AIM: To compare the efficacy of highly aspherical lenslets(HAL), defocus incorporated multiple segments(DIMS), and single-vision spectacle lenses(SVL)in slowing myopia progression in children and adolescents.

METHODS: In this retrospective cohort study, myopic children and adolescents aged 6-16 y who were prescribed spectacle lenses at the hospital between January 2023 and June 2023 were included. Participants were divided into the HAL, DIMS, and SVL groups according to the correction modality voluntarily selected by participants and their guardians. The follow-up duration was 12 mo. After 12 mo of wear, changes from baseline in sphere, cylinder, spherical equivalent(SE), axial length(AL), flat corneal curvature(K1), steep corneal curvature(K2), mean corneal curvature, and binocular visual function \〖binocular cross-cylinder(BCC), negative/positive relative accommodation(NRA/PRA)\〗 were compared among the three groups after 12-month spectacle wear. Three groups were further stratified by age into age≤10 y and age>10 y subgroups to explore the effect of age on myopia control efficacy of defocus lenses.

RESULTS: A total of 159 myopic participants(159 eyes; only the right eye was included for each subject)were enrolled. In the HAL group(55 participants), there were 24 males and 31 females, with a mean age of 10.07±2.14 y. The DIMS group consisted of 60 participants(33 males, 27 females), with a mean age of 10.02±1.88 y. The SVL group included 44 participants(21 males, 23 females), with a mean age of 10.59±1.93 y. There were no significant differences in K1, K2, mean corneal curvature, NRA, BCC, and PRA among the three groups after 12-month spectacle wear(all P>0.05). There were statistically significant differences in the changes in sphere, SE, and AL(all P<0.05). The changes in sphere, cylinder, SE, and AL in the HAL and DIMS groups were significantly lower than those in the SVL group(all P<0.0167). The DIMS group showed a significantly smaller cylinder progression than the SVL group(P<0.0167). In participants aged≤10 y, the change in spherical power in the HAL group was significantly smaller than those in the DIMS group and SVL group after 12-month spectacle wear(all P<0.0167). The change in cylindrical power in the DIMS group was smaller than that in the SVL group(all P<0.0167). Among participants aged>10 y, the changes in spherical power, SE, and AL in both the HAL group and DIMS group were significantly smaller than those in the SVL group after 12-month spectacle wear(all P<0.0167).

CONCLUSION: Both HAL and DIMS lenses can effectively slow the progression of refractive error and AL elongation in children and adolescents, without significant adverse effects on binocular visual function. Among children≤10 y, HAL lenses yield superior spherical power control, whereas DIMS lenses provide better astigmatism control than SVL.

Objective:To explore the feasibility and safety of the combined liver and kidney procurement technique with preservation of the donor diaphragm.Methods:A retrospective study was conducted on the clinical data of 135 donors with pulmonary infection who underwent combined liver and kidney procurement and their corresponding 370 recipients in the Department of Transplantation, Guangxi Zhuang Autonomous Region People's Hospital from January 2021 to August 2023. According to whether the donor diaphragm was resected during procurement, the donors were divided into diaphragm preservation group (67 cases) and diaphragm resection group (68 cases). The t-test and chi-square test were used to compare the baseline characteristics of the donors, donor procurement time, surgical injury to organs, donor-derived infection (DDI), delayed graft function (DGF), primary non-function (PNF), and perioperative death between the two groups.Results:There were no statistically significant differences in age, sex, body mass index, number of organs procured, number of organs transplanted, number of organs discarded, or positive rate of sputum cultures for different strains between the two groups (all P>0.05). The donor procurement time was (46.70±12.61) min in the diaphragm preservation group and (45.79±12.78) min in the diaphragm resection group, with no statistically significant difference ( P=0.679). No surgical injuries to other abdominal organs (such as intestines or, in the diaphragm resection group, the lungs) occurred during procurement. After transplantation, the incidence of delayed graft function in kidney recipients was 7.32% (9/123) in the diaphragm preservation group and 11.67% (14/120) in the diaphragm resection group, with no statistically significant difference between the two groups ( P=0.279). The incidence of DDI was 0 in the diaphragm preservation group and 7.07% (13/184) in the diaphragm resection group, showing a statistically significant difference ( P<0.001). No cases of primary non-function or perioperative death occurred in either group. Conclusion:Compared with the conventional method, the combined liver and kidney procurement technique that preserves the donor diaphragm does not significantly increase operative time, organ injury, delayed graft function, primary non-function, or perioperative mortality. It significantly reduces the incidence of donor-derived infections and is worthy of clinical promotion and application.

