AIM:To investigate the current status and influencing factors of knowledge-attitude-practice in myopia prevention and control among children and adolescents in Ningbo City, thereby providing a scientific basis for formulating targeted prevention strategies.METHODS: Children and adolescents aged 6-12 years old were selected from the medical-school collaborative myopia prevention network in Ningbo City between August 2024 and May 2025 using stratified cluster sampling. Information on myopia prevention knowledge(15 items)and practice(9 items)was collected through questionnaire surveys. Logistic regression models were used to analyze factors influencing myopia occurrence in children and adolescents.RESULTS: A total of 664 children and adolescents aged 6-12 years were enrolled in this study. Participants were divided by age into three groups: 6-7 years old(n=221), 8-9 years old(n=221), and 10-12 years old(n=222). Of the 664 questionnaires distributed, 637 valid questionnaires were returned(201 from the 6-7 age group, 235 from the 8-9 age group, and 201 from the 10-12 age group), yielding an effective response rate of 95.9%. Based on myopia screening results, the non-myopic group comprised 203 participants(31.9%), including 100 males and 103 females, with a mean age of 8.82±1.98 years old. The myopic group comprised 434 participants(68.1%), including 213 males and 221 females, with a mean age of 9.10±1.95 years old. The myopia prevalence rates in the 6-7, 8-9, and 10-12 age groups were 37.8%(76/201), 71.9%(169/235), and 94.0%(189/201), respectively(P<0.001). Regarding the knowledge and practice of myopia prevention, the overall awareness rate in the non-myopic group(59.7%±9.7%)was significantly higher than that in the myopic group(48.7%±8.5%; P<0.001). Additionally, the non-myopic group scored higher on the key practice of “regular eye examinations”(4.27±0.96)compared to the myopic group(4.10±1.05; P<0.05). Logistic regression analysis indicated that age was the primary risk factor for myopia occurrence.CONCLUSION: Age is the dominant factor in the onset of myopia, and there is a phenomenon of “knowledge-practice gap”; the traditional health education model has limitations, and a precise prevention and control system based on developmental patterns should be established.

Gorham-Stout disease(GSD) is a rare osteolytic disorder characterized by spontaneous and progressive osteolysis, along with abnormal angiogenesis and lymphangiogenesis, with no new bone formation. We present a case of a 15-year-old female admitted due to " recurrent right leg pain for 5 years, 11 months after undergoing right femoral fracture surgery". Through comprehensive integration of the patient's clinical phenotype, laboratory tests, imaging findings, pathological examinations, and molecular biological test results, GSD was considered highly likely. A multidisciplinary treatment approach was conducted, including a combination of zoledronic acid and sirolimus to inhibit osteolysis, along with rehabilitation training and orthopedic intervention, providing a personalized and comprehensive treatment strategy.

Gene therapy research for fundus diseases has made significant progress recently, offering new hope for refractory ocular conditions. This review summarizes the latest developments, evaluates challenges, and explores future trends. Gene therapies for inherited retinal diseases, including commercialized RPE65-LCA therapy, clinical advances in retinitis pigmentosa(RP)subtypes and Stargardt disease, and the “bilateral effect” in Leber hereditary optic neuropathy(LHON)therapy, were highlighted in this review. Gene therapy strategies for complex disorders such as age-related macular degeneration(ARMD)and diabetic retinopathy(DR)were discussed. Advances in gene delivery systems, including adeno-associated virus(AAV)vectors, non-viral vectors, and CRISPR/Cas9 applications, were also analyzed. Furthermore, major challenges, including safety, immunogenicity, long-term efficacy, and personalized approaches were also discussed. Research indicates fundus gene therapy is transitioning from proof-of-concept to clinical application. With continued innovation and experience, it promises to provide precise treatment options, significantly improving visual outcomes for patients.

