Objective To explore the changes in trabecular meshwork cell types and cellular communication patterns in primary open-angle glaucoma(POAG).Methods The POAG single-cell dataset GSE135337(including the trabecular meshwork samples of 3 cynomolgus macaque monkeys with POAG and 3 healthy cynomolgus macaque monkeys,data upda-ted to 2023)was downloaded from the Gene Expression Omnibus(GEO),two groups of samplesare named the POAG group and the control group.The downscaling,clustering,grouping,and visualization of data were performed using the Seurat package in R.The cellular communication pattern was analyzed by using the CellChat package in R to identify the differences in the cellular communication pattern between the POAG group and the control group.Meanwhile,the differen-tial gene analysis was performed based on the transcriptome sequencing(RNA-seq)dataset GSE27276(including the atrial horn tissue samples from 17 POAG patients and 19 healthy individuals,data updated to 2023)from the GEO to identify spe-cific cellular communication signaling changes.Results There were no significant differences in the cell types between the control group and the POAG group,including trabecular meshwork cells,macrophages,melanocytes,pericytes,Schlemm's canal cells,myelinating Schwann cells,nonmyelinating Schwann cells,smooth muscle cells,and vascular en-dothelial cells.There was a significant difference in the cellular communication intensity between the POAG group and the control group.The expression of macrophage migration inhibitory factor(MIF)-CD74,C-X3-C motif chemokine ligand 1(CX3CL1)-C-X3-C motif chemokine receptor 1(CX3CR1),and HBB in the POAG group was significantly up-regulated compared with the control group,while the expression of secreted phosphoprotein 1(SPP1)-(ITGA8+ITGB1),SPP1-(IT-GA4+ITGB1),IGF2-IGF2R,CCL8-CCR1,and CCL8/26/24/2-ACKR2 in the POAG group was significantly down-regulated compared with the control group.The RNA-seq analysis results confirmed that the expression levels of HBB,HBD,HBA,and CD74 were higher in the POAG group than in the control group.Conclusion The up-regulation of MIF-CD74 and the down-regulation of SPP1-(ITGA8+ITGB1)and SPP1-(ITGA4+ITGB1)in trabecular meshwork tissues may participate in the fibrotic process,which may be a potential pathogenic mechanism of POAG.

Aim Based on coronary CT-fractional flow reserve(CT-FFR)combined with machine learning methods,a nomogram prediction model for coronary in-stent restenosis(ISR)was developed to assess the risk of ISR.Methods Retrospective analysis was performed on patients who underwent re-examination after PCI at our hospital from January 2022 to January 2025.According to the exclusion criteria,a total of 210 patients were enrolled,including 100 cases of ISR and 110 cases of non-ISR.The dataset was randomly divided into training and test sets at a 7∶3 ratio.Af-ter univariate analysis to screen potential predictors,LASSO regression was applied to identify feature variables with non-ze-ro coefficients.Subsequently,three machine learning(ML)algorithms including random forest(RF),support vector machine(SVM),and extreme gradient boosting(XGB)were used to rank the importance of the significant factors.The intersection of the top 10 variables from each algorithm was used as input for bidirectional stepwise multivariate Logistic re-gression.An ISR risk score was then constructed and visualized using a nomogram.Results A total of 14 predictive factors were identified through LASSO regression,including diastolic blood pressure,C-reactive protein,triglycerides(TG),N-terminal pro-brain natriuretic peptide(NT-proBNP),low density lipoprotein cholesterol(LDLC),minimum stent diameter＜3 mm,systolic blood pressure,△CT-FFR,CT-FFR,interleukin-6(IL-6),body mass index,glycosylated hemoglobin(HbA1c),history of hypertension,and high density lipoprotein cholesterol(HDLC).Following stepwise screening using three ML algorithms and Logistic regression,six independent risk factors for ISR were identified:elevated△CT-FFR,IL-6,NT-proBNP,TG and CT-FFR values,and minimum stent diameter＜3 mm.The area under the curve for the training set and test set were 0.995(95％CI:0.989～1.000)and 0.965(95％CI:0.927～1.000),respectively.Decision curve analysis demonstrated high net benefit across threshold probabilities of 0～1.00 in the training set and 0～0.92 in the test set.The nomogram integrating these six predictors exhibited high accuracy and clinical utility.Con-clusion The ISR nomogram prediction model based on LASSO-ML combined with CT-FFR technology has high accuracy and clinical utility for ISR.

