AIM: To explore the impact of myopia severity in adolescents on the vascular density in the optic disc area and macular thickness, as well as their correlationship.METHODS: Cross-sectional study. A total of 106 cases(176 eyes)of adolescent myopia patients who chose Shanghai Zhongye Hospital for treatment were selected as the research subjects. They were divided into three groups according to the spherical equivalent(SE): low myopia, moderate myopia and high myopia. The vascular density in the optic disc area, macular thickness and microperimetry-related indicators of the three groups were compared. The correlation of the vascular density in the optic disc area with macular thickness was analyzed, as well as the mediating role of the two in SE with the average macular light sensitivity(MLS)of the retina.RESULTS: The baseline characteristics of the three groups of patients were comparable. With the increase of myopia degree, SE, the vessel density in all directions and the average vascular density of the optic disc area, the thickness of all regions of the macular area except the fovea, and the related indicators of microperimetry all decreased significantly, while the axial length and the thickness of the macular fovea increased significantly(all P<0.05). The generalized additive model showed that the vascular density in all directions and the average vascular density of the optic disc area, and the thickness of all regions of the macular area except the fovea had a negative impact on the degree of myopia, while the thickness of the macular fovea had a positive impact(all P<0.05). Pearson correlation analysis indicated that the vascular density of the optic disc area negatively correlated with the thickness of the macular fovea, and positively correlated with the thickness of other regions of the macula(all P<0.05). The mediation effect analysis showed that the thickness of all regions of the macula and the vascular density of some areas of the optic disc area had a significant mediating regulatory effect between SE and the overall MLS(all P<0.001).CONCLUSION: With the increase of myopia degree, the vascular density in the optic disc area and the thickness of all regions of the macula except the fovea decrease, while the thickness of the macular fovea increases; the vascular density in the optic disc area negatively correlated with the thickness of the macular fovea, and positively correlated with the thickness of other regions; the thickness of the macula and the vascular density in the optic disc area play a significant mediating role between SE and MLS.

This study aims to compare the vaccination rates and incidence of adverse reaction rates following administration of two domestically produced human papillomavirus (HPV) vaccines in individuals aged 9-30 years,investigate the impact of distinct manufacturing processes and vaccination schedules on adverse reaction rates. From November 2023 to June 2024, the Immunization Planning Department of Liuzhou Center for Disease Control and Prevention conducted a single-center, randomized, open-label, parallel-group trial using community-based recruitment of eligible participants aged 9 to 30 years. Participants were randomly assigned to receive either of two domestically produced HPV vaccines (Walrinvax or Cecolin). As specified in the vaccine package inserts, subjects were stratified into a two-dose regimen group (aged 9-14 years) and a three-dose regimen group (aged 15-30 years). Vaccination rates were recorded, and adverse reactions within 0-30 days post-vaccination were monitored. The results showed that a total of 400 participants were enrolled. Both the full vaccination rate and the timely completion rate were significantly higher in the two-dose regimen group compared to the three-dose regimen group (Fisher′s exact test, P<0.01; χ2=7.06, P<0.01). A total of 985 doses were administered. The overall adverse reaction rate was 18.78% (185/985), with local and systemic reactions occurring at 8.02% (79/985) and 10.76% (106/985), respectively. The most frequent adverse reactions were injection site pain (4.97%, 49/985) and fever (4.47%, 44/985). No grade 4 or special-interest adverse events were reported.The incidence of adverse reactions for the two domestic HPV vaccines with different production processes (at 0/6 months) was 13.96% (55/394) and 17.46% (69/395) respectively, with no statistically significant difference (χ2=1.83, P>0.05).The adverse reaction rate was significantly lower in the 9-14 years group (9.77%) compared the 15-30 years group (24.91%)(χ 2=35.67, P<0.01). In conclusion, both domestic HPV vaccines demonstrated a favorable safety profile in the 9-30 years age group, with mostly mild adverse reactions. Compared to the three-dose schedule (15-30 years group), the two-dose HPV vaccination schedule (9-14 years group) significantly reduced the incidence of adverse reactions and improved vaccination compliance.

