Allergic conjunctivitis is a common ocular inflammatory disease, with intense itching being the most typical and distressing symptom for patients. In recent years, with the in-depth study of the interaction between the nervous and immune systems, significant progress has been made in understanding the mechanism of itching in allergic conjunctivitis. This review elaborates on the neurobiological basis of itching in allergic conjunctivitis, with a focus on the complex dialogue between immune cells and sensory neurons, particularly the core role of the IL-33-ST2-CGRP signaling axis in mediating itching. Additionally, this article introduces new findings in genetic susceptibility research, including the identification of susceptibility genes for allergic conjunctivitis through transcriptome-wide association studies. The sensory nervous system not only transmits itch signals but also actively participates in the formation of antigen channels related to conjunctival goblet cells, thereby regulating the local uptake of allergens and the initiation of the immune response. Moreover, targeted novel therapeutic strategies offer hope for patients with refractory allergic conjunctivitis. Exploring the molecular and cellular mechanisms of itching in allergic conjunctivitis will provide a theoretical basis for the development of more effective treatment methods.

Objective:To describe the current status of responsive caregiving behavior of infant mothers,to analyze their influencing factors and pathways using the information-motivation-behavioral skills(IMB)model,and to provide a basis for further interventions related to responsive caregiving be-haviors and comprehensive promotion of early childhood development.Methods:This study was a cross-sectional survey using convenience sampling.Questionnaires were used to collect basic information about mothers and their infants,as well as data on mothers' responsive caregiving behavior,knowledge of re-sponsive caregiving,social support,and parenting self-efficacy.Multivariate linear regression models were employed to analyze the influencing factors of responsive caregiving behavior,and structural equa-tion modeling was used to analyze the pathways of these influencing factors.The criterion for inadequate responsive caregiving is defined as scores not exceeding the lower quartile(P25)of the total score.Results:Among 510 mothers of aged 0-12 months infants in Weifang City,the average score for respon-sive caregiving behavior was 16.41±3.99.The proportion of inadequate responsive caregiving was 25.7％.Mothers in the insufficient responsive caregiving group had lower scores in knowledge(7.70±1.41),social support(57.92±15.16),and parenting self-efficacy(30.36±6.48)compared with those in the sufficient group,with statistically significant differences(P＜0.001).Logistic regres-sion analysis indicated that the influencing factors for responsive caregiving included the level of know-ledge about responsive parenting[adjusted OR(aOR)=0.795,95％CI:0.566-0.838],social support(aOR=0.979,95％CI:0.961-0.996),and parenting self-efficacy(aOR=0.894,95％CI:0.857-0.932).Structural equation modeling revealed that knowledge of responsive caregiving(β=0.089,P=0.031),social support(β=0.153,P=0.001),and parenting self-efficacy(β=0.296,P＜0.001)were directly related to responsive caregiving behavior.Additionally,knowledge of responsive caregiving indirectly affected responsive caregiving behavior through parenting self-efficacy(β=0.095,P=0.014),and social support indirectly affected responsive caregiving behavior through parenting self-efficacy(β=0.497,P＜0.001).Conclusion:The current level of responsive caregiving behavior among mothers of 0-1-year-old infants in Weifang City is not satisfactory.Future development of responsive care-giving interventions should focus on providing caregivers with relevant knowledge of responsive caregiving based on their needs.Additionally,it is essential to offer social support from multiple aspects to enhance caregivers' parenting self-efficacy,thereby promoting improvements in responsive caregiving behavior.

