From Digital Human Modeling to Human Digital Twin: Framework and Perspectives in Human Factors

The human digital twin(HDT)emerges as a promising human-centric technology in Industry 5.0,but challenges remain in human modeling and simulation.Digital human modeling(DHM)provides solutions for modeling and simulating human physical and cognitive aspects to support ergonomic analysis.However,it has limitations in real-time data usage,personalized services,and timely interaction.The emerging HDT concept offers new possibilities by integrating multi-source data and artificial intelligence for continuous monitoring and assessment.Hence,this paper reviews the evolution from DHM to HDT and proposes a unified HDT framework from a human factors perspective.The framework comprises the physical twin,the virtual twin,and the linkage between these two.The virtual twin integrates human modeling and AI engines to enable model-data-hybrid-enabled simulation.HDT can potentially upgrade traditional ergonomic methods to intelligent services through real-time analysis,timely feedback,and bidirectional interactions.Finally,the future perspectives of HDT for industrial applications as well as technical and social challenges are discussed.In general,this study outlines a human factors perspective on HDT for the first time,which is useful for cross-disciplinary research and human factors innovation to enhance the development of HDT in industry.

Human Factors While Using Head-Up-Display in Low Visibility Flying Conditions

Flying an aircraft in low visibility is still a challenging task for the pilot.It requires precise and accurate situational awareness(SA)in real-time.A Head-up Display(HUD)is used to project collimated internal and externalflight information on a transparent screen in the pilot’s forwardfield of view,which eliminates the change of eye position between Head-Down-Display(HDD)instru-ments and outer view through the windshield.Implementation of HUD increases the SA and reduces the workload for the pilot.But to provide a betterflying capability for the pilot,projecting extensive information on HUD causes human factor issues that reduce pilot performance and lead to accidents in low visibility conditions.The literature shows that human error is the leading cause of more than 70%of aviation accidents.In this study,the ability of the pilot able to read background and symbology information of HUD at a different level of back-ground seen complexity,such as symbology brightness,transition time,amount of Symbology,size etc.,in low visibility conditions is discussed.The result shows that increased complexity on the HUD causes more detection errors.

Intervention decision-making in MAV/UAV cooperative engagement based on human factors engineering

Aiming at the intervention decision-making problem in manned/unmanned aerial vehicle（MAV/UAV） cooperative engagement, this paper carries out a research on allocation strategy of emergency discretion based on human factors engineering（HFE）.Firstly, based on the brief review of research status of HFE, it gives structural description to emergency in the process of cooperative engagement and analyzes intervention of commanders. After that,constraint conditions of intervention decision-making of commanders based on HFE（IDMCBHFE） are given, and the mathematical model, which takes the overall efficiency value of handling emergencies as the objective function, is established. Then, through combining K-best and variable neighborhood search（VNS） algorithm, a K-best optimization variable neighborhood search mixed algorithm（KBOVNSMA） is designed to solve the model. Finally,through three groups of simulation experiments, effectiveness and superiority of the proposed algorithm are verified.

Quantitative Analysis of Natural and Human Factors of Oasis Change in the Tail of Shiyang River over the Past 60 Years

The human and natural factors complicit in the driving forces of oasis change have always received considerable interest from the international research community. In this study, we used principal component analysis of natural and socio-economic statistical factors to quantitatively analyze the causal relationships and their contributions to the observed periodic expansion or shrinkage of the Minqin Oasis over almost 60 years. Our results show that human factors were the dominant factors governing expansion or shrinkage, with average contributions of 69.38% and 76.16%, respectively. Moreover, policy decisions have been the pivotal human factors. Under the influence of various policies, we have found that water resource utilization, land reclamation, population explosion, ecological protection and economic development have each played leading roles in different periods. This study provides a scientific basis for modelling the dynamics of an oasis for sustainable management.

Human Factors Analysis in Software Engineering

The general human factors analysis analyzes human functions, effects and influence in a system. But in a narrow sense, it analyzes human influence upon the reliability of a system, it includes traditional human reliability analysis, human error analysis, man-machine interface analysis, human character analysis, and others. A software development project in software engineering is successful or not to be completely determined by human factors. In this paper, we discuss the human factors intensions, declare the importance of human factors analysis for software engineering by listed some instances. At last, we probe preliminarily into the mentality that a practitioner in software engineering should possess. Key words human factors analysis - software engineering - software reliability CLC number TP 311.5 Foundation item: Supported by the National Natural Science Foundation of China (60173013)Biography: Xu Ren-zuo (1946-), male, Professor, research direction: software engineering, software reliability engineering, software safety and software testing.