Objective To explore the changes in trabecular meshwork cell types and cellular communication patterns in primary open-angle glaucoma(POAG).Methods The POAG single-cell dataset GSE135337(including the trabecular meshwork samples of 3 cynomolgus macaque monkeys with POAG and 3 healthy cynomolgus macaque monkeys,data upda-ted to 2023)was downloaded from the Gene Expression Omnibus(GEO),two groups of samplesare named the POAG group and the control group.The downscaling,clustering,grouping,and visualization of data were performed using the Seurat package in R.The cellular communication pattern was analyzed by using the CellChat package in R to identify the differences in the cellular communication pattern between the POAG group and the control group.Meanwhile,the differen-tial gene analysis was performed based on the transcriptome sequencing(RNA-seq)dataset GSE27276(including the atrial horn tissue samples from 17 POAG patients and 19 healthy individuals,data updated to 2023)from the GEO to identify spe-cific cellular communication signaling changes.Results There were no significant differences in the cell types between the control group and the POAG group,including trabecular meshwork cells,macrophages,melanocytes,pericytes,Schlemm's canal cells,myelinating Schwann cells,nonmyelinating Schwann cells,smooth muscle cells,and vascular en-dothelial cells.There was a significant difference in the cellular communication intensity between the POAG group and the control group.The expression of macrophage migration inhibitory factor(MIF)-CD74,C-X3-C motif chemokine ligand 1(CX3CL1)-C-X3-C motif chemokine receptor 1(CX3CR1),and HBB in the POAG group was significantly up-regulated compared with the control group,while the expression of secreted phosphoprotein 1(SPP1)-(ITGA8+ITGB1),SPP1-(IT-GA4+ITGB1),IGF2-IGF2R,CCL8-CCR1,and CCL8/26/24/2-ACKR2 in the POAG group was significantly down-regulated compared with the control group.The RNA-seq analysis results confirmed that the expression levels of HBB,HBD,HBA,and CD74 were higher in the POAG group than in the control group.Conclusion The up-regulation of MIF-CD74 and the down-regulation of SPP1-(ITGA8+ITGB1)and SPP1-(ITGA4+ITGB1)in trabecular meshwork tissues may participate in the fibrotic process,which may be a potential pathogenic mechanism of POAG.

Aim Based on coronary CT-fractional flow reserve(CT-FFR)combined with machine learning methods,a nomogram prediction model for coronary in-stent restenosis(ISR)was developed to assess the risk of ISR.Methods Retrospective analysis was performed on patients who underwent re-examination after PCI at our hospital from January 2022 to January 2025.According to the exclusion criteria,a total of 210 patients were enrolled,including 100 cases of ISR and 110 cases of non-ISR.The dataset was randomly divided into training and test sets at a 7∶3 ratio.Af-ter univariate analysis to screen potential predictors,LASSO regression was applied to identify feature variables with non-ze-ro coefficients.Subsequently,three machine learning(ML)algorithms including random forest(RF),support vector machine(SVM),and extreme gradient boosting(XGB)were used to rank the importance of the significant factors.The intersection of the top 10 variables from each algorithm was used as input for bidirectional stepwise multivariate Logistic re-gression.An ISR risk score was then constructed and visualized using a nomogram.Results A total of 14 predictive factors were identified through LASSO regression,including diastolic blood pressure,C-reactive protein,triglycerides(TG),N-terminal pro-brain natriuretic peptide(NT-proBNP),low density lipoprotein cholesterol(LDLC),minimum stent diameter＜3 mm,systolic blood pressure,△CT-FFR,CT-FFR,interleukin-6(IL-6),body mass index,glycosylated hemoglobin(HbA1c),history of hypertension,and high density lipoprotein cholesterol(HDLC).Following stepwise screening using three ML algorithms and Logistic regression,six independent risk factors for ISR were identified:elevated△CT-FFR,IL-6,NT-proBNP,TG and CT-FFR values,and minimum stent diameter＜3 mm.The area under the curve for the training set and test set were 0.995(95％CI:0.989～1.000)and 0.965(95％CI:0.927～1.000),respectively.Decision curve analysis demonstrated high net benefit across threshold probabilities of 0～1.00 in the training set and 0～0.92 in the test set.The nomogram integrating these six predictors exhibited high accuracy and clinical utility.Con-clusion The ISR nomogram prediction model based on LASSO-ML combined with CT-FFR technology has high accuracy and clinical utility for ISR.

