Phakic intraocular lens implantation has become one of the important means of correcting refractive errors today. Among them,the implantable collamer lens(ICL)is favored for its wide range of correction, excellent optical quality, and high safety, but the risks of postoperative complications such as glaucoma and anterior subcapsular opacification still exist. Vault is an important indicator for evaluating the safety after ICL implantation, and its ideal state is crucial for preventing complications. Studies have shown that iris morphology has a significant impact on vault. In order to further optimize surgical outcomes and improve surgical safety, this review comprehensively reviews the research progress of iris-related parameters in ICL implantation and discusses the importance of various parameters in preoperative evaluation and postoperative follow-up.

Objective To explore the potential categories of self-regulatory fatigue among maintenance hemodialysis patients and their relationships with self-management. Methods A total of 502 maintenance hemodialysis patients in Lanzhou were surveyed using a general information questionnaire, a Self-Regulatory Fatigue Scale, and a Self-Management Scale for Hemodialysis Patients. Potential profile analysis was conducted on self-regulatory fatigue, and its relationship with self-management was explored. Results Based on their self-regulatory fatigue status, maintenance hemodialysis patients could be categorized into four potential groups: low self-regulatory fatigue group (5.0%), moderate self-regulatory fatigue group (49.2%), high self-regulatory fatigue group (13.9%), and high cognitive regulatory fatiguegroup (31.9%). Gender, education level, and monthly per capita family income were identified as influencing factors for the potential categories of self-regulatory fatigue. Significant differences were observed in the total self-management scores among patients belonging to different potential categories of self-regulatory fatigue (F=50.617, P < 0.001). Conclusion Maintenance hemodialysis patients can be classified into four potential categories of self-regulatory fatigue, with patients in the low self-regulatory fatigue group demonstrating higher levels of self-management. Reducing the level of self-regulatory fatigue can contribute to enhancing patients'self-management capabilities.

Polycystic ovary syndrome(PCOS)is one of the most common gynecological endocrine disorders.Most pathophysiological changes of PCOS begin in the peripubertal phase,and these pathophysiological changes will continuously affect women's health in the later stages of their lives.The pathogenic mechanisms of PCOS remain unclear,involving key aspects such as the regulation of hypothalamic-pituitary function,ovarian cellular functions,androgen levels,and insulin resistance.Herein,we summarized the latest findings on the pathogenesis of PCOS from the perspectives of the genetic background,intrauterine development,neuroendocrine function,inflammatory factors,gut microbiome,and environmental factors.This review will help provide new ideas for a deeper understanding of the disease,as well as its clinical diagnosis and treatment.

Objective To assess the predictive effect of myocardial injury biomarkers (proBNP, CK-MB, and cTnI) on the severity of acute pancreatitis (AP). Methods The records of 246 patients diagnosed with acute pancreatitis who were treated at Ruijin Hospital Emergency Department from January 2015 to December 2016 were retrospectively analyzed. According to the revised 2012 Atlanta guidelines, these patients were divided into the mild acute pancreatitis (MAP, n=47), moderately severe acute pancreatitis (MSAP, n=151) and severe acute pancreatitis (SAP, n=48) groups. The highest plasma levels of troponin I (cTnI), creatine kinase (CK)-MB, N-terminal B-type brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and procalcitonin (PCT) were recorded for comparison within 72 h after admission. The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score, sequential organ failure assessment (SOFA), bedside index for severity in acute pancreatitis (BISAP) and Balthazar computed tomography severity index (CTSI) were calculated at admission within 72 h. Whether there is an occurrence of organ dysfunction, and the organ types and persist time of organ dysfunction were recorded. The analysis of variance, SNK-q test and paired samples t test were used for the statistical analysis. Results The levels of proBNP, CK-MB, and cTnI were significantly higher in the SAP group than in the non-SAP group. The receiver operating characteristic (ROC) curve demonstrated cTnI had the maximum predictive power (AUC=0.872), while proBNP had the least predictive ability (AUC=0.763). The established model, which is to explore whether the myocardial injury markers had the predictive value, showed that the combination of myocardial injury indicators (CK-MB, cTnI) and traditional indicators had higher predictive value for SAP than traditional indicators alone (AUC=0.966 vs. AUC=0.945, P=0.04). Conclusions The elevated markers of myocardial injury had certain predictive value for severe acute pancreatitis.

