Glaucoma， characterized by pathological elevation of intraocular pressure， progressive optic nerve damage， and apoptosis of retinal ganglion cells， is one of the leading causes of irreversible blindness. It is strongly associated with significant vision loss and a decline in quality of life. Although pharmacological therapy remains the primary approach to managing glaucoma， clinical outcomes are often suboptimal， highlighting the urgent need for safe and effective alternative treatments. In traditional Chinese medicine （TCM）， glaucoma is categorized as part of the "five wind internal obstruction" syndrome， and TCM has amassed substantial experience in the prevention and treatment of this condition. Therefore， this article provided a comprehensive review of recent findings on the relationship between glaucoma and relevant signaling pathways， as well as the regulatory effects of TCM on these pathways in the treatment of glaucoma. TCM can exert therapeutic effects by modulating key signaling pathways， including the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-κB （TLR4/MyD88/NF-κB） signaling pathway， Janus kinase （JAK）/signal transducer and activator of transcription （JAK/STAT） pathway， phosphoinositide 3-kinase/serine-threonine protein kinase/mammalian target of rapamycin （PI3K/Akt/mTOR） pathway， nucleotide-binding oligomerization domain-like receptor protein 3 （NLRP3） inflammasome pathway， and nuclear factor erythroid 2-related factor 2/heme oxygenase-1 （Nrf2/HO-1） pathway. These pathways are involved in reducing inflammation， inhibiting apoptosis and ferroptosis， and ameliorating oxidative stress. By synthesizing current research， this article offers theoretical insights and practical references for advancing the understanding of the pathological mechanisms underlying glaucoma， innovating strategies for optic nerve protection， and promoting integrative TCM and Western medical approaches in glaucoma management.

OBJECTIVE: To explore the clinical and genetic features of a child with Pontocerebellar hypoplasia type 2B (PCH2B) due to compound heterozygous variants of the TSEN2 gene. METHODS: A PCH2B patient presented at Department of Pediatric Neurology, Xiangya Hospital of Central South University in June 2023 was selected as the study subject. Clinical data of the patient were retrospectively analyzed. The patient and her parents were subjected to whole exome sequencing and bioinformatic analysis. Pathogenicity of the candidate variants were classified based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). A literature review was also conducted by searching the China National Knowledge Infrastructure (CNKI), Wanfang Data, and PubMed databases from their establishment to May 2025 using keywords "TSEN2 gene" "PCH2B" and "Pontocerebellar Hypoplasia 2B" to summarize the clinical and genotypic features of patients with PCH2B due to variants of the TSEN2 gene. This study was approved by the Medical Ethics Committee of the Hospital (No.: #202310892). RESULTS: The patient, a 6-year-5-month-old girl, had exhibited severe global developmental delay, developmental regression, autism spectrum disorder, myoclonus of eyelids, feeding difficulty, irritability, progressive microcephaly, esotropia, and hypotonia. MRI showed reduced volume of bilateral cerebellar hemispheres and vermis. Genetic testing revealed that she has harbored compound heterozygous variants of the TSEN2 gene (NM_025265.4), namely c.1054A>T (p.Lys352*) and c.899G>T (p.Ser300Ile), which were inherited from her father and mother, respectively. Both variants were classified as likely pathogenic based on the ACMG guidelines and were previously unreported. Literature review has identified six PCH2B patients with missense, nonsense, frameshift, and splice site variants of the TSEN2 gene. Their main clinical manifestations included global developmental delay, progressive microcephaly, feeding difficulties, irritability, and vermis hypoplasia. Cranial MRI and genetic testing are crucial for definite diagnosis. CONCLUSION The c.1054A>T (p.Lys352*) and c.899G>T (p.Ser300Ile) compound heterozygous variants of the TSEN2 gene probably underlay the pathogenesis in this patient. Above findings has expanded the genotypic and phenotypic spectra of TSEN2-related PCH2B, and offered guidance for genetic counseling for this family.
Child ; Female ; Humans ; Cerebellar Diseases/genetics* ; Exome Sequencing ; Heterozygote ; Mutation

