AIM: To compare the diagnostic efficiency of binocular uncorrected distance visual acuity(UCDVA), pre-cycloplegia refraction spherical equivalent(PR-SE), axial length(AL)difference, and their different combinations in the screening of anisometropia in children and adolescents, and to evaluate the practical value of different indicator combinations in simplifying the screening process when taking cycloplegic retinoscopy results as the gold standard for diagnosing anisometropia.METHODS: This was a retrospective study. A total of 500 consecutive cases of children and adolescents aged 6-18 years with known refractive status were included. Taking cycloplegic retinoscopy results as the gold standard for anisometropia diagnosis, the binocular UCDVA, PR-SE, and AL difference were incorporated into ROC curve analysis to assess the diagnostic efficacy of each indicator. Furthermore, predictive models were constructed and reliability analysis was performed.RESULTS: The average age of the included cases was 10.75±2.24 years, including 239 males and 261 females. The AUC of the interocular PR-SE difference(0.972, 95%CI: 0.960-0.984)was significantly higher than that of other indicators. The Youden index was the largest when the bincular UCDVA difference was 0.25, the PR-SE difference was 0.743, and the AL difference was 0.31. When the interocular PR-SE difference used 0.743 and 1.00 D as screening cutoffs, the former had a higher AUC(AUC=0.924, 95%CI: 0.895-0.953). Comparison of different constructed predictive models showed that when the binocular PR-SE difference was ≥0.743 D, the negative predictive value reached 98.89%, making it suitable for initial screening. The combination of UCDVA+PR-SE+AL had the highest specificity and positive predictive value, while the PR-SE+AL combination had the highest consistency rate.CONCLUSION: The binocular PR-SE difference is the best choice for single-indicator screening. Combining UCDVA and AL can increase the specificity to 98.00% and the positive predictive value to 88.24%. The PR-SE+AL combination can achieve the highest consistency rate.

To investigate the mechanism of action of Syngnathus extract in treating knee osteoarthritis of rats, forty-eight male SD rats were randomly divided into the blank group, model group, positive drug group, as well as low-dose, medium-dose, and high-dose groups of Syngnathus extract. The rat model of knee osteoarthritis was constructed by intra-articular injection of sodium iodoacetate. After successful modeling, celecoxib(18 mg·kg~(-1)·d~(-1)) and Syngnathus extract(0.4, 0.8, and 1.6 g·kg~(-1)·d~(-1)) were given in different groups by gavage intervention for two weeks. Hematoxylin-eosin(HE) staining was used to observe the histopathological changes of cartilage in knee joints, and enzyme-linked immunosorbent assay(ELISA) was used to detect the expression level of inflammatory factors in serum. Real-time fluorescence quantitative PCR, Western blot, and immunohistochemistry were used to detect the levels of phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/mammalian target protein of rapamycin(mTOR) pathway-related mRNA and protein expression. The results showed that, comparied with the blank group, the cartilage surface of the knee joints of rats in the model group was uneven, with disorganized levels and defective cartilage tissue. The serum levels of interleukin-1β(IL-1β), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α) and the mRNA levels of PI3K, Akt, and mTOR in cartilage tissue, as well as the protein expression levels of phosphorylated PI3K(p-PI3K)/PI3K, phosphorylated Akt(p-Akt)/Akt, phosphorylated mTOR(p-mTOR)/mTOR, and P62 were significantly increased. Beclin1 protein expression was decreased. Comparied with the model group, the number of chondrocytes in the knee joint of rats in each group of Syngnathus extract increased, and the arrangement of chondrocytes was relatively neat. The cartilage layer was restored, and the serum levels of IL-1β, IL-6, and TNF-α, as well as the mRNA expression levels of PI3K, Akt, and mTOR in cartilage tissue were significantly reduced. The protein expression levels of p-PI3K/PI3K, p-Akt/Akt, p-mTOR/mTOR, and P62 were significantly reduced in the rats in the middle-dose and high-dose groups of Syngnathus extract, and the Beclin1 protein expression was significantly increased. The protein expression levels of p-PI3K/PI3K, p-Akt/Akt, and P62 in rats in the low-dose group of Syngnathus extract were significantly reduced. In summary, Syngnathus extract may be used to treat knee osteoarthritis by inhibiting the expression of PI3K/Akt/mTOR signaling pathway, so as to alleviate the inflammatory response in the organism, enhance the autophagy activity of chondrocytes, and reduce the apoptosis of chondrocytes.
Animals ; TOR Serine-Threonine Kinases/genetics* ; Male ; Rats, Sprague-Dawley ; Signal Transduction/drug effects* ; Proto-Oncogene Proteins c-akt/genetics* ; Rats ; Osteoarthritis, Knee/metabolism* ; Drugs, Chinese Herbal/administration & dosage* ; Phosphatidylinositol 3-Kinases/genetics* ; Humans