Human Factors/Ergonomics (HFE) in Leadership and Management: Organizational Interventions to Reduce Stress in Healthcare Delivery

Clinician Burnout is a personal and public health issue. Most occupational stressors contributing to clinician burnout are systemic. The combination of organizational interventions along with individual interventions is necessary to make significant lasting difference in reducing burnout, improving clinician and patient satisfaction and reducing latent error in healthcare delivery. Application of Human Factors/Ergonomics (HFE) science in healthcare leadership and management is a gap in current training for leaders. HFE uses concepts from organizational, educational and cognitive science, systems science and industrial engineering. HFE application is especially necessary in a fast changing highly stressful healthcare environment which impacts the wellbeing of clinicians and the safety of patients under care. Practical suggestions for working with various healthcare leadership styles and organizational dynamics, while aligning wellness efforts with institutional mission are discussed. Concrete examples of decreasing extraneous mental load on clinicians to preserve their brainpower to achieve quality patient care are illustrated. Organizational interventions in combination with individual interventions to reduce and manage burnout have enormous potential to improve clinician wellbeing and satisfaction in taking care of patients, reduce costs, risk of error and create the safe working environment needed to sustainably give high quality care to patients.

Promoting Clinician Well-Being and Patient Safety Using Human Factors Science: Reducing Unnecessary Occupational Stress

Our healthcare delivery system has accumulated complexity of payment, regulation systems, expectations and requirements. Often these are not designed to align with clinical thinking process flow of patient care. As a result, clinicians are utilizing enormous mental (cognitive) resource to comply with these complexities, over and above the baseline mental effort required to give good care to the patient. Recent studies suggest a significant number of physicians, advanced practice providers and nurses no longer want to stay in healthcare due to difficult work expectations and conditions that have become unreasonable. Technology has benefitted healthcare delivery, but also is a conduit of many expectations that have been grafted upon clinician workloads, exceeding the resources provided to accomplish them. Cognitive load is a measure of mental effort and is divided into Intrinsic, Germane and Extraneous Cognitive Load. Extraneous Cognitive Load (ECL) is what is not necessary and can be removed by better design. High cognitive load is associated with increased risk of both medical error and clinician burnout. Chronic high level occupational stress occurs from dealing with this job/resource imbalance and is showing serious personal health impact upon clinicians and the quality of the work they can provide for patients. Since organizational systems have become more complex, leadership methods, clinician wellbeing and patient safety efforts need to adjust to adapt and succeed. Safety efforts have tended to predominantly follow methods of a few decades ago with predominant focus upon how things go wrong (Safety I) but are now being encouraged to include more of the study of how things go right (Safety II). Human Factors/Ergonomics (HFE) science has been used in many industries to preserve worker wellbeing and improve system performance. Patient safety is a product of good system performance. HFE science helps inform mechanisms behind Safety I and II approach. HFE concepts augment existing burnout and safety interventions by providing a conceptual roadmap to follow that can inform how to improve the multiple human/technology, human/system, and human/work environment interfaces that comprise healthcare delivery. Healthcare leaders, by their influence over culture, resource allocation, and implementation of requirements and workflows are uniquely poised to be effective mitigators of the conditions leading to clinician burnout and latent medical error. Basic knowledge of HFE science is a strategic advantage to leaders and individuals tasked with achieving quality of care, controlling costs, and improving the experiences of receiving and providing care.

