Ocular accommodation refers to the process by which the ciliary muscle creates a clear image of the object in the retina by changing the refractive power of the lens. When the accommodation ability of the eye is insufficient, the imaging focus falls on the region behind the retina and hyperopic defocus is easily formed, resulting in axial growth and leading to the development of myopia, and it is found that most myopic patients usually have some accommodation dysfunction. Myopia has become a public health problem in China, and the prevalence of adolescents has increased dramatically. How to prevent and stop the occurrence and development of myopia is a major challenge. Previous studies have found that ocular accommodation dysfunction is associated with the occurrence and development of myopia, and the measurement of parameters related to accommodation function has certain guiding significance for the prevention and control of myopia. The purpose of this paper is to review the correlation between myopia and ocular accommodation function, with a view to providing new ideas for the prevention, control and treatment of myopia.

Objective:To explore the diagnostic value of whole blood cell parameters logistic regression model for radiation injury on radiation workers by comparing the differences of whole blood cell parameters between occupational radiation injury population and occupational health examination population.Methods:In February 2023, 184 radiation workers who received occupational health examinations in our hospital and occurrenced chromosome aberration from July 2021 to July 2022 were retrospectively selected as the radiation injury group. And other 184 radiation workers encountered in the same period without chromosome aberration occurrence were selected as the control group. Collected whole blood cell parameters from two groups of research subjects, conducted comparative analysis, constructed a logistic regression model, and evaluated the diagnostic value of the logistic regression model for radiation injury on radiation workers by receiver operating characteristic curve (ROC) and area under curve (AUC) . In addition, with the same standard, 60 radiation workers with chromosome aberration and 60 radiation workers without chromosome aberration from August 2022 to January 2023 were included in the validation queue to validate the logistic regression model.Results:Neu_X, Neu_Y, Neu_Z, Lym_X, Lym_Y, Lym_Z, Mon_X, Mon_Y, Mon_Z, Micro, MCHC in the radiation injury group were significantly higher than those in the control group, and the difference was statistically significant ( P<0.05) . And MCV and Macro in the radiation injury group were lower than those in the control group, and the difference was statistically significant ( P<0.05) . Moreover, logistic regression analysis showed that Lym_X, Lym_Y, Lym_Z, MCHC, Micro were all independent risk factors for diagnosing radiation injury on radiation workers ( OR=1.08、1.02、0.99、1.06、51.32, P<0.05) . ROC curve analysis showed that the AUC, sensitivity, specificity, and accuracy of the logistic regression model based by Lym_X, Lym_Y, Lym_Z, MCHC and Micro in diagnosing radiation injury on radiation workers were 0.80, 85.9%, 65.8% and 75.9% respectively. The validation queue verified the logistic regression model and the AUC, sensitivity, specificity, and accuracy of the logistic regression model were 0.80, 81.7%, 71.7% and 76.7% respectively, the model fitted well. Conclusion:Radiation damage can cause changes in multiple whole blood cell parameters of radiation workers. The logistic regression model based by Lym_X, Lym_Y, Lym_Z, MCHC and Micro showed good diagnosis ability and can be used for the screening of radiation injury on radiation workers.

