Objective To investigate the potential value of nobiletin(NOB)in the treatment of dry eyes in type 2 di-abetes mellitus(T2DM-DE)and its effect on the expression of cystic fibrosis transmembrane conductance regulators(CFTRs).Methods The T2DM mouse model was established by a high-fat diet combined with streptozotocin,and then the T2DM-DE mouse model was induced by benzalkonium chloride.These mice were divided into 6 groups:the NC group,the T2DM-DE group,the L-NOB group,the M-NOB group,the H-NOB group,and the CFTR inhibitor group.Mice in the NC and T2DM-DE groups were provided with phosphate buffer saline(PBS)containing 0.5％Tween80 through oral ga-vage;those in the L-NOB,M-NOB,and H-NOB groups were provided with 50,100,and 200 mg?kg-1?d-1 NOB solu-tions,respectively,through oral gavage;those in the CFTR inhibitor group were provided with 200 mg?kg-1?d-1 NOB solution through oral gavage and intraperitoneally injected with 1 mg?kg-1?d-1 CFTR(inh)-172.The intervention in these groups was provided for 4 weeks.The fasting blood glucose(FPG),tear secretion,tear film break-up time(BUT),corne-al fluorescein sodium staining grade,and interleukin-1 β(IL-1 β),IL-6,IL-8,and tumor necrosis factor-α(TNF-α)levels in tears of mice were detected.Besides,the periodic acid-Schiff(PAS)staining of conjunctival goblet cells and the terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)staining of the cornea were performed respectively.The mRNA and protein expression levels of CFTRs,Bax,and Bcl-2 in the cornea were measured by the real-time quantitative polymerase chain reaction(RT-qPCR)and Western blot.Results Compared with the NC group,the FPG of mice in the T2DM-DE group increased;the level of IL-1β,IL-6,IL-8,and TNF-α in tears increased;the corneal fluorescein sodium staining grade and TUNEL positive rate increased(all P＜0.05);the tear secretion,BUT,and the number of conjunctival goblet cells decreased;the mRNA and protein expression levels of CFTRs decreased(all P＜0.05).Compared with the T2DM-DE group,the FPG of mice in the L-NOB,M-NOB,and H-NOB groups decreased;the levels of IL-1β,IL-6,IL-8,and TNF-α in tears decreased;the corneal fluorescein sodium staining grade and TUNEL positive rate decreased(all P＜0.05),the tear secretion,BUT,and the number of conjunctival goblet cells increased;the mRNA and protein expression levels of CFTRs increased(all P＜0.05).Compared with the H-NOB group,the FPG of mice in the CFTR inhibitor group increased;the levels of IL-1 β,IL-6,IL-8,and TNF-α in tear increased;the corneal fluorescein sodium staining grade and TUNEL positive rate increased(all P＜0.05);the tear secretion,BUT,and the number of conjunctival goblet cells de-creased;the mRNA and protein expression levels of CFTRs decreased(all P＜0.05).Conclusion NOB can reduce the blood glucose level by activating CFTRs,inhibit inflammation,and promote the survival of conjunctival goblet cells and cor-neal cells in T2DM-DE mice,thus playing a role in the treatment of T2DM-DE.

The Chinese Medical Association was established in 1915 and is an important social force for the development of medical science and technology and health care in China. The Hematology Branch of the Chinese Medical Association was established in 1980. With the support of the association's industry university research platform, it has made achievements such as the "Shanghai Protocol" for acute promyelocytic leukemia and the "Beijing Protocol" for hematopoietic stem cell transplantation, which have rewritten international guidelines and promoted China's hematology from its inception to international leadership. The article reviews the development process of diagnosis and treatment of hematological diseases, with a focus on the key role played by the Chinese Medical Association in the development of hematology in China.