Reviews and prospects of human factors research on curve driving

In order to fully understand the research progress of human factors and traffic safety in curve driving,from the perspective of driver-vehicle-road-environment dynamic traffic system,this paper explored the current research status and development trend of human factors of curve driving,and displayed the development process and structural relationship of human factors research of curve driving by using scientific knowledge map.Through the core collection database of Web of Science,1408 English literatures related to human factors research of curve driving published from 2012 to 2022(as of October 1,2022)were obtained,and the literatures in this field were sorted and analyzed based on the VOSviewer visualization software.The results show that China,Tongji University and Accident Analysis and Prevention are the country,institution and journal with the largest contribution rate in the field of human factors research on curve driving.Co-citation analysis shows that the research contents in this field are divided into 5 clusters:driver’s visual characteristics,risk of collision,vehicle dynamics characteristics,the influence of traffic engineering facilities on driving behavior,selection of driving speed.The co-occurrence analysis of keywords shows that the topics of curve geometry design and vehicle dynamics,driving behavior and risk,driving speed and safety,behavior prediction and intervention measures are the current research hotspots in the research field.It is found that the development trend of traffic safety improvement in curves is to construct a continuous,consistent,multi-level visual reference frame conforming to driving expectation through visual guiding technology,and summarizes the technical concept of linear visual guidance.This study can provide a reference for the study of human factors of curve driving.

Disinfection Byproducts and Their Precursors in Drinking Water Sources:Origins,Influencing Factors,and Environmental Insights

Tracing the contamination origins in water sources and identifying the impacts of natural and human processes are essential for ecological safety and public health.However,current analysis approaches are not ideal,as they tend to be laborious,time-consuming,or technically difficult.Disinfection byproducts(DBPs)are a family of well-known secondary pollutants formed by the reactions of chemical disinfectants with DBP precursors during water disinfection treatment.Since DBP precursors have various origins(e.g.,natural,domestic,industrial,and agricultural sources),and since the formation of DBPs from different precursors in the presence of specific disinfectants is distinctive,we argue that DBPs and DBP precursors can serve as alternative indicators to assess the contamination in water sources and identify pollution origins.After providing a retrospective of the origins of DBPs and DBP precursors,as well as the specific formation patterns of DBPs from different precursors,this article presents an overview of the impacts of various natural and anthropogenic factors on DBPs and DBP precursors in drinking water sources.In practice,the DBPs(i.e.,their concentration and speciation)originally present in source water and the DBP precursors determined using DBP formation potential tests—in which water samples are dosed with a stoichiometric excess of specific disinfectants in order to maximize DBP formation under certain reaction conditions—can be considered as alternative metrics.When jointly used with other water quality parameters(e.g.,dissolved organic carbon,dissolved organic nitrogen,fluorescence,and molecular weight distribution)and specific contaminants of emerging concern(e.g.,certain pharmaceuticals and personal care products),DBPs and DBP precursors in drinking water sources can provide a more comprehensive picture of water pollution for better managing water resources and ensuring human health.

Human-artificial intelligence interaction in gastrointestinal endoscopy

The number and variety of applications of artificial intelligence(AI)in gastr-ointestinal(GI)endoscopy is growing rapidly.New technologies based on machine learning(ML)and convolutional neural networks(CNNs)are at various stages of development and deployment to assist patients and endoscopists in preparing for endoscopic procedures,in detection,diagnosis and classification of pathology during endoscopy and in confirmation of key performance indicators.Platforms based on ML and CNNs require regulatory approval as medical devices.Interactions between humans and the technologies we use are complex and are influenced by design,behavioural and psychological elements.Due to the substantial differences between AI and prior technologies,important differences may be expected in how we interact with advice from AI technologies.Human-AI interaction(HAII)may be optimised by developing AI algorithms to minimise false positives and designing platform interfaces to maximise usability.Human factors influencing HAII may include automation bias,alarm fatigue,algorithm aversion,learning effect and deskilling.Each of these areas merits further study in the specific setting of AI applications in GI endoscopy and professional societies should engage to ensure that sufficient emphasis is placed on human-centred design in development of new AI technologies.

PRaG 3.0 therapy for human epidermal growth factor receptor 2-positive metastatic pancreatic ductal adenocarcinoma:A case report

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly fatal disease with limited effective treatment especially after first-line chemotherapy.The human epidermal growth factor receptor 2(HER-2)immunohistochemistry(IHC)positive is associated with more aggressive clinical behavior and shorter overall survival in PDAC.CASE SUMMARY We present a case of multiple metastatic PDAC with IHC mismatch repair proficient but HER-2 IHC weakly positive at diagnosis that didn’t have tumor regression after first-line nab-paclitaxel plus gemcitabine and PD-1 inhibitor treatment.A novel combination therapy PRaG 3.0 of RC48(HER2-antibody-drug conjugate),radio-therapy,PD-1 inhibitor,granulocyte-macrophage colony-stimulating factor and interleukin-2 was then applied as second-line therapy and the patient had confirmed good partial response with progress-free-survival of 6.5 months and overall survival of 14.2 month.She had not developed any grade 2 or above treatment-related adverse events at any point.Percentage of peripheral CD8^(+) Temra and CD4^(+) Temra were increased during first two activation cycles of PRaG 3.0 treatment containing radiotherapy but deceased to the baseline during the maintenance cycles containing no radiotherapy.CONCLUSION PRaG 3.0 might be a novel strategy for HER2-positive metastatic PDAC patients who failed from previous first-line approach and even PD-1 immunotherapy but needs more data in prospective trials.

