Chronic epididymitis (CE) is a long-standing inflammatory condition of the epididymis caused by unresolved acute infections, chronic infections, medication use, or other factors. Clinically, it is characterized by persistent dull pain or a dragging sensation in one or both sides of the scrotum. The disease course typically exceeds three months and is marked by insidious onset and recurrent episodes. Current studies suggest that CE may disrupt the epididymal microenvironment through multiple pathological processes, including local inflammatory responses, oxidative stress, fibrotic remodeling, and autophagy. These alterations impair sperm maturation, transport, and capacitation, thereby contributing to male reproductive dysfunction and infertility. This review summarizes the major etiologies and pathophysiological characteristics of CE and its impact on male reproductive function. It focuses on the roles of inflammatory cytokines and related signaling pathways, oxidative stress mechanisms, and fibrotic progression in the pathogenesis of CE. Moreover, it explores targeted therapeutic strategies based on these mechanisms, aiming to provide a theoretical basis for identifying key molecular targets and signaling pathways involved in CE-induced male reproductive impairment.

Objective:To analyze the clinical characteristics of inconsistent symptoms and signs of dry eye in patients with Sj?gren syndrome (SS).Methods:A case-control study was performed.Thirty-eight patients (38 eyes) who visited the dry-eye outpatient department at Peking University People's Hospital were enrolled from January to October 2021.The patients were divided into a non-SS (NSS) group (25 cases, 25 eyes) and a SS group (13 cases, 13 eyes) according to without or with SS.The data of right eyes were analyzed.The patients' subjective symptoms were scored and their objective clinical parameters were evaluated.Evaluation of subjective symptoms included Ocular Surface Disease Index (OSDI), Standard Patient Evaluation of eye dryness (SPEED) Questionnaire and Dry Eye Questionnaire-5 (DEQ-5).Objective clinical parameters included Schirmer Ⅰ test (SⅠt), tear film breakup time (TBUT), SICCA ocular staining score (OSS), National Eye Institute (NEI) score, Marx line score, non-invasive tear film breakup time (NIBUT), non-invasive tear meniscus height (NITMH), meibomian gland loss area ratio, the number of corneal subepithelial nerves, total nerve length, mean nerve length, maximum nerve length, minimum nerve length, nerve curvature, and number of dendritic cells.Differences in subjective symptoms and clinical parameters were compared between the two groups, and correlation analysis between ocular symptom scores and objective clinical parameters was performed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Peking University People's Hospital (No.RDY2020-03).Written informed consent was obtained from each subject.Results:The OSDI, SPEED and DEQ-5 scores of SS group were 10.9(2.1, 23.1), 4.0(2.0, 7.0) and 7.0(3.5, 9.5), respectively, which were significantly lower than 37.5(26.0, 64.9), 10.5(7.0, 13.0) and 13.0(6.8, 14.3) of NSS group ( Z=-2.70, -3.01, -2.14; all P<0.05).TBUT was longer in the SS group than in the NSS group, and the difference was statistically significant ( Z=-2.10, P=0.038).No significant difference was found in SⅠt, OSS, Marx line score, NIBUT, NITMH, meibomian gland loss area ratio, the number of corneal subepithelial nerves, total nerve length, mean nerve length, maximum nerve length, minimum nerve length, nerve curvature, and number of dendritic cells (all P>0.05).The OSS of nasal conjunctiva was significantly higher in the SS group than in the NSS group ( Z=-2.32, P=0.023).There were no correlations between the subjective symptoms and objective clinical parameters in NSS group (all P>0.05).The SPEED score was positively correlated with the Marx line score of upper eye lid ( rs=0.573, P=0.041) and the OSDI score was negatively correlated with the minimum nerve length ( rs=-0.606, P=0.037) in SS group. Conclusions:Patients with SS dry eye have more nasal conjunctival staining and fewer subjective symptoms than NSS dry eye patients with the same signs, which manifests as a separation of symptoms and signs.