Objective:To explore the application of dental scenario-based clinical thinking teaching and examination system in oral education.Methods:A total of 70 resident physicians from the 2022 class at the dental base of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were selected and randomly divided into a control group (30 participants) and an experimental group (40 participants). The control group was taught using traditional teaching methods, and the experimental group was taught and trained using the dental scenario-based clinical thinking teaching and examination system. After one year of teaching, both groups participated in a unified annual assessment. Finally, the teaching effectiveness was evaluated through a questionnaire survey on the experimental group. The questionnaire data were analyzed using the Chi-square test in IBM SPSS 24.0 statistical software, and the t-test was conducted using GraphPad Prism 8.0.2 software. Results:The average score before teaching was (78.83±2.61) in the control group and (78.28±3.29) in the experimental group, with no statistical significant difference between the two groups ( t=0.77, P=0.447). The average score in the annual assessment after teaching was (78.57±3.50) in the control group and (81.75±4.63) in the experimental group, with statistical significant difference between the two groups ( t=3.15, P=0.002). The questionnaire survey indicated that students highly recognized the dental scenario-based clinical thinking teaching and examination system, noting its advantages of innovative and interesting lectures, the ability to improve clinical thinking skills, and not being limited by location or time. Conclusions:The dental scenario-based clinical thinking teaching and examination system can stimulate students' interest and enthusiasm for independent learning. The system has received high levels of acceptance among students. The application and development of the dental scenario-based clinical thinking teaching and examination system hold significant value.

Objective To evaluate the diagnostic efficacy of sound touch viscoelastography(STVi)and shear wave elastography(SWE)in distinguishing between benign and malignant breast nodules.Methods A total of 104 breast nodules(52 benign and 52 malignant)from 102 patients scheduled for surgical treatment at Binzhou Medical University Hospital between October 2024 and February 2025 were prospectively enrolled.All nodules were pathologically confirmed through surgical excision or core needle biopsy.The viscosity coefficient and Young's modulus of both intranodular and perinodular tissues within a 2-mm range were measured using the Mindray Resona A20S ultrasound system.The diagnostic performance of each parameter,the correlation between elastic parameter values and the maximum nodule diameter,as well as the inter-correlation between the two parameters were systematically analyzed.Results The elasticity parameters were significantly higher in malignant nodules[maximum intranodular Viscosity coefficient(Vimax):5.93(4.33,8.47)Pa·s,maximum Young's modulus(Emax):81.18(58.31,120.33)kPa;maximum Viscosity coefficient of the surrounding 2-mm tissue(Vi2max):7.57(5.40,10.16)Pa·s,maximum Young's modulus(E2max):117.21(65.66,170.66)kPa]compared to benign nodules[Vimax:3.70(2.69,5.32)Pa·s,Emax:41.42(28.29,64.25)kPa;Vi2max:4.30(3.63,5.65)Pa·s,E2max:47.23(36.42,74.67)kPa](P<0.05).The diagnostic performance of the 2-mm perinodular tissue(Vi2max:0.78,E2max:0.81)surpassed that of intranodular tissue(Vimax:0.72,Emax:0.77)(P<0.05).The combined diagnostic model(Vi2+E2,Vi+E)achieved AUC values of 0.82 and 0.77,respectively,which outperformed STVi alone(P<0.05)and showed marginally better performance than SWE alone,although the difference was not statistically significant(P>0.05).The maximum nodule diameter showed a moderate correlation with the elasticity parameters,with E2max exhibiting the strongest correlation(r=0.510,P<0.05).Conclusions Both STVi and SWE show clinical value in distinguishing between benign and malignant breast nodules.Particularly,elasticity parameters obtained from the 2-mm perinodular tissue demonstrate better diagnostic performance than those measured within the nodule itself,and combining these parameters enhances the overall diagnostic accuracy of STVi.

