Objective: To explore the differences and consistency among three objective refraction methods, namely, retinoscopy after cycloplegia, the Spot binocular vision screener, and automated computer refractometry in preschool children, so as to provide evidence for optimizing refractive assessment strategies in this population. Methods: A total of 116 preschool children aged 2-6 years who were referred to the Ophthalmology Department of Anhui Women and Children s Medical Center because of abnormal vision screening results between August 2025 and March 2026 were enrolled by using purposive sampling. After adequate cycloplegia was achieved with 1% atropine ophthalmic gel, objective refraction was performed by using cycloplegic retinoscopy, the Spot Vision Screener, and an autorefractor. Differences in spherical equivalent (SE) among the three methods were compared using the Friedman test, while differences in myopia detection rates were assessed using Cochran s Q test. Cycloplegic retinoscopy was used as the reference standard to evaluate the diagnostic accuracy and reliability of the Spot Vision Screener and the autorefractor for myopia detection. Results: The median (interquartile range) spherical equivalent (SE) values for the right eye were identical across the three methods:1.50 (0.75, 2.50) D for cycloplegic retinoscopy, the Spot Vision Screener, and the autorefractor. For the left eye, the corresponding values were 1.50 (0.50, 2.50), 1.50 (0.50, 2.50), and 1.63 (0.75, 2.50) D, respectively. There were no significant differences in SE measurements among the three methods for either eye ( χ 2=3.77, 3.28, both P >0.05). The myopia detection rates of cycloplegic retinoscopy, the Spot Vision Screener, and the autorefractor were 13.79%, 12.07%, and 13.79%, respectively, for the right eye, and 13.79%, 14.66%, and 12.93%, respectively, for the left eye, with no significant differences among the three methods (Cochran s Q =1.60, 1.14, both P >0.05). Using cycloplegic retinoscopy as the reference standard, both the Spot Vision Screener and the autorefractor demonstrated high diagnostic accuracy and reliability for detecting myopia. Compared with the Spot Vision Screener, the autorefractor showed higher sensitivity (right eye:93.75%, 81.25%; left eye:88.24%, 76.47% ), Youden index (right eye:0.93, 0.80; left eye:0.86, 0.74), overall agreement (right eye:98.28%, 96.55%; left eye:96.55%, 94.83%), and Cohen s Kappa coefficient (right eye:0.93, 0.85; left eye:0.86, 0.78). Conclusion Under standardized cycloplegic conditions, the Spot Vision Screener and the autorefractor can serve as alternatives to retinoscopy for assessing refractive status, particularly in large scale screening and in children with poor cooperation.

ObjectiveTo investigate the clinical efficacy of Qihuang Jianpi Zishen granules in the treatment of systemic lupus erythematosus （SLE），observe their effects on renal podocyte injury，and decipher related mechanisms. MethodsSixty-two SLE patients with renal damage who met the inclusion criteria and treated in the First Affiliated Hospital of Anhui University of Chinese Medicine between November 2022 and July 2024 were selected. They were randomly allocated into a control group and an observation group （31 patients in each group）. The control group was treated with oral hydroxychloroquine sulfate，prednisone acetate，and mycophenolate mofetil. The observation group received Qihuang Jianpi Zishen granules orally in addition to the regimen in the control group. After 12 weeks of continuous treatment，the SLE Responder Index-4 （SRI-4） response rate was evaluated for both groups. Comparisons were made between the two groups before and after treatment regarding disease activity scores，traditional Chinese medicine （TCM） symptom scores，kidney-related indicators ［serum creatinine （SCr），cystatin C （Cys C），24-hour urine protein quantitation （24 h Pro），urine protein/creatinine ratio （UPCR），and urine albumin/creatinine ratio （UACR）］，immune and inflammatory markers ［anti-double-stranded DNA antibody，interferon-γ （IFN-γ），and monocyte chemoattractant protein-1 （MCP-1）］，urinary podocyte injury markers （Nephrin，Podocin，and WT-1），and mRNA levels of apoptosis-related factors （Bax，Bcl-2，and Caspase-3） in peripheral blood mononuclear cells. Adverse reactions were recorded. ResultsAfter 12 weeks of treatment，the SRI-4 response rate in the observation group was 48.38%（15/31），which was higher than that in the control group 36.66%（11/30）. Within-group comparisons showed that after treatment，both groups exhibited decreases in TCM symptom scores，kidney-related indicators （UACR，UPCR，24 h Pro，SCr，and CysC），inflammatory markers （IFN-γ and MCP-1），podocyte injury markers （Nephrin，Podocin，and WT-1），and the mRNA levels of Bax and Caspase-3 （P<0.05，P<0.01） and an increase in the mRNA level of Bcl-2 （P<0.01）. After treatment，the observation group showed lower disease activity score，TCM symptom scores，levels of UACR，UPCR，24 h Pro，SCr，IFN-γ，MCP-1，and podocyte injury markers （Nephrin，Podocin，WT-1），and mRNA level of Bax （P<0.05，P<0.01） and higher mRNA level of Bcl-2 （P<0.05） than the control group. No serious adverse reactions occurred during the treatment period. ConclusionQihuang Jianpi Zishen granules can effectively reduce the disease activity，TCM symptoms，proteinuria，podocyte injury，and renal damage in patients with SLE by regulating the immune-inflammatory state，mitigating podocyte injury，and inhibiting cell apoptosis.