OBJECTIVES: Mobile phone dependence has become increasingly prominent among university students, posing significant risks to their social functioning and mental health. Previous studies suggest that perfectionistic personality traits may be key psychological predictors of mobile phone dependence, but the underlying mechanisms remain unclear. This study aims to identify core symptoms of mobile phone dependence among university students and to examine the pattern of associations between different dimensions of perfectionism and mobile phone dependence. METHODS: A cross-sectional questionnaire survey was conducted among 1404 university students nationwide. The Mobile Phone Involvement Questionnaire (MPIQ) and the Forst Multidimensional Perfectionism Scale (FMPS) were used to assess mobile phone use and perfectionism traits. The EBIC-GLASSO network model was constructed to analyze the network structure linking perfectionism and mobile phone dependence. RESULTS: A total of 56.48% of university students in the sample met the criteria for mobile phone dependence. The total FMPS score was positively correlated with the total MPIQ score (r=0.47, P<0.001). Results of multiple linear regression controlling for demographic variables showed that dimensions of FMPS score significantly predicted MPIQ score (all P<0.05). Network analysis revealed that the central dimension in perfectionism is "organization" (expected influence=2.69) and the core symptom of mobile phone dependence was "I lose track of how much I am using my smartphone" (expected influence= 0.78). Bridge centrality analysis identified "organization" as a key bridging factor linking perfectionism and mobile phone dependence (bridge strength=1.96). Among the symptom-to-symptom connections, "parental expectations" showed the strongest positive association with "arguments have arisen with others because of my mobile phone use" (partial correlation coefficient=0.15), serving as a risk factor. In contrast, "organization" was most strongly negatively associated with the same symptom (partial correlation coefficient=-0.13), serving as a protective factor, suggesting a protective effect. CONCLUSIONS Mobile phone dependence is common among college students and is primarily characterized by a lack of self-control in phone use. Although perfectionism is generally positively associated with mobile phone dependence, its internal dimensions appear to exert a dual effect. Specifically, "parental expectations" and "doubt over actions" may increase the risk of mobile phone dependence, whereas "organization" serves as a protective factor, particularly against interpersonal conflicts related to phone dependency.
Humans ; Perfectionism ; Students/psychology* ; Cell Phone ; Universities ; Cross-Sectional Studies ; Male ; Female ; Surveys and Questionnaires ; China ; Young Adult ; Adult ; Adolescent ; Personality

Objective:To investigate the trajectory of frailty in elderly patients on maintenance hemodialysis(MHD)following SARS-CoV-2 infection and its associated risk factors.Methods:This prospective cohort study focused on elderly patients who underwent baseline frailty assessment(T0)during hemodialysis treatment at Beijing Friendship Hospital for over 3 months between December 1st, 2022, and December 31th, 2022, and were diagnosed with SARS-CoV-2 infection.The Fried Frailty Phenotype was evaluated at 1 month(T1), 3 months(T2), and 6 months(T3)post-infection.Frailty trajectory after infection was analyzed using repeated measurement ANOVA.Patients were divided into stable/improvement or exacerbation groups based on their frailty status at T0 and T3, with logistic regression analysis employed to identify risk factors for different frailty trajectories.Results:A total of 130 elderly maintenance hemodialysis patients, with a median age of 66 years(range: 63-71 years)and 62 males(47.7%), were included in the study.Six months after the infection, a majority of surviving patients saw their frailty scores return to baseline levels.Specifically, 72 patients(55.4%)either maintained or improved to robust or pre-frail states, while 9 patients(6.9%)progressed to a pre-frail state, 18 patients(13.8%)progressed to a frail state, and 31 patients(23.8%)remained in a frail state.Results from multivariate logistic regression analysis indicated that low grip strength( OR: 6.30, 95% CI: 1.48-26.73)and all-cause hospitalization( OR: 5.01, 95% CI: 1.19-21.03)were identified as risk factors for non-frail patients transitioning to frailty( P<0.05). Conclusions:The majority of elderly maintenance hemodialysis patients who survived SARS-CoV-2 infection returned to their baseline level of frailty or showed improvement within 6 months.Non-frail patients with low grip strength or those who were hospitalized were more likely to deteriorate towards frailty.

