Post-cataract surgery dry eye(PCSDE)is a common complication, with an incidence of 9.2%-72.6%, and approximately 20% of patients experience persistent long-term symptoms. In the era of refractive cataract surgery, dry eye has become a critical factor affecting surgical satisfaction due to rising patient expectations for visual quality. Emerging evidence highlights that the interplay between neurosensory abnormalities and immune-inflammatory responses drives PCSDE chronicity, with psychoneurological factors gaining increasing attention. This review systematically examines PCSDE pathogenesis and contributing factors from this novel perspective, including surgical variables(incision design, operative duration, techniques), patient-related factors(age, meibomian gland function, systemic diseases, psychological status), and perioperative management(drug toxicity, disinfectant use). Additionally, based on the latest clinical evidence, comprehensive prevention and treatment strategies including preoperative optimization of ocular surface conditions, intraoperative ocular surface protection techniques, and personalized postoperative regimens are summarized. A deeper understanding of the multifactorial mechanisms of PCSDE is crucial for enhancing the quality of cataract surgery and improving patient outcomes. This review establishes a novel framework for PCSDE management based on neuro-immune-psychological interactions, offering crucial theoretical updates and practical guidance to enhance visual quality and patient satisfaction in refractive cataract surgery.

ObjectiveTo investigate the mechanism of ferroptosis mediated by long-chain acyl-CoA synthetase 4 （ACSL4） signalling pathway in rats with coronary heart disease with blood stasis syndrome and the intervention effect of Xuefu Zhuyutang. MethodsSPF male SD rats were randomly divided into normal group， sham-operation group， model group， trimetazidine group （5.4 mg·kg^-1）， low-， medium-， and high-dose group （3.51， 7.02，14.04 g·kg^-1） of Xuefu Zhuyutang. The coronary artery left anterior descending ligation method was used to prepare a model of coronary heart disease with blood stasis syndrome， and continuous treatment for 7 d was conducted， while the sham-operation group was only threaded and not ligated. The general macroscopic symptoms of the rats were observed， and indicators such as electrocardiogram， echocardiography， and blood rheology were detected. The pathological morphology of myocardial tissue was observed by hematoxylin-eosin （HE） staining， and the changes in mitochondria in myocardial tissue were observed by transmission electron microscopy. The level of iron deposition in myocardial tissue was observed by Prussian blue staining. The levels of 12-hydroxyeicosatetraenoic acid （12-HETE） and 15-HETE were detected in serum by enzyme-linked immunosorbent assay. A biochemical colourimetric assay was used to detect the levels of Fe²⁺， lipid peroxidation （LPO）， glutathione （GSH）， and T-GSH/glutathione disulfide （GSSG） in myocardial tissue. DCFH-DA fluorescence quantitative assay was employed to detect the levels of reactive oxygen species （ROS）. Western blot and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was adopted to detect the protein and mRNA expressions of glutathione peroxidase 4 （GPX4）， ferritin heavy chain 1 （FTH1）， ACSL4， and ly-sophosphatidylcholine acyltransferase3 （LPCAT3） in myocardial tissue. ResultsCompared with those in the normal group， the rats in the model group were poor in general macroscopic symptoms. The electrocardiogram showed widened QRS wave amplitude and increased voltage， bow-back elevation of the ST segments， elevated T waves， J-point elevation， and accelerated heart rate. Echocardiography showed a significant reduction in left ventricular ejection fraction （LVEF） and left ventricular fraction shortening （LVFS） （P<0.01）. Blood rheology showed that the viscosity of the whole blood （low， medium， and high rate of shear） was significantly increased （P<0.01）. HE staining showed an abnormal structure of myocardial tissue. There was a large area of myocardial necrosis and inflammatory cell infiltration and a large number of connective tissue between myocardial fibers. Transmission electron microscopy showed that the mitochondria were severely atrophy or swelling. The cristae were reduced or even broken， and the matrix was flocculent or even vacuolated. Prussian blue staining showed that there were a large number of iron-containing particles， and the iron deposition was obvious. The content of 12-HETE and 15-HETE in the serum was significantly increased （P<0.01）. The content of Fe²⁺， LPO， and ROS in myocardial tissue was significantly increased （P<0.01）. The content of GSH was significantly decreased （P<0.01）， and T-GSH/GSSG was decreased （P<0.01）. The protein and mRNA expressions of GPX4 and FTH1 in myocardial tissue were both significantly decreased （P<0.05， P<0.01）， while those of ACSL4 and LPCAT3 increased significantly （P<0.01）. Compared with the model group， the general macroscopic symptoms and electrocardiogram results of rats in low-， medium- and high-dose groups of Xuefu Zhuyutang were alleviated， and the differences in LVEF/LVFS ratios were all significantly increased （P<0.05， P<0.01）. The differences in whole-blood viscosity （low， medium， and high rate of shear） were all significantly decreased （P<0.01）. The results of HE staining and transmission electron microscopy showed that the morphology， structure， and mitochondria of cardiomyocytes were improved. The content of 12-HETE and 15-HETE in serum was reduced to different degrees in low-， medium-， and high-dose groups of Xuefu Zhuyutang （P<0.05， P<0.01）. The content of Fe²⁺， LPO， and ROS was significantly reduced in the medium- and high-dose groups of Xuefu Zhuyutang （P<0.05， P<0.01）， and the content of GSH and T-GSH/GSSG was significantly increased （P<0.05， P<0.01）. The protein and mRNA expressions of GPX4 and FTH1 were significantly increased to varying degrees in the medium- and high-dose groups of Xuefu Zhuyutang （P<0.05， P<0.01）， and ACSL4 and LPCAT3 were decreased to different degrees in the low-， medium-， and high-dose groups of Xuefu Zhuyutang （P<0.05， P<0.01）. ConclusionXuefu Zhuyutang can regulate iron metabolism and anti-lipid oxidation reaction to mediate ferroptosis through the ACSL4 signalling pathway， thus exerting a protective effect on rats with coronary heart disease with blood stasis syndrome.

