AIM: To evaluate the safety and efficacy of allogeneic intrastromal lenticule implantation combined with corneal collagen cross-linking(CXL)in patients with moderate to advanced keratoconus.METHODS: A retrospective case series analysis was conducted. A total of 19 patients(20 eyes)with moderate to advanced keratoconus who underwent combined allogeneic intrastromal lenticule implantation and CXL at the Jinan Mingshui Eye Hospital from June 2021 to December 2023 were included. The uncorrected distance visual acuity(UCVA), thinnest corneal thickness, central corneal epithelial thickness, anterior corneal flat keratometry(Kf), steep keratometry(Ks), and mean keratometry(Km), as well as the first applanation time(A1T), the first applanation length(A1L), the velocity during the first applanation moment(VIN), the second applanation time(A2T), the second applanation length(A2L), the velocity during the second applanation moment(VOUT), highest concavity time(HCT), highest concavity radius(HCR), peak distance(PD), deformation amplitude(DA), stiffness parameter at first applanation(SP-A1), integrated radius(IR), central corneal thickness(CCT), intraocular pressure(IOP), corneal thickness-corrected IOP, biomechanically intraocular pressure IOP(bIOP), and corneal thickness variation rate(ARTH)were compared between the two groups before surgery and at 1 wk, 1, 3 and 6 mo after surgery.RESULTS: All patients successfully completed the surgery without any intraoperative complications. No significant differences were observed between pre-operative and post-operative measurements for UCVA or the corneal biomechanical parameters, including A1L, A2L, PD, A1T, A2T, VIN, VOUT, DA, IOP, and bIOP(all P>0.05). Significant differences were found between pre-operative and post-operative values for corneal thinnest point thickness, central corneal epithelial thickness, Kf, Ks, Km, and the corneal biomechanical parameters, including HCT, HCR, SP-A1, ARTH, IR, and CCT(all P<0.05). The anterior corneal curvature demonstrated an initial increase followed by a decrease post-operatively. Furthermore, significant differences were observed between pre-operative and post-operative values for HCT, HCR, SP-A1, ARTH, IR, and CCT(all P<0.005).CONCLUSION: Allogenic intrastromal lenticule implantation combined with corneal collagen cross-linking demonstrates favorable safety and stability in treating moderate-to-advanced keratoconus. This combined procedure effectively increases corneal thickness and rigidity, resulting in corneas that are more resistant to deformation postoperatively.

Aging is a natural process in which tissue and organ function declines as organisms age. Aging is the inevitable outcome of the organism and is irreversible. The aging process is accompanied by degenerative changes in the morphological structure of multiple organs of the body, leading to an increase in the incidence of chronic diseases such as hypertension, cardiovascular and cerebrovascular diseases, hyperlipidemia, and diabetes year by year. In recent years, natural phytochemicals have attracted widespread attention from the public due to their advantages such as non-toxicity or low toxicity, low cost, and various biological activities. Epigallocatechin gallate (EGCG) is a dietary polyphenol extracted from green tea, which has a variety of biological functions including anti-oxidation, anti-inflammation, hypoglycemic, hypolipidemic and anti-aging activities. The EGCG-mediated anti-aging mechanism has been investigated in many studies with different aging models. This article reviews the research progress on rodents, nematodes, fruit flies, and cell aging models, focusing on summarizing the lifespan extension and physiological changes of rodents, nematodes and fruit flies after EGCG intervention from multiple angles, and exploring potential mechanism by which EGCG delays aging and extends lifespan. This review provides a theoretical reference for the study of the anti-aging mechanism of phytochemicals.

Aging is a natural process in which tissue and organ function declines as organisms age. Aging is the inevitable outcome of the organism and is irreversible. The aging process is accompanied by degenerative changes in the morphological structure of multiple organs of the body, leading to an increase in the incidence of chronic diseases such as hypertension, cardiovascular and cerebrovascular diseases, hyperlipidemia, and diabetes year by year. In recent years, natural phytochemicals have attracted widespread attention from the public due to their advantages such as non-toxicity or low toxicity, low cost, and various biological activities. Epigallocatechin gallate (EGCG) is a dietary polyphenol extracted from green tea, which has a variety of biological functions including anti-oxidation, anti-inflammation, hypoglycemic, hypolipidemic and anti-aging activities. The EGCG-mediated anti-aging mechanism has been investigated in many studies with different aging models. This article reviews the research progress on rodents, nematodes, fruit flies, and cell aging models, focusing on summarizing the lifespan extension and physiological changes of rodents, nematodes and fruit flies after EGCG intervention from multiple angles, and exploring potential mechanism by which EGCG delays aging and extends lifespan. This review provides a theoretical reference for the study of the anti-aging mechanism of phytochemicals.