Objective To investigate the effectiveness and safety of combining Omalizumab with compound glycyrrhetinic acid glycoside in the management of chronic urticaria that exhibits poor response to antihistamine therapy.Methods 92 patients with chronic urticaria who were treated with H1 antihistamines and still had symp-toms from February 2022 to February 2024 in the hospital were selected as the study subjects.The study partici-pants were randomly assigned to either the observation group,consisting of 46 cases,or the control group,also comprising 46 cases,using a random number table method.The control group received subcutaneous injection of omalizumab for treatment.The observation group was treated with oral compound glycyrrhizin tablets on the basis of the control group.After 24 weeks of treatment,compare the efficacy,adverse reactions,Urticaria Activity Score over 7 days(UAS7),Dermatology Life Quality Index(DLQI),Immunoglobulin(Ig)E,and High Sensitivity C-reactive protein(hs CRP)between the two groups,and record the recurrence rate.Results After treatment,the UAS7,DLQI,IgE and hs-CRP of both groups of patients decreased compared to before treatment,and the observation group demonstrated lower results compared to the control group(P<0.05).After treatment,the overall effectiveness rate in the observation group exceeded that of the control group(P<0.05),and the recurrence rate was lower than that of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of drugs(P>0.05).Conclusion The combination therapy of omali-zumab and compound glycyrrhetinic acid glycoside in the treatment of chronic urticaria patients with low response to antihistamines helps reduce IgE expression,improve treatment effectiveness,lower recurrence rates,and does not increase adverse drug reactions.

Objective:To explore the mechanisms of oxaliplatin resistance mediated by TET2 methylation in the treatment of acute lymphoblastic leukemia (ALL) using bioinformatics methods.Methods:The data on drug-resistant and sensitive cell lines related to oxaliplatin treatment for ALL were download using the Genomics of Drug Sensitivity in Cancer (GDSC) database (updated in December 2023); the drug-resistant cell lines were screened based on half maximal inhibitory concentration ( IC50) > 10 μmol/L, and the difference in IC50 between drug-resistant and sensitive cell lines were analyzed using Mann-Whitney U test. The cancer driver mutation genes in drug-resistant cell lines were retrieved using the Cancer Cell Line Encyclopedia (CCLE) database (updated in December 2023). Using the protein-protein interaction (PPI) network functional enrichment analysis (STRING) database (updated in June 2024), PPI network analysis was performed on cancer driver mutation genes with biological functions. A confidence threshold of ≥ 0.7 (high confidence) and an average network node degree above 4 (high average) were selected to screen for cancer driver mutation genes with significant biological functions. Using the microRNA Data Integration Portal (mirDIP) database (updated in June 2024), the coexpression data of microRNA (miRNA) and mutant target genes were queried, miRNA-target gene pairs were screened according to the highest score threshold of 1% miRNA and interaction score > 0.9, and the regulatory effect of miRNA on mutant genes was analyzed. DNA methylation data were download from the Methylation in Human Cancer (MethHC) database (updated in June 2024) and the methylSig R software package was used to analyze the differentially methylated regions (DMR) of DNA methylation between drug-resistant and sensitive cell lines; genes with P < 0.05 and absolute difference > 0.2 were selected, and they were divided into high methylation gene group and low methylation gene group. Spearman correlation analysis and Spearman rank test were performed for the degree of methylation and gene expression, and the key genes with P < 0.01 were screened to reveal the relationship between methylation degree and gene expression. Results:As a result of searching the GDSC database, there were a total of 9 drug-resistant cell lines and 17 sensitive cell lines related to oxaliplatin treatment for ALL; after Z-score normalization of IC50 data between drug-resistant and sensitive cell lines, the average rank of drug-resistant cell lines was 21, and the average rank of sensitive cell lines was 8.5, with a statistically significant difference ( Z = -4.08, P < 0.01). Eight cancer driver mutation genes with significant biological functions that lead to drug resistance of the cell lines were screened using the CCLE database and STRING database. According to the mirDIP database, there were a total of 12 pairs of miRNA-target gene pairs with miRNA-target gene interaction scores >0.9. miRNA had strong regulatory effects on the expressions of NRAS and MAP2K1 target genes. In the MethHC database, the β values (numerical value of increased methylation level) of DMR for genes such as TP53, RXRG and SGIP in drug-resistant cell lines were 0.151, 0.165 and 0.149, respectively, compared to those in sensitive cell lines, the differences were statistically significant (all P < 0.01). The degree of methylation of SGIP gene was negatively correlated with the relative expression level of SGIP mRNA ( r = -0.71, P < 0.01), and SGIP gene underwent high methylation at promoter site 143886940. The cg08321569 locus in the TET2 gene domain of drug-resistant cell lines exhibited persistent high methylation, with a methylation level of β = 0.89. This locus was located 1.2 kb downstream of the transcription start point of exon 4, and the degree of TET2 methylation was negatively correlated with the relative expression level of TET2b mRNA ( r = -0.81, P < 0.01). Conclusions:TET2 methylation may be an important factor for oxaliplatin resistance in the treatment of ALL.

