Keratoconus(KC)is a blinding eye disease caused by a variety of factors, with its pathogenesis still not well understood. In recent years, it has been discovered that sex hormones and prolactin-induced protein(PIP)have a profound impact on the cornea, with more noticeable changes when there are abnormalities in their body content. It has been found that various sex hormone receptors are distributed in the cornea. Based on this, this article reviews a multitude of studies on how sex hormones and PIP affect the cornea, along with relevant clinical research. It has been observed that sex hormones and PIP also play a role in KC patients and influence the occurrence and progression of KC. Additionally, it has been noted that pregnant and lactating women may be more susceptible to KC. Sex hormones and PIP have the potential to become new diagnostic and therapeutic targets. This article not only provides new insights but also offers important references for clinical practice.

Keratoconus(KC)is a blinding eye disease caused by a variety of factors, with its pathogenesis still not well understood. In recent years, it has been discovered that sex hormones and prolactin-induced protein(PIP)have a profound impact on the cornea, with more noticeable changes when there are abnormalities in their body content. It has been found that various sex hormone receptors are distributed in the cornea. Based on this, this article reviews a multitude of studies on how sex hormones and PIP affect the cornea, along with relevant clinical research. It has been observed that sex hormones and PIP also play a role in KC patients and influence the occurrence and progression of KC. Additionally, it has been noted that pregnant and lactating women may be more susceptible to KC. Sex hormones and PIP have the potential to become new diagnostic and therapeutic targets. This article not only provides new insights but also offers important references for clinical practice.

Ferroptosis is a unique and new mode of cell death, which is driven by iron-dependent lipid peroxidation and mainly characterized by the accumulation of reactive oxygen species in cytoplasm and lipids. Ferroptosis plays an important role in the pathogenesis of many ocular fundus diseases, such as retinitis pigmentosa, age-related macular degeneration, diabetic retinopathy, retinal detachment, retinoblastoma and so on. The use of ferroptosis-related inhibitors or activators can regulate the course of the disease and provide new ideas for the research, prevention and treatment of ophthalmic diseases.

Objective To investigate the effects of fibrin-derived peptide Bβ15-42(FgBβ15-42)on mitophagy in acute kidney injury(AKI)with ischemia-reperfusion at the cellular level.Methods Human kidney-2(HK2)cells were cultured in vitro and ran-domly divided into five groups:normal control group(Control group),hypoxia/reoxygenation(H/R)model group(H/R group),H/R+9μmol/L FgBβ15-42 peptide group(Fg group),H/R+20μmol/L chloroquine group(CQ group),and H/R+9μmol/L FgBβ15-42 peptide+20μmol/L chloroquine group(Fg+CQ group).Control group:cells were homogenized and replaced with complete medium and incubated in an aerobic incubator(5％CO2,21％O2)for 28hours.H/R group:cells were added to sugar-free and serum-free DMEM/F12medium and then placed in a hypoxic incubator(5％CO2,1％O2 and 94％N2)for 24hours,washed with PBS and added to DMEM/F12medium containing serum and then placed in a reoxygenated environment(5％CO2,21％O2)for 4hours.Fg group:mod-eled according to the above method,intervention was performed by adding FgBβ15-42 peptide 9μmol/L to the complete medium when reoxygenation was performed after the completion of hypoxia.CQ group:pre-treatment with chloroquine(20μmol/L)in serum-free medium at the time of homogenization,with the same post-procedural steps as in the H/R group.Fg+CQ group:the intervention was performed according to the dosing sequence of the CQ group and FgBβ15-42 group at different time periods as mentioned above,and the modeling time of the H/R group.After the intervention,CCK-8 was used to detect the cell viability of HK2.The mitochondrial morphol-ogy,mitophagosome structure and number were observed by electron microscope.The expression levels of autophagy related proteins p62 and LC3 were detected by Western blot.Results Compared with the control group,the survival rate of H/R group was decreased(P＜0.01);the mitochondrial damage was obvious,such as swelling and spinous rupture,and the number of mitophagosomes increased.The expression of autophagy protein LC-3 Ⅱ/Ⅰ was up-regulated(P＜0.05),and the expression of autophagy substrate protein p62 was down-regulated(P＜0.01).Compared with H/R group,the survival rate of Fg,CQ and Fg+CQ groups increased(P＜0.01),mito-phagosome was decreased.the expression of LC-3 Ⅱ/Ⅰ was down-regulated(P＜0.01),the expression of p62 was up-regulated(P＜0.05),and autophagy was inhibited.Conclusion The intervention of FgBβ15-42 peptide can reduce the level of autophagy and mitophagy in H/R-AKI cells,and has a protective effect on H/R injury in HK2 cells.

Objective To investigate the relationship between the expression of matrix metalloproteinase(MMP)-2,MMP-9,MMP-13 and disease activity in pemphigus patients.Methods A total of 60 pemphigus patients treated in the dermatology department of the hospital from January 2021 to January 2023 were select-ed as the study group,and another 60 healthy volunteers who underwent physical examination in the same pe-riod were recruited as the control group.The levels of MMP-2,MMP-9 and MMP-13 in serum and the expres-sion of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells were compared between the two groups,and the relationship between the expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells of patients with pemphigus was analyzed.Pemphigus patients were divided into acute phase group(n=22),chronic phase group(n=23)and stable phase group(n=15)according to their disease activi-ty.The expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells of the three groups were compared,as well as the correlation between the three indexes and disease activity.Receiver operating characteristic(ROC)curve was plotted for analysis.Results The levels of MMP-2,MMP-9 and MMP-13 in serum and the expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells in the study group were higher than those in the control group,with statistical significance(P＜0.05).The expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells in severe patients were higher than those in moderate and mild patients,and the difference was statistically significant(P＜0.05).The expression of MMP-2,MMP-9 and MMP-13 and disease activity scores of mononuclear cells in acute attack group were higher than those in chronic attack group,and the differences were statistically significant(P＜0.05).The ex-pression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells were positively correlated with disease activity(rMMP-2=0.545,rMMP-9=0.592,rMMP-13=0.580,P＜0.05).ROC curve analysis showed that compared with the single diagnostic efficacy of MMP-2,MMP-9 and MMP-13 expression in peripheral blood mononuclear cells,the three combined diagnostic efficacy was better.Conclusion The expression of MMP-2,MMP-9 and MMP-13 in peripheral blood mononuclear cells of pemphigus patients is related to the disease activity,and these three indicators can be used as reference indicators for the diagnosis of pemphigus disease activity.