Objective: To analyze the association of participation in non-sports extracurricular tutoring classes with the prevalence of screening myopia, axial length (AL) and axial length to corneal radius ratio (AL/CR) among primary school students, so as to provide evidences for formulating myopia prevention and control policies. Methods: In December 2024, combination of convenience and cluster sampling method was used to select 2 273 students from two primary schools in Hefei City, Anhui Province. Ophthalmic examinations and questionnaire surveys were conducted to obtain information on myopia, AL, AL/CR and participation in various types of extracurricular tutoring. A binary Logistic regression model was used to analyze the association between non-sports tutoring and screening myopia, and multiple linear regression models were used to examine the associations between non-sports tutoring and AL and AL/CR. Results: Among the surveyed students, the participation rate in non-sports extracurricular tutoring classes was 64.9% , and the overall prevalence of screening myopia was 39.1%. The average AL and AL/CR were (23.60± 1.01 ) mm and (3.00±0.12), respectively. Univariate analysis showed that students who attended non-sports, music, or academic tutoring classes for ≥2 h per week had higher risks of screening myopia and greater AL/CR values than non-participants (screening myopia: OR =1.38, 1.82, 1.55; AL/CR: β =0.01, 0.03, 0.03; all P <0.05). After adjusting for sex, grade, and participation in sports tutoring, multivariate analysis indicated that participation in non-sports and musical instrument tutoring classes for ≥2 h per week remained significantly associated with higher risks of screening myopia ( OR =1.26, 1.49, both P <0.05). Multiple linear regression showed that participation in musical instrument tutoring for ≥2 h per week was positively correlated with AL ( β=0.14, P < 0.05). Conclusions Participation in non-sports extracurricular tutoring is common among primary school students. Attending non-sports tutoring classes for ≥2 h per week increases the risk of screening myopia.

Objective:To analyze the genetic characteristics and evolutionary origin of hepatitis B virus (HBV) subgenotype D3 in China in 2020.Methods:Serum samples and demographic details from patients infected with HBV D3 subgenotype were collected. HBV genomic sequences were obtained by nested PCR amplification and subsequent sequencing. Phylogenetic analysis, nucleotide homology, amino acid mutation and evolution rate of the S protein were conducted by comparing with reference sequence using bioinformatics tools.Results:The complete HBV gene sequences of 14 samples of D3 subtype HBV were obtained. Compared with 97 reference sequences, it was found that the sequences with the highest homology were from India, Mongolia, Iran and China, with the homology ranging from 96.0% to 97.9%. Mutations of 24 amino acids were found in 14 strains of D3 subtype. Among them, T131A, Y134F and T140I were associated with immune escape-related mutations. The genetic diversity of HBV D3 subtype increased slowly before 1975, remained relatively constant from 1975 to 2000, and began to decline after 2000. Evolutionary rate analysis showed that samples QGLD D3-02 and 03 originated from a common ancestor with the Iranian reference strain in 1872, and the other 12 samples QGLD D3-04-17 originated from a common ancestor with the Mongolian reference strain in 1843.Conclusions:The gene sequence of HBV D3 subtype in China had the highest homology with reference sequences from India, Iran, Mongolia and China. Evolutionary rate analysis revealed that 14 cases of HBV D3 subtype originated from a common ancestor with reference strains from Mongolia and Iran, which enriched the sequence and evolution information of HBV D3 subtype and provided a reference basis for the molecular epidemiological study of HBV.