Objective To investigate the adverse pregnancy outcomes of fetuses with increased nuchal translucency(NT).Methods A total of 376 pregnant women at the Third Affiliated Hospital of Zhengzhou University from May 2023 to January 2024 were selected as research subjects,who had a diagnosis of fetal NT ≥ the 95th percentile and complete pregnancy outcomes for singleton pregnancies.The fetuses were divided into simple thickening group(n=320)and thickening with structural abnormalities group(n=56)based on NT ultrasound results.The interventional prenatal diagnosis outcomes and pregnancy outcomes of two groups were compared.Results The rate of chromosomal abnormalities and the incidence of adverse pregnancy outcomes were higher in thickening with structural abnormalities group compared to simple thickening group with statistically significant differences(P＜0.05).The overall incidence of adverse pregnancy outcomes in NT thickened fetuses was 31.65％,but after excluding chromosomal abnormalities and structural malformations,the good pregnancy outcome rate in NT thickened fetuses was 98.09％.Conclusion NT thickening is associated with adverse pregnancy outcomes in fetuses,and the risk of poor fetal outcome is further increased when NT thickening combined with structural abnormalities in early pregnancy,but the pregnancy outcome is better in fetuses with NT thickening after excluding chromosomal abnormalities and structural malformations.

Objective:To investigate the predictive value of the Japanese nutritional risk index(NRI)for one-year all-cause mortality risk among elderly maintenance hemodialysis (MHD)patients.Additionally, it seeks to compare the predictive abilities of NRI with those of the geriatric nutritional risk index (GNRI)and the mini nutritional assessment short-form(MNA-SF).Methods:This research was conducted as a prospective cohort study.Elderly patients(aged ≥60 years)who underwent hemodialysis treatment at Beijing Friendship Hospital of Capital Medical University for more than three months between July and October 2019 were selected for inclusion.The NRI score was utilized to evaluate the nutritional status of the participants, with the maximum point of the Jordan index designated as the cut-off value, thereby categorizing patients into high-risk and low-risk groups.The follow-up period concluded in August 2020, with all-cause mortality serving as the primary outcome measure.Kaplan-Meier methods were employed to construct survival curves, and the Cox proportional hazards model was applied to analyze the association between NRI and all-cause mortality.Furthermore, area under the curve(AUC) of receiver operating characteristic(ROC)curves were utilized to compare the predictive values of the three nutritional assessment methods(NRI, GNRI, and MNA-SF)regarding mortality risk.Results:A total of 150 patients were included in the study, with a median age of 69(64.75) years.The cohort comprised 73 males(48.7%)and 77 females(51.3%). Based on the NRI, patients were categorized into a low-risk group(NRI<5; n=81, 54.0%)and a high-risk group(NRI ≥ 5; n=69, 46.0%). Of the 150 patients, 147 completed the follow-up.During the follow-up period, 15 patients died, with 13 from the high-risk group and 2 from the low-risk group.The Kaplan-Meier survival curve indicated that the 1-year cumulative survival rate for patients in the high-risk group was significantly lower than the low-risk group (log-rank χ2=11.71, P<0.001). Furthermore, multivariate Cox regression analysis revealed a significant association between NRI and 1-year all-cause mortality in elderly patients undergoing MHD ( HR=3.779, 95% CI: 1.036-13.783, P=0.044). Additionally, NRI demonstrated a high predictive value for 1-year all-cause mortality risk in elderly MHD patients, with an AUC of 0.755(95% CI: 0.654-0.855), a sensitivity of 86.7%, and a specificity of 59.1%.Its predictive capability was slightly superior to that of the GNRI(AUC=0.691, 95% CI: 0.548-0.835)and the MNA-SF(AUC=0.634, 95% CI: 0.475-0.793), although no statistically significant differences were observed( Z=0.880, 1.177, P=0.379, 0.239). Conclusions:The NRI score demonstrates effective predictive capability for one-year all-cause mortality risk in elderly MHD patients and may serve as a more suitable nutritional assessment method for this population.