Objective:To summarize the clinical characteristics of focal cerebral arteriopathy (FCA) in children, and to analyze its influencing factor of prognosis.Methods:A retrospective cohort study was conducted. Clinical data from 40 children with FCA who were hospitalized at the Department of Neurology, Beijing Children′s Hospital, Capital Medical University, from September 2015 to August 2024 were collected. A centralized follow-up was conducted in October 2024 via outpatient clinics or the internet. The pediatric stroke outcome measure (PSOM) was used to evaluate their outcomes. Based on the PSOM, the children were further divided into a group with normal neurological function and another group with abnormal neurological function. Differences between groups were analyzed using the Mann-Whitney U test and Fisher exact test. Univariate Logistic regression analysis was performed to identify the influencing factors for neurological outcomes in children with FCA. Results:A total of 40 children were included, with 20 males and 20 females, and the onset age of 9.2 (6.8, 12.5) years. Among them, 12 cases (30%) had a history of varicella within 1 year before onset. There were 23 cases (58%) presenting with transient ischemic attack (TIA) or recurrent fluctuating symptoms of onset, while 3 cases (8%) developed progressive stroke within the first month of onset. The M1 segment of the middle cerebral artery was the most commonly affected vascular site, with a total of 16 cases (40%). Arterial occlusion occurred in 8 cases (20%). Lumbar puncture was completed in 36 children, and white blood cell counts in cerebrospinal fluid was increased in 6 cases. All 23 patients who completed magnetic resonance vessel wall imaging (VWI) showed circular enhancement of the arterial wall. A total of 28 patients (70%) received antiplatelet or anticoagulation therapy, and 16 patients (40%) received hormone therapy. At admission, the pediatric National Institute of Health Stroke Scale (PedNIHSS) score was 6.0 (2.0, 8.8) points, which decreased to 0.5 (0, 3.0) points at discharge. The follow-up duration was 1.6 (0.8, 4.9) years, with 1 case lost to follow-up. There was 1 case presenting with recurrence course manifesting as TIA. Among the 39 cases who completed the follow-up, 23 cases (59%) were assessed as neurologically normal by PSOM, while 16 cases (41%) were assessed as neurologically abnormal. Among the 29 cases who completed the imaging review, magnetic resonance angiography (MRA) review in 23 cases indicated stability or improvement in the original arterial stenosis, with 6 cases experiencing transient worsening of arterial stenosis early in the disease course (within 2 months), which later improved. Arterial stenosis progression occurred in 6 cases at the final review of 29 cases who completed the imaging review, with 1 case developing progressive cerebral arteriopathy. The proportion of patients with headache, altered consciousness, and aphasia in the abnormal neurological function group, as well as the PedNISS scores at admission and discharge, were all higher than those in the normal neurological function group (all P<0.05). Univariate Logistic regression analysis revealed that only a PedNISS score>6 points at onset was an influencing factor for abnormal neurological function ( OR=20.58, 95% CI 3.93-107.70, P<0.001). Conclusions:Childhood FCA often presents with fluctuating onset, and the proximal segment of the middle cerebral artery is frequently affected. Progression of arterial stenosis is common within 2 months of the disease course, but clinical progression and new ischemic lesions are uncommon. Most patients have a favorable long-term prognosis. PedNIHSS score>6 points at admission is related to abnormal neurological function outcomes.

