Objective To observe the subfoveal choroidal thickness (SFCT) and choriocapillary blood flow area (CBFA) in the patients with idiopathic macular hole (IMH).Methods This is a prospective clinical study.Thirty-two patients with unilateral IMH (4 in stage 2,17 in stage 3,11 in stage 4) and 32 age-and sexmatched normal controls were enrolled in this study.All eyes were divided into three groups,including group A (32 affected eyes),group B (32 fellow eyes) and group C (32 normal eyes of controls).There was no significant difference in age (t=0.865) and gender (x2=0.000) in IMH patients versus normal control subjects (P＞0.05).There was no significant difference in refraction (F=0.957) and ocular axial length (F=0.562) between group A,B and C.The SFCT was detected by enhanced depth imaging of spectral-domain optical coherence tomography (OCT).The CBFA was detected by OCT angiography.The differences of SFCT and CBFA in three groups were analyzed by Kruskal-Wallis and non-parametric test.Results The mean SFCT was (182.53 ±64.52) μtm in group A,(199.21 t73.07) μtm in group B and (254.21 ±56.85) μtm in group C respectively.The SFCT was thinner in group A and B than that in group C (Z=-4.362,-3.190;P＜0.05),but was the same in group A and B (Z=-1.171,P＞0.05).The mean CBFA was (5.09±0.31) mm2 in group A,(5.41 ±0.20) mm2 in group B and (5.39±0.15) mm2 in group C respectively.The CBFA was reduced in group A than that in group B and C (Z=-4.467,-4.048;P＜0.05),but was samc in group B and C (Z=0.420,P＞0.05).Conclusion SFCT and CBFA are both reduced in IMH eyes.

Ras-associated domain family 1A (RASSF1A) genes are members of the RASSF family, which bind to Ras in a guanosine triphosphate(GTP)-dependent manner and then induce Ras-mediated apoptosis. The protein encoded by the RASSF1A gene is similar to the Ras effector protein, which can interact with DNA repair protein XPA, and can also inhibit the accumulation of cyclin D1, thereby inducing cell cycle arrest. The deletion or abnormal expression of RASSF1A gene is related to the pathogenesis of various malignant tumors, indicating that it has tumor suppressor function. RASSF1A gene methylation has been found in at least 37 tumors, and RASSF1A gene may be the most frequently described methylated gene in human cancers. In this paper, the abnormal methylation of RASSF1A gene in different malignant tumors was introduced, and the research progress of its related effects and mechanisms in malignant tumors of the respiratory system, digestive system, genitourinary system, and nervous system in recent years was reviewed, with a view to malignant tumors early diagnosis, individual molecular targeted therapy and prognostic evaluation provide important guidance.

Objective To explore the systematic , standardized nursing intervention on stress response during perioperative period of Laser Assisted in Situ Keratomileusis (LASIK) patients.Methods A total of 200 cases of LASIK patients were randomly divided into the observation group and the control group with 100 cases in each group.The control group was treated with conventional care , while the observation group was treated with systematic and standardized nursing interventions .The blood pressure and anxiety scores of two groups of patients with heart rate were compared .Results Before the study the blood pressure , heart rate and anxiety scores between the groups had no significant difference (P>0.05).After the nursing intervention, the blood pressure, heart rate and anxiety scores were (112.73 ±16.95) mmHg, (76.43 ±11.29) beat/min and (32.67 ±3.94) in the observation group, which were significantly lower than (129.45 ±21.17) mmHg, (84.32 ±12.13) beat/min and (50.03 ±2.95) in the control group (t =-6.17, -4.76, -35.32, respectively;P<0.01).Conclusions The standardized and systematic nursing intervention can reduce the stress response of patients during the LASIK operation period and can help patients to better adapt to the operation.It can also improve the operation effect , promote the postoperative recovery and prevent the complications .

