Myopia is an important public health issue.Great attention has been paid to myopia in children and teenager since its incidence is progressing rapidly worldwide, especially in Asia.Although there are substantial reports on both myopia progression and its risk factors in children and teenager, challenges are encountered when attempting to compare results among individual studies due to different population, definition of myopia, cycloplegic eye drops, refraction methods, and so on.This review aimed to summarize the reports on myopia progression and its risk factors such as age, gender, refractive state, near work, outdoor activities, parental myopia, or parental bearing age in children and teenager (＜18 years) since 1990.

Objective To compare the changes in optic disc parameters after intraocular pressure (lOP) reduction between primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG) eyes, and to determine if there is a difference of lamina eribrosa compliance between POAG and PACG. Design Prospective comparative study. Participants 36 PACG (49 eyes) and 35 POAG (49 eyes). Methods Patients underwent Heidelberg Retina Tomography (HRT Ⅱ) and Humphrey visual field test before IOP reduction. HRT and Humphrey visual field test were repeated one month after the IOP was reduced by laser, anti-glaucomatous medications or surgery treatment. Factors that affected the change in IOP were assessed including age, pretreatment IOP, IOP reduction, initial cup: disc ratio and diagnosis (POAG/PACG). Main outcome measures Changes of HRT parameters including cup area, mean cup depth, cup volume, and rim area after IOP reduction. Results The cup area, mean cup depth and cup volume decreased, and rim area in-creased significantly when the IOP was reduced (P<0.05), but there were no significant differences in the changes between PACG and POAG patients (P>0.05). Changes of these four HRT parameters were related to the amount of IOP reduction and the baseline ratio of cup to disc(P>0.05), but not related to age and pre-treatment IOP (P<0.05). Conclusions The cup became smaller and the rim area in-creased after IOP lowering with treatment in both POAG and PACG, and the magnitude of the change was similar in both groups. The lamina cribrosa compliance may not be different between POAG and PACG. (Ophthalmol CHN, 2009, 18: 264-269)

Glaucoma is the leading cause of irreversible blindness worldwide.Screening for glaucoma is a critical intervention to identify individuals at an earlier stage of the disease.However,there is controversy about the necessity of glaucoma screening.Screening is a critical intervention for primary prevention of disease.The screening which suited to the level of our economic development has important benefits for our country,society,families and individuals.Glaucoma has fulfils the criteria of WHO for population screening:(1) Glaucoma is a major public health problem in the world.(2) Glaucoma can be detected in its earlier stage.(3) There are suitable and acceptable examinations for glaucoma screening.(4) Early detection and subsequent treatment could delay or retard glaucoma disease progression.(5) With appropriate strategy design,glaucoma screening can creat good economic benefit.The screening strategies depend on the level of social economy development,the health policies of developed areas tend to prevent disease in its early stages.In poor areas,the limited medical resources are used to treat patients in the advanced stages.In the relatively developed area with complete health care facilities and incomplete referral mechanisms,screening for glaucoma is a critical intervention to identify individuals at an earlier stage of the disease.Glaucoma Screening project in Wenzhou suggested that screening should be implement in relatively developed regions of high density of population to improve efficiency;screening should aim for multiple eye diseases to lower the cost per unit benefit.

Background Blindness and low vision represent significant public health issues in China.Late diagnosis is the major reason for the irreversible vision impairment.A feasible,cost-effective screening and referral program is very important for the eye health care,prevention and treatment of blindness in China.Objective This study was to evaluate the feasibility and effectiveness of a health examination center-based opportunistic eye disease screening program.Methods This was a cross-sectional study.Subjects undergoing a routine physical examination at the health examination center of the Fourth People's Hospital of Shenyang were invited to attend this program.Presenting visual acuity,intraocular pressure,and nonmydriatic fundus photography were obtained.Optic diso photographs were evaluated independently by two ophthalmologists.Blindness and moderate to severe vision impairment were defined based on the criteria of World Health Organization Visual Impairment Classification in 2009.Glaucoma,diabetic retinopathy (DR) and other suspected eye diseases were diagnosed according to the fundus photography and intraocular pressure.This study was approved by Ethic Committe of the Fourth People's Hospital of Shenyang,the informed consent of each subject was obtained.Results Totally,15 303 subjects were enrolled and 15 197 of them finished the exanimations,giving a response rate of 99.3％.The overall percentage of blindness and moderate to severe visual impairment was 0.08％ (12/15 197) and 2.34％ (355/15 197).Two hundred and twenty-eight (1.50％) subjects were defined as glaucoma suspects and 80 individuals (0.53％) were diagnosed as epimacular membrane.Other suspected eye diseases included DR (0.41％),branchial retinal vessel occlusion (0.24％),macular degeneration (0.09 ％),and macular hole (0.06％).More than 95 ％ of the eye disease suspects have never been previously diagnosed or treated.A total of 358 subjects (2.36％) were defined as ocular hypertension suspects.Conclusions This health examination center-based opportunistic eye disease screening shows a good efficiency and feasibility.It may become an optional program in the national eye health care project,as well as the work of prevention and treatment of blindness.