Objective:To explore the diagnostic value of whole blood cell parameters logistic regression model for radiation injury on radiation workers by comparing the differences of whole blood cell parameters between occupational radiation injury population and occupational health examination population.Methods:In February 2023, 184 radiation workers who received occupational health examinations in our hospital and occurrenced chromosome aberration from July 2021 to July 2022 were retrospectively selected as the radiation injury group. And other 184 radiation workers encountered in the same period without chromosome aberration occurrence were selected as the control group. Collected whole blood cell parameters from two groups of research subjects, conducted comparative analysis, constructed a logistic regression model, and evaluated the diagnostic value of the logistic regression model for radiation injury on radiation workers by receiver operating characteristic curve (ROC) and area under curve (AUC) . In addition, with the same standard, 60 radiation workers with chromosome aberration and 60 radiation workers without chromosome aberration from August 2022 to January 2023 were included in the validation queue to validate the logistic regression model.Results:Neu_X, Neu_Y, Neu_Z, Lym_X, Lym_Y, Lym_Z, Mon_X, Mon_Y, Mon_Z, Micro, MCHC in the radiation injury group were significantly higher than those in the control group, and the difference was statistically significant ( P<0.05) . And MCV and Macro in the radiation injury group were lower than those in the control group, and the difference was statistically significant ( P<0.05) . Moreover, logistic regression analysis showed that Lym_X, Lym_Y, Lym_Z, MCHC, Micro were all independent risk factors for diagnosing radiation injury on radiation workers ( OR=1.08、1.02、0.99、1.06、51.32, P<0.05) . ROC curve analysis showed that the AUC, sensitivity, specificity, and accuracy of the logistic regression model based by Lym_X, Lym_Y, Lym_Z, MCHC and Micro in diagnosing radiation injury on radiation workers were 0.80, 85.9%, 65.8% and 75.9% respectively. The validation queue verified the logistic regression model and the AUC, sensitivity, specificity, and accuracy of the logistic regression model were 0.80, 81.7%, 71.7% and 76.7% respectively, the model fitted well. Conclusion:Radiation damage can cause changes in multiple whole blood cell parameters of radiation workers. The logistic regression model based by Lym_X, Lym_Y, Lym_Z, MCHC and Micro showed good diagnosis ability and can be used for the screening of radiation injury on radiation workers.

From October 2021 to February 2023, we retrospectively analyzed the clinical and laboratory data of six patients (three male and three female, median age: 54 years, age range: 29-73 years) with mast cell leukemia (MCL) diagnosed in the First Affiliated Hospital of Soochow University (The Mastocytosis Collaborative Network of China). All patients had acute MCL, with at least one C-finding present. The main clinical presentations were hypoalbuminemia ( n=4), fatigue ( n=3), fever ( n=2), abdominal discomfort ( n=2), osteolytic lesions ( n=2), dizziness ( n=1), skin flushing ( n=1), and weight loss ( n=1). Splenomegaly and lymphadenopathy were noted in six and three patients, respectively. Six patients were strongly positive for CD117, five were positive for CD30 and CD25, and four were positive for CD2. Four patients had a normal karyotype and two patients had an abnormal karyotype. Gene mutations were detected in 4/6 cases. The median serum tryptase level was 24.9 (range: 20.1-171.9) μg/L. Two patients were treated with venetoclax and azacitidine for induction (one patient achieved partial remission by combination with afatinib, while there was no remission after combination with dasatinib in the other patient). Two patients did not achieve complete remission despite treatment with cladribine and imatinib, respectively. One patient treated with interferon combined with glucocorticoids was lost to follow-up, and one patient abandoned treatment. The follow-up time ranged from 1.1 to 21.7 months. Three patients died and two survived. Overall, MCL is a rare subtype of systemic mastocytosis with heterogeneous clinical course, and these patients have poor outcome. A better understanding of the clinical characteristics, treatment, and prognosis of MCL is urgently needed.

Objective To explore the risk factors for developing chronic pulmonary heart disease in patients with pneumoconiosis.Methods The medical records of pneumoconiosis patients admitted to an occupational disease hospital in Sichuan Province between January 2012 and November 2021 were collected.Kaplan-Meier(K-M)method,or product-limit method,was used to plot the incidence curves of pulmonary heart disease in the pneumoconiosis patients.Cox proportional hazard regression model was used to analyze the influencing factors associated with chronic pulmonary heart disease in patients with pneumoconiosis.Results A total of 885 pneumoconiosis patients were included in this study.The follow-up time was 12 to 115 months and the median follow-up time was 43 months.A total of 138 patients developed chronic pulmonary heart disease and the incidence density of pulmonary heart disease was 38.50/1000 person-years.Multivariate Cox proportional hazard regression analysis showed that the influencing factors of pneumoconiosis inpatients developing chronic pulmonary heart disease included the following,being 50 and older(hazard ratio[HR]=1.85,95%confidence interval[CI]:1.25-2.74),stage Ⅲ pneumoconiosis(HR=2.43,95%CI:1.48-4.01),resting heart rate≥100 beats/min(HR=2.62,95%CI:1.63-4.21),the complication of chronic obstructive pulmonary disease(COPD)(HR=4.52,95%CI:2.12-9.63),underweight(HR=2.40,95%CI:1.48-3.87),overweight and obesity(HR=0.54,95%CI:0.34-0.86),and triacylglycerol(TG)(HR=0.69,95%CI:0.49-0.99).Conclusion Old age,stage Ⅲ pneumoconiosis,high resting heart rate,low BMI,and the complication of COPD are risk factors for chronic pulmonary heart disease in pneumoconiosis patients,while overweight and obesity and TG are protective factors.Early identification of the risk factors and the adoption of the corresponding prevention measures are the key to preventing chronic pulmonary heart disease in patients with pneumoconiosis.