Oxidative stress and its closely related pathophysiological processes of vascular damage and inflammation have been recognized as important pathogenic mechanisms in many ocular diseases.Kaempferol, a natural flavonoid compound, exhibits great promise in preventing and treating various eye disorders due to its potent antioxidant, anti-inflammatory, and anti-angiogenic activities.In dry eye models, kaempferol effectively suppresses ocular surface inflammation, promotes corneal repair, and increases tear secretion.In glaucoma treatment, kaempferol protects retinal ganglion cells and alleviates optic nerve damage.For retinal degenerative diseases, such as age-related macular degeneration, kaempferol protects retinal pigment epithelial cells from oxidative stress-induced damage and apoptosis.In ocular neovascular diseases, which encompass corneal, retinal, and choroidal neovascularization, kaempferol effectively blocks pathological neovascularization formation by inhibiting the expression and signaling of key proangiogenic factors, such as vascular endothelial growth factor.Kaempferol has significant therapeutic potential for multiple eye diseases through multi-target mechanisms, and its further research will provide a scientific basis for its clinical application and development of innovative therapeutics.This review summarizes recent advances in kaempferol research in ophthalmology.

Objective To develop a refined management model for operating rooms and assess its clinical impact on op-erational efficiency and cost control.Methods The study included 10,728 elective surgeries from January to June 2024 as the study group and 9 414 elective surgeries from January to June 2023 as the control group.The differences in operational metrics before and after implementing the refined management model were compared.The model was developed through comprehensive management by hospital leadership and multi-department collaboration,focusing on management structure,systems,processes,information technology,and resource allocation.Results In terms of efficiency,the on-time start rate of the first surgeries in the study group was significantly higher than in the control group(P＜0.05).The turnover time between surgeries was shorter in the study group(P＜0.01),and the rate of unexpected surgery cancellations was lower(P＜0.01).The average cost per surgery for consumables,excluding the impact of centralized procurement of consumables,was approximately 971 yuan,representing an 11% reduction compared to the previous year,despite a 14% increase in surgical volume.The average daily operating cost per operating room was about 12 303 yuan,a 7% reduction.Economic benefits increased by 8.43 million yuan,a 38% year-on-year increase.Conclusion Implementing a refined management model in operating rooms can significantly enhance efficiency,re-duce costs,and achieve dual improvements in social and economic benefits.

Chronic epididymitis (CE) is a long-standing inflammatory condition of the epididymis caused by unresolved acute infections, chronic infections, medication use, or other factors. Clinically, it is characterized by persistent dull pain or a dragging sensation in one or both sides of the scrotum. The disease course typically exceeds three months and is marked by insidious onset and recurrent episodes. Current studies suggest that CE may disrupt the epididymal microenvironment through multiple pathological processes, including local inflammatory responses, oxidative stress, fibrotic remodeling, and autophagy. These alterations impair sperm maturation, transport, and capacitation, thereby contributing to male reproductive dysfunction and infertility. This review summarizes the major etiologies and pathophysiological characteristics of CE and its impact on male reproductive function. It focuses on the roles of inflammatory cytokines and related signaling pathways, oxidative stress mechanisms, and fibrotic progression in the pathogenesis of CE. Moreover, it explores targeted therapeutic strategies based on these mechanisms, aiming to provide a theoretical basis for identifying key molecular targets and signaling pathways involved in CE-induced male reproductive impairment.

Objective:To analyze the clinical characteristics of inconsistent symptoms and signs of dry eye in patients with Sj?gren syndrome (SS).Methods:A case-control study was performed.Thirty-eight patients (38 eyes) who visited the dry-eye outpatient department at Peking University People's Hospital were enrolled from January to October 2021.The patients were divided into a non-SS (NSS) group (25 cases, 25 eyes) and a SS group (13 cases, 13 eyes) according to without or with SS.The data of right eyes were analyzed.The patients' subjective symptoms were scored and their objective clinical parameters were evaluated.Evaluation of subjective symptoms included Ocular Surface Disease Index (OSDI), Standard Patient Evaluation of eye dryness (SPEED) Questionnaire and Dry Eye Questionnaire-5 (DEQ-5).Objective clinical parameters included Schirmer Ⅰ test (SⅠt), tear film breakup time (TBUT), SICCA ocular staining score (OSS), National Eye Institute (NEI) score, Marx line score, non-invasive tear film breakup time (NIBUT), non-invasive tear meniscus height (NITMH), meibomian gland loss area ratio, the number of corneal subepithelial nerves, total nerve length, mean nerve length, maximum nerve length, minimum nerve length, nerve curvature, and number of dendritic cells.Differences in subjective symptoms and clinical parameters were compared between the two groups, and correlation analysis between ocular symptom scores and objective clinical parameters was performed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Peking University People's Hospital (No.RDY2020-03).Written informed consent was obtained from each subject.Results:The OSDI, SPEED and DEQ-5 scores of SS group were 10.9(2.1, 23.1), 4.0(2.0, 7.0) and 7.0(3.5, 9.5), respectively, which were significantly lower than 37.5(26.0, 64.9), 10.5(7.0, 13.0) and 13.0(6.8, 14.3) of NSS group ( Z=-2.70, -3.01, -2.14; all P<0.05).TBUT was longer in the SS group than in the NSS group, and the difference was statistically significant ( Z=-2.10, P=0.038).No significant difference was found in SⅠt, OSS, Marx line score, NIBUT, NITMH, meibomian gland loss area ratio, the number of corneal subepithelial nerves, total nerve length, mean nerve length, maximum nerve length, minimum nerve length, nerve curvature, and number of dendritic cells (all P>0.05).The OSS of nasal conjunctiva was significantly higher in the SS group than in the NSS group ( Z=-2.32, P=0.023).There were no correlations between the subjective symptoms and objective clinical parameters in NSS group (all P>0.05).The SPEED score was positively correlated with the Marx line score of upper eye lid ( rs=0.573, P=0.041) and the OSDI score was negatively correlated with the minimum nerve length ( rs=-0.606, P=0.037) in SS group. Conclusions:Patients with SS dry eye have more nasal conjunctival staining and fewer subjective symptoms than NSS dry eye patients with the same signs, which manifests as a separation of symptoms and signs.