Purpose To investigate the cortical thickness features in Parkinson's disease(PD)patients at various stages and their association with dopamine transporter(DAT)levels in the putamen.Materials and Methods We retrospectively enrolled 30 PD patients and 15 healthy subject who underwent 11C-CFT PET and T1 MRI scans at the Department of Nuclear Medicine/PET Center of Huashan Hospital from August 2016 to October 2020.DAT average radioactivity in the anterior and posterior putamen was analysis using SPM12 software,with the occipital lobe as the reference region.Cortical segmentation and reconstruction were performed on T1 images using Freesurfer v7.2.The differences in cortical thinning between the groups were compared using a general linear model.Additionally,the relationship between cortical thickness in various brain regions and DAT uptake in the putamen were assessed.Results Compared to healthy subjects,significant cortical thinning was observed in the left inferior parietal lobule and the right and left inferior middle frontal gyrus of PD patients(all P<0.05).There was a significant positive correlation between the cortical thickness of the left inferior parietal lobule and right inferior middle frontal gyrus and DAT uptake in the corresponding anterior/posterior parts of the putamen(r=0.30-0.47,all P<0.05).Furthermore,the DAT uptake in the right precentral gyrus was positively correlated with the ipsilateral posterior putamen,exhibiting a stronger correlation than on the contralateral side(r=0.32,P=0.029).Conclusion The results show that the thickness of the thinning cortex area in the PD patients correlates significantly positively with DAT levels in the putamen,highlighting the importance of the basal ganglia cortical circuit and providing a basis for further research into the neural mechanisms of PD.

Objective:To evaluate the prognosis of patients with resectable pancreatic ductal adenocarcinoma (PDAC) treated by gemcitabine and nab-paclitaxel (AG) or AG combined with pro-grammed death-1 (PD-1) inhibitor regimen and application value of the Cleveland Clinic Foundation (CCF) risk score.Methods:The retrospective cohort study was conducted. The clinicopathological data of 151 PDAC patients who were treated by AG regimen or AG combined with PD-1 inhibitor regimen in Zhejiang Cancer Hospital from January 2013 to March 2024 were collected. There were 84 males and 67 females, aged (64±9)years. Observation indicators: (1) comparison of clinical characteristics among resectable PDAC patients with different CCF risk score; (2) analysis of influencing factors for overall survival time of resectable PDAC patients; (3) survival of resectable PDAC patients. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the rank sum test. Univariate and multivariate analyses were conducted using the Cox regression model. Kaplan-Meier method was used to calculate survival rate and plot survival curve, and Log-rank test was used for survival analysis. Results:(1) Comparison of clinical characteristics among resectable PDAC patients with different CCF risk score. Based on CCF risk score, 102 of 151 patients were classified as low risk and 49 cases were classified as intermediate-to-high risk. There were signi-ficant differences in sex, age, smoking status, alcohol consumption, hypertension, and diabetes between the two categories ( P<0.05). (2) Analysis of influencing factors for overall survival time of resectable PDAC patients. Results of multivariate analysis showed that the treatment regimen was an indepen-dent influencing factor for overall survival time of resectable PDAC patients ( hazard ratio=1.976, 95% confidence interval as 1.065?3.666, P<0.05). (3) Survival of resectable PDAC patients. The follow-up time of 151 patients was 21.8(18.7,24.2)months, and the median overall survival time was 23.3(19.0,32.4)months. The follow-up time was 22.1(18.9,30.7)months of patients treated by AG regimen and 11.2(8.1,23.3)months of patients treated by AG combined with PD-1 inhibitor regimen, respectively. The median overall survival time of the two types of patients was 24.4(17.2,31.7)months and 16.9(8.9,24.9)months. The 1-year overall survival rates were 79.1% and 60.0%, and the 2-year overall survival rates were 53.4% and 28.5%, respectively. There was a significant difference in the overall survival between the two types of patients ( hazard ratio=1.913, 95% confidence interval as 1.041?3.516, P<0.05). Of the intermediate-to-high risk patients, the follow-up time was 18.5(8.8,28.1)months of 37 patients treated by AG regimen and 8.1(7.3,9.0)months of 12 patients treated by AG combined with PD-1 inhibitor regimen. The median overall survival time of the two types of patients was 32.4(15.7,49.0)months and 8.9(5.7,12.1)months, respectively. The 1-year overall survival rates were 82.7% and 31.3%, and the 2-year overall survival rates were 66.5% and 0, respectively. There was a significant difference in the overall survival between the two types of patients ( hazard ratio=5.402, 95% confidence interval as 1.811?16.118, P<0.05). Conclusions:The treatment regimen is an independent influencing factor for overall survival in patients with resectable PDAC. Compared with the AG combined with PD-1 inhibitor regimen, AG regimen is associated with good survival of patients with resectable PDAC. For patients classified as intermediate-to-high risk based on the CCF risk score, AG regimen is assiociated with a better overall survival compared to AG combined with PD-1 inhibitor regimen.