Objective: To explore the correlation and lag effects of environmental factors on pediatric respiratory disease visits at hospital, so as to provide scientific basis for disease prediction and optimizing clinical diagnosis and treatment. Methods: Data from 503 889 pediatric respiratory disease outpatient and emergency visits a central hospital in Minhang District of Shanghai between 2017 and 2019, along with concurrent meteorological data were collected. A distributed lag non-linear models (DLNM) was constructed to explore the specific relationship between pediatric respiratory disease consultations and various environmental factors and to quantify the cumulative lag effects of environmental factors on respiratory disease consultations. Results: Among the environmental factors, temperature, fine particulate matter (PM 2.5 ), inhalable particulate matter (PM 10 ), nitrogen dioxide (NO 2), and sulfur dioxide (SO 2) were associated with pediatric respiratory disease visits. After adjusting for temperature, PM 2.5 and PM 10 concentrations did not show significant immediate or lag effects. The relative risk (RR) of pediatric respiratory disease visits increased with rising NO 2 concentrations. When NO 2 concentration ≥55 μg/m 3, significant immediate and lagged effects (lag 3, 5, and 7 days) were observed. The RR values were 1.05, 1.13, 1.17, and 1.21( P <0.05). The RR values showed an inverted “U” shaped relationship with SO 2 concentrations. When SO 2 concentration ≥5 μg/m 3, significant lagged effects (lag 3, 5, and 7 days) were observed. The RR values were 1.03 , 1.03, and 1.04 ( P <0.05). Conclusion High concentrations of NO 2 and SO 2 increase the risk of pediatric respiratory disease visits, with observable lag effects.

Objective To investigate the effects of software follow-up mode application on stigma sense,social function and survival quality in the patients with schizophrenia.Methods A total of 100 inpa-tients with schizophrenia in the psychiatric department of this hospital from January to December 2023 were selected as the study subjects and divided into the observation group(software follow-up)and the control group(telephone follow-up)according to different follow-up modes,50 cases in each group.At discharge from hospital and in 4,8,12 weeks after discharge,the Chinese version of Stigma Scale for Mental illness(SSMI-C)was adopted to evaluate the stigma sense of the patients,the Social Disability Screening Schedule(SDSS)was used to evaluate the patients'social function,the patients'survival quality was evaluated by the Generic Qual-ity of Life Inventory-74(GQOLI-74).The changes of above scores were compared between the two groups.Results The SSMI-C,SDSS and GQOLI-74 scores at discharge from hospital had no statistical difference be-tween the two groups(P＞0.05).Compared with at discharge from hospital,the SSMI-C and SDSS scores in 4,8,12 weeks of follow up in the two groups were decreased,the GQOLI-74 score was increased,moreover the scores of SSMI-c and SDSS in the observation group were lower than those in the control group,the GQOLI-74 score was higher than that in the control group,and the differences were statistically significant(P＜0.05).Conclusion Conducting the regular follow-up on discharged patients with schizophrenia by the follow-up soft-ware could reduce the stigma of the patients,improve the social functional defect and improve the survival quality.