Objective:To analyze the prenatal ultrasonographic features and prognosis of fetal perirenal urinoma.Methods:This retrospective study included eight fetuses with perirenal urinoma diagnosed by prenatal ultrasound in the Women and Children's Hospital of Chongqing Medical University from January 2017 to August 2023. Descriptive analysis was performed on their prenatal ultrasonographic features, intrauterine intervention measures, postnatal treatment, and prognosis.Results:Among the eight cases, the prenatal ultrasonographic diagnosis was consistent with the postnatal clinical diagnosis in seven cases, with one misdiagnosis (postnatally confirmed as giant renal cyst with multicystic dysplastic kidney). Prenatal ultrasonographic features of fetal perirenal urinoma included cystic mass adjacent to the renal capsule; obvious compression of the surrounding organs and the affected kidney; increased craniocaudal diameter of the affected kidney with thin parenchyma, increased echogenicity, indistinct corticomedullary differentiation, and pyeletasis; poorly visualized partial renal arteries; normal or mildly enlarged contralateral kidney; adequate bladder filling; normal amniotic fluid volume. Two cases underwent intrauterine cyst aspiration with subsequent cyst size reduction (slight re-enlargement during follow-up). Among the remaining six untreated cases, one case showed stable cyst size, while five cases exhibited initial significant cyst enlargement followed by stabilization or regression trend. All eight cases were born at full term (three delivered vaginally and five by cesarean section). The affected kidney was significantly atrophied within one week after birth by ultrasound observation. Impaired function of the affected kidney was shown in four patients by follow-up after discharge (including two cases of intrauterine treatment),one case abandoned treatment due to other illnesses, two cases were lost to follow-up after discharge.Conclusions:Prenatal ultrasound images of perirenal urinary cysts infetuses exhibit typical features. Intrauterine treatment can reduce the compression of large cysts and hydronephrosis on fetal organs, but there is no significant improvement in the recovery of renal function.

This paper reports the clinical data and the diagnosis and treatment of a patient with exogenous insulin autoimmune syndrome(EIAS)induced by long-term use of exogenous insulin(Eucrin 50).For diabetes patients with hyperinsulin-induced hypoglycemia,detection of IAA is helpful for diagnosis EIAS.Due to different test methods affect IAA results,if negative,EIAS cannot be completely excluded.The polyethylene glycol precipitation method can assist in early diagnosis.

This paper reports the clinical data and the diagnosis and treatment of a patient with exogenous insulin autoimmune syndrome(EIAS)induced by long-term use of exogenous insulin(Eucrin 50).For diabetes patients with hyperinsulin-induced hypoglycemia,detection of IAA is helpful for diagnosis EIAS.Due to different test methods affect IAA results,if negative,EIAS cannot be completely excluded.The polyethylene glycol precipitation method can assist in early diagnosis.

This study aims to compare the vaccination rates and incidence of adverse reaction rates following administration of two domestically produced human papillomavirus (HPV) vaccines in individuals aged 9-30 years,investigate the impact of distinct manufacturing processes and vaccination schedules on adverse reaction rates. From November 2023 to June 2024, the Immunization Planning Department of Liuzhou Center for Disease Control and Prevention conducted a single-center, randomized, open-label, parallel-group trial using community-based recruitment of eligible participants aged 9 to 30 years. Participants were randomly assigned to receive either of two domestically produced HPV vaccines (Walrinvax or Cecolin). As specified in the vaccine package inserts, subjects were stratified into a two-dose regimen group (aged 9-14 years) and a three-dose regimen group (aged 15-30 years). Vaccination rates were recorded, and adverse reactions within 0-30 days post-vaccination were monitored. The results showed that a total of 400 participants were enrolled. Both the full vaccination rate and the timely completion rate were significantly higher in the two-dose regimen group compared to the three-dose regimen group (Fisher′s exact test, P<0.01; χ2=7.06, P<0.01). A total of 985 doses were administered. The overall adverse reaction rate was 18.78% (185/985), with local and systemic reactions occurring at 8.02% (79/985) and 10.76% (106/985), respectively. The most frequent adverse reactions were injection site pain (4.97%, 49/985) and fever (4.47%, 44/985). No grade 4 or special-interest adverse events were reported.The incidence of adverse reactions for the two domestic HPV vaccines with different production processes (at 0/6 months) was 13.96% (55/394) and 17.46% (69/395) respectively, with no statistically significant difference (χ2=1.83, P>0.05).The adverse reaction rate was significantly lower in the 9-14 years group (9.77%) compared the 15-30 years group (24.91%)(χ 2=35.67, P<0.01). In conclusion, both domestic HPV vaccines demonstrated a favorable safety profile in the 9-30 years age group, with mostly mild adverse reactions. Compared to the three-dose schedule (15-30 years group), the two-dose HPV vaccination schedule (9-14 years group) significantly reduced the incidence of adverse reactions and improved vaccination compliance.

