Dry eye （DE） is a prevalent multifactorial disease of the ocular surface， clinically characterized by tear film homeostasis imbalance accompanied by related ocular surface symptoms. Specifically， the tear film is a thin liquid layer of tears covering the cornea and conjunctiva through blinking， while tear film homeostasis serves as the foundation for maintaining normal ocular surface structure and function. Insufficient tear secretion and excessive tear film evaporation lead to tear hyperosmolarity and the production of inflammatory mediators， disrupting tear film homeostasis and subsequently forming DE. Additionally， cascade reactions are triggered， resulting in a "vicious cycle of DE" that exacerbates the disease severity and prolongs its duration. Therefore， for DE treatment， it is crucial to restore tear film homeostasis and terminate this vicious cycle. Traditional Chinese medicine （TCM）， which differentiates and treats DE based on systemic conditions， often achieves favorable therapeutic outcomes， offering additional treatment options for DE. Studies have demonstrated that TCM can alleviate DE by regulating tear film homeostasis and terminating the vicious cycle. This review systematically summarizes recent basic experimental research in China and abroad on TCM in alleviating DE by regulating tear film homeostasis， aiming to provide a theoretical basis for clinical treatment and an insight for research design.

ObjectiveThis paper aims to investigate the effects and mechanism of Mimenghua prescription in modulating the mitogen-activated protein kinase kinase （MEK）/rat sarcoma viral oncogene homolog （Ras）/rapidly accelerated fibrosarcoma kinase （Raf）/extracellular signal-regulated kinase （ERK） signaling pathway to inhibit inflammatory responses in a dry eye animal model. MethodsA total of 60 C57BL/6J mice （eight weeks old， half male and half female） were used in the experiment. Ten mice were randomly selected as the blank control group， while the remaining 50 were exposed to a controlled dry system and received instillation of 0.2% benzalkonium chloride （BAC） into the eyes for four weeks to establish a dry eye mouse model. After successful modeling， the mice were randomly divided into five groups： Model group， sodium hyaluronate group， and Mimenghua prescription groups with low dose （4.83 g·kg^-1）， medium dose （9.67 g·kg^-1）， and high dose （19.34 g·kg^-1）. The mice in the model group received an equal volume of normal saline via gavage for four weeks. The mice in the sodium hyaluronate group received instillation of sodium hyaluronate eye drops twice daily for 14 consecutive days. The tear secretion volume， tear film break-up time （TBUT）， and corneal fluorescein staining were evaluated once every two weeks. After four weeks of administration， mice were euthanized， and their lacrimal gland tissues and corneas were harvested. Hematoxylin-eosin （HE） staining was used to assess histopathological morphology. Western blot was performed to detect the protein expression levels of MEK， Ras， Raf， and ERK. Enzyme-linked immunosorbent assay （ELISA） was used to measure the contents and expressions of MEK， Ras， Raf， ERK， and interleukin （IL）-1β in lacrimal gland and corneal tissues of the mice in each group. Quantitative real-time polymerase chain reaction （Real-time PCR） was employed to determine mRNA expression levels of MEK， Ras， Raf， and ERK. ResultsThe Mimenghua prescription groups and the sodium hyaluronate group exhibited significantly increased tear secretion volume （P<0.05） and prolonged TBUT （P<0.05） after treatment. Ocular surface damage of mice was visibly recovered. Western blot results indicated that protein expression levels of MEK， Ras， Raf， and ERK in the lacrimal gland and corneal tissues were significantly downregulated in the sodium hyaluronate group and Mimenghua prescription group with high dose （P<0.05）. ELISA results showed that IL-1β levels were highest in the model group but significantly reduced in the sodium hyaluronate group and Mimenghua prescription groups （P<0.05）. Both ELISA and Real-time PCR results demonstrated that the expression levels of MEK， Ras， Raf， and ERK in the lacrimal glands and corneal tissues were significantly elevated in the model group （P<0.05）， but markedly downregulated in the sodium hyaluronate group and Mimenghua prescription groups （P<0.05）， suggesting that Mimenghua prescription can decrease the expressions of MEK， Ras， Raf， and ERK in the lacrimal glands and corneal tissues. ConclusionMimenghua prescription can reduce inflammatory responses， increase tear secretion， prolong TBUT， and promote corneal recovery by inhibiting the MEK， Ras， Raf， and ERK signaling pathways in lacrimal gland and corneal tissues.