Objective:To develop the Nurse Managers Negative Leadership Behavior Scale and test its reliability and validity.Methods:This study is a cross-sectional study. The Nurse Managers Negative Leadership Behavior Scale item pool was formed through literature review and semi-structured interviews. A total of 28 nursing management experts from Hubei Province, Beijing, Guangdong Province and other places were selected for expert consultation to form the first draft of the scale. The scale was further revised through pre-experiment and item analysis. In May 2022, 300 nurses from the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were selected by convenient sampling for a questionnaire survey to test the reliability and validity of the scale. A total of 300 questionnaires were distributed, and 265 valid questionnaires were recovered, with an effective recovery rate of 88.33%. One week after the survey, 20 nurses were randomly selected to re-issue the questionnaire for the retest reliability test of the scale.Results:Totally, 19 experts completed two rounds of expert consultation, with expert authority coefficient of 0.880, Kendall harmony coefficient of 0.160 and 0.130 ( P<0.05) . Exploratory factor analysis extracted six factors, including neglect of needs, personal attack, right satisfaction, unpredictable behavior, slack work and improper supervision, and the cumulative variance interpretation rate was 75.125%. The confirmatory factor analysis showed that the model fitted well and the factor structure was stable. The Nurse Managers Negative Leadership Behavior Scale included six dimensions and 36 items. The total Cronbach's α coefficient of the scale was 0.880, the split-half reliability coefficient was 0.895, and the retest reliability coefficient was 0.876. The content validity index of the scale was 0.930, and the content validity index of each item was 0.800 to 1.000. Conclusions:The Nurse Managers Negative Leadership Behavior Scale has good reliability and validity, and can be used to evaluate the negative leadership behavior of head nurses in China.

Objective:To explore the effect of online and offline blended scenario simulation teaching in the practice of nursing undergraduates.Methods:From August 2020 to May 2021, convenience sampling was used to select 76 nursing undergraduates in the class of 2017 who practiced in the Cardiology Department of the Second Affiliated Hospital of Harbin Medical University as the research object. The undergraduates were randomly divided into the experimental group and the control group, 38 in each group. The control group received the traditional graduation practice training, and the experimental group received online and offline blended scenario simulation teaching on this basis. After the practice, the clinical thinking ability of the two groups of students was evaluated by the Clinical Thinking Ability Evaluation Scale, the clinical practice ability of the two groups of students was evaluated by the Objective Structured Clinical Examination (OSCE) , and a teaching satisfaction survey was conducted.Results:The total score of clinical thinking ability, critical thinking ability, systematic thinking ability, evidence-based thinking ability, OSCE total score of the students in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The students in the experimental group thought that the teaching method was helpful for in-depth understanding and application of theoretical knowledge, improving nursing assessment skills, clinical coping skills and communication skills, and at the same time helping to cultivate critical thinking and teamwork awareness, and arouse learning enthusiasm, and the differences were statistically significant (all P<0.05) . Conclusions:The online and offline blended scenario simulation teaching can effectively improve the clinical thinking ability, clinical practice ability and teaching satisfaction of nursing undergraduates, and it has good effect in the graduation practice of undergraduate nursing students.

OBJECTIVE： To establish GC-MS method for the content determination of three toxic impurities in glycerophosphorylcholine raw materials ，such as epichlorohydrin ，glycidyl，3-chloro-1，2-propanediol. METHODS ：Four batches of glycerophosphorylcholine raw materials were used as test samples. The determination was performed on ZB-WAXplus TM column， and the injector temperature was 200 ℃；the sample injection adopted splitless injection mode ，using helium （He）as carrier gas ， in constant current mode ；the temperature program for the column was initially heating at 30 ℃ for 1 min，rising to 220 ℃ at a speed of 30 ℃/min then remaining 5 min. The ion source was electrospray ion source （EI），the ion source temperature was 200 ℃，and the ionization energy was 70 eV；transmission interface temperature was 250 ℃，and mass spectrum monitoring mode was selected ion （SIM）. Detection ions were epichlorhydrin [mass charge ratio （m/z）49，57，62]，glycidyl（m/z 31，43，44）， 3-chloro-1，2-propanediol（m/z 44，61，79）. The solvent delay time was 3 min. RESULTS ：The linear range of epichlorhydrin ， glycidyl and 3-chloro-1，2-propanediol were 29.86-746.48，172.91-922.18，21.18-211.85 ng/mL，respectively（all r＞0.999 0）. The detection limits were 19.91，115.27，10.59 ng/mL，respectively. The limits of quantitation were 29.86，172.91，21.18 ng/mL， respectively. RSDs of precision （n＝6），reproducibility （n＝6） and stability （placed at room temperature for 12 h，n＝8） tests were all lower than 10％. The average recoveries were 93.88％，91.45％，91.86％，and RSDs were 5.10％，3.10％，2.49％ （n＝9），respectively. In the 4 batches of glycerophosphorylcholine raw materials ，three toxic impurities were all not detected. CONCLUSIONS：Established GC-MS method is simple ，efficient，accurate and repeatable ，and it can be used to determine the contents of three toxic impurities in glycerophosphorylcholine raw materials ，such as epichlorohydrin ，glycidyl，3-chloro-1， 2-propanediol.