Objective:To summarize the clinical characteristics of focal cerebral arteriopathy (FCA) in children, and to analyze its influencing factor of prognosis.Methods:A retrospective cohort study was conducted. Clinical data from 40 children with FCA who were hospitalized at the Department of Neurology, Beijing Children′s Hospital, Capital Medical University, from September 2015 to August 2024 were collected. A centralized follow-up was conducted in October 2024 via outpatient clinics or the internet. The pediatric stroke outcome measure (PSOM) was used to evaluate their outcomes. Based on the PSOM, the children were further divided into a group with normal neurological function and another group with abnormal neurological function. Differences between groups were analyzed using the Mann-Whitney U test and Fisher exact test. Univariate Logistic regression analysis was performed to identify the influencing factors for neurological outcomes in children with FCA. Results:A total of 40 children were included, with 20 males and 20 females, and the onset age of 9.2 (6.8, 12.5) years. Among them, 12 cases (30%) had a history of varicella within 1 year before onset. There were 23 cases (58%) presenting with transient ischemic attack (TIA) or recurrent fluctuating symptoms of onset, while 3 cases (8%) developed progressive stroke within the first month of onset. The M1 segment of the middle cerebral artery was the most commonly affected vascular site, with a total of 16 cases (40%). Arterial occlusion occurred in 8 cases (20%). Lumbar puncture was completed in 36 children, and white blood cell counts in cerebrospinal fluid was increased in 6 cases. All 23 patients who completed magnetic resonance vessel wall imaging (VWI) showed circular enhancement of the arterial wall. A total of 28 patients (70%) received antiplatelet or anticoagulation therapy, and 16 patients (40%) received hormone therapy. At admission, the pediatric National Institute of Health Stroke Scale (PedNIHSS) score was 6.0 (2.0, 8.8) points, which decreased to 0.5 (0, 3.0) points at discharge. The follow-up duration was 1.6 (0.8, 4.9) years, with 1 case lost to follow-up. There was 1 case presenting with recurrence course manifesting as TIA. Among the 39 cases who completed the follow-up, 23 cases (59%) were assessed as neurologically normal by PSOM, while 16 cases (41%) were assessed as neurologically abnormal. Among the 29 cases who completed the imaging review, magnetic resonance angiography (MRA) review in 23 cases indicated stability or improvement in the original arterial stenosis, with 6 cases experiencing transient worsening of arterial stenosis early in the disease course (within 2 months), which later improved. Arterial stenosis progression occurred in 6 cases at the final review of 29 cases who completed the imaging review, with 1 case developing progressive cerebral arteriopathy. The proportion of patients with headache, altered consciousness, and aphasia in the abnormal neurological function group, as well as the PedNISS scores at admission and discharge, were all higher than those in the normal neurological function group (all P<0.05). Univariate Logistic regression analysis revealed that only a PedNISS score>6 points at onset was an influencing factor for abnormal neurological function ( OR=20.58, 95% CI 3.93-107.70, P<0.001). Conclusions:Childhood FCA often presents with fluctuating onset, and the proximal segment of the middle cerebral artery is frequently affected. Progression of arterial stenosis is common within 2 months of the disease course, but clinical progression and new ischemic lesions are uncommon. Most patients have a favorable long-term prognosis. PedNIHSS score>6 points at admission is related to abnormal neurological function outcomes.