Objective:To compare the effect of immediate and delayed post-space preparation on apical sealing ability between 2 root canal obturation techniques.Methods:60 freshly extracted single-rooted human premolars were collected and instrumented by M3-Pro instruments.The specimens were randomly divided into 6 groups and respectively treated by AH-Plus sealer with warm vertical compac-tion(WVC)followed by delayed post-space preparation(PSP)(A1);AH-Plus sealer with WVC followed by immediate PSP(A2);AH-Plus sealer with WVC,control group(A3);iRoot SP sealer with single cone(SC)followed by delayed PSP(B1);iRoot SP sealer with SC followed by immediate PSP(B2);iRoot SP sealer with SC,control group(B3).In group A1,A2,B1 and B2,gutta percha was removed by 1# starter drill and post-space was prepared by 2# finishing drill leaving 5 mm of apical filling.In control groups(A3 and B3),only apical 5 mm of the specimens was obturated.Dye leakage was measured as the linear penetration(LP)of the stain.The SPSS one-way analysis of variance test was used for statistical analysis.Results:The LP(mm)of group A1,A2,A3,B1,B2 and B3 was 3.986±0.500,3.382±0.806,2.178±0.554,3.844±0.877,3.416±0.579 and 1.897±0.217 respectively.Among A1,A2 and A3 groups,P＜0.05.The LP of group A1 was higher than that of group A2(P＜0.05).Among group B1,B2 and B3,P＜0.05,but be-tween group B1 and B2,P＞0.05.Between group A1 and B1,P＞0.05.Between A2 and B2,P＞0.05.Conclusion:Apical sealing is affected by PSP with the 2 root obturation techniques.Delayed PSP may have negative effect on apical sealing compared with immediate PSP,especially in the specimens compacted by AH-Plus sealer with WVC.

Objective To analyze the differences in total corneal astigmatism(TCA)and vectors in different regions centered on the corneal apex or pupil.Methods This cross-sectional study enrolled 102 patients(102 eyes)with age-re-lated cataracts who underwent phacoemulsification combined with intraocular lens implantation at the Weifang Eye Hospital from October 2021 to June 2022.Before surgery,anterior segment biometrical examinations were performed using Penta-cam to collect the TCA and axes at 2 mm,4 mm,and 6 mm diameter rings and zones with the corneal apex or pupil as the center,and vector analysis was made.Results In the ring mode,a significant difference was observed between the cor-neal apex-centered and pupil-centered astigmatism values for the 6 mm diameter(P＜0.05).In the zone mode,there were statistically significant differences between the corneal apex-centered and pupil-centered astigmatism values for the 2 mm,4 mm,and 6 mm diameters(all P＜0.05).The analysis of the zone and ring modes centered on the corneal apex showed that there were statistically significant differences in astigmatism values for the 2 mm and 6 mm diameters(both P＜0.05).The analysis of the zone and ring modes centered on the pupil showed that there were statistically significant differences in astigmatism values for the 2 mm,4 mm,and 6 mm diameters(all P＜0.05).In the same center,there were no statistically significant differences in astigmatism axes for 2 mm,4 mm,and 6 mm diameters under the ring and zone modes(all P＞0.05).In the same mode,there were no statistically significant differences in astigmatism axes for 2 mm,4 mm,and 6 mm diameters centered on the corneal apex and pupil(all P＞0.05).Vector analysis showed that in the ring mode,the apex-centered to pupil-centered TCA difference of 4 mm on the Y axis was statistically significant(P＜0.05).The comparison between the zone and ring centered on the pupil showed that the TCA difference of 4 mm on the Y axis was statistically sig-nificant(P＜0.05),whereas the other differences were not statistically significant(all P＞0.05).Conclusion The TCA shows a mild difference between the corneal apex-centered and pupil-centered modes and between the ring and zone modes,but the astigmatism axis has no obvious difference.There are some differences between vector analysis and con-ventional analysis of TCA.