Objective:To understand the changing trend and influencing factors of lens power (LP) in children aged 3-12 in Jing'an District, Shanghai.Methods:A cross-sectional study was conducted.One hundred and thirty-one eyes of 131 patients with refractive errors were included in the Optometry Clinic of Shanghai Eye Hospital from October 2019 to January 2020.The 1% atropine sulfate was employed to dilate pupils for children aged 6 years or younger, and 0.5% topiramate for children older than 6 years.The axial length, mean keratometry (Km), anterior chamber depth (ACD), lens thickness (LT) and central corneal thickness (CCT) were measured using an IOL Master.The spherical equivalent (SE) and best corrected visual acuity (BCVA) were measured after cycloplegia using autorefractor and phoropter, and the LP was calculated using the Bennett formula.The patients were divided into different age groups, including 3-4 years group (16 eyes), 5-6 years group (20 eyes), 7-8 years group (25 eyes), 9-10 years group (33 eyes) and 11-12 years group (37 eyes). There were 57 eyes in the male group and 74 eyes in the female group.The patients were also divided into different refractive groups, including mild myopia group (38 eyes), moderate myopia group (12 eyes), high myopia group (25 eyes), emmetropia group (11 eyes), mild hyperopia group (9 eyes), moderate hyperopia group (13 eyes), and high hyperopia group (23 eyes). The differences in ocular biological parameter measurements between different age groups, different gender groups and different refractive groups were compared and the correlations between age, eye parameters and LP were analyzed using Pearson correlation analysis.The contribution of multiple influencing factors to LP was analyzed by multiple linear regression models.The study protocol followed the Declaration of Helsinki and was approved by an Ethics Committee of Shanghai General Hospital, Shanghai Jiao Tong University Hospital (No.2020KY018). Written informed consent was obtained from each guardian of the subject.Results:The average LP of children in the 3-4 years group, 5-6 years group, 7-8 years group, 9-10 years group and 11-12 years group were (27.35±1.88), (24.71±1.92), (22.92±1.87), (21.49±1.54) and (21.25±1.55) D, respectively.With the increase of age, the LP value was decreased gradually.There were significant differences between 3-4 years group and 5-6 years group, 5-6 years group and 7-8 years group, 7-8 years group and 9-10 years group (all at P<0.05). The average LP value of girls was obviously higher than that of boys ( t=-3.38, P<0.01). The LP value of the high myopia group was significantly lower than that of the emmetropia group, and the LP values of the moderate myopia and the low myopia group were significantly lower than that of the hyperopia group, and the LP values of the low hyperopia group and the moderate hyperopia group were significantly higher than that of the emmetropia group (all at P<0.05). The LP value was negatively correlated with age, AL, ACD and CCT ( r=-0.76, -0.79, -0.38, -0.18; all at P<0.05), and was positively correlated with SE and LT ( r=0.62, P<0.05; r=0.68, P<0.01). There was no obvious correlation between Km and LP ( r=0.07, P=0.45). The independent influencing factors of LP were analyzed through multiple linear regression equations, showing that LP=-0.430×AL+ 0.329×LT-0.267×age-0.108×gender-0.084×CCT (male=1, female=0). The standardized coefficients of each factor arranged in descending order were AL, LT, age, gender and CCT (all at P<0.05). Conclusions:The LP of children aged 3-12 in Jing'an District of Shanghai decreases with age and increases with SE.LP values of girls are higher than those of boys.

Objective:To construct a sensitive indicator system of specialized nursing quality for children with hematological tumors, so as to provide a reference for evaluating the nursing quality of children with hematological tumors.Methods:Taking Donabedian's "structure-process-outcome" three-dimensional quality model as the theoretical framework, the first draft of the index system was constructed through literature review. From January to February 2021, 15 clinical nursing and nursing management experts from the Department of Pediatrics and Hematology Oncology were selected by convenience sampling to conduct two rounds of expert consultation to determine the sensitive indicators system of specialized nursing quality for children with hematological tumors. Analytic hierarchy process was used to determine the weights of indicators at all levels.Results:Among two rounds of expert consultation, the effective recovery rates of the questionnaires were all 100.00% (15/15) , and the expert authority coefficient were all 0.85, and the Kendall harmony coefficients were from 0.397 to 0.609, and the differences were all statistically significant ( P<0.01) . The final formed sensitive indicators of specialized nursing quality for children with hematological tumors included 3 first-level indicators and 7 second-level indicators. Conclusions:The sensitive indicator system of specialized nursing quality for children with hematological tumors constructed based on the Delphi method is scientific and applicable, and the specialty features are outstanding. The indicator system can be used to standardize clinical nursing practice and improve the nursing quality of children with hematological tumors.