ObjectiveTo construct a competency model for "dual-qualified" teachers in vocational undergraduate rehabilitation therapy programs based on the World Health Organization's rehabilitation competency framework (RCF) and relevant domestic and international standards, and explore the training pathways for rehabilitation therapy teachers in China. MethodsLiterature analysis and comparative research methods were employed to systematically review RCF, physiotherapist-education-framework-FINAL, the Minimum-Standards-for-the-Education-of-Occupational-Therapists, and the "dual-qualified" teacher standards in vocational education for China. Focusing on the characteristics of vocational undergraduate talent cultivation, it took the integration of the "educator-clinical rehabilitation therapist" dual roles as its starting point, combining rehabilitation industry competence with educator standards as its basic principle, and using RCF as its foundational dimension. It then integrated advanced competency dimensions required of vocational undergraduate teachers to form a dimensional framework. Following the systematic curriculum development concept of the work process, the core activities of each dimension were designed by combining, improving and expanding the concept integration method, and describing the ability characteristics in a graded and progressive manner, to construct a model. ResultsThis model was guided by the core concepts of three types of values ​​and four types of professional beliefs. Vertically, it encompassed 28 activities across eight competency dimensions, including teaching practice, rehabilitation practice, digital literacy, professionalism, learning and development, management and leadership, applied research, and social service. Horizontally, it encompassed 53 corresponding competency characteristics across three advanced levels (beginner, intermediate and advanced). ConclusionThis model, through its vertical dimension design and horizontal progressive development, clearly describes the advancement of vocational undergraduate rehabilitation therapy teachers from newly hired teachers to backbone teachers and professional leaders. It not only aligns with the general requirements of the national standards for "dual-qualified" teachers in higher vocational colleges in China, but also incorporates an international perspective on rehabilitation education and practice, and possesses the characteristics of vocational undergraduate education that integrates multiple abilities and roles. At the theoretical level, it provides core theoretical support for establishing standardized and internationalized "dual-qualified" teacher standards for vocational undergraduate rehabilitation therapy programs in China; at the practical level, it serves as an "action map" for teacher professional development, assessment and evaluation, providing a key reference for constructing a systematic high-end skilled rehabilitation talent training system.

ObjectiveTo construct a competency model for "dual-qualified" teachers in vocational undergraduate rehabilitation therapy programs based on the World Health Organization's rehabilitation competency framework (RCF) and relevant domestic and international standards, and explore the training pathways for rehabilitation therapy teachers in China. MethodsLiterature analysis and comparative research methods were employed to systematically review RCF, physiotherapist-education-framework-FINAL, the Minimum-Standards-for-the-Education-of-Occupational-Therapists, and the "dual-qualified" teacher standards in vocational education for China. Focusing on the characteristics of vocational undergraduate talent cultivation, it took the integration of the "educator-clinical rehabilitation therapist" dual roles as its starting point, combining rehabilitation industry competence with educator standards as its basic principle, and using RCF as its foundational dimension. It then integrated advanced competency dimensions required of vocational undergraduate teachers to form a dimensional framework. Following the systematic curriculum development concept of the work process, the core activities of each dimension were designed by combining, improving and expanding the concept integration method, and describing the ability characteristics in a graded and progressive manner, to construct a model. ResultsThis model was guided by the core concepts of three types of values ​​and four types of professional beliefs. Vertically, it encompassed 28 activities across eight competency dimensions, including teaching practice, rehabilitation practice, digital literacy, professionalism, learning and development, management and leadership, applied research, and social service. Horizontally, it encompassed 53 corresponding competency characteristics across three advanced levels (beginner, intermediate and advanced). ConclusionThis model, through its vertical dimension design and horizontal progressive development, clearly describes the advancement of vocational undergraduate rehabilitation therapy teachers from newly hired teachers to backbone teachers and professional leaders. It not only aligns with the general requirements of the national standards for "dual-qualified" teachers in higher vocational colleges in China, but also incorporates an international perspective on rehabilitation education and practice, and possesses the characteristics of vocational undergraduate education that integrates multiple abilities and roles. At the theoretical level, it provides core theoretical support for establishing standardized and internationalized "dual-qualified" teacher standards for vocational undergraduate rehabilitation therapy programs in China; at the practical level, it serves as an "action map" for teacher professional development, assessment and evaluation, providing a key reference for constructing a systematic high-end skilled rehabilitation talent training system.