Objective:To construct and evaluate the predictive performance of a multiphase ultrasound radiomics model for microvascular invasion（MVI）in hepatocellular carcinoma（HCC）.Methods:A total of 126 patients with pathologically confirmed HCC were retrospectively enrolled from 4 medical centers between May 2018 and July 2025，including the First Hospital of Shanxi Medical University，Shanxi Province Third People's Hospital，Changzhi People's Hospital，and the Organ Transplant Center of the Affiliated Hospital of Qingdao University. A total of 630 ultrasound images of the lesions in different phases were collected，from which 1 561 radiomic features were extracted. The patients from medical institutions in Shanxi Province were chosen as the training set（ n=91），and the patients from the Organ Transplant Center of the Affiliated Hospital of Qingdao University were chosen as the validation set（ n=35）. In the training set，37.4%（34/91）patients presented MVI（+），whereas in the validation set，54.3%（19/35）patients presented MVI（+）. Radiomics features were extracted from ultrasound images，and features related to the MVI（+）were selected through dimensionality reduction analysis. Five multiple machine learning algorithms were used to construct predictive models，which were then evaluated using an external validation set. The Radscore was calculated，and a nomogram was constructed combining Radscore with ultrasound and clinical characteristics to predict MVI. Results:The model combining radiomics features from the portal venous phase and the delay phase showed the best predictive performance in both the training and validation sets，with area under curve（AUC）values of 0.835 and 0.727，respectively. The prediction model developed using radiomics Radscore and clinical indicators could be represented and presented as a nomogram.Conclusions:The radiomics model based on multi-phase ultrasound offers a novel approach for non-invasive preoperative prediction of MVI in liver cancer. Furthermore，its integration with clinical features aids in optimizing clinical treatment strategies.

Aim To analyze the correlation between serum retinol-binding protein 4(RBP4),low density lipo-protein cholesterol to albumin ratio(LDLC/Alb),monocyte to high density lipoprotein ratio(MHR)and plaque stability in carotid atherosclerosis population and their predictive value for acute ischemic stroke(AIS).Methods A total of 197 patients with asymptomatic carotid atherosclerosis admitted to our hospital from September 2021 to January 2023 were selected for a prospective cohort study,and they were categorized into occurred group and non-occurred group according to whether AIS occurred within 12 months.Baseline information at time of visit,results of the cervical ultrasonography and serum RBP4,LDLC/Alb,MHR levels were compared between the two groups.Spearman/Pearson and receiver operating characteristic(ROC)curve were used to analyze the corr-elation of RBP4,LDLC/Alb and MHR with carotid atherosclerosis and plaque stability,and the value of predicting AIS in carotid atherosclerosis population.Hosmer-Lemeshow goodness of fit test was used to evaluate the calibration ability of serum RBP4,LDLC/Alb and MHR to jointly predict AIS in carotid atherosclerosis population.Results The carotid intima-media thickness(IMT)was higher in occurred group than that in non-occurred group.There were more soft plaques and mixed plaques in occurred group than in non-occurred group(P＜0.05).Serum levels of RBP4,LDLC/Alb and MHR were higher in occurred group than those in non-occurred group(P＜0.05).The correlation analysis showed that the levels of serum RBP4,LDLC/Alb and MHR were positively correla-ted with IMT(r=0.803,0.740,0.710)and plaque properties(r=0.736,0.685,0.703)(P＜0.001).ROC curve a-nalysis showed that the AUC of serum RBP4,LDLC/Alb and MHR in predicting AIS in carotid atherosclerosis population was 0.796,0.821 and 0.828,respectively,and the AUC of MHR was the largest;the AUC of the combination of serum RBP4,LDLC/Alb and MHR was 0.936,which was higher than that of MHR(Z=2.978,P＜0.05),the predictive sensi-tivity and specificity were 88.24％and 87.40％.Hosmer-Lemeshow goodness of fit test showed that there was no signifi-cant difference between serum RBP4,LDLC/Alb and MHR in predicting AIS and the actual observation value in carotid atherosclerosis population(P＞0.05),and the prediction model had good calibration ability.Conclusion Serum RBP4,LDLC/Alb,and MHR are positively correlated with carotid atherosclerosis and plaque stability,and can predict the occurrence of AIS.Combined detection of the three can be used as a method for early identification of potential high-risk populations for AIS,providing a new,quantifiable guidance scheme for the prevention and treatment of AIS in carotid ath-erosclerotic population.

