value of mNGS and treatment outcomes following targeted therapy.Results:The study included 16 patients (12 males, 4 females; median age 32.5 years, range 3–60 years). Diarrhea occurred a median of 3.93 months post-transplant (range 1.63–10.40 months). Stool cultures were negative except for one case with Candida. One patient tested positive for Clostridium difficile antigen. Endoscopy revealed mucosal congestion, edema, erosion, and bleeding, with focal inflammation on pathology. mNGS detected pathogens in 87.5% (14/16) of cases, including mixed infections in 78.5% (11/14). Common pathogens were Klebsiella pneumoniae, Enterococcus faecium, Escherichia coli, Rhizopus microsporus, EBV, and CMV. Targeted treatment adjustments led to symptom improvement in 87.5% of patients.Conclusion:Allo-HSCT patients are prone to infectious diarrhea due to immunosuppression. Molecular analysis of endoscopic biopsy tissues using mNGS can accurately identify pathogens, guide targeted therapy, and improve clinical outcomes.

Objective:To investigate the current status of clinical practice of optical surface guided radiation therapy (SGRT) technology in China.Methods:A survey questionnaire was designed based on a similar investigation conducted by the European Society for Radiotherapy and Oncology in collaboration with the American Association of Physicists in Medicine on SGRT. The questionnaire covered aspects such as the installation, implementation, commissioning, quality assurance, clinical application, challenges, and cost considerations of SGRT systems. An online questionnaire was distributed to 49 institutions in China that have installed or are in the process of installing SGRT systems. Data were summarized and analyzed using Excel and SPSS 29 software.Results:Among the 49 institutions, 96% had at least one SGRT system. In terms of commissioning, quality assurance and implementation, it was mainly operated by physicists (94%) and technicians (82%), the cycle of test items for quality assurance was only achieved by the highest percentage of units with end-to-end test items for the annual inspection (50%). Eighty-six percent of the institutions used phantoms provided by suppliers, and 53% followed supplier recommendations or guidelines. For the installation of the first SGRT system, 37% of the institutions reported that initial staff training required more than 48 hours, while 73% found the training content easy to understand. Regarding the clinical application of SGRT technology, the majority of the institutions (53%) had used it for 1-3 years, with breast radiotherapy being the most commonly used treatment site. The primary scenario of SGRT application was intra-fraction motion monitoring / patient monitoring (69%). Furthermore, 47% of the institutions combined SGRT with open-face masks, and 71% used visual feedback devices for breath-hold or free-breathing gating. In terms of treatment thresholds, the median thresholds for monitoring and positioning were the same for breast, abdominopelvic (non- stereotactic body radiation therapy), and head-and-neck (non-brain stereotactic radiosurgery) treatments but varied for other sites.Conclusions:Although SGRT technology requires a relatively long initial training period, it is generally well accepted in terms of training and operation. Clinically, SGRT has been widely applied in breast radiotherapy, playing a crucial role in patient monitoring and intra-fraction motion management. However, most institutions have had limited clinical experience with the technology, highlighting the need for continuous technical supervision and improvement. The establishment of standardized protocols is necessary to ensure broader clinical adoption and long-term effectiveness.

Objective:To evaluate the diagnostic value of intestinal tissue metagenomic next-generation sequencing (mNGS) in severe diarrhea following haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Methods:Sixteen patients who developed severe diarrhea or hematochezia after haploidentical allo-HSCT at the First Affiliated Hospital of Fujian Medical University (June 2023–August 2024) were enrolled. All underwent gastrointestinal endoscopy and mNGS for microbial detection. Clinical, endoscopic, pathological, and microbiological data were analyzed to evaluate the diagnostic value of mNGS and treatment outcomes following targeted therapy.Results:The study included 16 patients (12 males, 4 females; median age 32.5 years, range 3–60 years). Diarrhea occurred a median of 3.93 months post-transplant (range 1.63–10.40 months). Stool cultures were negative except for one case with Candida. One patient tested positive for Clostridium difficile antigen. Endoscopy revealed mucosal congestion, edema, erosion, and bleeding, with focal inflammation on pathology. mNGS detected pathogens in 87.5% (14/16) of cases, including mixed infections in 78.5% (11/14). Common pathogens were Klebsiella pneumoniae, Enterococcus faecium, Escherichia coli, Rhizopus microsporus, EBV, and CMV. Targeted treatment adjustments led to symptom improvement in 87.5% of patients.Conclusion:Allo-HSCT patients are prone to infectious diarrhea due to immunosuppression. Molecular analysis of endoscopic biopsy tissues using mNGS can accurately identify pathogens, guide targeted therapy, and improve clinical outcomes.