Objective: To understand the epidemiological characteristics and relevant factors on the comorbidity of hyperactivity behavior and allergic disease among preschool children in urban areas of Ma'anshan city. Methods: During April 2014 to April 2015, 91 kindergartens over 3 years old were investigated. In the investigation, 16 439 questionnaires were distributed to parents, and 15 291 valid questionnaires were collected. Conners abbreviated symptom questionnaire (brief symptom questionnaire) was filled out by parents to assess the children's hyperactive behaviors. Information of allergic disease history was reported by parents, including allergic dermatitis/eczema, food/drug allergy, allergic rhinitis and asthma. Multivariate unconditional logistic regression was used to analyze the relevant factors of comorbidity of hyperactivity behavior and allergy diseases. Results: The average age of the 15 291 children were (4.5±1.0) years old, among which 53.7% (8 218/15 291) were boys. The prevalence of hyperactive behaviors was 8.6%(1 317/15 291), and the comorbidity rate of hyperactivity and allergic deseases was 1.7% (258/15 291). After confounding factors including gender, age, delivery mode, father's age and pregnancy complications adjusted, poor sleep quality (OR=4.45, 95%CI: 2.85-6.94), long duration of watching TV at weekend (OR=1.39, 95%CI: 1.00-1.94) and poor eating behavior (OR=1.78, 95%CI: 1.07-2.98) were relevant factors of the comorbidity of hyperactivity and allergic diseases. Conclusion The prevalence of comorbidity of hyperactivity behavior and allergic disease among preschool children in urban areas of Ma'anshan city was not high. Poor night sleep quality, long duration of watching TV and frequently picky eating were relevant factors of the comorbidity of hyperactive behaviors and allergic diseases.

Objective To identify the dietary patterns among preschoolers in Ma'anshan,and to investigate its association with the education levels of the parents.Methods A total of 16 439 children aged 3-6 were recruited from 91 kindergartens in Ma'anshan city to participate in the study.Food frequency and socio-demographic information were collected through questionnaire survey.Dietary data was collected using a food frequency questionnaire (FFQ),and principal-components analysis was used to derive the dietary patterns.Ordinal multinomial logistic regression was employed to explore the association between the education level of parents and the dietary patterns.Results Five dietary patterns-"processed","beverage","snack","protein" and "vegetarian" were identified.Data showed that the total variance was 48.02％ and the cumulative proportion of processed reached 24.78％.Low educational level of the father was positively associated with both "beverage"(OR=1.36,95％CI:1.15-1.63) and "snack" dietary pattern (OR=1.21,95％CI:1.01-1.43).Low educational level of mother was positively associated with the "processed" (OR =1.31,95％CI:1.09-1.57) and "beverage"dietary pattern (OR=1.48,95％CI:1.23-1.77),and showed a negative correlation with "protein" (OR=0.62,95％ CI:0.52-0.74) and "vegetarian" dietary pattern (OR=0.72,95％ CI:0.60-0.86).Conclusion Findings from this study showed that preschoolers in Ma'anshan tend to choose unhealthy dietary pattern.Dietary pattern was directly influenced by the parents,and especially the education level of the mothers.

OBJECTIVETo determine the genetic cause for two mentally retarded patients from a family, and to correlate their genotypes with clinical phenotypes.

METHODSRoutine G-banded karyotyping analysis was performed. Single nucleotide polymorphism (SNP) microarray analysis was used to detect microdeletions or microduplications. Fluorescence in situ hybridization (FISH) was used to ascertain the origin of chromosomal abnormalities.

RESULTSBoth proband and his uncle showed a normal karyotype. SNP microarray analysis has identified a 1.147-Mb microdeletion at 16p13.3 (85 880-1 233 819) and a 2.948-Mb microduplication at 19q13.42-q13.43 (56 008 597-58 956 816). FISH analysis confirmed that the patient has inherited a derivative chromosome 16 from his father. The proband presented with mental retardation, reduced speech, and facial dysmorphism (hypertelorism, down-slanting palpebral fissure, low nasal bridge and wide gap between front teeth). His uncle presented with a milder phenotype with mental retardation.

CONCLUSIONBoth the proband and his uncle have carried a chromosome microdeletion at 16p and microduplication at 19q, which were originated from their fathers carrying a balanced t(16;19) translocation. Combined SNP microarray analysis and FISH assay are useful for the detection the copy number variations and delineation of potential structural changes, which may help with evaluation of recurrence risk for this family.

Adult ; Child ; Chromosome Deletion ; Chromosome Duplication ; Chromosomes, Human, Pair 16 ; Chromosomes, Human, Pair 19 ; Humans ; In Situ Hybridization, Fluorescence ; Intellectual Disability ; genetics ; Karyotyping ; Male ; Oligonucleotide Array Sequence Analysis ; Polymorphism, Single Nucleotide ; Translocation, Genetic

OBJECTIVETo examine the effect of parents' occupational and life exposure during six months before pregnancy on executive function of preschool children.