Oxidative stress and its closely related pathophysiological processes of vascular damage and inflammation have been recognized as important pathogenic mechanisms in many ocular diseases.Kaempferol, a natural flavonoid compound, exhibits great promise in preventing and treating various eye disorders due to its potent antioxidant, anti-inflammatory, and anti-angiogenic activities.In dry eye models, kaempferol effectively suppresses ocular surface inflammation, promotes corneal repair, and increases tear secretion.In glaucoma treatment, kaempferol protects retinal ganglion cells and alleviates optic nerve damage.For retinal degenerative diseases, such as age-related macular degeneration, kaempferol protects retinal pigment epithelial cells from oxidative stress-induced damage and apoptosis.In ocular neovascular diseases, which encompass corneal, retinal, and choroidal neovascularization, kaempferol effectively blocks pathological neovascularization formation by inhibiting the expression and signaling of key proangiogenic factors, such as vascular endothelial growth factor.Kaempferol has significant therapeutic potential for multiple eye diseases through multi-target mechanisms, and its further research will provide a scientific basis for its clinical application and development of innovative therapeutics.This review summarizes recent advances in kaempferol research in ophthalmology.

Objective:To investigate the clinical characteristics of patients with high-myopia macular hole retinal detachment (MHRD) combined with choroidal detachment and to preliminarily analyze factors associated with postoperative hole closure.Methods:A retrospective clinical case series study. A total of 68 patients with high myopia (68 eyes) with MHRD diagnosed by Department of Ophthalmology, Peking University People’s Hospital from January 2019 to April 2024 were included in this study. Among them, there were 14 males (14 eyes) and 54 females (54 eyes). The mean age was (61.10±9.66) years. All eyes were treated with pars plana vitrectomy (PPV) combined with silicone oil or gas filling. Best corrected visual acuity (BCVA), intraocular pressure, and B-mode ultrasonography were performed. The BCVA test was performed using the Snellen visual acuity chart, which was statistically converted to logarithm of the minimum angle of resolution (logMAR) visual acuity. The range of choroidal detachment was defined according to the number of involved quadrants observed in B-mode ultrasound or surgery, which was divided into 1 to 4 quadrants. Axial length (AL) was measured under retinal reattachment. In 68 eyes, there were 17 eyes with choroidal detachment and 51 eyes without choroidal detachment, respectively. There were 17 eyes with choroidal detachment, and the detachment range involved 1, 2, 2 and 12 eyes in 1, 2, 3 and 4 quadrants, respectively. During operation, 13% C 3F 8 was filled in 2 eyes, all of which were not complicated with choroidal detachment. 66 eyes were filled with silicone oil. According to whether the patients were complicated with choroidal detachment, the patients were divided into the group without choroidal detachment and the group with choroidal detachment. Independent sample t test, Welch two-sample t test or Mann-Whitney U test were used for comparison between groups. Generalized linear regression and logistic regression were used to analyze the relationship between the aperture size of postoperative unclosed holes and the closed hole after surgery and clinical factors. Results:At 3 months after surgery, the logMAR BCVA of the affected eye was 1.29±0.43, with a preoperative to postoperative difference ranging from -1.60 to 0.70 (-0.51±0.51) logMAR units. The AL ranged from 26.6 to 34.3 (29.60±2.12) mm. Among 68 eyes, macular hole of 37 (54.4%, 37/68) eyes were open and 31 (45.6%, 31/68) eyes were closed, respectively. The hole diameter of the open eye was (753±424) μm. There was no significant difference in age, course of disease and AL between the two groups ( W=412.0, 477.5, 427.0; P>0.05). Before operation, BCVA in patients with choroidal detachment was worse ( W=257.5) and intraocular pressure was lower ( t=4.051) in patients with choroidal detachment compared with those without choroidal detachment, with statistical significance ( P<0.05). At 3 months after surgery, BCVA in patients with choroidal detachment was significantly worse than that in patients without choroidal detachment, with statistical significance ( W=284.0, P<0.05). There were no significant differences in logMAR BCVA difference ( t=0.616) and macular hole closure rate ( χ 2=0.000) before and after surgery ( P>0.05). The reoperation rate of retinal detachment due to persistent or recurrent retinal detachment was significantly higher in the group with choroid detachment than in the group without choroid detachment, and the difference was statistically significant (odds ratio=6.424, P<0.05). Logistic regression analysis showed that young age was significantly correlated with macular hole closure failure after surgery ( β=0.077, P=0.015). There was no correlation between AL, duration of disease, BCVA before surgery, intraocular pressure, wether combined with choroid detachment range and postoperative hole closure ( β=-0.072, 0.000, 0.672, -0.085, -0.391; P>0.05). Conclusions:Concomitant choroidal detachment adversely affected on both pre-operative and post-operative visual acuity in high myopia MHRD. It is closely associated with the risk of recurrent retinal detachment and the needs of multiple operations, but has no significant effect on hole closure rate. Lower age of onset may be a risk factor for macular hole closure.