Objective To evaluate the change of energy metabolism during cisplatin-induced acute kidney injury.Methods Adult CD-1 male mice were intraperitoneally injected with a single dose of cisplatin (20 mg/kg), and renal function and renal tissue pathology were tested;gene expression was analyzed and signaling pathways were en-riched in cisplatin-treated renal tubular epithelial cells using transcriptome; the contents of renal glycolysis and a-mino acid metabolites were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) .Re-sults Serum urea nitrogen and blood creatinine significantly increased in cisplatin-treated mice.Pathological his-tology observed swelling and shedding of renal tubular epithelial cells.Transcriptome analysis revealed that 2632 genes were upregulated and 2799 genes were downregulated in cisplatin-treated HK-2 cells.GO and KEGG analy-sis showed that differential genes were enriched in energy metabolism.The GSEA analysis results showed that cispl-atin caused an upregulation of the oxidative phosphorylation pathway and a downregulation of the glycolysis pathway in renal tubular epithelial cells, further KEGG analysis demonstrated that cisplatin caused changes in the expression of amino acid genes in renal cells.Metabolomics showed that the contents of glycolytic intermediates and several a-mino acids were altered in the kidney of cisplatin-treated mice.Conclusion Cisplatin-induced acute renal injury is accompanied by modification in renal tubular cell glycolysis and amino acid metabolism.

Objective:To systematically review qualitative research on the experiences of palliative care patients and caregivers in home medication management, so as to improve their drug management capabilities and optimize grassroots palliative care services as a reference.Methods:This review was conducted using databases including the Cochrane Library, PubMed, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure, Wanfang Data, VIP Database, and China Biology Medicine disc, searching for qualitative research on the medication management experiences of palliative care patients and caregivers up to April 30, 2024. The quality of the literature was assessed using the Australian Joanna Briggs Institute Evidence-Based Health Care Center standards for qualitative research quality assessment. A convergent integrated approach was employed to synthesize and integrate the findings.Results:Eleven articles were included, all of which were from abroad, synthesizing 51 findings into 7 new categories, which were then integrated into 3 composite outcomes: complex feelings of patients and caregivers in home medication management, including responsibility and self-efficacy, anxiety and fatigue; challenges in home medication management, including polypharmacy and experiences using pain medication, disagreements over medication management at home, and perceived inadequacies in primary healthcare resources;the need for multifaceted support, including desires for more medication guidance and communication with palliative care professionals in the community.Conclusions:Due to the complexity of medication needs and insufficient regulatory support, home medication management in palliative care presents challenges. It is recommended to enhance the self-efficacy and medication management skills of patients and caregivers, improve risk response capabilities, optimize medication administration processes, and strengthen training for healthcare professionals. Government agencies should also support policies to ensure a safe and comfortable home medication environment for palliative care patients in China.

Objective:To compare the clinical efficacy of 1 h and 12 h getting out of bed after transradial percutaneous coronary intervention (PCI), and to provide evidence for early safe getting out of bed after PCI.Methods:The quasi-experimental method was used in this study. A total of 84 patients undergoing radial artery PCI in the Cardiovascular Center of the Affiliated Hospital of Gansu University of Chinese Medicine from July 2022 to May 2023 were selected by purpose sampling method, and were divided into the control group and the experimental group by random number table method, with 42 patients in each group. The control group was given 12 h post-operative getting out of bed activity program, and the experimental group was given 1 h post-operative getting out of bed activity program. The quality of life and self-care ability of daily life were compared before and after intervention. Besides patients′ rehabilitation satisfaction was compared after intervention.Results:Ultimately there were 42 patients in each group completed the research. In the control group, there were 24 males, 18 females, aged (66.08 ± 6.78) years old; in the experimental group there were 22 males, 20 females, aged (68.03 ± 7.17) years old. Before intervention, there were no significant differences in quality of life, self-care ability of daily life and adverse cardiac events between 2 groups (all P>0.05). After intervention, the scores of quality of life in physical function, social relationship, emotional function and environment were (77.20 ± 4.17), (42.40 ± 3.71), (68.10 ± 4.74) and (76.90 ± 4.38), respectively. Higher than (74.50 ± 3.91), (40.20 ± 3.94), (67.70 ± 3.88), (74.35 ± 3.41) in the control group, the differences between the two groups were statistically significant ( t values were 2.17-2.98, all P<0.05). The scores of daily self-care ability in grooming, eating, dressing, going to the toilet, going up and down stairs, bed chair transfer and flat walking were (4.62 ± 1.33), (6.37 ± 2.26), (8.00 ± 2.48), (6.25 ± 2.46), (4.62 ± 2.08), (10.12 ± 3.09), (10.50 ± 3.54) points, higher than the control group (4.06 ± 1.96), (5.75 ± 1.79), (6.37 ± 2.26), (5.25 ± 1.10), (3.37 ± 2.62), (8.75 ± 2.19), (8.87 ± 2.11) points. The differences between the two groups were statistically significant ( t values were 2.29-3.30, all P<0.05). The scores of rehabilitation satisfaction of experimental group in rehabilitation treatment effect, team professional level and rehabilitation treatment arrangement were (4.55 ± 0.50), (4.82 ± 0.38), (4.77 ± 0.42) points, respectively, which were higher than (4.20 ± 0.64), (4.47 ± 0.64), (4.40 ± 0.81) points of control group. The differences between the two groups were statistically significant ( t=2.69, 2.96, 2.59, all P<0.05). Conclusions:Getting out of bed 1 h after radial artery PCI is safe and effective, which can significantly improve patients′ quality of life, self-care ability and satisfaction.It is expected to be clinically promoted and trialed.