Objective:To analyze the abnormal dose monitoring result of radiation staff in medical institutions and provide a basis for standardizing the personal dose management of radiation staff in medical institutions.Methods:Through the occupational radiation disease monitoring subsystem of the National Radiation Health Information Platform, 516 individual dose monitoring abnormal result of 410 radiation workers in a single monitoring period, which in 168 medical institutions under the 18 cities in Henan province were collected from 2020 to 2022 as research objects. Based on gender, age, length of service, occupational category, medical institution level, whether the dosimeter wearing standard, the abnormal result of radiation workers were grouped to analyze the influencing factors of individual dose monitoring result.Results:The incidence of abnormal individual dose monitoring result in 2020-2022 was 6.83 × 10 -3, 5.22 × 10 -3 and 6.30 × 10 -3, respectively. Abnormal results were mainly distributed in male radiology workers (66.83%), diagnostic radiology (59.51%) and interventional radiology (34.63%), tertiary (54.39%) and secondary medical institutions (36.34%). In the case of wearing personal dosimeter in a standard or irregular way, there were statistically significant differences in the incidence of abnormal outcomes between different levels of medical institutions and different occupational categories( χ2=14.42, 6.56, 32.96, 177.15, P<0.05). The median annual individual dose of radiology workers with " abnormal exposure dose" due to increased workload was 3.95 mSv, and the annual individual dose of interventional radiology workers was higher than that of radiotherapeutic workers ( Z=5.07, P<0.05). Conclusions:The education and training of radiological protection should be strengthened, and the wearing of individual dosimeters should be standardized; focus on the occupational exposure of interventional radiology staff, and take effective measures to reduce their exposure dose.

Objective:To explore whether thyroxine (T 4) could promote differentiated thyroid cancer (DTC) progression by binding to integrin α vβ 3in vitro and its downstream mechanism. Methods:Papillary thyroid cancer cell lines TPC-1, K1 and follicular thyroid cancer (FTC) cell line FTC133 were cultured in vitro, and the expressions of integrin α vβ 3 in those 3 DTC cell lines were determined with immunofluorescence and flow cytometry analysis. After the treatment of T 4, tetraiodo thyroacetic acid (Tetrac) and Arg-Gly-Asp (RGD) peptide alone or in combination, the proliferation and metastatic potential of DTC cell lines were detected by cell counting kit-8 (CCK-8), Transwell migration and invasion assays. The small interfering RNA (siRNA) transfection was used to verify whether integrin α v or β 3 subunit knockdown could reverse the effect of T 4 on DTC cells. The expression levels of downstream signaling proteins phosphorylated extracellular signal-regulated kinase (p-ERK)1/2 and total extracellular signal-regulated kinase (ERK)1/2 were detected by Western blot. The effects of mitogen-activated protein kinase kinase (MEK)1/2 inhibitor (GSK1120212) on the proliferation, migration and invasion of T 4-treated cells were detected. One-way analysis of variance and Tukey test were used for data analysis. Results:The integrin α vβ 3 expressions in TPC-1, K1 and FTC133 cells were all positive, with the relative mean fluorescence intensity (MFI) of 61.93±18.61, 16.89±2.43 and 32.36±0.83, and the percentages of positive cells of (94.38±1.30)%, (74.11±3.87)% and (50.67±1.78)%, respectively ( F values: 13.36 and 217.30, P=0.006 and P<0.001). Compared with control group, the proliferation, migration and invasion in the three DTC cell lines treated with T 4 were significantly enhanced (96 h, F values: 62.67-297.50, q values: 13.15-20.73, all P<0.001). T 4-induced cell proliferation, migration and invasion were markedly reversed by Tetrac or RGD (96 h, q values: 8.61-17.54, all P<0.001). T 4-induced cell proliferation, migration and invasion were also significantly inhibited by the knockdown of integrin α v or β 3 subunit (72 h, F values: 7.75-70.98, q values: 4.77-15.21, all P<0.05). Western blot results showed that the phosphorylation levels of ERK1/2 in DTC cells were significantly increased by T 4 treatment, and the T 4-induced activation of ERK1/2 signaling pathway could be blocked by Tetrac, RGD, integrin α v or β 3 subunit knockdown. T 4-induced cell proliferation, migration and invasion were significantly reversed by GSK1120212 (96 h, F values: 47.53-151.40, q values: 10.32-16.65, all P<0.001). Conclusion:T 4 can promote cell proliferation and metastasis of DTC cells by binding to integrin α vβ 3 and activating the ERK1/2 pathway.