OBJECTIVE: To review the clinical characteristics of patients with traumatic spinopelvic dissociation (SPD) and explore the diagnostic and therapeutic methods. METHODS: A clinical data of 22 patients with SPD who underwent surgical treatment between March 2019 and August 2024 was retrospectively analyzed. There were 13 males and 9 females, with an average age of 35.5 years (range, 14-61 years). The causes of injury included falling from height in 16 cases, traffic accidents in 5 cases, and compression injury in 1 case. Sacral fractures were classified based on morphology into "U" type (9 cases), "H" type (7 cases), "T" type (4 cases), and "λ" type (2 cases). According to the Roy-Camille classification, there were 4 cases of type Ⅰ, 12 cases of type Ⅱ, 2 cases of type Ⅲ, and 4 cases of type Ⅳ. The Cobb angle was (35.7± 22.0)°. Sixteen patients were accompanied by lumbosacral trunk and cauda equina nerve injury, which was classified as grade Ⅱ in 5 cases, grade Ⅲ in 5 cases, and grade Ⅳ in 6 cases according to the Gibbons grading. The time from injury to operation was 2-17 days (mean, 5.7 days). Based on the type of sacral fracture and sacral nerve injury, 6 cases were treated with closed reduction and minimally invasive percutaneous sacroiliac screw fixation, 16 cases were treated with open reduction and lumbar iliac fixation (8 cases)/triangular fixation (8 cases). Among them, 11 patients with severe fracture displacement and kyphotic deformity leading to sacral canal stenosis or bony impingement within the sacral foramen underwent laminectomy and sacral nerve decompression. X-ray films and CT were reviewed during followed-up. The Matta score was used to evaluate the quality of fracture reduction. At last follow-up, the Majeed score was used to assess the functional recovery, and the Gibbons grading was used to evaluate the nerve function. RESULTS: All operations were successfully completed. All patients were followed up 8-64 months (mean, 20.4 months). Two patients developed deep vein thrombosis of the lower limbs, 2 had incision infections, and 1 developed a sacral pressure ulcer; no other complications occurred. Radiological examination showed that the Cobb angle was (12.0±6.8)°, which was significantly different from the preoperative one ( t=6.000, P<0.001). The Cobb angle in 16 patients who underwent open reduction was (14.9±5.5)°, which was significantly different from the preoperative one [(46.8±13.9)° ] ( t=8.684, P<0.001). According to the Matta scoring criteria, the quality of fracture reduction was rated as excellent in 8 cases, good in 7 cases, fair in 5 cases, and poor in 2 cases, with an excellent and good rate of 68.2%. Bone callus formation was observed at the fracture site in all patients at 12 weeks after operation, and bony union achieved in all cases at last follow-up, with a healing time ranging from 12 to 36 weeks (mean, 17.6 weeks). At last follow-up, the Majeed score was rated as excellent in 7 cases, good in 10 cases, fair in 4 cases, and poor in 1 case, with an excellent and good rate of 77.3%. One patient experienced a unilateral iliac screw breakage at 12 months after operation, but the fracture had already healed, and there was no loss of reduction. Among the 16 patients with preoperative sacral nerve injury, 11 cases showed improvement in nerve function (6 cases) or recovery (5 cases). CONCLUSION SPD with low incidence, multiple associated injuries, and high incidence of sacral nerve injury, requires timely decompression of the sacral canal for symptomatic sacral nerve compression, fractures reduction, deformities correction, and stable fixation.
Humans ; Adult ; Female ; Male ; Retrospective Studies ; Middle Aged ; Spinal Fractures/diagnostic imaging* ; Adolescent ; Sacrum/diagnostic imaging* ; Fracture Fixation, Internal/methods* ; Young Adult ; Pelvic Bones/surgery* ; Treatment Outcome ; Bone Screws