Objective To systematically integrate the experience of medical staff participating in remote home palliative care,and to provide a reference for further promoting the development of remote home palliative care and improving the service quality in China.Methods PubMed,Web of Science,CINAHL,Cochrane Library,Embase,CNKI,Wanfang Database,VIP Database,and Chinese Biomedical Literature Database were searched to collect qualitative studies on the experience of medical staff participating in remote home palliative care,and the search time was from inception to November 2023.The quality of the included literature was evaluated according to the 2016 edition of the Qualitative Research Quality Evaluation Criteria of the Joanna Briggs Institute for Evidence-Based Health Care in Australia,and the results were summarized by meta-synthesis method.Results A total of 11 studies were included,and 40 research results were extracted,and 11 categories were formed,which were summarized into 3 integrated results.① Medical staff perceived the benefits of participating in remote home palliative care:improving the efficiency of medical services,breaking through the limitations of time and space,enhancing job satisfaction,and improving the continuity of palliative care.②Medical staff recognized the challenges of participating in remote home palliative care:poor stability of remote working environment,complex equipment operation,insufficient theoretical knowledge and professional skills,inability to meet the special care needs of patients,and difficulty in defining service time.③Medical staff believe that remote home palliative care services need to be improved:pay attention to the importance of family participation,use remote palliative care as an auxiliary method,and pay attention to establishing a doctor-patient trust relationship.Conclusion There are many benefits and challenges for medical staff to participate in remote home palliative care,and hospital managers should provide multi-faceted support for medical staff,strengthen the construction of remote home palliative care team,establish an online and offline linkage mechanism,and continuously improve the quality of remote home palliative care in China.

Objective:To evaluate the effect of pre-infusion of hypertonic saline on the postoperative cognitive function in elderly patients.Methods:This was a prospective study. Seventy-six patients of both sexes, aged≥60 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, who underwent elective shoulder arthroscopic surgery under brachial plexus block combined with general anesthesia from June 2022 to January 2023 in our hospital, were selected and divided into 2 groups ( n=38 each) by the random number table method: hypertonic saline group and normal saline group. At 30 min before anesthesia induction, 3% hypertonic saline of 4 ml/kg was intravenously infused in hypertonic saline group, and normal saline 4 ml/kg was intravenously infused in normal saline group. The occurrence of intraoperative cerebral desaturation events was recorded. Venous blood samples were collected at 24 h postoperatively, and the plasma concentrations of interleukin-1beta (IL-1β), IL-6, tumor necrosis factor-alpha and S-100β were measured by enzyme-linked immunosorbent assay, and the expression of neutrophil CD11b was detected by flow cytometry. Rey auditory verbal learning test, trail making test, digit symbol substitution test, and stroop color-word test were performed at 1 day before surgery and 5 days after surgery, and the postoperative cognitive dysfunction was assessed using the Z-score method. Results:Compared with normal saline group, the concentrations of plasma IL-6, tumor necrosis factor-alpha and S-100β and expression of neutrophil CD11b were significantly decreased in hypertonic saline group, and the incidence of cognitive dysfunction and cerebral desaturation events was decreased in hypertonic saline group ( P<0.05). Conclusions:Pre-infusion of hypertonic saline can reduce inflammatory responses and improve postoperative cognitive function in elderly patients.