Inetetamab combined with tegafur as second-line treatment for human epidermal growth factor receptor-2-positive gastric cancer: A case report

BACKGROUND Human epidermal growth factor receptor-2(HER-2)plays a vital role in tumor cell proliferation and metastasis.However,the prognosis of HER2-positive gastric cancer is poor.Inetetamab,a novel anti-HER2 targeting drug independently developed in China,exhibits more potent antibody-dependent cell-mediated cytotoxicity than trastuzumab,which is administered as the first-line treatment for HER2-positive gastric cancer in combination with chemotherapy.In this case,the efficacy and safety of inetetamab combined with tegafur was investigated as a second-line treatment for HER2-positive gastric cancer.CASE SUMMARY A 52-year-old male patient with HER2-positive gastric cancer presented with abdominal distension,poor appetite,and fatigue two years after receiving six cycles of oxaliplatin combined with tegafur as first-line treatment after surgery,followed by tegafur monotherapy for six months.The patient was diagnosed with postoperative recurrence of gastric adenocarcinoma.He received 17 cycles of a combination of inetetamab,an innovative domestically developed anti-HER2 monoclonal antibody,and tegafur chemotherapy as the second-line treatment(inetetamab 200 mg on day 1,every 3 wk combined with tegafur twice daily on days 1–14,every 3 wk).Evaluation of the efficacy of the second-line treatment revealed that the patient achieved a stable condition and progression-free survival of 17 months.He tolerated the treatment well without exhibiting any grade 3-4 adverse events.CONCLUSION Inetetamab combined with chemotherapy for the treatment of metastatic HER2-positive gastric cancer demonstrates significant survival benefits and acceptable safety.

Advances in targeted therapy for human epidermal growth factor receptor 2 positive in advanced gastric cancer

Emerging therapeutic methods represented by targeted therapy are effective supplements to traditional first-line chemoradiotherapy resistance.Human epidermal growth factor receptor 2(HER2)is one of the most important targets in targeted therapy for gastric cancer.Trastuzumab combined with chemotherapy has been used as the first-line treatment for advanced gastric cancer.The safety and efficacy of pertuzumab and margetuximab in the treatment of gastric cancer have been verified.However,monoclonal antibodies,due to their large molecular weight,inability to penetrate the blood-brain barrier,and drug resistance,lead to decreased therapeutic efficacy,so it is necessary to explore the efficacy of other HER2-targeting therapies in gastric cancer.Small-molecule tyrosine kinase inhibitors,such as lapatinib and pyrrotinib,have the advantages of small molecular weight,penetrating the blood-brain barrier and high oral bioavailability,and are expected to become the drugs of choice for perioperative treatment and neoadjuvant therapy of gastric cancer after validation by large-scale clinical trials in the future.Antibo-drug conjugate,such as T-DM1 and T-DXd,can overcome the resistance of monoclonal antibodies despite their different mechanisms of tumor killing,and are a supplement for the treatment of patients who have failed the treatment of monoclonal antibodies such as trastuzumab.Therefore,after more detailed stratification of gastric cancer patients,various gastric cancer drugs targeting HER2 are expected to play a more significant role.

Efficacy of recombinant human epidermal growth factor plus sodium hyaluronate eye drops in diabetic dry eye post-cataract surgery

