Objective To investigate the expression of interferon inducible protein-10 (IP-10) in peripheral blood mononuclear cells (PBMC) of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), and its correlation with disease severity.Methods Eighty patients with HBV-ACLF, 60 patients with chronic hepatitis B (CHB), and 25 healthy controls were enrolled from the Affiliated Hospital of Hubei University of Arts and Science during October 2013 and February 2015.IP-10 mRNA in PBMC was measured by real time quantitative PCR.Independent sample t test was used to analyze the difference in IP-10 mRNA expression between HBV-ACLF patients with model for end-stage liver disease (MELD) ＜ 30 and ≥30, and Pearson correlation test was performed to analyze the correlations of IP-10 mRNA expression with alanine aminotransferase (ALT), total bilirubin (TBil) and international normalized ratio (INR).Results The expressions of IP-10 mRNA in HBV-ACLF patients was 1.00 ± 0.19, which was higher than those in CHB patients and healthy controls (0.64 ± 0.08 and 0.41 ± 0.06, t =3.841 and 16.661, all P ＜ 0.01).The expression of IP-10 mRNA in HBV-ACLF patients with MELD ＜ 30 was 0.96 ±0.19, which was lower than that in patients with MELD ≥ 30 (1.14 ± 0.21, t =-2.283, P ＜0.05).Pearson correlation analysis showed that IP-10 mRNA level in HBV-ACLF patients was positively correlated with ALT, TBil and INR (r =0.697, 0.738 and 0.775, all P ＜ 0.01).Conclusion IP-10 mRNA is over-expressed in PBMC of patients with HBV-ACLF, and it is correlated with disease severity, which suggests that IP-10 may play an important role in the progression of liver failure.

CD4+CD25+ Regulatory T cells (Treg) have been found to down-regulate immune activation in HIV-1 infection. However, whether the depletion of Treg benefits to the disease status of HIV infection remains undefined. To address this issue, we enumerated the Treg absolute counts and frequency in 75 antiviral-na(i)ve HIV-1-infected individuals in this study. It was found that HIV-infected patients displayed a significant decline in Treg absolute counts but a significant increase in Treg frequency. In addition, with disease progression indicated by CD4 T-cell absolute counts, circulating Treg frequency gradually increased; while Treg absolute counts were gradually decreased, suggesting that the alteration of Treg number closely correlated with disease progression in HIV infection.Functional analysis further showed that Treg efficiently inhibit both CD4 and CD8 T cell proliferation in vitro. Thus, our findings indicates that Treg actively participate in pathogenesis of chronic HIV infection,influencing the disease progression.

Abstract Myopia has become a major global public health problem. Exposure to outdoor light may explain the protective effect of outdoor activities on myopia. Currently, a growing number of studies focus on the effects of the spectrum on eye health. Recent studies have found that violet light may have a protective effect on myopia, but the mechanism of action between violet light and myopia is not yet fully understood. The paper reviews the association between violet light and myopia prevention and control, and the possible mechanisms of violet light and myopia to provide a reference value for further exploration of the role of violet light on myo pia .

Objective: To describe the linear growth trajectory and BMI growth trajectory of children aged 0-6 years, and to investigate the relationship between different growth trajectory patterns and refractive error of preschool children. Methods: The participants were selected from Ma anshan Birth Cohort Study (MABC), which was established from May 2013 to September 2014. In this study, 15 follow up interviews were conducted among 2 037 live births between 42 days after birth and 72 months of age to collect the data of body length and body weight. And at the age of (72±6) months, data of the naked eye visual acuity was measured by professional ophthalmologist in Ma anshan Maternal and Child Health Hospital. The latent class growth model was conducted to identify distinct linear growth trajectory and BMI Z score trajectories of 0 to 6 year old infants and young children. Multinomial Logistic regression model was used for analyzing the relationship between distinct growth trajectories and ametropia in 6-year-old children. Results: According to the latent class growth model, children showed three obvious linear growth trajectories: slow growth trajectory ( n =302), normal growth trajectory ( n =1 162), and fast growth trajectory ( n =573). And BMI growth trajectory were also divided into three patterns: slow growth trajectory ( n =630), normal growth trajectory ( n =1 058), and fast growth trajectory ( n =349). Multinomial Logistic regression analysis showed that linear slow growth trajectory was a risk factor for hyperopia in 6-year-old children ( OR =1.80, 95% CI =1.09-2.98, P <0.05). But it was not significantly associated with myopia. There was no significant correlation between fast growth BMI pattern and slow growth BMI pattern with myopia and hyperopia in 6-year-old children. Conclusion Slower growth patterns in linear growth trajectories were associated with hyperopia in 6-year-old children.It should pay close attention to the height growth pattern of preschool children. Regular examination of physical development indicators and distance vision can help prevent the occurrence and development of ametropia in preschool children.