Objective:To explore the effects of curcumin on the biological characteristics and expressions of NF-κB pathway-related proteins in glucocorticoid-resistant acute lymphoblastic leukemia (ALL) cell line Jurkat.Methods:The drug-resistant ALL cell line Jurkat was selected, and 1 μmol/L dexamethasone was used as the optimal concentration for drug resistance of Jurkat cells, and the cells were passaged and cultured. The cells were divided into 10, 25 and 50 μmol/L curcumin groups, as well as 50 μmol/L pyrrolidinedithiocarbamate (PDTC) group, and control group (equal volume of culture medium without drug was added). The cells in each group were cultured for 72 h, and the cell morphology was observed under an inverted microscope. The CCK-8 method was used to detect the proliferation ability of Jurkat cells, flow cytometry was used to detect the apoptosis ability and cell cycle of Jurkat cells, real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expressions of NF-κB p65, NF-κB p50, IκBα, and A20 mRNA, and Western blotting was used to detect the expressions of NF-κB p65, NF-κB p50, IκBα, caspase-8, caspase-3, bcl-2, and A20 proteins.Results:Jurkat cells were treated with 10, 25, 50 μmol/L curcumin and 50 μmol/L PDTC for 72 h. In the control group, the cell membranes were basically intact, the size was uniform, the cell was round and transparent, and the cell nucleus had uniform fluorescence; a large number of deformed cells and cell fragments were observed in curcumin groups with different concentrations and 50 μmol/L PDTC group, with concentrated and fragmented nuclei and obvious apoptosis. After treating Jurkat cells with different concentrations of curcumin and 50 μmol/L PDTC for 24, 48 and 72 h, respectively, the cell proliferation inhibition rates in curcumin groups with different concentrations and PDTC group were higher than those in the control group (all P < 0.01). The apoptosis rates at 72 h in the control group, 10 μmol/L curcumin group, 25 μmol/L curcumin group, 50 μmol/L curcumin group, and 50 μmol/L PDTC group were (4.9±0.1)%, (99.2±0.1)%, (99.9±0)%, (100.0±0)%, and (100.0±0)%, respectively, and the difference was statistically significant ( F = 2 876 604.40, P < 0.001); compared with the control group, the apoptosis rates in curcumin groups with different concentrations and 50 μmol/L PDTC group were higher, and the differences were statistically significant (all P < 0.01). Compared with the control group, the proportions of S-phase and G 2-phase cells were lower and the proportion of G 1-phase cells was higher in curcumin groups with different concentrations and 50 μmol/L PDTC group at 72 h, and the differences were statistically significant (all P < 0.01). Compared with the control group, the protein and mRNA expressions of NF-κB p65 and NF-κB p50 in curcumin groups with different concentrations and 50 μmol/L PDTC group were lower (all P < 0.01), while the protein expressions of IκBα, caspase-8 and caspase-3 were higher (all P < 0.01), the protein expression of bcl-2 was lower ( P < 0.01), and the protein and mRNA expressions of A20 were higher (both P < 0.01). Conclusions:Curcumin can effectively reverse glucocorticoid resistance and promote apoptosis in Jurkat cells, which may be related to the influence of curcumin on NF-κB pathway-related proteins.