Objective To investigate the effect of rehabilitation training combined with acupuncture ( RTA) on upper limb function of stroke patients by Kinect. Methods Stroke patients with upper limb dysfunction werrandomly divided into control group (rehabilitation training) and treatment group ( RTA), with 15 cases in each group. The modified Barthel Index ( MBI), Fugl Meyer assessment ( FMA), and Wolf motor function test (WMFT) were compared between two groups before and after treatment. The changes in motor time ( MT), motor unit number (MUN), index of curvature (IC), elbow flexion angle (EFA), shoulder flexion angle (SFA),and shoulder adduction angle ( SAA) during three actions, namely, placing forearm on the table, extending elbow and drinking water, were evaluated by Kinect and then compared between two groups before and after treatment. Results After 6 weeks of intervention, the scores of MBI, FMA, WMFT and elbow extension in treatment group were higher than those in control group (P<0. 05). The scores of MBI, FMA, WMFT and three actions after treatment were higher than those before treatment (P<0. 05). For three actions, the improvement of MT, MUN, IC, EFA, SFA, and SAA in treatment group were better than those in control group ( P< 0. 05). Compared with pre-treatment, for the action of forearm placement on the table and elbow extension, both treatment group and control group showed an increase in EFA (P<0. 05), and a decrease in MT, MUN, IC, SFA and SA (P<0. 05). For the action of drinking water, both treatment group and control group showed an increase in EFA and SAA (P< 0. 05), and a decrease in MT, MUN, IC and SAA ( P< 0. 05). Conclusions RTA can improve the upper limb function of stroke patients. Kinect can accurately reflect the changes in upper limb function of stroke patients, and it is suitable for clinical work.

【Objective】 To genetically analyze the D^el sample from a blood donor in Jiangyin and make clear the molecular basis of the serological phenotype. 【Methods】 The EDTA anticoagulant blood were collected: buffy coat were used for nucleic acid extract and cDNA analysis; red blood cells for serological test. Tube method and microcolumn gel were used for serological test. Genotyping kit were used for exon analysis. Gene mutation was analyzed using the sequence analyzer. 【Results】 Serological analysis demonstrated the sample′s RhD phenotype was D^el. The phenotype of RhCE was CCEe. Real-time fluorescence quota PCR result demonstrated the existence of all exones. Weak D15 and RHD^* DEL1 [RHD(1227G>A)], which had a high frequency of occurrence in China, were excluded according to real-time fluorescence quota PCR result. Sequence analyzing result verified RHD(28C>T) SNP mutation in cDNA. The genotype of this sample was RHD^*01 W. 61[RHD(28C>T)]. 【Conclusion】 A weak D61 was found among blood donors in our city, Jiangyin.

Objective:To construct a sensitive indicator system of specialized nursing quality for children with hematological tumors, so as to provide a reference for evaluating the nursing quality of children with hematological tumors.Methods:Taking Donabedian's "structure-process-outcome" three-dimensional quality model as the theoretical framework, the first draft of the index system was constructed through literature review. From January to February 2021, 15 clinical nursing and nursing management experts from the Department of Pediatrics and Hematology Oncology were selected by convenience sampling to conduct two rounds of expert consultation to determine the sensitive indicators system of specialized nursing quality for children with hematological tumors. Analytic hierarchy process was used to determine the weights of indicators at all levels.Results:Among two rounds of expert consultation, the effective recovery rates of the questionnaires were all 100.00% (15/15) , and the expert authority coefficient were all 0.85, and the Kendall harmony coefficients were from 0.397 to 0.609, and the differences were all statistically significant ( P<0.01) . The final formed sensitive indicators of specialized nursing quality for children with hematological tumors included 3 first-level indicators and 7 second-level indicators. Conclusions:The sensitive indicator system of specialized nursing quality for children with hematological tumors constructed based on the Delphi method is scientific and applicable, and the specialty features are outstanding. The indicator system can be used to standardize clinical nursing practice and improve the nursing quality of children with hematological tumors.