Objective:To investigate the role of the Brock, Mayo, and PKUPH combined model in risk stratification of solitary pulmonary nodules (SPNs) in health check-up population.Methods:An ambispective cohort study was conducted on 668 eligible SPNs cases from the health management center in Chongqing General Hospital from June 2018 to June 2019. The exposure condition was prospectively followed or historically retrospected, and the clinical outcomes were prospectively followed. SPNs were classified into benign and malignant groups. Descriptive statistics and univariate analysis were performed to assess the differences in risk characteristics between two groups. Receiver operating characteristic (ROC) curve, clinical decision curve, and Hosmer-Lemeshow goodness-of-fit test were used to evaluate and compare the predictive performance, clinical utility, and calibration of the combined model versus individual Brock, Mayo, and PKUPH models.Results:Among the 668 SPNs cases, 82 (12.28%) were diagnosed as malignant. Age, sex, smoking history, extrapulmonary tumor history, diameter, upper lobe, clear border and spicule sign in the malignant group were significantly different from those in the benign group (all P<0.05). The combined model demonstrated superior predictive performance, clinical utility, and calibration compared to the best-performing individual Brock model [Area under the curve (AUC): 0.88 (95% CI: 0.84-0.92) vs 0.86 (95% CI: 0.82-0.91)]. Besides, multi-grade risk stratification enabled by the combined model was better than binary classification, with the malignant rate of the four risk levels were 0.60%, 4.62%, 14.58% and 56.07%, respectively. Conclusion:The combined model addresses the limitations of individual models in SPNs risk stratification for health examination populations, improving predictive performance, clinical utility, and calibration, while proposing a superior multi-grade risk stratification system.

Sj?gren syndrome(SS)is an immune disease mainly characterized by lymphocytes infiltrate in salivary and lacrimal glands,leading to glandular secretion disorders and dryness in the mouth and eyes.In recent years,clinical application of ultrasound elastography(USE)increased widespread,providing a new imaging method for diagnosis of SS.The research progresses of USE in SS were reviewed in this article.