METHODSPregnant women involved in the study came from the Ma'anshan Birth Cohort Study,a part of the China-Anhui Birth Cohort Study. Between October 2008 and October 2010, pregnant women who accepted pregnancy care in four municipal medical and health institutions in Ma'anshan city were recruited as study objects. A total of 5,084 pregnant women and 4,669 singleton live births entered in this cohort. Between April 2014 and April 2015, a total of 3,803 pre-school children were followed up. Finally, except 32 preschool children did not have EF evaluation result, there were 3,771 children included in this study. By using self-designed " Maternal health handbook", we researched parents' general demographic characteristics, and life and occupational exposure during six months before pregnancy. To research preschool children's executive function, we used the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Univariate and multivariate statistical method was used to analyze the association of parents' life and occupational exposure during six months before pregnancy and preschool children's EF.

RESULTS3,771 preschool children's detected rate of inhibitory self-control index (ISCI), flexibility index (FI), emergent metacognition index (EMI) and global executive composite (GEC) dysplasia were 4.8% (182), 2.3% (88), 16.5% (623) and 8.6% (324) respectively. During six months before pregnancy, children whose parents were lived in a noise environment (OR=1.86, 95% CI: 1.36-2.54), whose maternal were exposed to pesticides were the risk of ISCI dysplasia(OR=3.60, 95% CI: 1.45-8.95). During six months before pregnancy, children whose maternal were exposed to pesticides (OR=6.72, 95% CI: 2.50-18.07) and whose father were exposed to occupational lead (OR=2.10, 95% CI: 1.25-3.54) were the risk of FI dysplasia. During six months before pregnancy, children whose parents were lived in a noise environment (OR=1.42, 95%CI: 1.18-1.71) and whose father were exposed to occupational lead (OR=1.30, 95%CI: 1.02-1.65) were the risk of EMI dysplasia. During six months before pregnancy, children whose parents were lived in a noise environment (OR=1.58, 95% CI: 1.24-2.01) and whose maternal were exposed to pesticides (OR=2.39, 95% CI: 1.02-5.58) were the risk of GEC dysplasia.

CONCLUSIONThe development of executive function is worse among preschool children whose parents live in noise environment, mother exposed to pesticides, and father exposed to occupational lead during six months before pregnancy.

Child ; Child, Preschool ; China ; Cohort Studies ; Environmental Exposure ; adverse effects ; Executive Function ; Family Characteristics ; Female ; Humans ; Lead ; adverse effects ; Male ; Occupational Exposure ; adverse effects ; Parents ; Pesticides ; adverse effects ; Pregnancy ; Prenatal Exposure Delayed Effects ; epidemiology ; psychology

OBJECTIVETo investigate the related influencing factors of preschool children's emotional and behavioral problems in early life and explore the associations between the symptoms of depression or anxiety during pregnancy and emotional and behavioral problems in preschool children.

METHODSBased on the Ma'anshan Birth Cohort Study of the China-Anhui Birth Cohort Study (C-ABCS), women were recruited at their first clinical visit between October 2008 and October 2010 in four municipal medical and health institutions of Ma'anshan City, a total of 5 084 pregnant women and 4 669 singletons live births were included in the birth cohort. Women completed measures of depressive (Self-Rating Anxiety scale) and anxious (Center for Epidemiologic Studies Depression) symptoms in pregnancy. By the age of 3-6 follow-up, 3 653 children were followed with completed information between April 2014 and April 2015, strengths and difficulties questionnaires were used to assessed offspring emotional and behavioral problems. Logistics regression was used to investigate the relationship between the symptoms of depression or anxiety during pregnancy and emotional and behavioral problems in preschool children.

