Cataract surgery is one of the most common ophthalmologic procedures. Advances in technology and medical policies have made it more precise. Residual refractive errors and deviation of target diopters are a main cause of dissatisfaction among patients. Refractive enhancement after cataract surgery can correct or eliminate these errors, improving patients' visual quality of life. There are multiple options for correcting residual refractive errors. The best approach depends on factors like the cause of the error, degrees of residual refractive errors, type of intraocular lens, ocular comorbidities, and patient preference. This paper summarizes the incidence and types of residual refractive errors, advancements in refractive enhancement surgeries, and provides practical solutions for clinical practice.

Abstract Breastfeeding has an irreplaceable effect on the growth and development of premature infants and the reduction of complications during hospitalization. In recent years, with the opening of China′s birth policy, the incidence of premature babies has increased, and the corresponding complications have also gradually increased. Breast milk not only carries a rich supply of nutrients, including rich proteins, lipids, sugars to support the normal growth and development of infants, but also contains a large number of immunoglobulins, hormones and other bioactive substances to promote the improvement of body immune function and the development of nervous system. In recent years, many studies have been carried out on the current situation of breast milk operation in breast milk bank, the collection and influencing factors of breast milk, the strategies of breast milk enrichment and its effects on the growth and development of premature infants and complications. Therefore, breast-feeding and intensive breast-feeding can effectively promote the growth and development of premature infants, and reduce the occurrence of complications.

Objective : To explore the polymorphism of endothelial nitric oxide synthase(eNOS) gene in umbilical cord blood of preterm infants and its relationship with major complications in preterm infants. Methods : A total of 254 preterm infants(<37 weeks) who were hospitalized were selected as the study subjects. Umbilical cord blood was collected at delivery to determine the genotypes and alleles of eNOS gene at three loci: rs61722009, rs2070744,and rs1799983. Clinical data of the preterm infants were recorded, and the relationship between eNOS gene polymorphism and major complications in preterm infants was analyzed. Results: (1) The TC+CC genotype at locus rs2070744 was an independent risk factor for bronchopulmonary dysplasia(BPD) in preterm infants, with an OR(95%CI) of 1.266(1.017-1.577).(2) The GT+TT genotype at locus rs1799983 was an independent risk factor for retinopathy prematurity(ROP), with an OR(95%CI) of 1.184(1.008-1.391).(3) The AB+AA genotype at locus rs61722009 was also an independent risk factor for ROP,with an OR(95%CI) of 1.335(1.033-1. 726).(4) There was no significant relationship between gene polymorphism and the occurrence of respiratory distress syndrome( RDS) and periventricular-intraventricular hemorrhage( PIVH). Conclusion eNOS gene polymorphism is associated with the occurrence of BPD and ROP in preterm infants. The evaluation of e NOS gene polymorphism by umbilical cord blood measurement is helpful for the prevention and correct management of some serious complications.

Objective To investigate the relationships of serum levels of Xenin-25 and activin A with pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 269 pregnant women with GDM admitted to our hospital between December 2020 and February 2023 were enrolled.Serum levels of Xenin-25 and activin A were measured,and pregnancy outcomes were recorded.Based on pregnancy outcomes,patients were divided into poor pregnancy outcome group(91 cases)and good pregnancy outcome group(178 cases).The influencing factors of adverse preg-nancy outcomes of GDM patients and the predictive value of Xenin-25 and activin A for GDM preg-nancy outcomes were analyzed.Results The poor pregnancy outcome group had higher age,pre-pregnancy body mass index(BMI),proportion of adverse obstetric history,as well as levels of fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),and activin A compared to the good preg-nancy outcome group,and serum level of Xenin-25 was lower in the poor pregnancy outcome group(P＜0.05).High HbA1c and high activin A levels were identified as risk factors for pregnancy out-comes in GDM patients,while high Xenin-25 was a protective factor for pregnancy outcomes(P＜0.05).The areas under the curve(AUCs)for predicting adverse pregnancy outcomes in GDM pa-tients using Xenin-25 and activin A were 0.895 and 0.865,respectively,while the AUC for com-bined prediction was 0.981,which was higher than that of Xenin-25 or activin A alone(P＜0.05).Conclusion Xenin-25 and activin A in GDM patients are associated with adverse pregnancy outcomes and can serve as biomarkers for predicting pregnancy outcomes.