Objective : To explore the factors influencing the efficacy of first-generation EGFR tyrosine kinase inhibitors(EGFR-TKIs) in patients with EGFR-mutated advanced lung adenocarcinoma and to construct and validate a corresponding nomogram prediction model. Methods : A total of 220 patients with EGFR-mutated advanced lung adenocarcinoma treated with icotinib were enrolled and randomly divided into a training group(154 cases) and a validation group(66 cases) in a 7 ∶3 ratio. Cox regression analysis was performed to identify factors affecting the efficacy of first-generation EGFR-TKIs in the training group. A prediction model was constructed, and calibration curves and receiver operating characteristic(ROC) curves were plotted to validate the model′s performance. Results: In the training group, the objective response rate was 35.71%, the disease control rate was 77.27%, the median progression-free survival(PFS) was 12.5 months, the median overall survival was 18 months, the 2-year OS rate was 66.23%, and the PFS rate was 42.21%. Univariate analysis showed that brain metastasis, bone metastasis, TNM stage, differentiation degree, neutrophil-to-lymphocyte ratio(NLR), post-treatment p53 levels, p53 difference(Δp53), post-treatment cancer antigen gene(CAGE) levels, and CAGE difference(ΔCAGE) were associated with PFS(P2=4.429, P=0.351). ROC curve analysis in the training group showed that the nomogram model had a sensitivity of 80.00%, specificity of 77.53%, and AUC of 0.864 for predicting therapeutic efficacy, while the validation group showed a sensitivity of 74.08%, specificity of 71.43%, and AUC of 0.835. Conclusion Changes in lung cancer autoantibodies(Δp53 and ΔCAGE), TNM stage, and NLR are key factors influencing the efficacy of first-generation EGFR-TKIs in EGFR-mutated advanced lung adenocarcinoma. The nomogram prediction model based on p53 and CAGE demonstrates good predictive performance.

Objective:To evaluate the performance of deep learning reconstruction (DLR) in visualizing lenticulostriate arteries (LSAs) on cerebral CT angiography (CTA).Methods:This cross-sectional study retrospectively analyzed cerebral CTA from 38 patients who underwent cerebral CTA at the Fourth Affiliated Hospital of Harbin Medical University between January and December 2023. Images were reconstructed using filtered back projection (FBP), three-dimensional adaptive iterative dose reduction (AIDR), and DLR-advanced inteuigent clear-IQ engine(AiCE) algorithms (FBP group, AIDR group, DLR-AiCE group). On axial images, the mean CT values, standard deviation (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured at the origin of LSAs, cerebrospinal fluid in lateral ventricles, temporal muscle, and head of the caudate nucleus. Subjective evaluations were performed for overall vascular visualization and LSAs delineation. Comparisons of subjective and objective evaluation indexes among the 3 groups were performed using the complex measurement ANOVA, Friedman test, or χ2 test. Results:The CT, SD, SNR and CNR values at the origin of LSAs, cerebrospinal fluid in lateral ventricles, temporal muscle, and head of the caudate nucleus demonstrated statistically significance among DLR-AiCE group, AIDR group and FBP group ( P<0.001), in which, except for the difference between the FBP group and the AIDR group in the CT value of the head of the caudate nucleus and the CT value of the cerebrospinal fluid of the lateral ventricle which was not statistically significant ( P>0.05), the remaining pairwise comparisons between the groups for each site measurements were statistically significant ( P<0.001). The difference in the overall comparison of the subjective scores of the overall vessels and LSAs in the images of the DLR-AiCE group, the AIDR group, and the FBP group was statistically significant ( P<0.001), and the two-by-two comparisons showed a statistically significant difference ( P<0.001) except for the difference in the subjective scores of LSAs between the FBP group and the AIDR group. Conclusion:The DLR-AiCE algorithm significantly reduces image noise and improves image quality, enabling superior visualization of LSAs, thereby enhancing diagnostic confidence.

