AIM: To explore the efficacy of 0.05% cyclosporine A combined with olopatadine eye drops in treating allergic conjunctivitis-related dry eye disease.METHODS: A total of 63 patients(63 eyes)with allergic conjunctivitis-related dry eye disease in the People's Hospital of Guangxi Zhuang Autonomous Region from August 2022 to April 2023 were enrolled and randomly divided into control group(n=33)and observation group(n=30). The patients of the control group were administrated with 0.1% olopatadine eye drops and 0.3% sodium hyaluronate eye drops, while the observation group was administrated with 0.1% olopatadine eye drops and 0.05% cyclosporine A eye drops. The ocular surface disease index(OSDI), total ocular symptom score(TOSS), conjunctival congestion score, conjunctival papillae and follicle score, Schirmer I test(SⅠt), tear meniscus height(TMH), meibomian gland secretion ability and property score, meibomian gland loss area score, corneal fluorescein staining(CFS), tear film break-up time(BUT), noninvasive first tear film break-up time(NIBUTf), noninvasive average tear film break-up time(NIBUTav)before and after treatment and the drug safety during the treatment period of both groups of patients were evaluated.RESULTS: After treatment, OSDI, TOSS, conjunctival congestion score, conjunctival papillae and follicle score, SⅠt, TMH, meibomian gland secretion ability score and property score, CFS, BUT, NIBUTf, and NIBUTav of the observation group showed improvements compared with those before treatment(all P<0.017). Among these, OSDI, TOSS, conjunctival congestion score, conjunctival papillae and follicle score, BUT, NIBUTf, and NIBUTav demonstrated significant improvement compared with the control group(all P<0.05). There was no statistically significant difference in meibomian gland loss area score between the two groups before and after treatment(P>0.05). During the treatment period, there were no local or systemic adverse reactions.CONCLUSION: The combined use of 0.05% cyclosporine A and olopatadine eye drops can significantly improve ocular discomfort symptoms of patients with dry eye disease associated with allergic conjunctivitis, such as red eyes, itchy eyes and foreign body sensation, promote tear film stability and have high safety.

AIM: To construct a risk nomogram prediction model of macular edema(ME)based on the risk factors of ME after phacoemulsification in diabetic cataract(DC)patients.METHODS: A retrospective collection of data was conducted on 1 751 DC patients(1 751 eyes)who underwent cataract phacoemulsification surgery in the hospital from January 2022 to December 2024. Based on whether they developed ME after surgery, the patients were divided into the ME group(n=138)and the N-ME group(n=1 613). By conducting univariate and Logistic multiple regression analysis, the risk factors for postoperative ME in DC patients undergoing phacoemulsification were identified. A nomogram of risk prediction model was constructed, and the receiver operating characteristic(ROC)curve, calibration curve, Hosmer-Lemeshow goodness of fit test were plotted to evaluate the discrimination and calibration of the model. The decision curve was used to evaluate the clinical return on investment of the model.RESULTS: Age, course of diabetes, proportion of insulin treatment, proportion of retinopathy, best corrected visual acuity(BCVA), central subfield macular thickness(CSMT), macular volume, glycated hemoglobin(HbA1c), vascular endothelial growth factor(VEGF)in the ME group were higher than those in the N-ME group(all P<0.05). Multivariate Logistic regression analysis showed that diabetes course, retinopathy, BCVA, CSMT, macular volume, HbA1c and VEGF were the risk factors for ME after phacoemulsification in DC patients(all P<0.05). A nomogram of risk prediction model was constructed based on risk factors, and the ROC curve suggested good model differentiation [AUC of training set was 0.998(95% CI: 0.997-1.000), and AUC of validation set was 0.999(95% CI: 0.997-1.000)], set: R2=0.917, χ2=0.806, P=0.999; verification set: R2=0.900, χ2=0.675, P=1.000). The decision curve showed that the model had a high net return rate within the probability range of 0.00-1.00 threshold.CONCLUSION: Diabetes course, retinopathy, BCVA, CSMT, macular volume, HbA1c and VEGF are risk factors for ME after cataract phacoemulsification in DC patients. The nomogram of risk prediction model based on this construction has good differentiation and consistency in predicting the risk of ME after cataract phacoemulsification in DC patients.