Objective:To culturally adapt the eHealth Literacy Questionnaire (eHLQ) into Chinese and validate its reliability and validity in stroke patients, so as to provide a basis for comprehensive evaluation of electronic health literacy in stroke patients.Methods:From May to September 2024, the Brislin translation model was adopted for translation, and the expert consultation was used for cultural adaptation. Followed by preliminary testing to finalize the Chinese version of eHLQ. A convenience sample of the stroke patients was recruited from Beijing Tiantan Hospital, Capital Medical University and Tianjin Huanhu Hospital between October 2024 to February 2025 to conduct a cross-sectional study and evaluate the scale's reliability and validity.Results:Finally, 415 stroke patients were included, with 284 males and 131 females, aged (61.26 ± 9.75) years. The Chinese eHLQ comprised 7 dimensions and 35 items. The item-level content validity index ranged from 0.875 to 1.000, and the scale-level content validity index of universal agreement was 0.857. Exploratory factor analysis revealed KMO value of 0.922, with a cumulative variance contribution rate of 68.90% and factor loading ranging from 0.515 to 0.803. Confirmatory factor analysis demonstrated satisfactory model fit indices: χ2/ df was 1.639, incremental fit index was 0.913, Tucker-Lewis index was 0.902, comparative fit index was 0.912, goodness-of-fit index was 0.812, and root mean square error of approximation was 0.056. The overall Cronbach α coefficient was 0.941, with subscale Cronbach α ranging from 0.825 to 0.894. The test-retest reliability was 0.954. Conclusions:The Chinese version of the eHLQ exhibits excellent reliability and validity, serving as an effective tool for assessing eHealth literacy among stroke patients in China.

To perform the phylogenetic characterization of an isolated porcine rotavirus(PoRV)and investigate its pathogenicity in suckling mice and piglets.A G4P[23]genotype PoRV strain JSJR2023 was successfully isolated from the diarrheic piglet feces through propagation in MA104 cells.The viral proliferation kinetics were analyzed using TCID50 assays,followed by complete genome sequencing through Sanger sequencing platforms.Comprehensive genotyping and phylogenetic reconstruction were conducted using MEGA7.0 with maximum likelihood algorithms.Pathogenicity was assessed in the following animal models:5-day-old C57BL/6 mice and 3-day-old piglets.Multidimensional evaluation included clinical monitoring(diarrhea scoring,growth parameters),virological detection,and histopathological analysis of intestinal tissues.The virus strain JSJR2023 could replicate efficiently in MA104 cells,achieving peak titers of 107.5 TCID50/mL.Whole genome genotype analysis showed that the strain belonged to G4-P[23]-I5-R1-C1-M1-A8-N1-T1-E1-H1.Phylogenetic analysis indicated that the VP3 and NSP4 genes of JSJR2023 strain were most closedrelated to human species rotaviruses,suggesting genetic reassortment between human and porcine RV strains.The animal experiments in suckling mice showed that the JSJR2023 strain infection caused diarrhea symptoms,intestinal edema and congestion,and shedding of intestinal villus epithelial cells.The pathogenicity experiments in piglets showed that compared with the control group,the challenged group of pig-lets had severe diarrhea symptoms,accompanied by reduced appetite and listlessness.Post-mortem examination revealed that the intes-tines were significantly thinner,congested,and filled with yellow watery contents.The challenged piglets showed typical pathological changes such as thinning of the intestinal wall and shortening and shedding of intestinal villi.In conclusion,this study successfully iso-lated a human-porcine recombinant G4P[23]PoRV strain and established the infection models in suckling mice and piglets,providing important tools for investigating the pathogenic mechanism of PoRV,evaluating vaccines and developing antiviral drug.

The American Institute of Ultrasound in Medicine(AIUM)practice parameter for the performance of an ultrasound examination of the neonatal and infant spine was revised and published by the AIUM in collaboration with other academic organizations in the United States,to intend to provide the medical ultrasound community with recommendations for the performance of high-quality ultrasound examination of the neonatal and infant spine.The practice parameter propose indications and contraindications for the performance of an ultrasound examination of the neonatal and infant spine,elaborate on specifications of the spinal ultrasound examination,especially the methods for determining the vertebral body level of the end of the spinal cord and key points for evaluating the movement of nerve roots.Following this practice parameter will maximize the detection of abnormalities of the infant spine.This interpretation aims to help beginners and primary care practitioners more easily master the techniques of an ultrasound examination of the neonatal and infant spine,promote the standardized implementation and popularization of this examination,and enhance the diagnostic accuracy for intraspinal pathologies.