BACKGROUND Dry eye syndrome(DES)after diabetic cataract surgery can seriously affect the patient’s quality of life.Therefore,effective alleviation of symptoms in patients with this disease has important clinical significance.AIM To explore the clinical effect of recombinant human epidermal growth factor(rhEGF)plus sodium hyaluronate(SH)eye drops on DES after cataract surgery in patients with diabetes.METHODS We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital,Affiliated Hospital of Nankai University between April 2021 and April 2023.They were classified into an observation group(42 cases,rhEGF+SH eye drops)and a control group(40 cases,SH eye drops alone),depending on the different treatment schemes.The therapeutic efficacy,dry eye symptom score,tear film breakup time(TFBUT),basic tear secretion score[assessed using Schirmer I test(SIt)],corneal fluorescein staining(FL)score,tear inflammatory markers,adverse reactions during treat-ment,and treatment satisfaction were compared between the two groups.RESULTS Therapeutic efficacy was higher in the observation group compared with the control group.Both groups showed improved TFBUT and dry eye,as well as improved SIt and FL scores after treatment,with a more pronounced improvement in the observation group.Although no marked differences in adverse reactions were observed between the two groups,treatment satisfaction was higher in the observation group.CONCLUSION rhEGF+SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy,fewer adverse reactions,and high safety levels.Thus,this treatment should be promoted in clinical practice.

Human epidermal growth factor receptor 2 expression level and combined positive score can evaluate efficacy of advanced gastric cancer

BACKGROUND Although treatment options for gastric cancer(GC)continue to advance,the overall prognosis for patients with GC remains poor.At present,the predictors of treatment efficacy remain controversial except for high microsatellite instability.AIM To develop methods to identify groups of patients with GC who would benefit the most from receiving the combination of a programmed cell death protein 1(PD-1)inhibitor and chemotherapy.METHODS We acquired data from 63 patients with human epidermal growth factor receptor 2(HER2)-negative GC with a histological diagnosis of GC at the Cancer Hospital,Chinese Academy of Medical Sciences between November 2020 and October 2022.All of the patients screened received a PD-1 inhibitor combined with chemotherapy as the first-line treatment.RESULTS As of July 1,2023,the objective response rate was 61.9%,and the disease control rate was 96.8%.The median progression-free survival(mPFS)for all patients was 6.3 months.The median overall survival was not achieved.Survival analysis showed that patients with a combined positive score(CPS)≥1 exhibited an extended trend in progression-free survival(PFS)when compared to patients with a CPS of 0 after receiving a PD-1 inhibitor combined with oxaliplatin and tegafur as the first-line treatment.PFS exhibited a trend for prolongation as the expression level of HER2 increased.Based on PFS,we divided patients into two groups:A treatment group with excellent efficacy and a treatment group with poor efficacy.The mPFS of the excellent efficacy group was 8 months,with a mPFS of 9.1 months after excluding a cohort of patients who received interrupted therapy due to surgery.The mPFS was 4.5 months in patients in the group with poor efficacy who did not receive surgery.Using good/poor efficacy as the endpoint of our study,univariate analysis revealed that both CPS score(P=0.004)and HER2 expression level(P=0.015)were both factors that exerted significant influence on the efficacy of treatment the combination of a PD-1 inhibitor and chemotherapy in patients with advanced GC(AGC).Finally,multivariate analysis confirmed that CPS score was a significant influencing factor.CONCLUSION CPS score and HER2 expression both impacted the efficacy of immunotherapy combined with chemotherapy in AGC patients who were non-positive for HER2.

An integrated graphic–taxonomic–associative approach to analyze human factors in aviation accidents

Human factors are critical causes of modern aviation accidents. However, existing accident analysis methods encounter limitations in addressing aviation human factors, especially in complex accident scenarios. The existing graphic approaches are effective for describing accident mechanisms within various categories of human factors, but cannot simultaneously describe inad- equate human-aircraft-environment interactions and organizational deficiencies effectively, and highly depend on analysts＇ skills and experiences. Moreover, the existing methods do not emphasize latent unsafe factors outside accidents. This paper focuses on the above three limitations and proposes an integrated graphi^taxonomic-associative approach. A new graphic model named accident tree （AceiTree）, with a two-mode structure and a reaction-based concept, is developed for accident modeling and safety defense identification. The AcciTree model is then integrated with the well-established human factors analysis and classification system （HFACS） to enhance both reliability of the graphic part and logicality of the taxonomic part for improving completeness of analysis. An associative hazard analysis technique is further put forward to extend analysis to fac- tors outside accidents, to form extended safety requirements for proactive accident prevention. Two crash examples, a research flight demonstrator by our team and an industrial unmanned aircraft, illustrate that the integrated approach is effective for identifying more unsafe factors and safety requirements.