This study predicts the potential mechanism of Hippocampus in the treatment of knee osteoarthritis(KOA) through network pharmacology, with preliminary verification using molecular docking and animal experiments. The database was used to screen the active chemical components of Hippocampus and the targets of KOA, and Gene Ontology(GO) functional analysis, Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis, and molecular docking were performed on the relevant core targets to preliminarily explore the potential targets and mechanisms of Hippocampus in the treatment of KOA. A rat KOA model was constructed by intra-articular injection of sodium iodoacetate, and the rats were intervened with different doses of Hippocampus decoction and celecoxib. The expression of relevant targets was detected through hematoxylin-eosin(HE) staining, enzyme-linked immunosorbent assay(ELISA), RT-qPCR, and Western blot to further validate the network pharmacology results. A total of 23 drug-like components of the Hippocampus were screened, and 128 common targets with KOA were identified, involving interleukin-17(IL-17) signaling pathway, transcription factor(FoxO) signaling pathway, tumor necrosis factor(TNF) signaling pathway. Molecular docking results showed that the screened core chemical components exhibited good affinity with key targets. HE staining demonstrated that Hippocampus improved the morphology of the cartilage layer. ELISA confirmed that Hippocampus significantly reduced the levels of IL-6 and TNF-α in the serum of KOA rats. Western blot and RT-qPCR analysis showed that Hippocampus significantly reduced the expression of IL-6, TNF-α, matrix metalloproteinase(MMP) 13, IL-17A, nuclear factor κB activator 1(ACT1), tumor necrosis factor receptor-associated factor 6(TRAF6) and nuclear factor κB(NF-κB) in cartilage tissue. The results suggest that Hippocampus can alleviate the degree of joint damage in the KOA rat model induced by sodium iodoacetate. The mechanism of action is related to the inhibition of the IL-17 signaling pathway, reduction of inflammation, and inhibition of extracellular matrix(ECM) degradation.
Animals ; Molecular Docking Simulation ; Rats ; Drugs, Chinese Herbal/administration & dosage* ; Network Pharmacology ; Male ; Osteoarthritis, Knee/metabolism* ; Rats, Sprague-Dawley ; Signal Transduction/drug effects* ; Humans ; Interleukin-17/metabolism* ; Tumor Necrosis Factor-alpha/metabolism* ; Disease Models, Animal ; Hippocampus/chemistry*

AIM: To evaluate the value of the ratio of axial length to corneal radius of curvature(AL/CR)in the diagnosis of myopia in children and adolescents.METHODS: The refraction and ocular biometric parameters of 2 182 cases of children and adolescents(4 364 eyes)who initially visited the optometry clinic of the Second People's Hospital of Beihai from January 2022 to December 2023 were collected and analyzed.RESULTS: The receiver operating characteristic curve(ROC curve)showed that AL/CR had a higher area under the curve(AUC=0.925, 95%CI: 0.917-0.933)in diagnosing myopia. When AL/CR was 3.053, the Youden index was the largest. As the threshold of AL/CR decreased, the sensitivity of myopia diagnosis increased, while the specificity decreased. Compared with screening myopia, the sensitivity of AL/CR=3.053 in diagnosing myopia was low, but the specificity was high, especially in the cases of hyperopia and pre-myopia.CONCLUSION: The accuracy of AL/CR in diagnosing myopia is superior to that of axial length and average corneal curvature, with higher specificity. As the threshold of AL/CR decreases, the sensitivity of diagnosing myopia increases, but the specificity decreases. In cases of hyperopia and pre-myopia, the specificity of AL/CR in diagnosing myopia is higher than that of screening myopia.