RESULTSThe detected rates of emotional symptoms, conduct problems, hyperactivity and peer problems in preschool children were 6.3% (229/3 653), 7.5% (274/3 653), 7.6% (278/3 653) and 2.8% (103/3 653), while 7.6% (277/3 653) for total difficulties, 10.9%(398/3 653) for prosocial behavior and 27.4%(981/3 557) for impact respectively. Prevalence of anxiety and depression in the first trimester was 2.7%(100/3 653) and 4.7%(171/3 653) respectively, and in the second trimester was 2.0%(66/3 375) and 3.6%(122/3 375) respectively. After we controlled the confoundings of gestation age, place of residence, family income, maternal education, paternal education, premature birth and folic acid supplement before pregnancy, multinomial logistic regression analysis showed that the risk of children's emotional symptoms in maternal anxiety in both first-trimester and second-trimester group was higher than the group of no depression and anxiety symptoms, and OR(95%CI) was 5.90(2.00-17.48). Compared with whose mother no depression in both first-trimester and second-trimester, the risk of children's emotional symptoms in maternal depression in both first-trimester and second-trimester group was higher, and OR(95% CI) was 3.07 (1.30-7.28). And the risk of children's total difficulties of maternal anxiety in second-trimester was 2.27 (95%CI: 1.10-4.71) times of no anxiety in second-trimester. While the risk of children's total difficulties of maternal depression in second-trimester was 2.20 (95%CI: 1.24-3.93) times of no depression in second-trimester. Maternal emotional symptoms were not significant associations with conduct problems, hyperactivity, peer problems and prosocial behaviors (P> 0.05).

CONCLUSIONThere was a negative impact of maternal anxiety and depression symptoms during pregnancy on emotional and behavioral problems in preschool children. These findings highlight the need for additional clinical and research attention to both maternal depression and anxiety in pregnancy, which may be helpful to reduce the incidence of children's emotional and behavioral problems and act as an important measure in prevention.

Anxiety ; epidemiology ; Child ; Child, Preschool ; China ; Cohort Studies ; Depression ; epidemiology ; Female ; Humans ; Logistic Models ; Mothers ; psychology ; Pregnancy ; Prevalence ; Problem Behavior ; psychology ; Surveys and Questionnaires

OBJECTIVETo examine the effect of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with childhood overweight and adiposity, and to explore possible early life risk factors for obesity in preschool children.

METHODSBasic information of pregnant women and gestation period came from the Ma'anshan Birth Cohort Study, a part of the China-Anhui Birth Cohort Study (C-ABCS). Pregnant women in routine health care from four municipal medical and health institutions were enrolled voluntarily during October 2008 and October 2010 in Ma'anshan City. A total of 5 084 pregnant women and 4 669 singleton live births were included in this study. Between April 2014 and April 2015, 3 797 children were followed up. Children whose BMI were >85th percentiles for age and genders of World Health Organization (WHO) reference were considered as overweight, and >95th percentiles for age and genders cut-off values were considered as obesity (pathological and secondary causes of obesity were excluded). Gestational weight gain was defined according to the Institute of Medicine (IOM) guidelines. Univariate and binary regression model analysis was used to examine the effect of pre-pregnancy BMI and GWG with childhood overweight and adiposity.

RESULTSOf the 3 797 pregnant women, the prevalence of underweight, normal weight, overweight and obesity were respectively 22.6% (n=858), 70.3% (n=2 671), 6.2% (n=234) and 0.9% (n=34). There were 3 563 pregnant women who were obtained gestational weight gain data, the prevalence of inadequate GWG, appropriate GWG, excessive GWG were respectively 12.4% (n=443), 25.9% (n=922) and 61.7% (n=2 198). The prevalence of overweight and obesity were 11.5% (n=437) and 10.8% (n= 411) in preschool children, respectively. After adjusting confounding factors including age at delivery, genders of children, children age, birth weight, breastfeeding and household economic status, binary logistic regression analysis showed that pre-pregnancy overweight and obesity(OR=2.01, 95% CI: 1.53-2.65), excessive GWG(OR=1.65, 95% CI: 1.35-2.03) were risk factors for overweight and obesity, and pre-pregnancy underweight was protective factor for childhood overweight and obesity (OR=0.49, 95% CI: 0.39-0.62). Joint associations of pre-pregnancy BMI and inappropriate GWG were also noticed in the study: compared to only pre-pregnancy higher BMI or excessive GWG or indequate GWG, combination of high pre-pregnancy BMI and excessive GWG or high pre-pregnancy BMI and inadequate GWG, adverse effects on childhood overweight and obesity were much higher,OR (95%CI) values were 2.90(1.97-4.28), 3.17(1.44-6.97) respectively.

CONCLUSIONBoth high pre-pregnancy BMI and inappropriate GWG are associated with greater offspring BMI. Pregnant women should achieve appropriate weight gain and help prevent obesity in their children.

Body Mass Index ; Child ; Child, Preschool ; China ; Cohort Studies ; Female ; Humans ; Overweight ; epidemiology ; Pediatric Obesity ; epidemiology ; Pregnancy ; Prevalence ; Regression Analysis ; Risk Factors ; Weight Gain