Objective:This study aims to demonstrate the feasibility of using Bio-layer Interferometry (BLI) for label-free detection of peripheral blood biomarkers, using C-reactive protein (CRP) as a model molecule.Methods:A total of 85 clinical remnant serum samples from routine laboratory tests were collected from Fuwai Hospital, Chinese Academy of Medical Sciences, from July 2021 to May 2022. The biotinylated anti-CRP antibody was immobilized onto streptavidin-functionalized BLI probes. The GatorPrime BLI system was used to detect series of diluted CRP standards in real-time, and to generate dynamic binding curves for establishing standard curves based on the relationship between concentration and initial binding rates. The sensitivity of the method, including the limit of blank (LoB), limit of detection (LoD), and limit of quantitation (LoQ), was evaluated according to Clinical & Laboratory Standards Institute (CLSI) guidelines. Serum samples and third-party quality control materials were used to evaluate the precision, while linearity was verified through the dilution of a high-concentration serum series. Method comparison between the label-free BLI assay and conventional clinical laboratory immunoassays was conducted using Passing-Bablok regression and Spearman correlation analysis.Results:The GatorPrime BLI system demonstrated a dynamic detection range of 0.6-300 mg/L for CRP standards, and the linearity within this range was validated using serum samples. The LoB, LoD, and LoQ for this method were determined to be 0.246 mg/L, 0.573 mg/L, and 2.158 mg/L, respectively. Precision analysis showed that the total laboratory imprecision of the four levels of quality control materials (21.15-57.26 mg/L) ranged from 5.8% to 9.0%, and the total imprecision of the two serum samples (2.32 mg/L and 100.06 mg/L) was 22.3% and 7.4%, respectively. Methodological comparison with two commonly used clinical laboratory immunoassays revealed a strong correlation with our method(Passing-Bablok regression: Y=?1.065+1.119 X and Y=?0.452+1.034 X, r=0.993 and r=0.976, P<0.001). Conclusions:The label-free BLI immunoassay method enables the detection of CRP across a broad concentration range in blood samples, with analytical performance meeting the requirements for laboratory testing. This method shows potential as a reliable and efficient alternative for CRP measurement in clinical practice.

Objective To investigate the relationships of serum levels of human fractalkine (CX3CL1) and chitinase-3-like protein 1 (YKL-40) with early cognitive impairment in elderly patients with Alzheimer's disease (AD). Methods A total of 110 AD patients in the Second Affiliated Hospital of Xinxiang Medical University from February 2021 to December 2023 were selected as AD group, and 50 healthy individuals with physical examination during the same period were selected as control group. Clinical materials and serum levels of CX3CL1 and YKL-40 were compared between the two groups, and multivariate Logistic regression models were used to analyze the influencing factors of cognitive impairment in AD patients. Based on the Mini-Mental State Examination (MMSE) score, the 110 AD patients were divided into mild cognitive impairment group (n=47), moderate cognitive impairment group (n=36), and severe cognitive impairment group (n=27). Spearman correlation analysis was performed to explore the relationships of serum CX3CL1 and YKL-40 with MMSE score, Addenbrooke's Cognitive Examination-Ⅲ (ACE-Ⅲ) score, and Montreal Cognitive Assessment (MoCA) score. Results The AD group had higher proportions of patients aged over 80 years, with an education level of primary school or below, smoking history, alcohol consumption history, diabetes mellitus, hypertension, AD family history, and living alone as well as higher serum levels of CX3CL1 and YKL-40 compared to the control group; conversely, the AD group had a lower proportion of patients engaging in no physical exercise/labor, and lower MMSE, ACE-Ⅲ, and MoCA scores, with significant between-group differences (P < 0.05). Advanced age, diabetes mellitus, and high serum levels of CX3CL1 and YKL-40 were independent risk factors for cognitive impairment in AD patients (P < 0.05), while an education level of college or above was a protective factor (P < 0.05). Compared with the mild cognitive impairment group, the moderate and severe cognitive impairment groups had higher serum levels of CX3CL1 and YKL-40, and the severe cognitive impairment group had higher serum levels of CX3CL1 and YKL-40 than the moderate group, with significant between-group differences (P < 0.05). Spearman correlation analysis revealed that serum CX3CL1 and YKL-40 were negatively correlated with MMSE, ACE-Ⅲ, and MoCA scores (P < 0.05). Conclusion Serum CX3CL1 and YKL-40 are highly expressed in elderly AD patients, and are closely related to early cognitive impairment in elderly AD patients.