ObjectiveTo construct a competency model for "dual-qualified" teachers in vocational undergraduate rehabilitation therapy programs based on the World Health Organization's rehabilitation competency framework (RCF) and relevant domestic and international standards, and explore the training pathways for rehabilitation therapy teachers in China. MethodsLiterature analysis and comparative research methods were employed to systematically review RCF, physiotherapist-education-framework-FINAL, the Minimum-Standards-for-the-Education-of-Occupational-Therapists, and the "dual-qualified" teacher standards in vocational education for China. Focusing on the characteristics of vocational undergraduate talent cultivation, it took the integration of the "educator-clinical rehabilitation therapist" dual roles as its starting point, combining rehabilitation industry competence with educator standards as its basic principle, and using RCF as its foundational dimension. It then integrated advanced competency dimensions required of vocational undergraduate teachers to form a dimensional framework. Following the systematic curriculum development concept of the work process, the core activities of each dimension were designed by combining, improving and expanding the concept integration method, and describing the ability characteristics in a graded and progressive manner, to construct a model. ResultsThis model was guided by the core concepts of three types of values ​​and four types of professional beliefs. Vertically, it encompassed 28 activities across eight competency dimensions, including teaching practice, rehabilitation practice, digital literacy, professionalism, learning and development, management and leadership, applied research, and social service. Horizontally, it encompassed 53 corresponding competency characteristics across three advanced levels (beginner, intermediate and advanced). ConclusionThis model, through its vertical dimension design and horizontal progressive development, clearly describes the advancement of vocational undergraduate rehabilitation therapy teachers from newly hired teachers to backbone teachers and professional leaders. It not only aligns with the general requirements of the national standards for "dual-qualified" teachers in higher vocational colleges in China, but also incorporates an international perspective on rehabilitation education and practice, and possesses the characteristics of vocational undergraduate education that integrates multiple abilities and roles. At the theoretical level, it provides core theoretical support for establishing standardized and internationalized "dual-qualified" teacher standards for vocational undergraduate rehabilitation therapy programs in China; at the practical level, it serves as an "action map" for teacher professional development, assessment and evaluation, providing a key reference for constructing a systematic high-end skilled rehabilitation talent training system.