Human factors quantification via boundary identification of flight performance margin

A systematic methodology including a computational pilot model and a pattern recognition method is presented to identify the boundary of the flight performance margin for quantifying the human factors. The pilot model is proposed to correlate a set of quantitative human factors which represent the attributes and characteristics of a group of pilots. Three information processing components which are influenced by human factors are modeled： information perception, decision making, and action execution. By treating the human factors as stochastic variables that follow appropriate probability density functions, the effects of human factors on flight performance can be investigated through Monte Carlo（MC） simulation. Kernel density estimation algorithm is selected to find and rank the influential human factors. Subsequently, human factors are quantified through identifying the boundary of the flight performance margin by the k-nearest neighbor（k-NN） classifier. Simulation-based analysis shows that flight performance can be dramatically improved with the quantitative human factors.

Relative importance of climate factors and human activities in impacting vegetation dynamics during 2000–2015 in the Otindag Sandy Land,northern China

In recent years, there has been increasing research interests in differentiating the relative importance of climate factors and human activities in impacting vegetation dynamics. In this study, based on residual trend method, we used MOD13A3（MODIS vegetation index product）, MCD12Q1（MODIS land cover product） and meteorological datasets to differentiate the relative importance of climate factors and human activities in impacting vegetation dynamics during 2000–2015 in the Otindag Sandy Land, northern China. Results show that during the study period（2000–2015）, the overall vegetation condition had improved in the Otindag Sandy Land. The driving forces of vegetation dynamics differed spatially in the whole study area over the study period. The area with vegetation degradation solely resulted from human activities accounted for 8.23% of the study area, while the area with vegetation degradation resulted from others（including climate factors and combination of climate factors and human activities） occupied 1.53%. The area with vegetation recovery benefitted from human activities occurred over 26.02% of the study area; the area benefitted from climate factors accounted for 23.69%; and the area benefitted from both climate factors and human activities occupied 37.74%. All in all, impacts of climate factors and human activities on vegetation dynamics varied at the county/city/banner scales and locality-specific measures should be adopted to protect the environments.

Production risk caused by human factors： a multiple case study of thermal power plants

Introduction： Thermal power plants are very popular in China. However, there has not been proportional research attention paid to production risk in these plants and human impact on production due to their importance in electricity generation. This study investigates production risks caused by human factors in thermal power plants and management methods to address identified human factors. Case description： Eighteen semi-structured interviews with front-line, middle and senior managers from four thermal power plants in China were carried out in this cross-sectional inductive study. Fault tree analysis and causal network analysis are used. Discussion and evaluation： We identify a range of production risks and human factors potentially influencing production in both negative and positive ways. We also recognize the most effective and practical relevant management methods to deal with identified human factors. Conclusion： By investigating production risk caused by human factors through the whole production process, this study emphasizes working attitude, safety consciousness, creativity and awareness of environmental protection as essential human factors potentially influencing production risks in thermal power plants. Through our analysis, by linking human factors to different types of production risk and supplying corresponding management methods to address these human factors, we offer practical human resource management approaches in the production management of thermal power plants.

Clinical observation of recombinant human nerve growth factor in the treatment of neurotrophic keratitis

AIM:To characterize changes of corneal nerve morphology and tear indices in patients with neurotrophic keratitis(NK)treated with recombinant human nerve growth factor(rhNGF).METHODS:In a prospective observational study,six patients(nine eyes)were locally treated with rhNGF.Visual acuity,corneal fluorescein staining score,the heights of the tear river,lipid layer thickness(LLT),tear ferning(TF)test,conjunctival impression cytology(CIC)examination,the densities of cornea subbasal nerve fibers were determined before and after treatment.RESULTS:Compared with baseline,there was a significant difference in corneal fluorescence staining scores(P<0.01);all patient corneal epithelial defects recovered completely within 8wk,but there was no significant improvement in the height of the tear river(P=0.202).LLT was significantly increased when compared with baseline(P=0.042);however,the function of conjunctival goblet cells and mucin content did not significantly improve using the TF test and CIC examination(P=0.557,P=0.539).After 8wk of treatment,the average corneal subbasal nerve fiber density increased significantly(P<0.01),as did the number of corneal nerve fiber branches(P=0.001).CONCLUSION:RhNGF can increase the density of corneal subbasal nerve fibers,promote the healing of persistent corneal epithelial defects and corneal ulcers in patients with NK,also improving tear function partially.