In 2016， the World Health Organization proposed the vision of eliminating viral hepatitis as a public health threat by 2030， and since then， China has actively promoted the elimination of hepatitis C as a public health threat and has made great achievements by formulating policies， clarifying main tasks， focusing on key issues， and implementing prevention and treatment measures. This article reviews the advances and achievements in China’s actions to eliminate hepatitis C as a public health threat since 2016， analyzes the existing problems and challenges， and puts forward recommendations for future prevention and control strategies， in order to provide a reference for achieving the goal of eliminating viral hepatitis as a public health threat by 2030.

Over the past three decades， China has made significant progress in the prevention and control of viral hepatitis， and the incidence rates of new-onset pediatric hepatitis B virus infections and acute viral hepatitis in the population have reduced to a relatively low level； however， there is still a heavy disease burden of chronic viral hepatitis in China， which severely affects the health status of the population. This study systematically summarizes the achievements of viral hepatitis prevention and control in China， analyzes existing problems and challenges， and proposes comprehensive prevention and control strategies and measures to eliminate viral hepatitis as a public health threat based on the national conditions of China， in order to provide a reference for related departments in China on how to achieve the action targets for eliminating viral hepatitis as a public health threat by 2030.

Objective To investigate the efficacy of Qihuang Jianpi Zishen Granules(QJZ)for inhibiting renal B cell differentiation in MRL/lpr mice and explore its underlying mechanism.Methods Thirty 8-week-old female MRL/lpr mice were randomly divided into model group,QJZ group,prednisone(Pred)group,QJZ+Pred group,and AIM2 inhibitor group(n=6),with 6 8-week-old female C57BL/6 mice as the normal control group.After treatments with normal saline,QJZ,Pred,or AIM2 inhibitor for 8 weeks,the mice were examined for urinary total protein-to-creatinine ratio(TPCR)and albumin-to-creatinine ratio(ACR),serum creatinine(Cr)and blood urea nitrogen(BUN)levels,and renal histopathology(with HE,Masson,and PAS staining)and ultrastructural changes(with electron microscopy).ELISA,immunohistochemistry,immunofluorescence staining and flow cytometry were used to detect blood levels of anti-dsDNA antibodies,cytokines and chemokines,renal deposition of complement components C3 and C4,renal expressions of AIM2,CD19,CD27 and CD138,and changes in splenic B lymphocyte subsets.The effect of QJZ on the AIM2/Blimp-1/Bcl-6 signaling axis was examined using Western blotting.Results QJZ treatment significantly improved Cr,BUN,TPCR and ACR in MRL/lpr mice,ameliorated renal pathologies,reduced the expressions of ds-DNA,BAFF,IL-21,CXCL12,CXCL13,C3 and C4,and increased IL-10 levels.QJZ significantly downregulated renal expressions of the key B-cell transcription factors Blimp-1 and XBP-1,upregulated Bcl-6 and PAX5 expressions,inhibited B-cell differentiation,and lowered the expressions of AIM2,CD27,CD138 and CD69.Inhibition of AIM2 similarly reduced renal Blimp-1 and XBP-1 expressions,increased Bcl-6 and PAX5 levels,suppressed B-cell differentiation,decreased IgG production,reduced C3 and C4 deposition,and alleviated renal pathology in MRL/lpr mice.Conclusion QJZ inhibits B cell differentiation and alleviates renal damage in systemic lupus erythematosus possibly by suppressing the AIM2/Blimp-1/Bcl-6 signaling pathway.