Objective: To analyze the effects of outdoor activities, sedentary behaviors and sleep duration on the risk of poor vision among primary and secondary school students after replacing them with each other, so as to provide a reference for precise intervention in the prevention and control of myopia among children and adolescents. Methods: From March to May 2023, a stratified cluster random sampling method was used to select 6 132 students in grades 4 to 12 in Hefei, Wuhu, Suzhou and Chizhou cities in Anhui Province. A questionnaire survey was conducted to collect the basic information, outdoor activities, sedentary behavior, and sleep duration, and a visual inspection was carried out by 5 m standard logarithmic visual acuity chart. The single activity model, segmentation model and isotemporal substitution model were used to analyze the relationship between outdoor activities, sedentary behaviors, sleep, and poor vision, and stratified analysis was performed by gender. Results: The detection rate of poor vision among the 6 132 primary and secondary school students was 76.9%, and the detection rate of poor vision was higher for girls ( 81.1 %) than for boys (72.6%), and the difference was statistically significant ( χ 2=61.37, P <0.01). The results of the single activity model and segmentation model showed that outdoor activity and sleep duration were correlated with a reduced risk of poor vision in primary and secondary school students ( OR =0.87, 0.88; 0.88, 0.91), while sedentary behavior was correlated with an increased risk of poor vision ( OR =1.05, 1.03) ( P <0.05). The results of the isotemporal substitution model showed that replacing the same amount of sedentary behavior with 1 h/d of outdoor activity was associated with 15% reduction in the risk of poor vision ( OR = 0.85), and replacing the same amount of sedentary behavior with 1 h/d of sleep was associated with a 12% reduction in the risk of poor vision ( OR =0.88) ( P <0.05). The results of the isotemporal substitution model stratified by gender showed that replacing the same amount of sedentary behavior with 1 h/d of outdoor activity and 1 h/d of sleep were associated with 22% and 8% reduction in the risk of poor vision in male students ( OR =0.78, 0.92), and replacing the same amount of sedentary behavior with 1 h/d of sleep was associated with 18% reduction in the risk of poor vision in female students ( OR =0.82) ( P <0.05). Conclusion Replacing sedentary behavior with 1 h/d of outdoor activity for boys and 1 h/d of sleep for girls and boys could reduce the risk of poor vision.

Objective To study the correlation between the levels of IP-10 mRNA in peripheral blood mononuclear cells (PBMCs) and prognosis of acute-on-chronic hepatitis B virus related liver failure (HBV-ACLF).Methods Fifty patients diagnosed with HBV-ACLF were administered a combined modality therapy and followed up until death or for 3 months.In addition,20 patients with chronic hepatitis B(CHB),20 patients with hepatitis B related cirrhosis and 20 healthy volunteers were matched for use as control.The levels of IP-10 mRNA in PBMCs were detected at baseline and last follow-up visit and compared between groups by statistical analysis.Results At baseline,the CHB group had a significantly higher level of IP-10 mRNA in PBNCs than the healthy control group(t =-6.972,P ＜0.01).However,the level of IP-10 mRNA in PBMCs of the liver failure group was significantly higher than that of boththe CHB group(t =2.510,P ＜ 0.05) and the healthy control group (t =8.648,P ＜ 0.01).When patients within the liver failure group were divided by survival and death occurring during the 3-month follow-up period,the patients who died were found to have a significantly higher level of IP-10 mRNA in PBMCs than the surviving patients(P ＜ 0.01).The area under the curve of ROC curve is 0.81,and cut off value is 0.9255.Conclusion The level of IP-10 mRNA in PBMCs is positively correlated with risk of death in patients with HBV-ACLF,and its detecting might predict the prognosis of HBV-ACLF.

Objective: To explore two visual acuity standards for examining uncorrected visual acuity (UCVA) to define poor vision in lower grade elementary school students, and to compare the difference of screening myopia rates when combined with non cycloplegic auto refraction (NCAR), so as to provide a scientific basis for standardizing UCVA examination methods using CAR as the gold standard of authenticity and reliability. Methods: From March 22nd to April 9th, 2023, a total of 549 first and second grade students aged 7-8 years from a primary school in Hefei City were selected for the study by convenient cluster sampling method. Two methods were employed for UCVA examination:the first method involved charts where the student could not make mistakes in identifying at least half of the characters per line (V1), and the second method used charts with character sizes ranging from 4.0 -4.5, 4.6-5.0 and 5.1-5.3, without allowing 1, 2 and 3 errors per line (V2). While NCAR was performed, then 187 students underwent CAR examination. Paired Wilcoxon rank-sum test and McNemar test were used to compare the differences between V1 and V2 methods in defining poor vision and screening myopia rates. Using CAR as the gold standard, the authenticity and reliability of defining screening myopia rates through the combination of V1 and V2 methods along with NCAR were evaluated. Results: The UCVA examination results for V1 and V2 showed statistically significant differences in both the right eye [5.0(4.9,5.0), 4.9(4.8,5.0)] and the left eye [ 5.0 (4.9,5.0), 4.9(4.8,5.0)] ( Z=-13.95, -13.34, P <0.01). The detection rates of poor vision for the right eye were 43.53% for V1 and 63.21% for V2, and the left eye with 44.08% for V1 and 62.11% for V2, with statistically significant differences ( χ 2= 106.01 , 95.09, P <0.01). When screening myopia rates were assessed for UCNA methods combined with NCAR, the right eye rates were 21.49% for V1 and 24.59% for V2, and the left eye rates were 21.31% for V1 and 23.13% for V2, with statistically significant differences ( χ 2=15.06, 8.10, P <0.01). Using CAR as the gold standard, the detection rates in the right eye and left eye were 16.58 % and 17.11%, respectively. The Youden indices for defining screening myopia in the right eye were 0.80 for V1 and 0.79 for V2, and the left eye with 0.85 for V1 and 0.83 for V2. The agreement rates for the right eye were 91.98 % for V1 and 89.30% for V2, and the left eye with 94.12% for V1 and 91.98% for V2. The Kappa values for the right eye were 0.73 for V1 and 0.67 for V2, and the left eye with 0.81 for V1 and 0.75 for V2. Conclusions Authenticity and reliability of two UCVA examination methods combined with NCAR in defining screening myopia are higher in V1 than V2 methods. It is recommended to unify the visual acuity examination methods by requiring the correct identification of more than half of the total number of visual markers in a row.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.