Objective:To analyze the clinical characteristics and outcomes of Haemophilus influenzae (Hi) meningitis in children. Methods:This is a retrospective case series study. This study included 34 Hi meningitis patients who admitted to Beijing Children′s Hospital, Capital Medical University, from January 1, 2010, to December 31, 2023. Data on clinical presentations, laboratory tests, hearing assessment and outcomes at discharge were collected. Patients were divided into 2 groups according to the outcome at discharge: favorable outcome group and unfavorable outcome group. Mann-Whitney U test and Fisher exact test was used to estimate the risk factors for an unfavorable outcome at discharge. Results:Thirty-four patients were enrolled. There were 16 males and 18 females. The age at onset ranged from 3 months to 12 years. Fever (34 patients (100%)), convulsions (17 patients (50%)), and coma (21 patients (62%)) were the common clinical presentations. Twenty-four patients (71%) developed complications. There were 15 patients (44%) needed treatment in the intensive care unit, 5 patients (15%) received intubation, and 4 patients (12%) had developed shock. The favorable outcome group included 23 patients, and the unfavorable outcome group included 11 patients. Female, patients with limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L were risk factors of unfavorable outcome at discharge (all P<0.05). Among the 23 patients (68%) in favorable outcomes group, 13 patients (57%) had data available on their long-term follow-up results, including 12 patients with favorable long-term outcomes and 1 patient with unfavorable long-term outcome. Among the 11 patients (32%) in unfavorable outcomegroup, 1 patient died, the other 10 patients (91%) had data available on their long-term outcomes. Eight patients had unfavorable long-term outcomes and 2 patients with favorable long-term outcomes. Patients who had unfavorable outcomes at discharge were at a greater risk of experiencing unfavorable long-term outcomes ( P=0.001). Conclusions:It is common for patients with Hi meningitis to have intracranial complications or develop into critical conditions. Patients who have limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and who exhibit a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L tend to have unfavorable outcomes; they need to be assessed for sequelae.

Objective To investigate the relationship between serum G protein-coupled estrogen receptor 1(GPER1),complement factor H(CFH)levels and pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 120 patients with GDM(GDM group)and 60 healthy pregnant women(control group)were included in this study.According to the pregnancy outcome,GDM patients were divided into the adverse pregnancy outcome(APO)group(50 cases)and the non-APO group(70 cases).The basic data of GDM patients were collected.Fasting blood glucose,fasting insulin and blood lipids were measured,and homeostasis model assessment of insulin resistance index(HOMA-IR)was calculated.The serum levels of GPER1 and CFH were detected by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to analyze the correlation between serum levels of GPER1,CFH and HOMA-IR in GDM patients.Multivariate unconditional Logistic regression and receiver operating characteristic(ROC)curve were used to analyze the relationship between serum GPER1 and CFH levels and APO in GDM patients and to predict energy efficiency.Results Compared with the control group,serum levels of GPER1 and CFH were increased in the GDM group(P<0.05).Serum GPER1 and CFH levels were positively correlated with HOMA-IR in GDM patients(r=0.722 and 0.714,respectively,P<0.001).Compared with the non-APO group,serum levels of GPER1 and CFH were increased in the APO group(P<0.05).Elevated levels of HOMA-IR,GPER1 and CFH were independent risk factors for APO in GDM patients(P<0.05).The combined prediction of serum GPER1 and CFH[AUC=0.887(95%CI:0.816-0.937)]was superior to serum GPER1[AUC=0.789(95%CI:0.705-0.858)]and CFH[AUC=0.786(95%CI:0.701-0.856)]alone in predicting APO in GDM patients.Conclusion Serum levels of GPER1 and CFH in GDM patients are increased,which are closely related to the enhancement of insulin resistance and APO.The combination of the two has a higher predictive efficiency for APO.