Cancer remains a leading cause of global mortality, necessitating the development of advanced therapeutic strategies with enhanced efficacy and reduced systemic toxicity. Among promising bioactive agents, lactoferrin (LF)—a multifunctional iron-binding glycoprotein abundantly found in mammalian milk and exocrine secretions—has garnered significant interest for its potent and multifaceted anti-cancer properties. This review provides a comprehensive analysis of the current understanding of LF’s role in oncology, encompassing its structural biology, diverse mechanisms of action, and groundbreaking advancements in its application through nano-engineering. LF exerts anti-tumor effects through multiple pathways, including extracellular action, intracellular action, and immune regulation. It demonstrates a remarkable affinity for cancer cell membranes, binding to overexpressed anionic components such as glycosaminoglycans and sialic acids, as well as to specific receptors including the low-density lipoprotein receptor-related protein-1 (LRP-1). This selective binding facilitates targeted uptake. Upon internalization, LF orchestrates a direct assault by inducing cell-cycle arrest in phases such as G0/G1 or S phase through the modulation of key regulators including cyclins, CDKs, and p53. Furthermore, it promotes programmed cell death via apoptotic pathways, involving caspase activation and downregulation of anti-apoptotic proteins such as survivin. A more recently elucidated mechanism is the induction of ferroptosis, an iron-dependent form of cell death characterized by overwhelming lipid peroxidation. Beyond direct cytotoxicity, LF acts as a potent immunomodulator. It enhances natural killer (NK) cell activity, modulates T-lymphocyte populations, and crucially reprograms tumor-associated macrophages (TAMs) from a pro-tumor M2 state to an anti-tumor M1 state, thereby reversing the immunosuppressive tumor microenvironment (TME). The translation of LF’s potential has been significantly accelerated by nanotechnology. The inherent biocompatibility and natural tumor-targeting capabilities of LF make it an ideal platform for sophisticated drug-delivery systems. This review details various fabrication strategies for LF-based nanoparticles (NPs), including self-assembly, sol-in-oil emulsion, and electrostatic nanocomplexes, among others. Research demonstrates that nano-formulations not only protect LF from degradation but also enhance its bioactivity and anti-cancer potency. More importantly, LF NPs serve as versatile carriers for a wide array of therapeutic agents, including conventional chemotherapeutics, natural compounds, and imaging agents. These engineered systems enable synergistic therapy and facilitate site-specific delivery. Notably, the ability of LF to bind to receptors on the blood-brain barrier (BBB) has been leveraged to develop nano-systems for glioblastoma treatment. Other innovative designs utilize LF to modulate the TME—for instance, by alleviating tumor hypoxia to sensitize cells to radiotherapy and chemotherapy. Despite compelling pre-clinical evidence, the clinical translation of LF and its nano-formulations remains nascent. While early-phase trials have established a favorable safety profile for recombinant human LF, larger Phase III studies have yielded mixed results, underscoring the complexity of its action in humans. Key challenges include enhancing drug targeting, optimizing loading efficiency, ensuring batch-to-batch reproducibility, and achieving deep tumor penetration. Future research must focus on the rational design of next-generation LF-NPs. This entails developing standardized manufacturing protocols, engineering “smart” stimuli-responsive systems for targeted drug release in the TME, and constructing multi-targeting platforms. A concerted interdisciplinary effort is paramount to bridge the gap between bench and bedside. In conclusion, LF, particularly in its nano-engineered forms, represents a highly promising and versatile agent in the oncological arsenal, holding immense potential for precise and effective cancer therapy.

Cancer remains a leading cause of global mortality, necessitating the development of advanced therapeutic strategies with enhanced efficacy and reduced systemic toxicity. Among promising bioactive agents, lactoferrin (LF)—a multifunctional iron-binding glycoprotein abundantly found in mammalian milk and exocrine secretions—has garnered significant interest for its potent and multifaceted anti-cancer properties. This review provides a comprehensive analysis of the current understanding of LF’s role in oncology, encompassing its structural biology, diverse mechanisms of action, and groundbreaking advancements in its application through nano-engineering. LF exerts anti-tumor effects through multiple pathways, including extracellular action, intracellular action, and immune regulation. It demonstrates a remarkable affinity for cancer cell membranes, binding to overexpressed anionic components such as glycosaminoglycans and sialic acids, as well as to specific receptors including the low-density lipoprotein receptor-related protein-1 (LRP-1). This selective binding facilitates targeted uptake. Upon internalization, LF orchestrates a direct assault by inducing cell-cycle arrest in phases such as G0/G1 or S phase through the modulation of key regulators including cyclins, CDKs, and p53. Furthermore, it promotes programmed cell death via apoptotic pathways, involving caspase activation and