Objective To explore the imaging findings of atypical teratoid/rhabdoid tumor(AT/RT)in the central nervous sys-tem of children and to improve the understanding of this disease.Methods A retrospective analysis was conducted on the imaging data of 55 children with AT/RT confirmed by pathology.Results Among the 55 AT/RT children,74.5％were under 3 years old,with a male-to-female ratio of 1.5∶1.Intracranial AT/RT appeared hyperdense or slightly hyperdense on CT scans and accompa-nied by calcification or hemorrhage occasionally.32 cases showed peripheral cystic changes in MRI images.38 cases showed heteroge-neous enhancement,9 cases showed ring-like or band-like enhancement.13 cases showed cerebrospinal fluid dissemination.The mean minimum apparent diffusion coefficient(ADC)value was(0.61±0.11)× 10-3mm2/s.Spinal AT/RT manifested as solitary or mul-tiple intramedullary and/or extradural lesions on MRI,which showed unclear boundary from the spinal cord.Hemorrhage within or at the edge of the lesion was seen in 2 cases,involvement of nerve roots and adjacent muscle tissues in 3 cases,and cerebrospinal fluid dissemination of the intracranial and spinal cord at varying degrees in 5 cases.Conclusion The imaging findings of pediatric AT/RT in the central nervous system are diverse,combining imaging characteristics with age of onset facilitates the accurate diagnosis.

Purpose To compare the HRCT findings of lung damage in patients with idiopathic inflammatory myopathies(IIMs)with positive and negative anti-Ro-52 antibody.Materials and Methods Fifty patients with IIMs admitted to Beijing Shijitan Hospital,Capital Medical University from January 2015 to July 2023 were retrospectively analyzed.The patients were divided into anti-Ro-52 antibody negative group(18 cases)and positive group(32 cases),the lung CT findings of the two groups were compared,the distribution of lung lesions and related signs were analyzed.Results The incidence of interstitial lung disease in the anti-Ro-52 antibody-negative group was 11.1%(1 case),which was lower than that in the positive group 75.6%(31 cases)(P=0.001).Among the interstitial lung disease-positive patients,the proportion of lesions in the anti-Ro-52 positive group was more symmetrical(28 cases,87.5%,P=0.022)and peripheral distribution(20 cases,62.5%,P=0.039)than that in the anti-Ro-52 negative group.Non-specific interstitial pneumonia-like lesions were the main lesions in the two groups,including 14 cases(43.8%)in the anti-Ro-52 positive group and 7 cases(38.9%)in the negative group.However,9 cases(28.1%)of the anti-Ro-52 positive group had acute interstitial pneumonia-like lesions and 1 case(5.6%)of the negative group had acute interstitial pneumonia-like lesions.Imaging accompanying signs:anti-Ro-52 positive combination and consolidation(14 cases,43.8%,P=0.009),nodular shadow(17 cases,53.1%,P=0.025),and reverse halo sign(12 cases,37.5%,P=0.021)were more than those in the anti-Ro-52 negative group.Conclusion IIMs patients with positive anti-Ro-52 antibody have a higher incidence of interstitial lung disease.HRCT findings are of great significance for diagnosis and treatment of IIMs.