Objective To investigate the mechanism of Qihuang Jianpi Zishen Granules(QJZ)for ameliorating renal damage in MRL/lpr mice.Methods With 6 female C57BL/6 mice as the normal control group,30 female MRL/lpr mice were randomized into model group,QJZ treatment groups at low,moderate and high doses,and prednisone treatment group(n=6).After 8 weeks of treatment,the mice were examined for 24-h urine protein,creatinine and albumin levels,serum levels of IgG,complement 3(C3),C4,anti-dsDNA,interferon γ(IFN-γ)and interleukin 17(IL-17).Kidney tissues were sampled for histopathological examination with HE staining and observation of glomerular ultrastructure changes using transmission electron microscopy(TEM).The expressions of MyD88/NF-κB pathway-related molecules in the kidney tissue were detected using RT-qPCR,Western blotting and immunohistochemistry.Results Compared with those in the model group,the mice treated with QJZ at the 3 doses and prednisone showed significant reductions in the renal injury biomarkers and serum IgG,anti-dsDNA,IFN-γ and IL-17 levels and elevation of serum C3 and C4 levels.HE staining revealed lessened glomerular endothelial cell proliferation and mesangial thickening in all the treatment groups.TEM observation further demonstrated reduced electron-dense deposits and diminished inflammatory cell infiltration in the glomeruli in the intervention groups.QJZ at the 3 doses and prednisone treatment all significantly lowered renal expression levels of MyD88,NF-κB,p65 and p52 in the mouse models.Conclusion QJZ can improve renal damage in MRL/lpr mice possibly by inhibiting overactivation of the MyD88/NF-κB pathway.

Objective:To analyze the awareness of HCV infection status and willingness for HCV-RNA testing among hepatitis C cases in four provinces in China and to provide a reference for adjusting HCV prevention and control strategies.Methods:From September 2021 to September 2022, a cross-sectional survey was conducted using stratified random cluster sampling in four provinces (Jiangsu, Henan, Hubei, and Yunnan) in China, with an estimated sample size of 6 468 participants. The questionnaire included sociodemographic information, HCV infection awareness, willingness for HCV-RNA testing, and history of high-risk behaviors from the survey participants. Logistic regression models were used to analyze the factors associated with HCV infection awareness and willingness for HCV-RNA testing among hepatitis C cases. Statistical analysis was performed using R 4.1.3 software.Results:A total of 10 563 hepatitis C cases were surveyed. The awareness rate of HCV infection was 86.74% (9 162/10 563), and the willingness rate for HCV-RNA testing was 85.21% (9 001/10 563). Multivariate logistic regression models analysis showed that the awareness rate of HCV infection was lower among individuals aged ≥60 years, urban residents (with New Rural Cooperative Medical Insurance ), those without a history of blood transfusion, those without a history of paid blood donation, those without a history of injection drug use, and those without a family member with hepatitis C case.The awareness rate was higher among individuals with high or technical secondary school education, college education or above, and those married with a spouse (all P<0.05). In terms of willingness for HCV-RNA testing, it was lower among females, individuals aged ≥60 years, and those without a history of blood transfusion, paid blood donation, or injection drug use. The willingness was higher among farmers or migrant workers, employees of enterprises or institutions, and those in other occupations (all P<0.05). Conclusions:There was room for improvement in the awareness proportion of HCV infection and willingness for HCV-RNA testing among hepatitis C cases in the four provinces of China. More convenient policies and measures should be provided to increase the awareness rate of HCV infection and the willingness to undergo HCV-RNA testing in this population.

Objective To analyze the expression and clinical significance of stimulator of interfer-on genes(STING),C-C motif chemokine ligand 5(CCL5),interferon regulatory factor 3(IRF3)and programmed death ligand-1(PDL1)in squamous cell lung cancer.Methods A total of 56 pa-tients with squamous cell lung cancer were enrolled.Resected tumor tissues and adjacent non-tumor tissues(located more than 5 cm from the tumor margin)were collected.Immunohistochemical staining was performed to detect the expression of STING,CCL5,IRF3 and PDL1.The correlations of STING,CCL5,IRF3 and PDL1 with clinical data were analyzed.The relationship between the expression of STING,CCL5,IRF3 and PDL1 in lung squamous cell carcinoma tissues and prognosis was also evalua-ted.The prognostic factors of patients with lung squamous cell carcinoma were analyzed.Results The positive rate of STING expression in lung squamous cell carcinoma tissues was significantly lower than that in adjacent non-tumor tissues,whereas the positive rates of CCL5,IRF3 and PDL1 were significantly higher(P＜0.05).The expression levels of STING,CCL5,IRF3 and PDL1 were associated with tumor diameter,TNM stage,lymph node metastasis and differentiation degree(P＜0.05).The 3-year survival rate of STING positive expression patients was significantly higher than that of STING negative expression patients(P＜0.05).The 3-year survival rate of CCL5 positive,IRF3 positive and PDL1 positive expression patients was significantly lower than that of CCL5 negative,IRF3 negative and PDL1 negative expression patients(P＜0.05).STING,CCL5,IRF3 and PDL1 were identified as prognostic factors for patients with squamous cell lung cancer(P＜0.05).Conclusion In squamous cell lung cancer tissues,STING is expressed at low levels,while CCL5,IRF3 and PDL1 are ex-pressed at high levels.These findings have significant clinical value in assessing the prognosis of pa-tients with squamous cell lung cancer.