downregulation of anti-apoptotic proteins such as survivin. A more recently elucidated mechanism is the induction of ferroptosis, an iron-dependent form of cell death characterized by overwhelming lipid peroxidation. Beyond direct cytotoxicity, LF acts as a potent immunomodulator. It enhances natural killer (NK) cell activity, modulates T-lymphocyte populations, and crucially reprograms tumor-associated macrophages (TAMs) from a pro-tumor M2 state to an anti-tumor M1 state, thereby reversing the immunosuppressive tumor microenvironment (TME). The translation of LF’s potential has been significantly accelerated by nanotechnology. The inherent biocompatibility and natural tumor-targeting capabilities of LF make it an ideal platform for sophisticated drug-delivery systems. This review details various fabrication strategies for LF-based nanoparticles (NPs), including self-assembly, sol-in-oil emulsion, and electrostatic nanocomplexes, among others. Research demonstrates that nano-formulations not only protect LF from degradation but also enhance its bioactivity and anti-cancer potency. More importantly, LF NPs serve as versatile carriers for a wide array of therapeutic agents, including conventional chemotherapeutics, natural compounds, and imaging agents. These engineered systems enable synergistic therapy and facilitate site-specific delivery. Notably, the ability of LF to bind to receptors on the blood-brain barrier (BBB) has been leveraged to develop nano-systems for glioblastoma treatment. Other innovative designs utilize LF to modulate the TME—for instance, by alleviating tumor hypoxia to sensitize cells to radiotherapy and chemotherapy. Despite compelling pre-clinical evidence, the clinical translation of LF and its nano-formulations remains nascent. While early-phase trials have established a favorable safety profile for recombinant human LF, larger Phase III studies have yielded mixed results, underscoring the complexity of its action in humans. Key challenges include enhancing drug targeting, optimizing loading efficiency, ensuring batch-to-batch reproducibility, and achieving deep tumor penetration. Future research must focus on the rational design of next-generation LF-NPs. This entails developing standardized manufacturing protocols, engineering “smart” stimuli-responsive systems for targeted drug release in the TME, and constructing multi-targeting platforms. A concerted interdisciplinary effort is paramount to bridge the gap between bench and bedside. In conclusion, LF, particularly in its nano-engineered forms, represents a highly promising and versatile agent in the oncological arsenal, holding immense potential for precise and effective cancer therapy.

Objective:To investigate the epidemiological dynamics and spatiotemporal diffusion trend of brucellosis in China from 2010 to 2024.Methods:Data on reported human brucellosis cases in mainland China from January 1, 2010, to December 31, 2024, were collected via the"China Information System for Disease Control and Prevention", including detailed information on the date of onset, gender, age, occupation, and residential address of the cases. The Joinpoint regression and spatial interpolation techniques were used to investigate the spatiotemporal dynamics and population distribution characteristics of human brucellosis in pastoral/semi-pastoral areas and other regions, as well as urban and rural areas, and explore the epidemic trends of the disease.Results:From 2010 to 2024, pastoral/semi-pastoral regions reported 252 094 brucellosis cases, with a mean annual incidence rate of 36.57±7.28 per 100 000. In contrast, other regions cumulatively recorded 519 748 cases during the same period, demonstrating a significantly lower mean annual incidence rate of 2.54±0.74 per 100 000. The incidence rate of human brucellosis in pastoral/semi-pastoral regions exhibited a declining-rebounding-declining trend. Specifically, the incidence rate decreased significantly from 2010 to 2017 (APC=-7.20; P<0.001) and increased notably from 2017 to 2021 (APC=18.00; P=0.015) with a decline again from 2021 to 2024 (APC=-7.53; P=0.027). In other regions, the incidence rate showed a fluctuating upward trend. Specifically, the incidence rate increased significantly from 2010 to 2015 (APC=20.37; P<0.001) and decreased notably from 2015 to 2018 (APC=-21.78; P<0.001), followed by an increase again from 2018 to 2024, a significant upward trend in incidence rate from 2018 to 2021 (APC=26.73; P<0.001) and a non-significant decline from 2021 to 2024 (APC=-0.99; P=0.735), resulting in the maintenance of a relatively high incidence level. Rural areas demonstrated significantly higher brucellosis incidence rates than urban settings (all P<0.001). Brucellosis exhibited a diffusion trend from the northern epidemic areas of China to neighboring regions, along with sporadic diffusion in southern regions between 2010 and 2024. The age structure of patients in pastoral/semi-pastoral areas differed significantly from that in other regions. Specifically, in pastoral/semi-pastoral areas, the incidence rate was higher among the 35-49 age groups, while in other regions, the incidence rate was higher among those aged 55-64. Conclusion:There are notable disparities in the incidence of human brucellosis between pastoral/semi-pastoral areas and other regions in China. Human brucellosis exhibits a diffusion trend from the northern epidemic areas of China to neighboring regions, along with sporadic diffusion in southern regions.

