ObjectiveTo investigate the potential mechanism of Qingguangan Ⅱ Formula （青光安Ⅱ号方， QGAⅡ） in the treatment of glaucoma from the perspectives of oxidative stress and the cyclic adenosine monophosphate/ protein kinase A （cAMP/PKA） signaling pathway. MethodsForty SD rats were randomly assigned to a medicated serum group （n=30）， which received QGAⅡby intragastric administration at 6.741 g/（kg·d）， and a blank group （n=10）， which received normal saline at 10 ml/（kg·d）. After 7 consecutive days of administration， medicated serum and blank serum were prepared. The optimal concentration of medicated serum for R28 cell intervention was determined using CCK-8 assay. An in vitro glaucoma model was established by exposing R28 cells to continuous hydrostatic pressure combined with oxygen-glucose deprivation （OGD） for 24 h to simulate the pathological microenvironment of glaucomatous optic nerve injury. The experiment set a control group （complete medium）， model group （glucose-free medium + tri-gas incubator）， medicated serum group （selected concentration of QGA-medicated serum + glucose-free medium + tri-gas incubator）， and blank serum group （blank serum + glucose-free medium + trigas incubator）. The total culture medium volume in each culture dish was 5 ml. After 24 h of culture， cell proliferation was assessed using the EdU immunofluorescence assay， and apoptosis was determined by flow cytometry. Malondialdehyde （MDA） content and superoxide dismutase （SOD） activity were measured using biochemical assays. Western Blotting was performed to detect the expression of oxidative stress-related proteins including 4-hydroxynonenal （4-HNE） and heme oxygenase-1 （HO-1）， apoptosis-related proteins including B-cell lymphoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， and cleaved caspase-3 （C-caspase-3）， and cAMP/PKA signaling pathway-related proteins including protein kinase A （PKA）， phosphorylated PKA （p-PKA）， cAMP response element-binding protein （CREB）， and phosphorylated CREB （p-CREB）. Intracellular cyclic adenosine monophosphate （cAMP） levels were determined by ELISA. In addition， a forskolin （agonist） group， an H89 （inhibitor） group， and a 7.5% medicated serum plus inhibitor group were established to further investigate the effects of QGAⅡ-medicated serum on oxidative stress and the cAMP/PKA signaling pathway in R28 cells. ResultsA concentration of 7.5% QGAⅡ-medicated serum was identified as the optimal concentration for subsequent experiments. Compared to the control group， the model group exhibited significantly decreased cell proliferation， SOD activity， Bcl-2 protein expression， p-PKA/PKA ratio， p-CREB/CREB ratio， and cAMP content， as well as increased apoptosis rate， MDA content， and the protein expression levels of 4-HNE， HO-1， Bax， and C-caspase-3 （P＜0.01）. Compared to the model group， the 7.5% medicated serum group showed significant improvements in all of the above parameters （P＜0.01）. In the forskolin group， the apoptosis rate and the expression levels of C-caspase-3 and Bax significantly decreased， whereas Bcl-2 expression and the p-PKA/PKA and p-CREB/CREB ratios increased compared to those in the model group （P＜0.01）. Compared to the 7.5% medicated serum group， the 7.5% medicated serum plus inhibitor group exhibited significantly increased expression of C-caspase-3 and Bax， together with significantly decreased Bcl-2 expression and reduced p-PKA/PKA and p-CREB/CREB ratios （P＜0.01）. ConclusionUnder continuous hydrostatic pressure and OGD-induced injury conditions， QGAⅡ- containing serum effectively mitigates oxidative stress in R28 cells， activates the cAMP/PKA signaling pathway， and inhibits apoptosis， thereby exerting a neuroprotective effect on retinal ganglion cells