Objective To investigate the relationship between serum G protein-coupled estrogen receptor 1(GPER1),complement factor H(CFH)levels and pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 120 patients with GDM(GDM group)and 60 healthy pregnant women(control group)were included in this study.According to the pregnancy outcome,GDM patients were divided into the adverse pregnancy outcome(APO)group(50 cases)and the non-APO group(70 cases).The basic data of GDM patients were collected.Fasting blood glucose,fasting insulin and blood lipids were measured,and homeostasis model assessment of insulin resistance index(HOMA-IR)was calculated.The serum levels of GPER1 and CFH were detected by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to analyze the correlation between serum levels of GPER1,CFH and HOMA-IR in GDM patients.Multivariate unconditional Logistic regression and receiver operating characteristic(ROC)curve were used to analyze the relationship between serum GPER1 and CFH levels and APO in GDM patients and to predict energy efficiency.Results Compared with the control group,serum levels of GPER1 and CFH were increased in the GDM group(P<0.05).Serum GPER1 and CFH levels were positively correlated with HOMA-IR in GDM patients(r=0.722 and 0.714,respectively,P<0.001).Compared with the non-APO group,serum levels of GPER1 and CFH were increased in the APO group(P<0.05).Elevated levels of HOMA-IR,GPER1 and CFH were independent risk factors for APO in GDM patients(P<0.05).The combined prediction of serum GPER1 and CFH[AUC=0.887(95%CI:0.816-0.937)]was superior to serum GPER1[AUC=0.789(95%CI:0.705-0.858)]and CFH[AUC=0.786(95%CI:0.701-0.856)]alone in predicting APO in GDM patients.Conclusion Serum levels of GPER1 and CFH in GDM patients are increased,which are closely related to the enhancement of insulin resistance and APO.The combination of the two has a higher predictive efficiency for APO.

Objective:To analyze the clinical characteristics and outcomes of Haemophilus influenzae (Hi) meningitis in children. Methods:This is a retrospective case series study. This study included 34 Hi meningitis patients who admitted to Beijing Children′s Hospital, Capital Medical University, from January 1, 2010, to December 31, 2023. Data on clinical presentations, laboratory tests, hearing assessment and outcomes at discharge were collected. Patients were divided into 2 groups according to the outcome at discharge: favorable outcome group and unfavorable outcome group. Mann-Whitney U test and Fisher exact test was used to estimate the risk factors for an unfavorable outcome at discharge. Results:Thirty-four patients were enrolled. There were 16 males and 18 females. The age at onset ranged from 3 months to 12 years. Fever (34 patients (100%)), convulsions (17 patients (50%)), and coma (21 patients (62%)) were the common clinical presentations. Twenty-four patients (71%) developed complications. There were 15 patients (44%) needed treatment in the intensive care unit, 5 patients (15%) received intubation, and 4 patients (12%) had developed shock. The favorable outcome group included 23 patients, and the unfavorable outcome group included 11 patients. Female, patients with limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L were risk factors of unfavorable outcome at discharge (all P<0.05). Among the 23 patients (68%) in favorable outcomes group, 13 patients (57%) had data available on their long-term follow-up results, including 12 patients with favorable long-term outcomes and 1 patient with unfavorable long-term outcome. Among the 11 patients (32%) in unfavorable outcomegroup, 1 patient died, the other 10 patients (91%) had data available on their long-term outcomes. Eight patients had unfavorable long-term outcomes and 2 patients with favorable long-term outcomes. Patients who had unfavorable outcomes at discharge were at a greater risk of experiencing unfavorable long-term outcomes ( P=0.001). Conclusions:It is common for patients with Hi meningitis to have intracranial complications or develop into critical conditions. Patients who have limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and who exhibit a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L tend to have unfavorable outcomes; they need to be assessed for sequelae.

As a classic prescription for invigorating spleen and replenishing qi, Sijunzi Decoction has a good clinical efficacy in the treatment of gastric cancer. It can improve chemotherapy resistance, reduce the toxic and side effects of chemotherapy, promote postoperative recovery, enhance immunity, improve the nutritional status of patients, improve the quality of life of patients and prevent precancerous lesions. Network pharmacology studies have shown that Sijunzi Decoction exerts anti-gastric cancer effects through multiple active ingredients, multiple targets and multiple pathways, and quercetin may be the main active component in Sijunzi Decoction to exert anti-gastric cancer effects. The main mechanisms of Sijunzi Decoction in the treatment of gastric cancer include regulating the expression of cell cycle and apoptosis-related gene proteins, and inhibiting the proliferation, migration, invasion and gastric cancer stem cell characteristics of gastric cancer cells.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.