Objective:To explore the medication adherence of elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City and analyze its influencing factors.Methods:From April to July 2023, convenience sampling was used to select rural 240 elderly patients with chronic diseases and polypharmacy in five administrative districts (counties) of Hangzhou as participants. The survey was conducted using the General Information Questionnaire, Social Support Rating Scale, Medication Knowledge and Beliefs Questionnaire, and the Chinese version of the 8-item Morisky Medication Adherence Scale. Multiple linear regression was used to analyze the factors influencing medication adherence in elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City.Results:A total of 240 questionnaires were distributed and 220 valid questionnaires were collected, with an effective response rate of 91.67%. Among 220 elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City, 135 had poor medication adherence. Multiple linear regression analysis showed that age, educational level, family doctor contract, medication knowledge, and beliefs were the influencing factors of medication adherence in elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou City ( P<0.05) . Conclusions:The medication adherence of elderly patients with chronic diseases and polypharmacy in rural areas of Hangzhou urgently needs to be improved. Medical and nursing staff should pay special attention to patients who are old, have a low level of education, have not signed a family doctor, and have poor knowledge and beliefs about medication. It is suggested that the contract system for family doctors be further promoted, focusing on health education on medication knowledge and beliefs, to improve medication adherence among elderly chronic disease patients in rural areas.

Objective:To explore the mediating role of self-perceived aging in the relationship between perceived social support and self-efficacy for exercise in aged patients undergoing surgery for lung cancer and provide a basis for formulating relevant clinical intervention strategies.Methods:Totally 220 aged lung cancer patients who underwent surgery and were hospitalized at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from April to June 2024 were recruited by convenience sampling. Patients completed a demographic questionnaire, the Self-Efficacy for Exercise (SEE) , the Ageing Perceptions Questionnaire (B-APQ) , and the Perceived Social Support Scale (PSSS) . The mediation effect of self-perceived aging between perceived social support and self-efficacy for exercise was analyzed using Model 4 in the SPSS Process macro.Results:A total of 220 questionnaires were distributed, and 207 valid questionnaires were returned, with an effective recovery rate of 94.09%. The total score for B-APQ was (46.93±11.35) , the SEE score was (44.12±12.83) , and the PSSS score was (53.18±13.53) . Perceived social support had a direct effect on self-efficacy for exercise (effect value: 0.278; P<0.01) . Self-perceived aging played a partial mediating role between perceived social support and self-efficacy for exercise, with a mediation effect value of 0.138 ( P<0.01) , accounting for 33.17% of the total effect (0.138/0.416) . Conclusions:Perceived social support directly influences self-efficacy for exercise in aged patients undergoing surgery for lung cancer and also exerts an indirect effect through self-perceived aging. It is recommended that healthcare providers guide these patients to establish a positive perception of aging while focusing on enhancing their social support levels to improve their self-efficacy for exercise and promote recovery.

Objective:To explore the family function of childbearing period cervical cancer patients and their caregivers based on the McMaster Family Functioning Theory, providing a reference for developing scientific and effective family support programs.Methods:This qualitative study employed a purposive sampling method to recruit 15 pairs of childbearing period cervical cancer patients and their caregivers from Wuxi Maternity and Child Health Hospital between March and April 2024. Face-to-face semi-structured interviews were conducted, and data were analyzed using Colaizzi's seven-step method to extract themes.Results:A total of five main themes were identified: role transitions and family structure changes; alterations in family interaction dynamics; evolving caregiving needs and distress; emotional disengagement in disease experiences among family members; family behavioral isolation.Conclusions:The cancer diagnosis posed threats to all six dimensions of family function (role distribution, problem-solving, communication, emotional involvement, emotional responsiveness, and behavioral control). Clinical practitioners should pay close attention to the family functioning of childbearing period cervical cancer patients and develop patient- and caregiver-centered family function intervention programs to help them better cope with the disease and improve clinical outcomes.