Objective:To investigate the expression of indoleamine 2,3-dioxygenase 1(IDO1)in different types of breast cancer tissues and its relationship with patient prognosis and immune cell infiltration.Methods:RNA sequencing data of breast cancer and corresponding clinical information from the TCGA database were collected.The differential expression of IDO1 mRNA in various breast cancer tissues(different subtypes,stages,menopause statuses,and age groups)and adjacent normal tissues were analyzed.Breast cancer patients with significant differences in IDO1 mRNA expression were divided into high and low expression groups,and their disease-specific survival(DSS)was compared between the two groups.The relationship between IDO1 mRNA expression and immune cell infiltration in cancer tissues with significant DSS differences was analyzed.Immunohistochemistry was used to detect IDO1 protein expression in ER-negative,PR-negative,HER2-positive,and stage Ⅱ breast cancer tissues,to verify the data from the database.Results:IDO1 mRNA was highly expressed in breast cancer tissues but varied across different breast cancer types.IDO1 mRNA was highly expressed in breast cancer tissues of patients with ER-negative,PR-negative,HER2-positive,HER2-negative subtypes,stage Ⅱ,T2 stage,N0 stage,M0 stage,premenopausal,postmenopausal,and age≤60 years(P<0.05 or P<0.01,or P<0.001).In the ER-negative,PR-negative,HER2-positive,and stage Ⅱ subgroups,breast cancer tissues patients with high IDO1 mRNA expression had significantly higher DSS than those with low expression(P<0.05 or P<0.01).In ER-negative,PR-negative,HER2-positive,and stageⅡ breast cancer tissues,IDO1 mRNA expression was associated with immune cell infiltration,including activated dendritic cells(aDCs),Th1 cells,T cells,CD56dim NK cells,CTLs,and Treg cells(all P<0.001).IDO1 protein was highly expressed in ER-negative,PR-negative,HER2-positive,and stage Ⅱ breast cancer tissues(all P<0.001),consistent with the data from the database.Conclusion:IDO1 expression varies across different types of breast cancer tissues.The expression of IDO1 is associated with the prognosis and immune cell infiltration in ER-negative,PR-negative,HER2-positive,and at stage Ⅱ breast cancer patients.

Objective To evaluate the diagnostic efficacy of sound touch viscoelastography(STVi)and shear wave elastography(SWE)in distinguishing between benign and malignant breast nodules.Methods A total of 104 breast nodules(52 benign and 52 malignant)from 102 patients scheduled for surgical treatment at Binzhou Medical University Hospital between October 2024 and February 2025 were prospectively enrolled.All nodules were pathologically confirmed through surgical excision or core needle biopsy.The viscosity coefficient and Young's modulus of both intranodular and perinodular tissues within a 2-mm range were measured using the Mindray Resona A20S ultrasound system.The diagnostic performance of each parameter,the correlation between elastic parameter values and the maximum nodule diameter,as well as the inter-correlation between the two parameters were systematically analyzed.Results The elasticity parameters were significantly higher in malignant nodules[maximum intranodular Viscosity coefficient(Vimax):5.93(4.33,8.47)Pa·s,maximum Young's modulus(Emax):81.18(58.31,120.33)kPa;maximum Viscosity coefficient of the surrounding 2-mm tissue(Vi2max):7.57(5.40,10.16)Pa·s,maximum Young's modulus(E2max):117.21(65.66,170.66)kPa]compared to benign nodules[Vimax:3.70(2.69,5.32)Pa·s,Emax:41.42(28.29,64.25)kPa;Vi2max:4.30(3.63,5.65)Pa·s,E2max:47.23(36.42,74.67)kPa](P<0.05).The diagnostic performance of the 2-mm perinodular tissue(Vi2max:0.78,E2max:0.81)surpassed that of intranodular tissue(Vimax:0.72,Emax:0.77)(P<0.05).The combined diagnostic model(Vi2+E2,Vi+E)achieved AUC values of 0.82 and 0.77,respectively,which outperformed STVi alone(P<0.05)and showed marginally better performance than SWE alone,although the difference was not statistically significant(P>0.05).The maximum nodule diameter showed a moderate correlation with the elasticity parameters,with E2max exhibiting the strongest correlation(r=0.510,P<0.05).Conclusions Both STVi and SWE show clinical value in distinguishing between benign and malignant breast nodules.Particularly,elasticity parameters obtained from the 2-mm perinodular tissue demonstrate better diagnostic performance than those measured within the nodule itself,and combining these parameters enhances the overall diagnostic accuracy of STVi.