Objective:To analyze clinical characteristics of recurrent appendicitis.Methods:A retrospective cohort study was carried out. Clinical data of patients who underwent appendectomy due to acute appendicitis confirmed by pathology in the Affiliated Hospital of Qingdao University from January 2011 to December 2015 were analyzed retrospectively. Exclusion criteria: (1) age of less than 18 years;(2) chronic appendicitis; (3) periappendiceal abscess; (4) appendiceal mucocele or mucinous neoplasms; (5) appendiceal neuroendocrine tumors or cancers; (6) appendicitis during pregnancy; (7) concurrent AIDS, hematological disease, autoimmune disease, inflammatory bowel disease or advanced cancer; (8) other simultaneous surgery. A total of 373 patients were enrolled the study. These patients were divided into the recurrent group (133 cases) and the first episode group (240 cases) according to the previous history of antibiotic therapy for acute appendicitis. The prevalence of recurrent appendicitis was calculated, and the clinical characteristics were analyzed, including gender, age, comorbidities and preoperative CT images.Results:Of 373 patients, 209 were male and 164 were female, with a median age of 42 (18 to 88) years. Median recurrent time of the recurrent group was 4 (1 to 60) months. Compared to the first episode group, the recurrent group had higher proportion of age <50 years [71.4% (95/133) vs. 57.5% (138/240), χ 2=7.081, P=0.008], higher proportion of concurrent diabetes [13.5% (18/133) vs. 5.4% (13/240), χ 2=7.399, P=0.007], shorter onset time [(41.7±13.6) hours vs. (59.4±56.2) hours, t=-3.286, P=0.001], lower proportion of abdominal tension and rebound pain [57.9% (77/133) vs. 66.7% (160/240), χ 2=5.065, P=0.024], lower score of modified Alvarado score [(5.6±1.9) point vs. (6.1±1.9) point, t=-2.417, P=0.016], lower WBC count [(10.5±4.6) ×10 9/L vs. (11.5±4.5)×10 9/L, t=-1.190, P=0.047], higher percentage of lymphocyte [(19.4±14.7)% vs. (16.1±13.3)%, t=2.069, P=0.039]. In the recurrent group, ratio of length of removed appendix ≥7 cm was higher as compared with the first episode group [44.4% (59/133) vs. 32.9% (79/240), χ 2=4.808, P=0.028], while the ratio of complicated appendicitis was significantly lower [8.3% (11/133) vs. 22.9% (55/240), χ 2=10.823, P=0.001]. CT images were available in 129 patients, intraluminal appendicoliths was found in 19 of 50 patients (38%) in the recurrent group, while in 16 of 79 patients (20.3%) in the first episode group, and there was statistically significant difference between the two groups (χ 2=4.880, P=0.027). Conclusions:Clinical characteristics of recurrent acute appendicitis include age less than 50 years, concurrent diabetes, short onset time, less abdominal tension or rebound pain, low modified Alvarado score, low WBC count, high percentage of lymphocyte, appendix length longer than 7 cm, non-complicated appendicitis and intraluminal appendicoliths.

