AIM: To characterize the current status, research hotspots, and evolutionary differences in clinical studies on amblyopia published in Chinese and English from 2015 to 2025, and to provide a reference for the clinical diagnosis and treatment as well as relevant research of amblyopia.METHODS: Clinical studies on amblyopia in both Chinese and English were retrieved from the CNKI, VIP, Wanfang and Web of Science(WoS)databases. Bibliometric and visualization analyses of publication output, institutions, authors, and keywords were conducted using Cite Space 6.4.R1 and VOS viewer 1.6.19.RESULTS: Totally 1 302 publications were included, comprising 920 Chinese and 382 English publications. The publications of Chinese literature declined after 2019, while that of English literature showed an upward trend. Relevant studies involved 18 countries, and the institutional cooperation connections of English literature were relatively closer. The core author cooperation networks of both Chinese and English literature presented multi-cluster distribution. A total of 360 and 283 keyword nodes were obtained from Chinese and English literature, respectively. The high-frequency keywords of both literatures covered four aspects, including amblyopia types, research populations, evaluation indicators, and treatment methods. Both Chinese and English studies focus on anisometropic and strabismic amblyopia. Chinese studies predominantly investigated children of different age groups, whereas adult amblyopia received earlier attention in the English literature. Visual acuity, contrast sensitivity, and stereopsis were the major outcome measures of common interest, while optical correction and occlusion therapy remained the mainstay treatments. Totally 19 and 13 keyword clusters were identified in the Chinese and English literatures, respectively. Burst analysis indicated that digital treatment such as binocular dichoptic training appeared relatively early in English literature. In recent years, quality of life and risk factor screening for amblyopia received increasing attention. In Chinese literature, growing focus was placed on digital visual training and traditional Chinese medicine intervention. In addition, neuroimaging evaluation based on resting-state functional magnetic resonance imaging was conducted much earlier in English studies.CONCLUSION:From 2015 to 2025, Chinese and English clinical research on amblyopia has shown diversified development, with substantial similarities in the major types of amblyopia investigated, visual function assessment, and basic treatment modalities, but differences in the timing and emphasis of some research hotspots. Clinical research on amblyopia is gradually expanding from improvement in visual acuity toward restoration of binocular visual function, multidimensional outcome assessment, and investigation of visual neural mechanisms, while treatment strategies are becoming increasingly digitalized and individualized. Future research should further optimize standardized treatment, strengthen investigations into adult amblyopia, binocular digital vision training, visual neural mechanisms, and multidimensional outcome assessment, and evaluate the clinical value of integrated traditional Chinese and Western medicine interventions through high-quality clinical studies.

Objective To explore the preventive effect and protective mechanism of electroacupuncture at Neiguan points on acute high altitude hypoxic brain injury by detecting the expression of EPO,p-PI3K,p-AKT and Bcl-2 proteins.Methods 48 male SD rats of SPF grade were randomly divided into control group,model group,western medicine group and Neiguan group.The acute high altitude hypoxic brain injury model was established using a hypobaric hypoxia chamber.The Western medication group received Citicoline Sodium via gastric gavage administration,while the Neiguan acupoint group was administered bilateral electroacupuncture stimulation at the Neiguan acupoints.The morphological changes of hippocampal tissues were observed by HE method,serum biochemical indexes were determined by ELISA method,neuronal apoptosis of rat hippocampal tissues was observed by TUNEL method and the positive rate was calculated,and the expression levels of EPO,p-PI3K,p-AKT and Bcl-2 proteins were detected in rat hippocampal tissues by Western-blot method.Results Compared with the control group,the model group exhibited extensive necrotic pyramidal cells with pyknotic and deeply stained nuclei,significantly elevated serum levels of GFAP,S100B,and UCH-L1(P<0.01),markedly increased hippocampal neuronal apoptosis(P<0.01),and upregulated protein levels of EPO,p-PI3K,p-AKT,and Bcl-2 in hippocampal tissue(P<0.01).Compared with the model group,both the western medication group and the electroacupuncture at Neiguan group exhibited a significant reduction in necrotic pyramidal cells in brain tissue,with occasional pyknotic and deeply stained nuclei.Serum levels of GFAP,S100B,and UCH-L1 were markedly decreased(P<0.01),hippocampal neuronal apoptosis was significantly reduced(P<0.01),and protein expression of EPO,p-PI3K,p-AKT,and Bcl-2 in hippocampal tissue was upregulated(P<0.01).No statistically significant differences were observed between the western medication group and the Neiguan electroacupuncture group(P>0.05).Conclusion Electroacupuncture at Neiguan may ameliorate acute high-altitude hypoxic brain injury,potentially through modulating EPO protein expression to activate the PI3K/AKT signaling pathway,thereby inhibiting hippocampal neuronal apoptosis.

Objective To investigate the protective effect and molecular mechanism of bloodletting acupuncture at Jing-well points on acute high-altitude hypoxia brain injury through regulating PI3K/AKT/mTOR signaling pathway-mediated mitochondrial autophagy,and to provide an effective target and theoretical basis for the clinical use of bloodletting acupuncture at Jing-well points to prevent and treat acute high-altitude hypoxia brain injury.Methods Male SD rats were randomly divided into Control group(n=15)and experimental group,and the experimental group was divided into Model group(n=15),Bloodletting Acupuncture at Jing-well Points of hand group(BAJP group,n=15),Bloodletting Acupuncture at Non-Acupoint group(BANA group,n=15).The low pressure oxygen chamber was depressurized to 6000 m altitude,and the rats in each experimental group were treated with low-pressure hypoxia for 72 h to replicate the acute high-altitude hypoxia brain injury rat model.The rats in the BAJP group were bled according to the order of"Shaoshang"(LU11),"Shangyang"(LI1),"Zhongchong"(PC9),"Guanchong"(SJ1),"Shaochong"(HT9),"Shaoze"(SI1),once a day for 7 days.The rats in the BANA group were bled by cutting the tail tip daily,and the amount of blood bled was 15-20 μL in both groups.The expression levels of PI3K,AKT and mTOR in hippocampal tissues of rats were detected by Western blot;AKT and mTOR mRNA expression levels in hippocampal tissues of rats were detected by PCR.Results Compared with the Control group,the number of degenerative necrotic vertebral cells in CA1 area of hippocampal tissue,swelling of mitochondria,appearance of autophagosomes,and increase of apoptosis in hippocampal tissue of Acute High-altitude Hypoxia(AHH)rats were significantly increased;After bloodletting acupuncture at Jing-well points of hand treatment,various brain injury manifestations in AHH rats were alleviated;Bloodletting acupuncture at non-acupoint had no significant ameliorating effect on AHH rats′ brain injury.Western blot detected a significant decrease in the phosphorylation levels of PI3K,AKT,and mTOR in the hippocampal tissues of AHH rats compared to Control group rats(P<0.01),and the phosphorylation levels of the three molecules were further decreased after bloodletting acupuncture at Jing-well points of hand treatment(P<0.01),and bloodletting acupuncture at non-acupoint treatment did not have significantly affect on the phosphorylation levels of these molecules(P>0.05),and AKT,mTOR mRNA expression levels further demonstrated the above trend.Conclusion Bloodletting acupuncture at Jing-well points of hand can play a protective role against acute high-altitude hypoxia brain injury with points specificity,and the mechanism may be related to the inhibition of PI3K/AKT/mTOR pathway to promote the elevated level of mitochondrial autophagy,improve mitochondrial physiology,and enhance the body′s ability to resist apoptosis and hypoxia.