The p53 protein is a key transcription factor and tumor suppressor, which activates in cellular stress response and prevents the cell malignant transformation by repairing or eliminating damaged cells. The p53 protein is mutated in more than 50% of malignant tumors, and is one of the proteins known to have the highest correlation with tumorigenesis and development. Restoring the tumor suppressor function of p53 protein has always been an important direction of anti-tumor research and development. In recent years, several anti-tumor treatment strategies based on p53 protein have entered the clinical trial stage and achieved promising efficacy. In this review, starting from the structure, function, and regulation of p53 protein, the research progress in anti-tumor treatment strategies based on p53 protein was summarized, including restoration of the function of mutp53 protein, degradation of mutp53 protein, targeting of the negative regulators of p53 protein, as well as immunotherapy and gene therapy based on p53 protein, with the aim of providing new innovative ideas for the subsequent researchers.

Objective:To retrieve, summarize, evaluate and integrate the best evidence for the prevention and management of center venous catheter dysfunction in hemodialysis patients.Methods:The relevant literature on prevention of center venous catheter dysfunction in hemodialysis patients was systematically searched in UpToDate, BMJ Best Practice, Cochrane Library, National Guideline Clearinghouse, Guidelines International Network, National Kidney Foundation, PubMed, CNKI and other databases, including guidelines, clinical decision-making, evidence summary, systematic evaluation and expert consensus. The search period was from January 1st, 2013 to March 1st, 2023. Two researchers independently evaluated the quality of the literature, evaluated the quality of the included literature and extracted evidence.Results:A total of 15 articles were included, including three guidelines, three clinical decision-making, five expert consensus, two systematic evaluations, one evidence summary and one government document. Ultimately, seven themes and 32 best evidence were formed, including personnel training and management, evaluation and monitoring, catheter insertion, catheter maintenance, drug prevention, catheter dysfunction management and health education.Conclusions:This study summarizes the best evidence for the prevention and management of center venous catheter dysfunction in hemodialysis patients. Medical staff can choose and apply this evidence-based basis based on clinical situations and patient preferences, thereby reducing the incidence of catheter dysfunction.

Objective:To analyze and evaluate the application effect of magnetic navigation-guided nasojejunal tube placement in critically ill patients by literature retrieval.Methods:The Chinese databases of CNKI,Wanfang,VIP and Chinese Biomedical Literature Service System were searched,as well as the literature on randomized controlled trials of magneto-guided nasojejunal tube placement in critically ill patients in foreign language databases of PubMed,CINAHL,Cochrane Library,Web of Science,and Embase,the search period was from January 2000 to September 2023.The literature were screened according to the inclusion and exclusion criteria,and the quality of the literature was evaluated.RevMan 5.4.1 software was used to conduct a meta-analysis of the four outcomes in the literature:success rate of placement,time required for successful placement,time to recovery of vital signs,and patient satisfaction.Results:A total of 7 randomized controlled trials of 7 studies were included,including 4 Chinese studies and 3 English studies,involving 682 patients.The success rate of magnetic navigation-guided nasojejunal tube placement was higher than that of bedside blind nasojejunal tube placement,the difference was statistically significant[OR=4.78,95%CI(2.16～10.58),P<0.0001].The time required for magnetic navigation guided nasojejunal tube placement was less than that of the bedside blind nasojejunal tube placemen,the difference was statistically significant[MD=-12.91,95%CI(-22.93～-2.90,P<0.00001].The time required for recovery of vital signs in patients with magnetic navigation guided nasojejunal tube placement was less than that of the bedside blind nasojejunal tube placemen,the difference was statistically significant[MD=-9.11,95%CI(-12.09～-6.13,P<0.00001].The satisfaction of patients with the magnetic navigation-guided nasojejunal tube placement was higher than that of patients with the bedside blind nasojejunal tube placement,the difference was statistically significant[OR=11.61,95%CI(3.96～34.01),P<0.00001].Conclusion:Compared with bedside blind nasojejunal tube placement,magnetic navigation-guided nasojejunal tube placement can significantly improve the success rate of nasojejunal tube placement in critically ill patients,reduce the time required for successful nasojejunal tube placement,reduce the recovery time of patients'vital signs,and improve patient satisfaction.

Traumatic cataract is relatively common in clinical practice. Typically, non-metallic foreign bodies entering the eye do not cause intraocular reactions, manifesting only as traumatic cataract, while metal foreign bodies entering the eye are more likely to cause complications. Foreign bodies entering the eye can be detected through ophthalmic examination or found during cataract surgery. However, a very small number of patients may experience missed diagnosis in clinical practice. This article reported a case of traumatic cataract with disappearance of intraocular metal foreign body, presenting with a history and signs of ocular trauma and foreign body entry into the eye, but no foreign body was found before, during or after surgery. The reasons for the disappearance of the metal foreign body were also analyzed.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.