AIM: To analyze the changes in binocular visual function before and after small incision lenticule extraction(SMILE)in patients with different degrees of myopia.METHODS:A prospective non-randomized controlled study was conducted. A total of 94 patients(188 eyes)who visited the refractive outpatient department of the ophthalmology department of the General Hospital of the PLA from June 2022 to June 2023 and voluntarily chose SMILE were consecutively included. They were grouped according to the degree of myopia, including 24 cases(48 eyes)in the low myopia group(-3.00 D

Glaucoma is a multifactorial degenerative optic neuropathy, and its irreversible and blinding pathological characteristics mainly come from the damage to the optic nerve, namely glaucomatous optic neuropathy(GON). The difficulty in the treatment of GON lies in the early intervention, and currently there is no optic neuroprotective drug for the treatment of all types of GON. The death of retinal ganglion cells(RGCs)is the core pathological change caused by various pathogenic mechanisms of GON. Recent studies have found that the widespread second messenger cyclic adenosine 3', 5' -monophosphate(cAMP)and its downstream effector protein kinase A(PKA)signal cascade play an important role in the pathogenesis of GON. It can also inhibit the apoptosis of RGCs and play a protective and therapeutic role in glaucoma. Therefore, this article reviews the role of cAMP/PKA pathway in the pathophysiological development of GON, focusing on its effects on glaucoma intraocular pressure regulation, oxidative stress, neuroinflammation and optic nerve degeneration, in order to find a common central regulatory target for the optic nerve damage caused by different pathological mechanisms of GON and promote the further understanding and clinical treatment of this disease.

Objective: To investigate the knowledge, attitudes, practices (KAP) and the situation of home blood pressure monitoring (HBPM) among hypertension patients in rural areas of Shanghai Municipality, so as to provide a basis for enhancing blood pressure management in this population. Methods: From June to October 2021, hypertension patients under management in Luodian Town and Luojing Town of rural areas of Shanghai Municipality were selected as survey subjects using a multistage random sampling method. Demographic information, KAP related to hypertension, and HBPM status were collected through questionnaire surveys. Patients were categorized into short disease duration (≤5 years), medium disease duration (6-10 years), and long disease duration (≥11 years) groups. KAP and HBPM status across different disease duration groups were analyzed statistically. Results: A total of 2 894 hypertensive patients were surveyed, including 1 317 (45.51%) males and 1 577 (54.49%) females. The median age was 69.00 (interquartile range, 10.00) years. There were 610 cases with short disease duration, accounting for 21.08%; 629 cases with medium duration, accounting for 21.73%; and 1 655 cases with long duration, accounting for 57.19%. The awareness of "hypertension control measures" was relatively high (97.89%), while awareness of "hypertension complications" was relatively low (71.70%). The adherence rate of "not perceiving difficulty in remembering to take medication on time and in correct doses" was relatively low (78.89%), and the proportion of participants who "walked ≥10 minutes per session at least once in the past 7 days" was relatively high (80.48%). A total of 1 209 cases (41.78%) engaged in HBPM, including 233 cases with short disease duration (19.27%), 252 cases with medium disease duration (20.84%), and 724 cases with long disease duration (59.88%). Compared with long disease duration hypertension patients, those with short disease duration had a alower awareness of "principles of pharmacological treatment for hypertension", a lower adherence rate of "medication should not be stopped after blood pressure control", and a lower proportion of providing their blood pressure measurement results to doctors (all P<0.017). However, they had higher proportions of alcohol consumption and daily salt intake >6 g/d (both P<0.017). Conclusions Short disease duration hypertension patients exhibit poorer performance in hypertension-related KAP and HBPM compared to long disease duration patients in rural areas of Shanghai Municipality. It is recommended to implement tailored health education based on disease duration, promote HBPM, and enhance blood pressure control rate.

