Objective:To compare the changes of corneal asphericity and higher-order aberrations after smart pulse technology-assisted transepithelial photorefractive keratectomy (Smart) for low and moderate myopia and to investigate the changes in the shape of the front corneal surface in patients with different diopters.Methods:A non-randomized controlled study design was used.Ninety-eight eyes of 54 patients with moderate or low myopia who underwent Smart surgery in Tianjin Medical University Eye Hospital from November 2018 to March 2019 were included.The 41 eyes of 23 patients with low myopia were set as the low-myopia group, and 57 eyes of 31 patients with moderate myopia were assigned as the moderate-myopia group.The Pentacam anterior segment analysis system was used to measure Q value, index of surface variance (ISV), corneal higher-order aberration (HOA), corneal vertical coma (Z 3-1), corneal horizontal coma (Z 31) and spherical aberration (Z 40) before surgery, 1 month and 3 months after surgery.The anterior surface morphology was compared between the low-myopia and moderate-myopia group.Pearson correlation analysis was used to analyze the correlations between measurement parameters.The study protocol was approved by an Ethics Committee of Tianjin Medical University Eye Hospital (No.2019KY-17). Written informed consent was obtained from each patient before surgery. Results:Corneal Q value, ISV, HOA and Z 40 were 0.445±0.191, 26.973±5.611, 0.671±0.142 and 0.384±0.188, respectively, in the low-myopia group at one month after surgery, which were significantly increased than corresponding preoperative values of -0.273±0.817, 13.784±2.376, 0.433±0.687 and 0.231±0.062 (all at P<0.05). Corneal Q value, ISV, HOA and Z 40 were 0.693±0.203, 34.038±5.773, 0.874±0.216 and 0.520±0.129, respectively, in the moderate-myopia group at one month after surgery, which were significantly increased than corresponding preoperative values of -0.309±0.104, 14.838±3.992, 0.409±0.081 and 0.228±0.089 (all at P<0.05). Corneal Q values, ISV, HOA and Z 40 in the moderate-myopia group were higher than those in the low-myopia group at different time points after surgery, showing significant differences between the two groups (all at P<0.05). There was no significant difference in postoperative 1-month and 3-month corneal Z 3-1 and Z 31 between the two groups (both at P>0.05). The results of correlation analysis showed that there were no significant differences in ΔQ value and ΔISV between the two groups, both of which were negatively correlated with spherical equivalent (ΔQ value: low-myopia group: r=-0.364, P=0.044; moderate-myopia group: r=-0.589, P<0.01; ΔISV: low-myopia group: r=-0.298, P=0.039; moderate-myopia group: r=-0.409, P=0.022). ΔQ value and ΔZ 40 were positively correlated in the moderate-myopia group ( r=0.348, P=0.009); there was no significant correlation between ΔQ value and ΔZ 40 in the low-myopia group ( r=0.180, P=0.266). Conclusions:The corneal high-order aberrations and ISV after Smart are increased in comparison with preoperative values in the low-myopia and moderate-myopia eyes, and the corneal Q values change from negative to positive.The effect of Smart on corneal asphericity is less in the low-myopia eyes.

【Objective】 To explore the risk factors for platelet transfusion refractoriness(PTR)in patients with hematological disorders, construct a prediction model and validate the model efficacy. 【Methods】 Patients with hematological disorders who received platelet transfusion therapy in the Chengdu Second People′s Hospital from December 2021 to December 2022 were retrospectively included to judge the effectiveness of platelet transfusion and screened for risk factors by univariate and multivariate logistic regression. A prediction model for PTR was constructed using receiver operating characteristic(ROC) curve, calibration curve and decision curve(DCA) to assess the differentiation, calibration and clinical value of the model, respectively. 【Results】 A total of 334 hematological patients were included, including 168 males and 176 females, with a PTR incidence of 40.4%. Univariate and multivariate logistic regression analysis showed that platelet transfusion volume, erythrocyte transfusion volume, and neutrophil ratio were risk factors for PTR(P<0.05). A prediction model for PTR in hematological patients was established based on these risk factors. The area under the model′s curve was 0.8377(95% CI: 0.723-0.772), the sensitivity was 58.52%, and the specificity was 89.95%. The calibration curve showed that the S∶P was 0.964, the maximum absolute difference Emax was 0.032, and the average absolute difference Eavg was 0.009. The DCA analysis showed that the model had clinical application value when the risk threshold ranged from 0.2 to 0.9. 【Conclusion】 The PTR prediction model based on platelet transfusion volume, erythrocyte transfusion volume and neutrophil ratio can provide a basis for effective platelet transfusion in hematological patients.