Since the first operational definition of cognitive frailty was proposed by the expert consensus group of the International Academy of Nutrition and Aging and the International Association of Gerontology and Geriatrics in 2013, frailty and neurocognitive assessment has become the standard diagnostic tool.Since then, the reported prevalence in the literature for cognitive frailty in community-dwelling elderly people vary by dozens of times, as a result of different scales and diagnostic cut-off points, seriously affecting health decision-making.This article reviewed the current literature with a focus on the re-recognition of the clinical significance of cognitive frailty, the limitations of existing assessment tools for diagnosis, and possible solutions in the future.

Gorham-Stout disease(GSD)is a sporadic chronic disease characterized by progressive bone dissolution,absorption,and disappearance along with lymphatic vessel infiltration in bone-marrow cavities.Although the osteolytic mechanism of GSD has been widely studied,the cause of lymphatic hyperplasia in GSD is rarely investigated.In this study,by comparing the RNA expression profile of osteoclasts(OCs)with that of OC precursors(OCPs)by RNA sequencing,we identified a new factor,semaphorin 3A(Sema3A),which is an osteoprotective factor involved in the lymphatic expansion of GSD.Compared to OCPs,OCs enhanced the growth,migration,and tube formation of lymphatic endothelial cells(LECs),in which the expression of Sema3A is low compared to that in OCPs.In the presence of recombinant Sema3A,the growth,migration,and tube formation of LECs were inhibited,further confirming the inhibitory effect of Sema3A on LECs in vitro.Using an LEC-induced GSD mouse model,the effect of Sema3A was examined by injecting lentivirus-expressing Sema3A into the tibiae in vivo.We found that the overexpression of Sema3A in tibiae suppressed the expansion of LECs and alleviated bone loss,whereas the injection of lentivirus expressing Sema3A short hairpin RNA(shRNA)into the tibiae caused GSD-like phenotypes.Histological staining further demonstrated that OCs decreased and osteocalcin increased after Sema3A lentiviral treatment,compared with the control.Based on the above results,we propose that reduced Sema3A in OCs is one of the mechanisms contributing to the pathogeneses of GSD and that expressing Sema3A represents a new approach for the treatment of GSD.

【Objective】 To analyze the effect of sample hemolysis on ELISA test results in blood screening laboratory, so as to determine the acceptable tolerance of hemolysis specific to laboratory test items and detection system, and provide reference for the formulation of tolerance standard of sample hemolysis. 【Methods】 Negative and weakly positive (S/CO was about 2) samples with different hemolysis degrees were tested by several commonly used domestic reagents for HBsAg, HIV Ag/Ab, anti-HCV and anti-TP, respectively. The effects of various degrees of hemolysis on the test results of negative and weakly positive samples for each item were analyzed. 【Results】 1) Hemolysis had no effect on the test results (reactive/non-reactive) of negative and weakly positive samples for HBsAg, anti-HCV and anti-TP ELISA items; 2) Hemolysis affected the test results (reactive/non-reactive) of negative and weakly positive samples for HIV Ag/Ab ELISA item. A tolerance of Hb 2 g/L was taken as the acceptable hemolysis degree for HIV Ag/Ab ELISA item. 【Conclusion】 In this study, the acceptable tolerance of hemolytic samples for corresponding test items and detection system in our laboratory were determined. The influence of hemolysis on ELISA test result is related to the reagent, equipment, environment and other factors, therefore the acceptable tolerance of hemolysis should be determined scientifically and reasonably based on the specific evaluation of each laboratory.