Objective:To analyze the prenatal ultrasonographic features and prognosis of fetal perirenal urinoma.Methods:This retrospective study included eight fetuses with perirenal urinoma diagnosed by prenatal ultrasound in the Women and Children's Hospital of Chongqing Medical University from January 2017 to August 2023. Descriptive analysis was performed on their prenatal ultrasonographic features, intrauterine intervention measures, postnatal treatment, and prognosis.Results:Among the eight cases, the prenatal ultrasonographic diagnosis was consistent with the postnatal clinical diagnosis in seven cases, with one misdiagnosis (postnatally confirmed as giant renal cyst with multicystic dysplastic kidney). Prenatal ultrasonographic features of fetal perirenal urinoma included cystic mass adjacent to the renal capsule; obvious compression of the surrounding organs and the affected kidney; increased craniocaudal diameter of the affected kidney with thin parenchyma, increased echogenicity, indistinct corticomedullary differentiation, and pyeletasis; poorly visualized partial renal arteries; normal or mildly enlarged contralateral kidney; adequate bladder filling; normal amniotic fluid volume. Two cases underwent intrauterine cyst aspiration with subsequent cyst size reduction (slight re-enlargement during follow-up). Among the remaining six untreated cases, one case showed stable cyst size, while five cases exhibited initial significant cyst enlargement followed by stabilization or regression trend. All eight cases were born at full term (three delivered vaginally and five by cesarean section). The affected kidney was significantly atrophied within one week after birth by ultrasound observation. Impaired function of the affected kidney was shown in four patients by follow-up after discharge (including two cases of intrauterine treatment),one case abandoned treatment due to other illnesses, two cases were lost to follow-up after discharge.Conclusions:Prenatal ultrasound images of perirenal urinary cysts infetuses exhibit typical features. Intrauterine treatment can reduce the compression of large cysts and hydronephrosis on fetal organs, but there is no significant improvement in the recovery of renal function.

Objective:To investigate the therapeutic effect of naringenin on diabetes retinopathy (DR) rats by regulating Janus kinase 2 (JAK2) /signal transducer and activator of transcription 3 (STAT3) /suppressor of cytokine signaling 1 (SOCS1) signaling pathway.Methods:A DR rat model was constructed and randomly separated into DR group, naringenin group, activator group, and naringenin+activator group, with normal rats as the control group. After intervention according to corresponding groups, blood glucose and glycosylated hemoglobin of rats were detected. Retinal tissue was separated, and interleukin-6 (IL-6), IL-1β, glutathione (GSH), and catalase (CAT) were detected. The pathological changes in rats and blood retinal vascular barrier permeability were detected, and the retinal tissue adhesion factor 1 (VCAM-1), anti vascular endothelial growth factor (VEGF) mRNA, and JAK2/STAT3/SOCS1 pathway related proteins were detected.Results:In the control group, blood glucose levels were (5.16±0.53) mmoL, glycosylated hemoglobin (4.26±0.45) %, IL-6 (63.11±6.35) pg/mL, IL-1β (23.11±2.38) pg/mL, Evans blue (EB) content (4.72±0.49) ng/mg, VCAM-1 (1.02±0.11), VEGF mRNA expression (0.93±0.10), p-JAK2/JAK2 (0.24±0.03), p-STAT3/STAT3 (0.19±0.02), GSH (17.62±1.81) nmoL/mg, CAT (11.68±1.19) IU/mg, and SOCS1 expression 1.44±0.16; while in DR group, blood glucose were (18.85±1.89) mmoL, HBA1c (11.62±1.18) %, IL-6 (89.17±8.99) pg/mL, IL-1β (52.11±5.28) pg/mL, EB (10.24±1.08) ng/mg, VCAM-1 1.56±0.16, VEGF 1.61±0.18, P-JAK2/JAK2 0.55±0.06 and P-STAT3/STAT3 0.47±0.05, all decreased compared with that of the control group ( P<0.05). The expressions of GSH were (8.27±0.88) nmoL/mg, CAT (6.85±0.71) IU/mg and SOCS1 0.86±0.09 in group DR, all increased compared with those of the control group ( P<0.05). In naringin group, blood glucose was (13.11±1.34) mmoL, HBA1c (7.36±0.76) %, IL-6 (67.08±6.75) pg/mL, IL-1β (31.61±3.22) pg/mL, EB content was (6.15±0.63) ng/mg, VCAM-1 1.15±0.12, VEGF mRNA expression 1.17±0.12, P-JAK2 /JAK2 0.29±0.03, and P-STAT3 /STAT3 0.21±0.03, all lower than those in DR Group ( P<0.05). However, the expressions of GSH were (15.22±1.59) nmoL/mg, CAT (10.95±1.11) IU/mg, and SOCS1 (1.37±0.15) ,all higher than those of DR group ( P<0.05). The activator reversed the protective effect of naringenin on DR Rats. Conclusion:Naringenin improves DR rat injury by regulating the JAK2/STAT3/SOCS1 signaling pathway.