Aim To analyze the correlation between serum retinol-binding protein 4(RBP4),low density lipo-protein cholesterol to albumin ratio(LDLC/Alb),monocyte to high density lipoprotein ratio(MHR)and plaque stability in carotid atherosclerosis population and their predictive value for acute ischemic stroke(AIS).Methods A total of 197 patients with asymptomatic carotid atherosclerosis admitted to our hospital from September 2021 to January 2023 were selected for a prospective cohort study,and they were categorized into occurred group and non-occurred group according to whether AIS occurred within 12 months.Baseline information at time of visit,results of the cervical ultrasonography and serum RBP4,LDLC/Alb,MHR levels were compared between the two groups.Spearman/Pearson and receiver operating characteristic(ROC)curve were used to analyze the corr-elation of RBP4,LDLC/Alb and MHR with carotid atherosclerosis and plaque stability,and the value of predicting AIS in carotid atherosclerosis population.Hosmer-Lemeshow goodness of fit test was used to evaluate the calibration ability of serum RBP4,LDLC/Alb and MHR to jointly predict AIS in carotid atherosclerosis population.Results The carotid intima-media thickness(IMT)was higher in occurred group than that in non-occurred group.There were more soft plaques and mixed plaques in occurred group than in non-occurred group(P＜0.05).Serum levels of RBP4,LDLC/Alb and MHR were higher in occurred group than those in non-occurred group(P＜0.05).The correlation analysis showed that the levels of serum RBP4,LDLC/Alb and MHR were positively correla-ted with IMT(r=0.803,0.740,0.710)and plaque properties(r=0.736,0.685,0.703)(P＜0.001).ROC curve a-nalysis showed that the AUC of serum RBP4,LDLC/Alb and MHR in predicting AIS in carotid atherosclerosis population was 0.796,0.821 and 0.828,respectively,and the AUC of MHR was the largest;the AUC of the combination of serum RBP4,LDLC/Alb and MHR was 0.936,which was higher than that of MHR(Z=2.978,P＜0.05),the predictive sensi-tivity and specificity were 88.24％and 87.40％.Hosmer-Lemeshow goodness of fit test showed that there was no signifi-cant difference between serum RBP4,LDLC/Alb and MHR in predicting AIS and the actual observation value in carotid atherosclerosis population(P＞0.05),and the prediction model had good calibration ability.Conclusion Serum RBP4,LDLC/Alb,and MHR are positively correlated with carotid atherosclerosis and plaque stability,and can predict the occurrence of AIS.Combined detection of the three can be used as a method for early identification of potential high-risk populations for AIS,providing a new,quantifiable guidance scheme for the prevention and treatment of AIS in carotid ath-erosclerotic population.

Purpose To investigate the clinicopathological features,molecular subtypes,and prognostic factors of diffuse midline glioma(DMG)with H3K27 alterations.Methods Clinical data from 19 patients from DMG were col-lected.The clinical manifestations,histopathological features,immunophenotypes,and molecular genetic characteris-tics were analyzed.Relevant literature was also reviewed.Results Among the 19 patients,12 cases had tumors loca-ted in the thalamus,while 7 cases had tumors in other midline regions(including 4 cases in the brainstem,1 case in the cerebellum,and 2 cases in the spinal cord).Clinical symptoms primarily included dizziness,gait instability,and blurred vision.Histological features were diverse,with 12 cases classified as high-grade gliomas and 7 cases as low-grade.Immunohistochemistry revealed a loss of H3K27me3 expression in all cases,with 18 cases showing diffuse H3K27M positivity and 1 case expressing EZHIP.Of the 16 cases that underwent next-generation sequencing(NGS),1 case showed EGFR mutation(1/16,6％),while the remaining 15 cases had H3F3A K27M mutations(15/16,94％).Among these,7 cases had ATRX mutations(7/15,46.6％),5 cases had MAPK pathway alterations(5/15,33.3％,including 2 cases FGFR1,2 cases NF1,1 case co-mutated with BRAF and NF1),5 cases had PDGFRA mis-sense mutations(5/15,33.3％),4 cases had p53 missense or frameshift deletions(4/15,26.6％).One case each had a DICER1 missense mutation and an IDH1-S202R frameshift deletion(1/15,6.6％).The prognosis was general-ly poor,with a median survival of 9.5 months.Conclusion DMG exhibits high tumor heterogeneity and an overall poor prognosis.The predominant molecular aleration was the H3F3A K27M mutation.Patients with co-altered MAPK pathway showed relatively better outcomes,providing new insights into the molecular genetic characteristics of DMG.