Objective:To evaluate insulin sensitivity(IS)and pancreatic β-cell secretion function in the elderly, analyze the influencing factors, and compare these parameters with those observed in adults.Methods:A total of 301 participants were selected from the health examination population at the Geriatrics Endocrinology Department of Jiangsu Provincial People's Hospital, all of whom had no history of diabetes, between December 2018 and June 2021.Participants were categorized into elderly and adult groups based on age.Personal and medical histories were recorded, and various measurements, including height, weight, waist circumference, hip circumference, blood lipids, and nutritional metabolic indicators, were obtained.Body composition was assessed using dual-emission X-ray absorptiometry(DXA).The oral minimal model(OMM)method was utilized to derive the insulin sensitivity index(ISI), dynamic insulin secretion(Φd), static insulin secretion(Φs), total insulin secretion(Φt), and disposition index(DI).Participants were grouped according to the results of oral glucose tolerance tests.Finally, the factors influencing IS and pancreatic β-cell function were analyzed in both elderly and adult populations, as well as to identify any differences between the two groups.Results:Following adjustments for gender and body mass index(BMI), partial correlation analysis indicated a decrease in Φd, DI-Φd, and DI-Φt with advancing age( r=-0.219, -0.210, -0.187; P=0.005, 0.015, 0.017).In contrast, ISI, Φs, Φt, and DI-Φs showed no significant correlation with age.Although ISI levels were comparable between the elderly and adult groups, individuals newly diagnosed with diabetes in the elderly cohort exhibited higher DI-Φd, DI-Φs, and DI-Φt compared to those in the adult group after ISI correction.When incorporating age, high-density lipoprotein cholesterol(HDL-C), total muscle mass, the android to gynoid ratio(A/G), and fat mass index(FMI)into a binary Logistic regression model, the findings underscored FMI as a common risk factor for both elderly and adult cohorts concerning the ISI( OR=2.324, 1.773; P=0.032, 0.005).The A/G ratio was identified as a risk factor for DI-Φd in both age groups( OR=69 252.464, 407.653; P=0.012, 0.001).Furthermore, HDL-C was recognized as a protective factor for ISI( OR=0.024, P=0.012)in the elderly, while advancing age( OR=1.454, P=0.039)was found to be a risk factor for DI-Φs in this demographic.Total muscle mass and the A/G ratio were also acknowledged as risk factors for ISI( OR=1.054, 15.725; P=0.021, 0.026), with FMI serving as a risk factor for DI-Φs in the adult cohort( OR=1.826, P=0.035). Conclusions:The secretion function of pancreatic β-cells declines with age, whereas ISI remains unchanged.The factors affecting ISI, DI-Φd, and DI-Φs in elderly and adult populations show notable differences.This indicates that implementing targeted lifestyle interventions for distinct age groups may be more effective in preserving both ISI and pancreatic β-cell function.

Short-chain fatty acids are metabolites of the intestinal flora and serve as the main energy source for intestinal epithelial cells. At the same time, as important signaling molecules, it regulate a variety of cellular inflammatory responses and homeostatic proliferation through receptor-dependent and independent pathways. Short-chain fatty acids regulate the gut-liver axis and thereby directly act on the liver, participating in the pathogenesis and transformation of various liver diseases, including alcoholic liver disease, metabolic dysfunction-related liver disease, autoimmune liver disease, liver fibrosis, and hepatocellular carcinoma. In addition, short-chain fatty acids can inhibit HBV DNA replication. This article reviews the research progress on the role of short-chain fatty acids in aspects of the pathogenesis and transformation of chronic liver diseases.