This article aims to comprehensively explore the progress of binocular vision function examination of intermittent exotropia(IXT)and its relationship with ametropia. As a common type of strabismus, IXT not only affects patients' visual experience and mental health, but also may develop into constant exotropia as they age. This article outlines the definition, prevalence, and clinical manifestations of IXT; introduces the examination methods of IXT, including strabismus angle examination, eye position control evaluation, and changes in accommodation and convergence functions. The article also explores the changes in stereopsis and other related examinations in IXT patients, providing a scientific basis for the comprehensive evaluation of IXT. In addition, the article deeply analyzes the relationship between IXT and ametropia, especially myopia, anisometropia, and hyperopia, pointing out the importance of refractive correction in improving binocular vision function and promoting the recovery of stereopsis. This article aims to provide references for clinical work and help doctors better understand the diagnosis and treatment of IXT.

Background A simple measurement of central venous pressure (CVP)-mean by the digital monitor display has become increasingly popular. However, the agreement between CVP-mean and CVP-end (a standard method of CVP measurement by analyzing the waveform at end-expiration) is not well determined. This study was designed to identify the relationship between CVP-mean and CVP-end in critically ill patients and to introduce a new parameter of CVP amplitude (ΔCVP= CVPmax - CVPmin) during the respiratory period to identify the agreement/disagreement between CVP-mean and CVP-end.Methods In total, 291 patients were included in the study. CVP-mean and CVP-end were obtained simultaneously from each patient. CVP measurement difference (|CVP-mean - CVP-end|) was defined as the difference between CVP-mean and CVP-end. The ΔCVP was calculated as the difference between the peak (CVPmax) and the nadir value (CVPmin) during the respiratory cycle, which was automatically recorded on the monitor screen. Subjects with |CVP-mean - CVP-end|≥ 2 mmHg were divided into the inconsistent group, while subjects with |CVP-mean - CVP-end| < 2 mmHg were divided into the consistent group.Results ΔCVP was significantly higher in the inconsistent group [7.17(2.77) vs.5.24(2.18), P<0.001] than that in the consistent group. There was a significantly positive relationship between ΔCVP and |CVP-mean - CVP-end| (r=0.283, P <0.0001). Bland-Altman plot showed the bias was -0.61 mmHg with a wide 95% limit of agreement (-3.34, 2.10) of CVP-end and CVP-mean. The area under the receiver operating characteristic curves (AUC) of ΔCVP for predicting |CVP-mean - CVP-end| ≥ 2 mmHg was 0.709. With a high diagnostic specificity, using ΔCVP<3 to detect |CVP-mean - CVP-end| lower than 2mmHg (consistent measurement) resulted in a sensitivity of 22.37% and a specificity of 93.06%. Using ΔCVP>8 to detect |CVP-mean - CVP-end| >8 mmHg (inconsistent measurement) resulted in a sensitivity of 31.94% and a specificity of 91.32%.Conclusions CVP-end and CVP-mean have statistical discrepancies in specific clinical scenarios. ΔCVP during the respiratory period is related to the variation of the two CVP methods. A high ΔCVP indicates a poor agreement between these two methods, whereas a low ΔCVP indicates a good agreement between these two methods.
Humans ; Central Venous Pressure ; Respiration ; ROC Curve

Objective The radioactivity level survey was carried out in Weizhou Island area of Beihai, to comprehensively master the radiation environment status in the area, understand the natural radioactivity level and its distribution law, and provide basic data for scientific evaluation of radiation environment quality. Methods According to the relevant standards and technical specifications, the air absorbed dose rate of gamma radiation in Weizhou Island area was monitored from April 2020 to March 2021, the concentrations of radionuclides in water, soil and other environmental samples were sampled and analyzed, and the monitoring results were analyzed and discussed in combination with the regional characteristics. Results The results show that the air absorbed dose rate of gamma radiation in Weizhou Island area ranges from 0.2～122 nGy/h; the activity concentrations of ²³⁸U, ²²⁶Ra, ²³²Th, ⁴⁰K and ¹³⁷Cs in solid samples range 17.0～37.3 Bq/kg, < 0.501～29.5 Bq/kg, < 0.766～54.3 Bq/kg, 18.7～369 Bq/kg and < 0.212～1.48 Bq/kg, respectively, the concentrations of U and Th in well water and reservoir water range 0.065～0.25 μg/L, 0.046～0.079 μg/L, the activities of ²²⁶Ra, ⁴⁰K, total α and total β range 1.42～3.08 mBq/L, 0.069～0.231 Bq/L, 0.025～0.163 Bq/L, 0.082～0.572 Bq/L, respectively, the concentrations of U and Th in seawater samples range 1.81～2.25 μg/L, 0.634～0.648 μg/L, and the activities of ²²⁶Ra, ⁴⁰K, ⁹⁰Sr and ¹³⁷Cs range 9.38～19.7 mBq/L, 11.3～11.8 Bq/L、0.193～0.866 mBq/L、1.13～1.42 mBq/L. Conclusion The environmental ionizing radiation level in Weizhou island of Beihai is in the range of background fluctuation and at a relatively low level, indicating that the radiation environmental quality of Weizhou Island and its surrounding areas is good.