Objective:To explore the feasibility and safety of the combined liver and kidney procurement technique with preservation of the donor diaphragm.Methods:A retrospective study was conducted on the clinical data of 135 donors with pulmonary infection who underwent combined liver and kidney procurement and their corresponding 370 recipients in the Department of Transplantation, Guangxi Zhuang Autonomous Region People's Hospital from January 2021 to August 2023. According to whether the donor diaphragm was resected during procurement, the donors were divided into diaphragm preservation group (67 cases) and diaphragm resection group (68 cases). The t-test and chi-square test were used to compare the baseline characteristics of the donors, donor procurement time, surgical injury to organs, donor-derived infection (DDI), delayed graft function (DGF), primary non-function (PNF), and perioperative death between the two groups.Results:There were no statistically significant differences in age, sex, body mass index, number of organs procured, number of organs transplanted, number of organs discarded, or positive rate of sputum cultures for different strains between the two groups (all P>0.05). The donor procurement time was (46.70±12.61) min in the diaphragm preservation group and (45.79±12.78) min in the diaphragm resection group, with no statistically significant difference ( P=0.679). No surgical injuries to other abdominal organs (such as intestines or, in the diaphragm resection group, the lungs) occurred during procurement. After transplantation, the incidence of delayed graft function in kidney recipients was 7.32% (9/123) in the diaphragm preservation group and 11.67% (14/120) in the diaphragm resection group, with no statistically significant difference between the two groups ( P=0.279). The incidence of DDI was 0 in the diaphragm preservation group and 7.07% (13/184) in the diaphragm resection group, showing a statistically significant difference ( P<0.001). No cases of primary non-function or perioperative death occurred in either group. Conclusion:Compared with the conventional method, the combined liver and kidney procurement technique that preserves the donor diaphragm does not significantly increase operative time, organ injury, delayed graft function, primary non-function, or perioperative mortality. It significantly reduces the incidence of donor-derived infections and is worthy of clinical promotion and application.

To summarize and analyze the clinical data of one case of kidney transplantation in an HIV-positive child with end-stage renal disease (ESRD) in the Department of Transplantation, the People's Hospital of Guangxi Zhuang Autonomous Region, and to explore the safety and efficacy of kidney transplantation in HIV-positive children with ESRD. This pediatric recipient was found to be HIV-positive at birth and underwent kidney transplantation due to ESRD, with good postoperative recovery. During the 2.5-year follow-up, no rejection or rebound in HIV RNA levels was observed. The function of the transplanted kidney was good, and the quality of life was comparable to that of healthy individuals. It suggests that kidney transplantation in HIV-positive children with ESRD is safe and effective under adequate preoperative preparation and close postoperative follow-up.

Objective To explore the application effect of bedside critical ultrasound in volume management of acute kidney injury(AKI)donors.Methods Clinical data of 56 AKI donors and 106 recipients from the Transplantation Center of People's Hospital of Guangxi Zhuang Autonomous Region from October 1,2020 to May 31,2022 were collected.They were divided into the critical ultrasound group(34 donors,66 recipients)and the traditional central venous pressure(CVP)group(22 donors,40 recipients)according to the volume management methods.The AKI stage and recovery time,renal function indicators(serum creatinine(Scr),cystatin C,estimated glomerular filtration rate),donor Remuzzi score,cold ischemia time,biventricular inotrope usage rate and time,delayed graft function(DGF)incidence and recovery time,and renal function indicators at 6 and 12 months after surgery were compared and analyzed between the two groups.Results There were no statistically significant differences in gender,age,body weight,AKI stage,pre-acquisition renal function indicators,biventricular inotrope usage rate,renal function indicators at 6 and 12 months after surgery,DGF recovery time,donor Remuzzi score and cold ischemia time of the donors and recipients between two groups(all P>0.05).The AKI recovery time,continuous renal replacement therapy rate and biventricular inotrope usage time of donors in the critical ultrasound group were shorter or lower than those in the traditional CVP group(all P<0.05).The incidence of DGF in recipients of the critical ultrasound group was lower than that of the traditional CVP group(P<0.05).Subgroup analysis showed that there was no statistically significant difference in Scr at 6 and 12 months after surgery in recipients of the critical ultrasound group(P>0.05),while the Scr at 12 months after surgery was higher than that at 6 months in recipients of the traditional CVP group(P<0.05).Conclusions AKI kidneys may be used for kidney transplantation after active maintenance.Bedside critical ultrasound has unique advantages in volume management of AKI donors and may improve the function of AKI kidneys to a certain extent.