Objective To construct CD19-targeted chimeric antigen receptor natural killer(CAR-NK)cells armored with interleukin15(IL15)or IL15 receptor-linker(RLI)and preliminarily validate their proliferative capacity and anti-tumor activity in vitro.Methods Natural killer cells(NK92 and NK92MI)from patients with human malignant non-Hodgkin lymphoma were cultured,and CD19-targeted CAR-NK cells armored with IL15 or RLI were prepared using retroviral vector particles.IL15 secretion was measured by ELISA,and proliferative capacity was assessed via CFSE dilution assays.Human B-lymphocytic leukemia cells(Nalm6-GFP-Luc)and human colon cancer cells overexpressing CD19(hCD19-SW620-GFP-Luc)were cultured,with surface CD19 expression confirmed(>99%positivity for both).Anti-tumor activity was evaluated by measuring cytotoxicity at effector-to-target(E:T)ratios using luciferase-based assays(4/12 h),detecting surface CD107a expression via flow cytometry,and quantifying cytokine release using CBA assays.Results NK92/NK92MI-CD19 CAR cells armored with IL15 or RLI were successfully generated.IL15 secretion was significantly higher in armored groups versus non-armored controls(P<0.01).Without IL-2 stimulation,IL15/RLI enhanced CAR-NK proliferation(P<0.05).Both armored designs significantly increased tumor-killing efficiency(P<0.05)and CD107a degranulation.IL15/RLI-armored NK92-CD19 CAR cells exhibited elevated release of IL2,IL10,IL6,TNF-α,sFas,IFN-γ,and Granulysin(P<0.05),while armored NK92MI-CD19 CAR cells showed additional increases in Granzyme A,Granzyme B,and Perforin(P<0.05).Conclusion IL15/RLI-armored NK92/NK92MI-CD19 CAR cells demonstrate potent anti-tumor activity,supporting their combined clinical therapeutic potential for tumors.

AIM:To investigate the regulatory effects of proanthocyanidins on autophagy and apoptosis in the retinas of guinea pigs with form-deprivation myopia via the AMPK/Wnt/β-catenin pathway.METHODS:Fifty guinea pigs were randomly divided into a normal control group, a myopia model group, and low-dose, medium-dose, and high-dose proanthocyanidins groups(25, 50 and 100 mg/kg). Refractive power and axial length of right eye were measured using a retinoscope and A-scan ultrasound. Retinal pathological changes were observed via HE staining. Immunohistochemistry assessed p-AMPK and p-mTOR expression in the retina. Immunofluorescence detected p62 and LC3 expression. TUNEL staining evaluated retinal cell apoptosis. Western blot examined expression of proteins related to the AMPK/Wnt/β-catenin pathway and autophagy(p62, Beclin1, LC3-II/LC3-I), and apoptosis-related proteins(Bax, Bcl-2, Cleaved-Caspase3, Caspase3)in the retina.RESULTS:Compared with the control group, the myopia model group showed significantly reduced refractive power and significantly increased axial length(both P<0.05); retinal cell arrangement became sparse and retinal thickness thinned. The p-AMPK levels in the retina were significantly reduced, while p-mTOR levels were significantly increased(both P<0.05), indicating suppression of the AMPK-Wnt/β-catenin pathway. The p62 levels were significantly elevated and LC3 levels were significantly reduced(both P<0.05), suggesting inhibition of autophagy. Bax and Cleaved-Caspase3 were significantly increased, while Bcl-2 was significantly decreased, indicating significantly increased apoptosis(both P<0.05). Compared with the myopia model group, all proanthocyanidins dose groups significantly inhibited refractive error reduction and axial length growth(both P<0.05), restored retinal cell alignment and thickness, activated the AMPK/Wnt/β-catenin pathway, significantly increased p-AMPK expression, and suppressed p-mTOR expression(all P<0.05); significantly suppressed p62 expression, increased Beclin1 and LC3-II/LC3-I expression(both P<0.05), and activated retinal autophagy; significantly suppressed Bax and Cleaved-Caspase3 expression, increased Bcl-2 expression(both P<0.05), and inhibited retinal cell apoptosis.CONCLUSION:Proanthocyanidins enhance retinal autophagy by activating the AMPK/Wnt/β-catenin pathway, thereby inhibiting retinal apoptosis and preventing or alleviating the onset of myopia.