Objective:To observe and analyze the correlation between ectopic foveal inner layer (EIFL) and the EIFL-based idiopathic epiretinal membrane (ERM) staging system and the anatomic and functional prognosis of ERM eyes post pars plana vitrectomy (PPV).Methods:A retrospective study. From January 1, 2020 to October 30, 2023, 345 eyes of 330 patients diagnosed with idiopathic ERM in Department of Ophthalmology of Peking University People's Hospital and treated with standard transciliary flat three-channel 25G PPV combined with ERM and internal limiting membrane exfoliation were included in the study. Among them, 96 were males (111 eyes) and 234 were females (234 eyes). The mean age was (66.8±7.7) years. All study eyes received standard three-port 25G PPV combined with ERM and internal limiting membrane peeling. All study eyes underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations. BCVA was performed using a standard logarithmic visual acuity chart and converted to logarithm of the minimum angle of resolution visual acuity for statistical analysis. EIFL thickness and central foveal thickness (CFT) on OCT were measured. ERM eyes were grouped into stage Ⅰ, Ⅱ, Ⅲ and Ⅳ according to ERM staging scheme based on EIFL; disorganization of the retinal inner layers (DRIL) of study eyes were assessed and grouped into no, mild and severe groups. The correlation between ERM staging as well as EIFL thickness and the anatomical and functional prognosis 6 months post-PPV were analyzed.Results:Among 345 study eyes, 12, 87, 174 and 72 eyes were stage Ⅰ-Ⅳ ERM respectively, 63 with no DRIL, 216 with mild DRIL and 66 with severe DRIL. Among the 153 eyes with macular edema, the edema subsided in 66 eyes (43.1%, 66/153) 6 months after the operation. Eighty-seven eyes (56.9%, 87/153) did not regress. The edema subsided 6 months after the operation was not significantly correlated with the ERM stage before the operation ( χ2=3.331, R=?0.145, P=0.304) or the degree of DRIL ( χ2=0.655, R=?0.108, P=0.445). The results of the correlation analysis showed that logMAR BCVA 6 months after the surgery was positively correlated with the degree of DRIL before the surgery ( Tau-b=0.236), ERM stage ( Tau-b=0.194), CFT ( r=0.383), and EIFL thickness ( r=0.317) ( P<0.05). There was no significant correlation with the thickness of the outer nuclear layer before the operation ( r=0.004, P>0.05). Preoperative ERM stage ( Tau-b=0.303, P<0.001) and DRIL severity ( Tau-b= 0.238, P=0.001) were positively correlated with CFT at 6 months after surgery. Conclusion:The ERM stage and EIFL thickness before the operation are positively correlated with logMAR BCVA and CFT 6 months after the operation.