Hereditary angioedema (HAE) is a rare genetic disorder, typically managed with on-demand medications during acute attacks. Clinical trials and real-world studies have demonstrated the efficacy and safety of icatibant in treating acute HAE attacks. This article aims to summarize research findings on icatibant in HAE treatment, providing a reference for its clinical application.

ObjectiveTo assess the level of health literacy and its influencing factors among middle school students aged 12‒18 years in Jing’an District, Shanghai, so as to provide a solid scientific foundation for further developing more targeted intervention measures. MethodsA stratified cluster random sampling method was used to randomly select 4 middle schools in Jing’an District, Shanghai from November to December 2023, and conducted a health literacy questionnaire survey on non-graduating middle and high school students, respectively. The2023 Survey on the Status of Health Literacy among Middle School Students in Jing’an District, Shanghai was adopted, which consisted of two parts: health literacy and basic information. Health literacy was divided into three dimensions: health knowledge and concept literacy, healthy lifestyle and behavior literacy, and health skill literacy. Three dimensions could be categorized into six types of health literacy issue: scientific health literacy, infectious disease prevention and control literacy, chronic disease prevention and control literacy, safety and first aid literacy, basic health literacy, and health information literacy. ResultsA total of 1 161 middle school students were enrolled into this study, including 571 males and 570 females. The overall health literacy level of middle school students was 33.51%, with 34.81% among middle school students and 31.69% among high school students, respectively. Results of logistic regression analysis showed that health knowledge acquisition and awareness, as well as application frequency of health knowledge, were the influencing factors for the overall health literacy level among middle school students (P<0.05). The degree of family attention to health maintenance, health knowledge acquisition and awareness, and application frequency of health knowledge were the main influencing factors for the three dimensions and literacy of six types of health issues among middle school students (P<0.05). ConclusionThe levels of different types of health literacy among middle school students in Jing’an District are uneven, with the highest being safety and first aid literacy and the lowest being basic health literacy. It is recommended to take targeted measures to comprehensively improve the health literacy level of middle school students.

Objective: To investigate the current status and trends of depressive symptoms among middle school and college students in Hunan Province, and to explore the primary related factors of depressive symptoms, so as to provide a scientific basis for strengthening mental health among students. Methods: A total of 279 382 students in Hunan Province were selected through a stratified cluster random sampling method from 2021 to 2023. National Survey Questionnaire on Common Diseases and Health Influencing Factors among Students was adopted for the survey, and the Center for Epidemiological Studies Depression Scale was used to assess their depressive symptoms. The χ 2 test and trend χ 2 test were used to analyze depressive symptoms prevalence and trends, and multivariable Logistic regression was used to analyze the related factors of depressive symptoms. Results: The prevalence of depressive symptoms among students in Hunan Province from 2021 to 2023 were 19.66%, 20.17% and 21.47%, respectively, showing an upward trend ( χ 2 trend =9.07, P <0.01). In addition, the results of the multivariable Logistic regression analysis showed that students with healthy diet ( OR=0.43, 95%CI =0.40-0.45), adequate sleep ( OR=0.88, 95%CI =0.86-0.90), and acceptable screen time ( OR=0.61, 95%CI =0.60-0.62) had lower risks in depressive symptoms detection, while students with smoking ( OR= 1.95, 95%CI =1.88-2.02), secondhand smoke exposure ( OR=1.33, 95%CI =1.30-1.36) and Internet addiction ( OR= 4.19 , 95%CI =4.05-4.34) had higher risks in depressive symptoms detection, with differences in the degree of association among different genders, educational stages and urban rural groups ( OR=0.40-6.04, Z =-12.69-11.98) ( P <0.05). Conclusions There is an increasing trend of depressive symptoms among middle school and college students in Hunan Province from 2021 to 2023.Targeted depression prevention measures should be taken for students with different demographic characteristics to promote their mental health.