OBJECTIVES: To investigate the mechanism of Qihuang Jianpi Zishen Granules (QJZ) for ameliorating renal damage in MRL/lpr mice. METHODS: With 6 female C57BL/6 mice as the normal control group, 30 female MRL/lpr mice were randomized into model group, QJZ treatment groups at low, moderate and high doses, and prednisone treatment group (n=6). After 8 weeks of treatment, the mice were examined for 24-h urine protein, creatinine and albumin levels, serum levels of IgG, complement 3 (C3), C4, anti-dsDNA, interferon γ (IFN‑γ) and interleukin 17 (IL-17). Kidney tissues were sampled for histopathological examination with HE staining and observation of glomerular ultrastructure changes using transmission electron microscopy (TEM). The expressions of MyD88/NF-κB pathway-related molecules in the kidney tissue were detected using RT-qPCR, Western blotting and immunohistochemistry. RESULTS: Compared with those in the model group, the mice treated with QJZ at the 3 doses and prednisone showed significant reductions in the renal injury biomarkers and serum IgG, anti-dsDNA, IFN‑γ and IL-17 levels and elevation of serum C3 and C4 levels. HE staining revealed lessened glomerular endothelial cell proliferation and mesangial thickening in all the treatment groups. TEM observation further demonstrated reduced electron-dense deposits and diminished inflammatory cell infiltration in the glomeruli in the intervention groups. QJZ at the 3 doses and prednisone treatment all significantly lowered renal expression levels of MyD88, NF-κB, p65 and p52 in the mouse models. CONCLUSIONS QJZ can improve renal damage in MRL/lpr mice possibly by inhibiting overactivation of the MyD88/NF-κB pathway.
Animals ; Drugs, Chinese Herbal/therapeutic use* ; Female ; Mice, Inbred C57BL ; Mice, Inbred MRL lpr ; Myeloid Differentiation Factor 88/metabolism* ; Mice ; NF-kappa B/metabolism* ; Signal Transduction/drug effects* ; Kidney/metabolism* ; Interleukin-17

OBJECTIVES: To investigate the efficacy of Qihuang Jianpi Zishen Granules (QJZ) for inhibiting renal B cell differentiation in MRL/lpr mice and explore its underlying mechanism. METHODS: Thirty 8-week-old female MRL/lpr mice were randomly divided into model group, QJZ group, prednisone (Pred) group, QJZ+Pred group, and AIM2 inhibitor group (n=6), with 6 8-week-old female C57BL/6 mice as the normal control group. After treatments with normal saline, QJZ, Pred, or AIM2 inhibitor for 8 weeks, the mice were examined for urinary total protein-to-creatinine ratio (TPCR) and albumin-to-creatinine ratio (ACR), serum creatinine (Cr) and blood urea nitrogen (BUN) levels, and renal histopathology (with HE, Masson, and PAS staining) and ultrastructural changes (with electron microscopy). ELISA, immunohistochemistry, immunofluorescence staining and flow cytometry were used to detect blood levels of anti-dsDNA antibodies, cytokines and chemokines, renal deposition of complement components C3 and C4, renal expressions of AIM2, CD19, CD27 and CD138, and changes in splenic B lymphocyte subsets. The effect of QJZ on the AIM2/Blimp-1/Bcl-6 signaling axis was examined using Western blotting. RESULTS: QJZ treatment significantly improved Cr, BUN, TPCR and ACR in MRL/lpr mice, ameliorated renal pathologies, reduced the expressions of ds-DNA, BAFF, IL-21, CXCL12, CXCL13, C3 and C4, and increased IL-10 levels. QJZ significantly downregulated renal expressions of the key B-cell transcription factors Blimp-1 and XBP-1, upregulated Bcl-6 and PAX5 expressions, inhibited B-cell differentiation, and lowered the expressions of AIM2, CD27, CD138 and CD69. Inhibition of AIM2 similarly reduced renal Blimp-1 and XBP-1 expressions, increased Bcl-6 and PAX5 levels, suppressed B-cell differentiation, decreased IgG production, reduced C3 and C4 deposition, and alleviated renal pathology in MRL/lpr mice. CONCLUSIONS QJZ inhibits B cell differentiation and alleviates renal damage in systemic lupus erythematosus possibly by suppressing the AIM2/Blimp-1/Bcl-6 signaling pathway.
Animals ; Drugs, Chinese Herbal/therapeutic use* ; Mice, Inbred MRL lpr ; Female ; Mice ; Mice, Inbred C57BL ; Cell Differentiation/drug effects* ; B-Lymphocytes/drug effects* ; Proto-Oncogene Proteins c-bcl-6/metabolism* ; Kidney/drug effects* ; DNA-Binding Proteins/metabolism* ; Signal Transduction ; Lupus Nephritis