Objective:To investigate the current status of clinical practice of optical surface guided radiation therapy (SGRT) technology in China.Methods:A survey questionnaire was designed based on a similar investigation conducted by the European Society for Radiotherapy and Oncology in collaboration with the American Association of Physicists in Medicine on SGRT. The questionnaire covered aspects such as the installation, implementation, commissioning, quality assurance, clinical application, challenges, and cost considerations of SGRT systems. An online questionnaire was distributed to 49 institutions in China that have installed or are in the process of installing SGRT systems. Data were summarized and analyzed using Excel and SPSS 29 software.Results:Among the 49 institutions, 96% had at least one SGRT system. In terms of commissioning, quality assurance and implementation, it was mainly operated by physicists (94%) and technicians (82%), the cycle of test items for quality assurance was only achieved by the highest percentage of units with end-to-end test items for the annual inspection (50%). Eighty-six percent of the institutions used phantoms provided by suppliers, and 53% followed supplier recommendations or guidelines. For the installation of the first SGRT system, 37% of the institutions reported that initial staff training required more than 48 hours, while 73% found the training content easy to understand. Regarding the clinical application of SGRT technology, the majority of the institutions (53%) had used it for 1-3 years, with breast radiotherapy being the most commonly used treatment site. The primary scenario of SGRT application was intra-fraction motion monitoring / patient monitoring (69%). Furthermore, 47% of the institutions combined SGRT with open-face masks, and 71% used visual feedback devices for breath-hold or free-breathing gating. In terms of treatment thresholds, the median thresholds for monitoring and positioning were the same for breast, abdominopelvic (non- stereotactic body radiation therapy), and head-and-neck (non-brain stereotactic radiosurgery) treatments but varied for other sites.Conclusions:Although SGRT technology requires a relatively long initial training period, it is generally well accepted in terms of training and operation. Clinically, SGRT has been widely applied in breast radiotherapy, playing a crucial role in patient monitoring and intra-fraction motion management. However, most institutions have had limited clinical experience with the technology, highlighting the need for continuous technical supervision and improvement. The establishment of standardized protocols is necessary to ensure broader clinical adoption and long-term effectiveness.

Objective:To investigate the short-term effect of Helicobacter pylori ( HP) eradication on intraoperative bleeding during endoscopic submucosal dissection (ESD) for early gastric cancer. Methods:Patients who underwent ESD for early gastric cancer in Shanghai East Hospital from September 2021 to September 2023 were retrospectively analyzed for endoscopic, pathological and clinical data. The patients with current HP infection were included in the current infection group, and those who underwent eradication therapy within 10 weeks and successfully eradicated were included in the short-term after eradication group. The occurrence of intraoperative bleeding was compared. Results:A total of 345 patients were analyzed, with 156 in the current infection group and 189 in the short-term after eradication group. Compared with the current infection group, short-term after eradication group was effective in reducing the intraoperative bleeding rate [6.3% (12/189) VS 12.8% (20/156), χ2 =4.253, P=0.039] and significantly reduced the duration of operation (29±9 min VS 38±14 min, t=2.667, P=0.008). Intraoperative bleeding was significantly reduced in short-term after eradication group in lesions of the upper 1/3 of the stomach [12.5% (5/40) VS 32.1% (9/28), χ2 =3.887, P=0.049], while there were no significant differences in intraoperative bleeding between the current infection group and the short-term after eradication group in lesions of the middle 1/3 [5.4% (2/37) VS 10.0% (3/30), χ2 =0.506, P=0.477] and lower 1/3 [4.5% (5/112) VS 8.2% (8/98), χ2 =1.231, P=0.267] of the stomach. Conclusion:HP eradication therapy can effectively reduce intraoperative bleeding in ESD and significantly reduce the duration of operation in a short-term. For individuals with early gastric cancer and HP infection, undergoing eradication therapy before ESD is recommended, particularly for lesions situated in the upper 1/3 of the stomach.

Respiratory diseases(e.g.,lung inflammation and pulmonary fibrosis)are a serious threat to human health.Mitochondria,organelles unique to eukaryotic cells,not only have important functions in energy production,biosynthesis,and the maintenance of intracellular homeostasis but also act as diverse signaling organelles involved in inflammation,proliferation,differentiation,cell repair,and other processes.The mitochondrial quality control system involves mitochondrial biogenesis,dynamics,and autophagy.Certain pathological mechanisms of respiratory diseases,such as oxidative stress and inflammation,are closely related to the dysregulation of mitochondrial quality control systems.This paper summarizes the progress of research into mitochondrial quality control dysregulation in respiratory diseases(chronic obstructive pulmonary disease,pulmonary fibrosis,acute lung injury,asthma,and bacterial pneumonia)to explore new ideas for the prevention and treatment of respiratory diseases.

Epilepsy is a disorder of the brain charac-terized by abnormal neuron excitability.However,the underlying molecular mechanism of neuron excitability modulation remains elusive.With the help of bioinformatic methods,we have identified receptor-type tyrosine-pro-tein phosphatase-like N(PTPRN)as a critical gene dur-ing epileptogenesis.PTPRN recruits NEDD4L ubiquitin E3 ligase to NaV1.2 sodium channels,facilitating NEDD4L-mediated ubiquitination and endocytosis.Knockout of PTPRN endows hippocampal granule cells with augmented depolarization currents and higher intrinsic excitability,which is reflected by increased seizure susceptibility of transgenic mice.On the contrary,reduced neuron excit-ability and decreased seizure susceptibility are observed after PTPRN overexpression.Meanwhile,we find that a 133 aa fragment recaptures modulation effect of PTPRN full-length,and this fragment shows therapeutic potential towards epilepsy caused by NaV1.2 gain of function vari-ants.In brief,our results demonstrate PTPRN playsa criti-calroleinregulatingneuronexcitability,providing a poten-tial therapeutic approach for epilepsy.