【Objective】 To investigate cortical thickness changes in the face-head region of the primary motor cortex (PMC) and its effect on survival in amyotrophy lateral sclerosis (ALS) patients. 【Methods】 A retrospective analysis was performed on 105 ALS patients who underwent head MRI scan at the same time. The A4hf (face-head) region of PMC was used as the region of interest (ROI). According to clinical symptoms, patients were divided into two groups: bulbar involvement and non-bulbar involvement. The differences of clinical features and cortical thickness in ROI were analyzed. According to the symptoms of bulbar palsy, physical examination of nervous system and EMG of tongue muscle, the patients with bulbar palsy were divided into lower motor neuron (LMN), upper motor neuron (UMN) and LMN+UMN groups. The differences of bulbar subgroup score and ROI of cortical thickness were analyzed. Age at onset, body mass index, delayed time of diagnosis, bulbar subgroup score, and ROI cortical thickness were included in survival analysis. 【Results】 ① The ROI cortical thickness was significantly lower in bulbar involvement group than non-bulbar involvement group (-0.198±0.87 vs. 0.235±0.95, P=0.017). ② There were no significant differences in the bulbar subgroup scores or cortical thickness of ROI between LMN, UMN and LMN+UMN groups (P>0.05). ③ Survival analysis showed age of onset (HR=3.296, 95% CI:1.63-6.664, P=0.001), delayed time of diagnosis (HR=0.361, 95% CI:0.184-0.705, P=0.003), bulbar subgroup score (HR 0.389, 95% CI:0.174-0.868, P=0.021), and ZRE_ROI cortical thickness (HR=2.309, 95% CI:1.046-5.096, P=0.038) were independent influencing factors of ALS survival. 【Conclusion】 Cortical thickness in A4hf (face-head) region can more objectively reflect UMN signs of region bulbar. In addition to age of onset and delayed time of diagnosis, bulbar subgroup score and cortical thickness of face-head region are also independent influencing factors, and cortical thinning in face-head region is a protective factor for survival of ALS patients.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective:To explore the value of quantitative parameters of cortical and cancellous bone in the first lumbar vertebrae (L1) based on CT spinal bone quantification system for evaluating the severity of chronic obstructive pulmonary disease (COPD) in males.Methods:A total of 88 male patients with COPD diagnosed at the Second Affiliated Hospital of Shandong First Medical University from August 2021 to December 2022 were retrospectively analyzed. According to the 2023 edition of global initiative for chronic obstructive lung disease (GOLD), the patients were classified as GOLD Ⅰ (29 cases), GOLD Ⅱ (36 cases), and GOLD Ⅲ-Ⅳ (23 cases). And then 29 males with normal lung function during the same period were recruited. People with normal lung function and COPD patients of GOLD Ⅰ-Ⅱ were classified as non-severe COPD group (94 cases), COPD patients of GOLD Ⅲ-Ⅳ were classified into the severe COPD group (23 cases). On the CT images of L1, the CT spine bone quantification system was used to automatically segment cortical and cancellous bone. The total volume, cortical volume, cancellous volume, average cortical thickness, cortical bone average CT value and cancellous bone average CT value of L1 vertebral body were measured using the system respectively. Single factor analysis of variance was used to compare the differences of various parameters among normal lung function and COPD patients with different lung function grades. The efficacy of various parameters in evaluating the severity of COPD were calculated using the receiver operating characteristic curve.Results:The overall differences in L1 vertebral total volume, cancellous volume and cortical bone average CT value among people with normal lung function and COPD patients of GOLD Ⅰ, Ⅱ, and Ⅲ-Ⅳ were statistically significant ( F=3.60, 4.26, 5.39, P=0.016, 0.007, 0.002), and showed a downward trend as the severity of COPD progressed. There were no statistically significant difference in cortical volume, average cortical thickness and cancellous bone average CT value of L1 ( P>0.05). The area under the curve (AUC) for distinguishing severe and non-severe COPD was 0.64 (95%CI 0.54-0.72), 0.65 (95%CI 0.56-0.74) and 0.75 (95%CI 0.66-0.83) for the total vertebral volume, cancellous volume and cortical bone average CT value of L1 respectively. The AUC of cortical bone average CT value was the highest, with a cutoff value of 217 HU/mm 3, a sensitivity of 69.6% and a specificity of 80.9%. Conclusion:Male COPD patients have reduced bone mass compared to the same age male population. The L1 quantitative parameters measured based on the CT spinal bone quantification system can effectively evaluate the severity of lung function in male COPD patients. Among them, the cortical bone average CT value has the highest diagnostic efficacy.