Objective:To evaluate the effect of intrathecal insulin-like growth factor-1 (IGF-1) on chemotherapy-induced neuropathic pain (NP) in mice.Methods:Forty clean-grade healthy male C57 mice, aged 7-9 weeks, weighing 22-24 g, were divided into 4 groups ( n=10 each) using a random number table method: control group (group C), chemotherapy-induced NP group (group CIPN), low-dose IGF-1 group (group I1) and high-dose IGF-1 group (group I2). In CIPN, I1 and I2 groups, oxaliplatin 5 mg/kg was intraperitoneally injected for 5 consecutive days to establish chemotherapy-induced NP model.Normal saline 0.2 ml was given in group C. After measurement of the pain threshold at 10 days after establishment of the model, IGF-1 0.5 and 1.0 μg were intrathecally injected in group I1 and group I2, respectively.Normal saline 5 μl was intrathecally injected in C and CINP groups.Mechanical withdrawal threshold (MWT) was measured at 3, 5, 8, 10, 11, 13 and 15 days after establishment of the model.After measurement of the pain threshold at 15 days after establishment of the model, the expression of spinal IGF-1, IGF-1receptor (IGF-1R), interleukin (IL)-17A, IL-1β and tumor necrosis factor (TNF)-α was detected, and IGF-1 positive cells were counted using immunofluorescence. Results:Compared with group C, MWT was significantly decreased, the expression of spinal IGF-1 was down-regulated, the count of IGF-1 positive cells was decreased, and expression of IL-17A, IL-1β and TNF-α was up-regulated at 3-25 days after establishment of the model in CINP, I1 and I2 groups ( P<0.05). Compared with group CIPN, MWT was significantly increased at 15 days after establishment of the model in group I1, and MWT was increased, the expression of spinal IGF-1 was up-regulated, the count of IGF-1 positive cells was increased, and expression of IL-17A, IL-1β and TNF-α was down-regulated at 13 and 15 days after establishment of the model in group I2 ( P<0.05). Compared with group I1, the count of IGF-1 positive cells in spinal dorsal horn was increased in group I2 ( P<0.05). There was no significant difference in the expression of spinal IGF-1R among the 4 groups ( P>0.05). Conclusion:Intrathecal IGF-1 can alleviate chemotherapy-induced NP, and the mechanism may be related to inhibiting the inflammatory responses in spinal cord of mice.

Solid tumors always exhibit local hypoxia, resulting in the high metastasis and inertness to chemotherapy. Reconstruction of hypoxic tumor microenvironment (TME) is considered a potential therapy compared to directly killing tumor cells. However, the insufficient oxygen delivery to deep tumor and the confronting "Warburg effect" compromise the efficacy of hypoxia alleviation. Herein, we construct a cascade enzyme-powered nanomotor (NM-si), which can simultaneously provide sufficient oxygen in deep tumor and inhibit the aerobic glycolysis to potentiate anti-metastasis in chemotherapy. Catalase (Cat) and glucose oxidase (GOx) are co-adsorbed on our previously reported CAuNCs@HA to form self-propelled nanomotor (NM), with hexokinase-2 (HK-2) siRNA further condensed (NM-si). The persistent production of oxygen bubbles from the cascade enzymatic reaction propels NM-si to move forward autonomously and in a controllable direction along H