The paper reports a 32-year-old female acute myeloid leukemia patient who developed graft-versus-host disease after paternal hematopoietic stem cell transplantation, which subsequently led to renal thrombotic microangiopathy. She subsequently required a kidney transplant from the same donor 5 years later due to renal failure. Considering that both the bone marrow and kidney were from the same donor and the recovery of renal function was favorable, immunosuppressive therapy was discontinued after a short course of anti-rejection treatment, with maintained stable kidney function. This case suggests that under the condition of high chimerism, allogeneic hematopoietic stem cell transplantation and kidney transplantation from the same donor can achieve immune tolerance, potentially improving solid organ transplantation success rate. The findings provide a novel therapeutic approach for solid organ transplantation following allogeneic hematopoietic stem cell transplantation.

The paper reports a 32-year-old female acute myeloid leukemia patient who developed graft-versus-host disease after paternal hematopoietic stem cell transplantation, which subsequently led to renal thrombotic microangiopathy. She subsequently required a kidney transplant from the same donor 5 years later due to renal failure. Considering that both the bone marrow and kidney were from the same donor and the recovery of renal function was favorable, immunosuppressive therapy was discontinued after a short course of anti-rejection treatment, with maintained stable kidney function. This case suggests that under the condition of high chimerism, allogeneic hematopoietic stem cell transplantation and kidney transplantation from the same donor can achieve immune tolerance, potentially improving solid organ transplantation success rate. The findings provide a novel therapeutic approach for solid organ transplantation following allogeneic hematopoietic stem cell transplantation.

Objective To conduct a comparative analysis of the biomechanical characteristics of the lower limbs during stair descent in patients with hemiplegia using different method to provide theoretical references for reducing fall risk during stair descent.Methods Ten healthy subjects and 20 patients with hemiplegia were selected,and their kinematic and dynamic data during stair descent were collected using the Qualisys Motion capture system and the Kistler three-dimensional dynamometer.Their biomechanical characteristics and fall risks were also analyzed.Results Compared with that of healthy subjects and patients that step on the healthy side(SHS),the range of motion(ROM)of the affected side in the lower-limb joints of patients that step on the affected side(SAS)was smaller.SHS reduced the flexion and extension ranges of the healthy side of the knee joint,and the ROM of the affected side in the lower-limb joints of SHS patients was greater than that of SAS patients.The ground reaction force(GRF)curve changes of SAS patients in left and right directions during stair descent were relatively consistent with those of normal subjects.The maximum vertical GRF of the affected side in SAS patients at the moment of landing was 1.05 times the body weight,whereas that of the healthy side was 1.25 times the body weight,which was lower than that of normal subjects(1.5 times the body weight).The maximum vertical GRF of the healthy side in SHS patients at the moment of landing was 1.85 times the body weight,which was higher than that of SAS patients and normal subjects.Conclusions Compared with that of SAS patients,the affected limb side of SHS patients has a greater ROM and vertical GRF at the moment of landing during stair descent,making SHS difficult to master.SAS is most consistent with the biomechanical characteristics during stair descent of patients with hemiplegia.

Objective To predict the torque on the affected side of the hip,knee,and ankle joints in stroke patients during walking using principal component analysis(PCA)and backpropagation(BP)neural networks.Methods Kinematic and dynamic data from 30 stroke patients were synchronously collected using an 8-lens Qualisys infrared point high-speed motion capture system and Kistler three-dimensional(3D)force measurement platform.The torques of the hip,knee,and ankle joints in the stroke patients were calculated using OpenSim,and the initial variables with a cumulative contribution rate of 99％were screened using PCA.The normalized root mean square error(NRMSE),root mean square error(RMSE),mean absolute percentage error(MAPE),mean absolute error(MAE),and R2 were used as evaluation indicators for the PCA-BP model.The consistency between the calculated joint torque and predicted torque was evaluated using Kendall's W coefficient.Results PCA data showed that the trunk,pelvis,and affected sides of the hip,knee,and ankle joints had a significant impact on the torque of the affected sides of the hip,knee,and ankle joints on the x,y,and z axes(sagittal,coronal,and vertical axes,respectively).The NRMSE between predicted and measured values was 5.14％-8.86％,RMSE was 0.184-0.371,MAPE was 3.5％-4.0％,MAE was 0.143-0.248,and R was 0.998-0.999.Conclusions The established PCA-BP model can accurately predict the torque of the hip,knee,and ankle joints in stroke patients during walking,with a significantly shortened measurement time.This model can replace traditional joint torque calculation in the gait analysis of stroke patients,provides a new approach to obtaining biomechanical data of stroke patients,and is an effective method for the clinical treatment of stroke patients.