Objective:To understand the characteristics of type D personality in patients with ischemic stroke, and to explore the correlation between type D personality and carotid plaque vulnerability in patients with ischemic stroke.Methods:From November 2019 to December 2020, convenience sampling was used to select 125 patients with ischemic stroke who underwent carotid color Doppler ultrasound examination in the Department of Neurology, Affiliated Hospital of Jining Medical University as the research subject. Carotid plaques were measured by color Doppler ultrasound in patients with ischemic stroke to determine whether they were vulnerable plaques. The patients were investigated using the Type D Personality Scale.Results:The proportion of type D personality in ischemic stroke patients was 52.8% (66/125) . Logistic regression analysis showed that type D personality and the social inhibition dimension of type D personality were the influencing factors of carotid plaque vulnerability in patients with ischemic stroke ( P<0.05) . Conclusions:Type D personality is closely associated with carotid plaque vulnerability in ischemic stroke patients. Medical and nursing staff should strengthen the screening of type D personality in patients with ischemic stroke and implement early intervention.

Objective:To discuss the clinical value of cystatin C (Cys C), serum creatinine (Scr) and serum urea nitrogen (Urea) in the diagnosis of mycoplasma pneumoniae-associated nephritis (MPAN), thus to provide reference basis for MPAN diagnosis.Methods:From June 2015 to June 2017, 50 patients with MPAN who were treated in Women and Children Hospital of Guangdong Province were selected as observation group, and 50 healthy children who underwent physical examination in the hospital during the same period were selected as control group.The observation group was divided into group A, group B and group C according to the level of endogenous creatinine clearance rate.The serum levels of Cys C, Scr and Urea were compared between the control group and the observation group.The levels of Cys C, Scr and Urea and the abnormal rate in group A, group B and group C were compared.Results:In the observation group, the Cys C levels of groups A, B and C were (1.25±0.13)mg/L, (1.74±0.34)mg/L, (3.72±1.33)mg/L, respectively, the Scr levels were (150.46±21.09)μmol/L, (268.57±108.68)μmol/L, (476.66±91.25)μmol/L, respectively, the Urea levels were (8.75±1.09)mmol/L, (11.49±1.50)mmol/L and (17.68±2.92)mmol/L, respectively.In the control group, the Cys C, Scr and Urea levels were (0.74±0.23)mg/L, (56.86±42.36)mol/L, (3.43±1.33)mmol/L, respectively.Compared with the control group, the Cys C level of the observation group was higher, the differences were statistically significant ( t=20.379, 22.991, 13.128, all P<0.05). The Scr level of each group in the observation group were higher than those of the control group, the differences were statistically significant ( t=21.768, 21.423, 43.640, all P<0.05). The Urea level of each group in the observation group was higher than that of the control group, the differences were statistically significant ( t=37.501, 33.404, 46.661, all P<0.05). The levels of Cys C, Scr and Urea in group C were higher than those in group B, the differences were statistically significant ( t=9.737, 9.333, 12.389, all P<0.05). The Cys C, Scr and Urea levels in group C were higher than those in group A, the differences were statistically significant ( t=19.880, 35.753, 27.127, all P<0.05). The Cys C, Scr and Urea levels in group B were higher than those in group A, the differences were statistically significant ( t=13.207, 11.163, 11.177, all P<0.05). In the early stage of renal function injury, namely renal insufficiency compensation stage, the abnormal rate of Cys C(62.07%) was significantly higher than that of Scr and Urea(10.34%, 24.13%). Conclusion:The serum Cys C, Scr and Urea levels of MPAN patients are all higher than healthy people.The more severe the renal function damage is, the higher the serum Cys C, Scr and Urea levels are, which can provide clinical reference for the diagnosis, disease prediction and auxiliary diagnostic criteria of MPAN.In particular, Cys C is more important for the early diagnosis of MPAN.