Objective:To analyze clinical characteristics of recurrent appendicitis.Methods:A retrospective cohort study was carried out. Clinical data of patients who underwent appendectomy due to acute appendicitis confirmed by pathology in the Affiliated Hospital of Qingdao University from January 2011 to December 2015 were analyzed retrospectively. Exclusion criteria: (1) age of less than 18 years;(2) chronic appendicitis; (3) periappendiceal abscess; (4) appendiceal mucocele or mucinous neoplasms; (5) appendiceal neuroendocrine tumors or cancers; (6) appendicitis during pregnancy; (7) concurrent AIDS, hematological disease, autoimmune disease, inflammatory bowel disease or advanced cancer; (8) other simultaneous surgery. A total of 373 patients were enrolled the study. These patients were divided into the recurrent group (133 cases) and the first episode group (240 cases) according to the previous history of antibiotic therapy for acute appendicitis. The prevalence of recurrent appendicitis was calculated, and the clinical characteristics were analyzed, including gender, age, comorbidities and preoperative CT images.Results:Of 373 patients, 209 were male and 164 were female, with a median age of 42 (18 to 88) years. Median recurrent time of the recurrent group was 4 (1 to 60) months. Compared to the first episode group, the recurrent group had higher proportion of age <50 years [71.4% (95/133) vs. 57.5% (138/240), χ 2=7.081, P=0.008], higher proportion of concurrent diabetes [13.5% (18/133) vs. 5.4% (13/240), χ 2=7.399, P=0.007], shorter onset time [(41.7±13.6) hours vs. (59.4±56.2) hours, t=-3.286, P=0.001], lower proportion of abdominal tension and rebound pain [57.9% (77/133) vs. 66.7% (160/240), χ 2=5.065, P=0.024], lower score of modified Alvarado score [(5.6±1.9) point vs. (6.1±1.9) point, t=-2.417, P=0.016], lower WBC count [(10.5±4.6) ×10 9/L vs. (11.5±4.5)×10 9/L, t=-1.190, P=0.047], higher percentage of lymphocyte [(19.4±14.7)% vs. (16.1±13.3)%, t=2.069, P=0.039]. In the recurrent group, ratio of length of removed appendix ≥7 cm was higher as compared with the first episode group [44.4% (59/133) vs. 32.9% (79/240), χ 2=4.808, P=0.028], while the ratio of complicated appendicitis was significantly lower [8.3% (11/133) vs. 22.9% (55/240), χ 2=10.823, P=0.001]. CT images were available in 129 patients, intraluminal appendicoliths was found in 19 of 50 patients (38%) in the recurrent group, while in 16 of 79 patients (20.3%) in the first episode group, and there was statistically significant difference between the two groups (χ 2=4.880, P=0.027). Conclusions:Clinical characteristics of recurrent acute appendicitis include age less than 50 years, concurrent diabetes, short onset time, less abdominal tension or rebound pain, low modified Alvarado score, low WBC count, high percentage of lymphocyte, appendix length longer than 7 cm, non-complicated appendicitis and intraluminal appendicoliths.

Diabetes mellitus erectile dysfunction(DMED)is a common diabetic-related vascular,endo-crine and neuropathy in clinical practice,and patients with DMED often present with symptoms such as difficulty in erection,prolonged erection time,poor hardness,and short sexual intercourse.The etiological mechanism is complex,and it is often closely related to many factors such as oxidative stress(OS),inflammatory response,and neurological and endocrine lesions,which often cross-react and promote the progression of DMED lesions.In recent years,relevant studies have shown that OS and ferroptosis play a key role in DMED:OS can cause neuro-logical and Abnormal endocrine function,decreased synthesis or bioavailability of penile vascular endothelium,spongy endothelial cell dysfunction and decreased smooth muscle diastolic function,resulting in penile erectile dysfunction,and ferroptosis has also been confirmed to be closely related to DMED,controlling OS and ferroptosis to improve erectile function in diabetic patients is a reasonable and effective treatment pathway,but the mechanism of action of ferroptosis leading to DMED needs to be further studied.Therefore,this article reviews the latest infor-mation on the correlation between OS and ferroptosis and DMED,aiming to provide a useful reference for exploring the mechanism of DMED,clinical prevention and treatment of DMED,and providing potential directions for future research in this field.

Glaucoma is the leading irreversible blinding eye disease worldwide,and intraocular pressure(IOP)plays a key role in the occurrence and development of glaucoma.However,the underlying IOP regulatory mechanism remains un-clear.Currently,clinical IOP-lowering drugs work either by reducing aqueous humor formation or increasing aqueous hu-mor outflow with limited reduction amplitude.Recent studies demonstrate that IOP may be regulated by autonomic nerves.To understand the distribution and regulatory mechanism of autonomic nerves in the aqueous humor outflow pathway and provide new ideas for IOP-lowering study and novel drug exploration,we review the roles of the autonomic nervous system in the formation and outflow of aqueous humor in this article.