Objective To build a dataset encompassing a large number of stained tongue coating images and process it using deep learning to automatically recognize stained tongue coating images. Methods A total of 1 001 images of stained tongue coating from healthy students at Hunan University of Chinese Medicine and 1 007 images of pathological(non-stained)tongue coat-ing from hospitalized patients at The First Hospital of Hunan University of Chinese Medicine with lung cancer,diabetes,and hypertension were collected.The tongue images were randomi-zed into the training,validation,and testing datasets in a 7:2:1 ratio.A deep learning model was constructed using the ResNet50 for recognizing stained tongue coating in the training and validation datasets.The training period was 90 epochs.The model's performance was evaluated by its accuracy,loss curve,recall,F1 score,confusion matrix,receiver operating characteristic(ROC)curve,and precision-recall(PR)curve in the tasks of predicting stained tongue coating images in the testing dataset.The accuracy of the deep learning model was compared with that of attending physicians of traditional Chinese medicine(TCM). Results The training results showed that after 90 epochs,the model presented an excellent classification performance.The loss curve and accuracy were stable,showing no signs of overfitting.The model achieved an accuracy,recall,and F1 score of 92%,91%,and 92%,re-spectively.The confusion matrix revealed an accuracy of 92%for the model and 69%for TCM practitioners.The areas under the ROC and PR curves were 0.97 and 0.95,respectively. Conclusion The deep learning model constructed using ResNet50 can effectively recognize stained coating images with greater accuracy than visual inspection of TCM practitioners.This model has the potential to assist doctors in identifying false tongue coating and prevent-ing misdiagnosis.

OBJECTIVE To study the effects of transferrin-targeting peptide T7 （7pep） on intracellular transportation of polyethylene glycol-polycaprolactone （PEG-PCL） micelles in human cervical cancer HeLa cells. METHODS Using coumarin-6 （C6） as fluorescent indicator probe， both coumarin-6 （C6）-loaded PEG-PCL （PEG-PCL-C6） micelles and 7pep-modified PEG- PCL （7pep-PEG-PCL-C6） micelles were prepared by film-dispersion method. The particle size， polydispersity index and appearance morphology were compared between two types of micelles； the real-time uptake of two types of micelles by HeLa cells was compared， and the colocalization of two types of micelles with early endosomes （EE）， endocytic recycling compartments （ERC） and late endosomes （LE） after entry into the cells was observed. RESULTS The particle sizes of PEG-PCL-C6 and 7pep-PEG-PCL- C6 micelles were（75.0±2.3）and（82.0±1.5）nm； the polymer dispersity indexes were 0.17±0.20 and 0.17±0.32， respectively， with a regular spherical appearance. The colocalization results showed that entry speed and amount of 7pep-PEG-PCL-C6 micelles were significantly faster/more than those of PEG-PCL-C6 micelles. 7pep-PEG-PCL-C6 micelles entered EE faster than PEG-PCL-C6 micelles， while PEG-PCL-C6 micelles entered ERC at a faster rate than 7pep-PEG-PCL-C6 micelles， and both PEG-PCL-C6 micelles and 7pep-PEG-PCL-C6 micelles tended to accumulate gradually in LE； Pearson coefficient， signal overlap ratio， and colocalization ratio of 7pep-PEG-PCL-C6 micelles with LE were significantly lower 60 minutes after entering the cell than those 30 minutes after entering the cell （P＜0.05 or P＜0.01）. CONCLUSIONS Targeting 7pep modification can increase the entry speed and amount of PEG-PCL-C6 micelles， and also alter their intracellular transportation behavior.