Allergic conjunctivitis is the most common type of allergic eye disease, and the incidence in children and adolescents is increasing year by year. Drug therapy can only relieve some symptoms and only in a short period, while allergen immunotherapy is currently a therapy that can significantly improve the symptoms of chronic allergy and the course of the disease. This method has been used abroad for many years but has yet to be reported in China. The author reviews the effective mechanism and clinical efficiency of allergen immunotherapy and provides a reference for the further clinical application in China.

OBJECTIVE Aiming at the current vacancy of large language models(LLMs)in TCM evaluation,a TCM benchmark dataset is designed and constructed to comprehensively and objectively evaluate the mastery and reasoning performance of LLMs in TCM knowledge,providing scientific and reliable basis for optimizing the performance of LLMs in the field of TCM.METHODS This benchmark includes 29 506 questions across 13 subjects,with data collected from standardized TCM exams and textbooks.Three gen-eral-purpose models(GPT-3.5,ChatGLM3,Baichuan)and five Chinese medical models(PULSE,BenTsao,HuatuoGPT2,Bian-Que2,ShenNong)were evaluated with answer prediction and answer reasoning tasks.The evaluation results were quantitatively as-sessed using metrics including accuracy,F1 score,BLEU,and Rouge.RESULTS For the answer prediction task,Baichuan had the highest accuracy of 36.07%in single-choice questions,while ChatGLM3 achieved the highest accuracy of 18.96%and F1 score of 76.31%in multiple-choice questions.For the answer reasoning experiment,Baichuan scored highest on BLEU-1 with 24.71,while ChatGLM3 achieved the highest Rouge-1 score of 44.64.CONCLUSION In this study,general LLMs performed slightly better than Chinese medical LLMs.Meanwhile,all models'accuracy on choice questions remained below 60%,reflecting the significant challen-ges and room for improvement that LLMs still face in the field of TCM.

Objective:To understand the current status of core measures of enhanced recovery after surgery (ERAS) nursing in Anhui Province and analyze its promotion strategies, so we can provide reference for further implementation and promotion of clinical practice guidelines of ERAS.Methods:Design a Development Questionnaire of Enhanced Recovery After Surgery in Anhui Province based on the Clinical Practice Guidelines for Enhanced Recovery After Surgery in China (2021 edition) (I) and, a cross-sectional survey was conducted on surgical nurses in 132 secondary and above hospitals in Anhui Province from July to September 2023 by the convenience sampling method.Results:A total of 1 375 nurses from 13 cities in Anhui province participated in the survey. The nurses′ awareness rate of ERAS concept was 100.00%, but only 52.51% (722/1 375) of the nurses had received standardized ERAS training, and only 26.11% (359/1 375) of the nurses indicated that they had a multidisciplinary team such as medical care, anesthesia and nutrition were involved in the implementation of the ERAS. Nearly 38.33% (527/1 375) of the nurses said that the department lacked the relevant nursing quality control system, and the overall implementation rate of quality control training, development, feedback and monitoring was not high. Only 55.71% (766/1 375) of nurses reported that a quality control team has been established within their department, and only 40.44% (556/1 375) of departments conduct monthly checks on the implementation and progress of ERAS. In terms of the implementation of core measures, preoperative thromboprevention therapy, intraoperative temperature monitoring and management, postoperative multimodal analgesia were better; however, the implementation of preoperative fasting time ≤ 6 h, water ban time≤ 2 h, oral carbohydrate drinks or clean streaming drinks, oral intake of enteral nutritional supplementation when less than 60% of the normal amount was poor.Conclusions:There are still many deficiencies in the overall development of ERAS nursing in Anhui Province, and the implementation level of core measures also needs to be improved. It is necessary to combine the concept of precision nursing, strengthen the whole process management and quality control, so as to promote the clinical practice and promotion of ERAS.