Objective To identify the multidimensional needs of postoperative gastric cancer patients for home-based nutritional management based on patient journey maps,and to provide a reference for carrying out nutritional management interventions.Methods Using descriptive qualitative research methods,we facilitated semi-structured in-depth interviews with 9 pairs of postoperative gastric cancer homebound patients and their primary caregivers from a tertiary general hospital in Yichang City,China,from September 2024 to January 2025,and analysed the data and drew the patient journey maps by content analysis.Results Totally 24 sub-themes were summarised from 4 aspects,namely tasks,emotions,pain points and opportunity points,and journey maps involving the acute recovery period,the transitional adaptation period and the nutritional reconstruction period were formed.Conclusion The nutritional needs of homebound patients after gastric cancer surgery are complex and variable,and their needs for dietary guidance,eating-related symptom management,and real-time counselling are highlighted.In the future,appropriate intervention strategies can be developed based on the journey maps to meet the multidimensional nutritional needs of patients.

OBJECTIVE T o carry out the health economics evaluation and cost-benefit analysis of the type b Hae-mophilus influenzae(Hib)vaccination for the children who were hospitalized due to Hib infection so as to provide evidence for public health policies.METHODS The children who were diagnosed with Hib-related respiratory tract infections or meningitis and were hospitalized in respiratory medicine department,infection management depart-ment,emergency rooms and neurology department of Jiangxi Provincial Children's Hospital from Jan.1,2021 to Dec.31,2023 were recruited as the research subjects.Based on a 1∶1 matching condition,the matching variables included four items such as the same age for the admission to the hospital,same gender,same department and same grade of disease severity.The children for whom the primary immunization of Hib vaccination(including Hib monovalent vaccine and Hib-containing combination vaccine)were completed and the integrity of vaccination infor-mation could be checked out were assigned as the intervention group,while the children for whom the primary im-munization of Hib vaccination was not completed were chosen as the control group.The clinical data,vaccination data and the data such as length of hospital stay and hospitalization cost were collected from the children.The cost-benefit of the Hib vaccination among the children with Hib infection was observed.RESULTS A total of 622 hospi-talized children who were detected with Hib-positive respiratory tract infections or meningitis were enrolled in the study,and 73 children(20 children from infection management department,27 children from respiratory medi-cine department,26 children from emergency rooms)were finally included in the intervention group after matc-hing and multiple rounds of screening,73 children were chosen as the control group based on a 1∶1 matching con-dition.The male children accounted for 57.53％(42 cases)in both groups,and the female children accounted for 42.47％(31 cases)in both groups.With the respect to the length of hospital stay,it was 7.00(5.00,8.00)days in the intervention group,7.00(6.00,8.00)days in the control group(Z=-0.341,P=0.733).In terms of the hospitalization cost,it was 7 756.17(6 617.92,10 617.69)yuan in the intervention group,9 040.65(8 033.76,10 935.84)yuan in the control group(Z=-2.795,P=0.005).The cost of Hib vaccination was 343.03 yuan per capita in the intervention group,and the benefit-cost ratio(BCR)was 1∶3.74(343.03 yuan/1 284.48 yuan).CONCLUSIONS The Hib vaccination can save the hospitalization cost and has high cost effectiveness.It is sugges-ted that the Hib vaccination should be promoted and the coverage rate of Hib vaccination should be raised among the age-eligible children.