Child Compound Endothelium Corneum(CCEC)has the effects in invigorating the spleen and appetizing the appetite, and dissolving the accumulation of food. The recent studies have proved that it could improve gastrointestinal motility, restore physiological gastrointestinal peristalsis, increase gastrointestinal digestive motility, and enhance appetite. This trial aimed to evaluate its clinical efficacy and safety in the treatment of children's anorexia(spleen-stomach disharmony). A total of 240 children with anorexia in line with the inclusion and exclusion criteria were selected and randomly divided into experimental group and control group, with 120 in each group. Patients in the experimental group took CCEC and Erpixing Granules simulant. Patients in the control group took Erpi-xing Granules and CCEC simulant. After 21 days of treatment, there was no statistical difference in the recovery rate of anorexia, reduced food intake, eating time, weight change, traditional Chinese medicine syndrome effect, single symptom effect, and trace element Zn recovery rate between the two groups. Based on the non-inferiority test, the experimental group was not inferior to the control group in efficacy. How-ever, the effect of CCEC in reducing appetite in children with anorexia was better than that of control drugs(P<0.05). There was no statistical difference in the incidence of adverse events and adverse reactions between the two groups during the trial. This experiment confirmed the efficacy and safety of CCEC in the treatment of children's anorexia(spleen-stomach disharmony), with a safety and re-liability in clinical application. In addition, it was a better choice for children with anorexia who were mainly manifested by reduced appetite. Meanwhile, compared with granule, chewable tablets were more convenient to take in clinic. Therefore, the efficacy and safety of CCEC for the treatment of children's anorexia(spleen-stomach disharmony) were not inferior to those of Erpixing Granules, with a safety and reliability in clnic. However, due to the small sample size of this trial, the efficacy results only show a trend. It is suggested to further carry out a large-sample-size clinical study to define the clinical advantages of CCEC.
Anorexia/drug therapy* ; Child ; Double-Blind Method ; Endothelium ; Humans ; Reproducibility of Results ; Spleen ; Stomach ; Treatment Outcome

AIM: To understand the prevalence of refractive state of primary school students in Haicheng district, Beihai city.

METHODS: Cross-sectional study and cluster sampling were used. A total of 30 716 students aged 6 to 14 from 15 primary schools in Haicheng district, Beihai city, who had taken physical examination from October 2019 to January 2020, were selected for visual acuity and pupil diopter. SPSS17.0 statistical software was used for data analysis.

RESULTS: In the eyes of the 15 primary schools monitored in this study, 30 716 cases had mild myopia(29.62%), 0.50D < astigmatism < 2.00D(25.43%), metropia(21.05%)and mild hyperopia(15.85%). With the growth of age, the proportion of emmetropia and farsightedness declined as awhole. The proportion of myopia is on the rise. A total of 1 894 cases of wearing glasses 3 788 eyes. The rate of poor vision was 23.30%, and the rate of qualified correction of frame glasses was 64.57%. Compared with the left eye, the difference was statistically significant, and the P50 of the right eye was more negative than that of the left eye. The equivalent spherical mirror was compared between boys and girls. The difference was statistically significant, and the P50 of equivalent spherical mirror of girls was more negative than that of boys.

CONCLUSION: With the growth of age, the proportion of mild hyperopia and squarely eyes decreases year by year; The proportion of myopia increases year by year; Among the students with poor eyesight, the number of those who regularly wear glasses is small; However, after wearing glasses, there are still some students whose glasses are not up to standard. The refractive state of the right eye is more negative than that of the left eye; Female students tend to be more negative than male students in the refractive state.

Objective: Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear. Methods: A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( Results: Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks. Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
Adult ; Aged ; COVID-19/virology* ; China/epidemiology* ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome