Objective:To observe the high-risk histopathological feature (HRF) and their correlation with prognosis in children with intraocular retinoblastoma (RB) in the intraocular stage after failed eyepreserving treatment and enucleation surgery.Methods:A single-center retrospective case study. From August 2018 to January 2023, 64 children (64 eyes) with advanced intraocular RB who were diagnosed in Department of Ophthalmology of Beijing Children's Hospital and underwent enucleation surgery after failed eye-preserving treatment were included in the study. The median follow-up time was 51 months. The gender of the children patients, the age of visit and enucleation, International Intraocular Retinoblastoma Classification (IIRC), the initial chemotherapy regimen (hereinafter referred to as "chemotherapy"), the time of enucleation surgery, pathological results, post-enucleation treatment methods and prognosis were collected. The Mann-Whitney U test was used for comparison between groups. Survival analysis was performed using the Kaplan-Meier method, and the log-rank test was used for comparison between groups. Results:Among 64 cases and 64 eyes, 37 were male and 27 were female. The age of seeking medical treatment was 20 (11-31) months. The age at which the surgery was performed was 29 (16-40) months. The number of eyes in IIRC stage D and E was 16 and 48 respectively. The initial chemotherapy regimens simply applied (hereinafter referred to as "alone") intravenous systemic chemotherapy (IVC) and ophthalmic artery infusion chemotherapy (IAC) in 40 cases and 11 cases, 13 cases of IVC+IAC. All patients with positive HRF received systemic adjuvant chemotherapy after surgery. There were 37 eyes (57.8%, 37/64) positive for HRF. There was no statistically significant difference in the positive rate of HRF between children in IIRC stage D and stage E ( χ2=0.021, P=0.884). Among the 37 eyes with HRF, the numbers of eyes with extensive choroidal invasion, posterior lamina cribrosa optic nerve invasion, scleral invasion and optic nerve stump involvement were 17 (45.9%, 17/37), 16 (43.2%, 16/37), 3 (8.1%, 3/37) and 3 (8.1%, 3/37), respectively. During the follow-up period, there were 5 cases (7.8%, 5/64) of extraocular metastasis of the tumor and death, all of which were stage E and had HRF. Among them, the initial treatment plan was IAC for 4 cases, one case of IVC. The survival rates of children among the IVC, IAC or IVC+IAC regimens were 97.5% (39/40), 63.6% (7/11), and 100.0% (13/13), respectively. The comparison of survival rates among different chemotherapy regimens showed statistically significant differences ( χ2=14.233, P<0.001). The results of survival analysis showed that the cumulative survival rate of those with extensive choroidal invasion, posterior lamina cribrosa optic nerve infiltration, and those who received IAC was significantly lower than that of those without extensive choroidal invasion, posterior lamina cribrosa optic nerve infiltration, and those who received IVC+IAC and IVC ( P<0.05). Conclusions:Eye-preserving treatment for children with advanced intraocular RB may increase the positive rate of HRF and the risk of extraocular metastasis. The IVC+IAC eye-protecting treatment plan can improve the survival rate of children.

Objective:To observe the high-risk histopathological feature (HRF) and their correlation with prognosis in children with intraocular retinoblastoma (RB) in the intraocular stage after failed eyepreserving treatment and enucleation surgery.Methods:A single-center retrospective case study. From August 2018 to January 2023, 64 children (64 eyes) with advanced intraocular RB who were diagnosed in Department of Ophthalmology of Beijing Children's Hospital and underwent enucleation surgery after failed eye-preserving treatment were included in the study. The median follow-up time was 51 months. The gender of the children patients, the age of visit and enucleation, International Intraocular Retinoblastoma Classification (IIRC), the initial chemotherapy regimen (hereinafter referred to as "chemotherapy"), the time of enucleation surgery, pathological results, post-enucleation treatment methods and prognosis were collected. The Mann-Whitney U test was used for comparison between groups. Survival analysis was performed using the Kaplan-Meier method, and the log-rank test was used for comparison between groups. Results:Among 64 cases and 64 eyes, 37 were male and 27 were female. The age of seeking medical treatment was 20 (11-31) months. The age at which the surgery was performed was 29 (16-40) months. The number of eyes in IIRC stage D and E was 16 and 48 respectively. The initial chemotherapy regimens simply applied (hereinafter referred to as "alone") intravenous systemic chemotherapy (IVC) and ophthalmic artery infusion chemotherapy (IAC) in 40 cases and 11 cases, 13 cases of IVC+IAC. All patients with positive HRF received systemic adjuvant chemotherapy after surgery. There were 37 eyes (57.8%, 37/64) positive for HRF. There was no statistically significant difference in the positive rate of HRF between children in IIRC stage D and stage E ( χ2=0.021, P=0.884). Among the 37 eyes with HRF, the numbers of eyes with extensive choroidal invasion, posterior lamina cribrosa optic nerve invasion, scleral invasion and optic nerve stump involvement were 17 (45.9%, 17/37), 16 (43.2%, 16/37), 3 (8.1%, 3/37) and 3 (8.1%, 3/37), respectively. During the follow-up period, there were 5 cases (7.8%, 5/64) of extraocular metastasis of the tumor and death, all of which were stage E and had HRF. Among them, the initial treatment plan was IAC for 4 cases, one case of IVC. The survival rates of children among the IVC, IAC or IVC+IAC regimens were 97.5% (39/40), 63.6% (7/11), and 100.0% (13/13), respectively. The comparison of survival rates among different chemotherapy regimens showed statistically significant differences ( χ2=14.233, P<0.001). The results of survival analysis showed that the cumulative survival rate of those with extensive choroidal invasion, posterior lamina cribrosa optic nerve infiltration, and those who received IAC was significantly lower than that of those without extensive choroidal invasion, posterior lamina cribrosa optic nerve infiltration, and those who received IVC+IAC and IVC ( P<0.05). Conclusions:Eye-preserving treatment for children with advanced intraocular RB may increase the positive rate of HRF and the risk of extraocular metastasis. The IVC+IAC eye-protecting treatment plan can improve the survival rate of children.

Objective:To study the correlation between myopia growth and physical development of primary school student in Shihezi area of Xinjiang Uyghur Autonomous Region by measuring the ocular biometry and physical parameters of the eye, and to provide an objective basis for the development of myopia prevention and control.Methods:A cross-sectional study design was used. The Grade 1-6 students from 33 schools in Shihezi area were randomly selected in October 2023. The children were classified according to age into the low age group (6-9 years) and the high age group (10-13 years).The children′s height, weight, axial length (AL), maximum keratometry (steepest keratometry, K1), and minimum keratometry (flattest keratometry, K1) were measured. The body mass index (BMI), keratometric astigmatism (ΔK), mean keratometry (K), corneal radius (CR) and AL/CR were calculated. Correlation analyses were performed between ocular biometry and physical parameters. LASSO regression analysis was used to screen the best variables, and linear regression models were constructed after adjusting for confounding factors of age and sex.Results:A total of 3 986 children aged 6-13 years were included in this study, including 2 094 boys (52.53%) and 1 892 girls (47.47%); 2 162 in the lower age group and 1 824 in the upper age group. Girls had higher K, ΔK and AL/CR values than boys (43.38 D vs 42.7 D, t=-7.84, P<0.01; 1.1 D vs 1.01 D, t=-2.14, P=0.03; 2.97 vs 2.96, t=3.32, P=0.02). Boys had higher AL, height, weight and BMI than girls (23.47 mm vs 23.02 mm, t=13.77, P<0.01; 1.34 m vs 1.33 m, t=3.02, P=0.03; 32 kg vs 29.5 kg, t=7.82, P<0.01; 17.4 vs 16.52, t=10.36, P<0.01). LASSO regression was used to screen the 3 physical parameter variables (height, weight, and BMI) to determine that height was the best physical parameter variable for AL/CR. After adjusting for confounders, it was shown that in the low age group (6-9 years), there was a significant positive correlation between children′s height and AL/CR ( b=0.174, 95% CI: 0.106 to 0.241, P<0.001), whereas in the high age group (10-13 years), there was no correlation between children′s height and AL/CR ( b=0.086, 95% CI:-0.038 to 0.21, P=0.174). Conclusion:There was a positive correlation between height and myopia growth in the lower age group of children in Shihezi area, Xinjiang Uyghur Autonomous Region; there was no correlation between height and myopia growth in the higher age group.

AIM:To investigate the expression of centromere protein-H(CENP-H)in adrenocortical carcino-ma(ACC)and its relationship with disease progression and prognosis,and to explore the impact of CENP-H gene knock-down on the viability and migration of ACC cells.METHODS:The mRNA expression level of CENP-H in 76 ACC pa-tients and 128 healthy controls,and its correlations with tumor stages and prognosis were analyzed by GEPIA2 database.The mRNA expression of CENP-H in different stages of ACC and its correlation with disease prognosis were further ana-lyzed by ULCAN database.The protein expression of CENP-H was examined by immunohistochemical staining of paraffin-embedded ACC and normal adrenal gland specimens.Knockdown of CENP-H by siRNA(siCENP-H)was performed in human ACC cell line H295R.The viabilty of H295R cells transfected with siCENP-H or siNC was measured by CCK-8 as-say,the cell migration was detected by wound-healing assay,and the protein levels of CENP-H,p-ERK1/2,t-ERK1/2,p-P38,t-P38,p-JNK1/2 and t-JNK1/2 were detected by Western blot.RESULTS:The mRNA level of CENP-H was signifi-cantly higher in ACC than that in normal controls,and was correlated with tumor stages and prognosis.The protein level of CENP-H was significantly higher in ACC specimens than that in normal adrenal gland.Knockdown of CENP-H in H295R cells resulted in decreased cell viability and migration.The protein levels of p-P38 and p-JNK1/2 were decreased in si-CENP-H group.CONCLUSION:CENP-H is highly expressed in ACC,and is correlated with tumor stages and poor prognosis.Knockdown of CENP-H can inhibit the viability and migration of ACC cells,and its mechanism may related to inactivation of P38 and JNK signaling pathways.

Objective:To study the correlation between myopia growth and physical development of primary school student in Shihezi area of Xinjiang Uyghur Autonomous Region by measuring the ocular biometry and physical parameters of the eye, and to provide an objective basis for the development of myopia prevention and control.Methods:A cross-sectional study design was used. The Grade 1-6 students from 33 schools in Shihezi area were randomly selected in October 2023. The children were classified according to age into the low age group (6-9 years) and the high age group (10-13 years).The children′s height, weight, axial length (AL), maximum keratometry (steepest keratometry, K1), and minimum keratometry (flattest keratometry, K1) were measured. The body mass index (BMI), keratometric astigmatism (ΔK), mean keratometry (K), corneal radius (CR) and AL/CR were calculated. Correlation analyses were performed between ocular biometry and physical parameters. LASSO regression analysis was used to screen the best variables, and linear regression models were constructed after adjusting for confounding factors of age and sex.Results:A total of 3 986 children aged 6-13 years were included in this study, including 2 094 boys (52.53%) and 1 892 girls (47.47%); 2 162 in the lower age group and 1 824 in the upper age group. Girls had higher K, ΔK and AL/CR values than boys (43.38 D vs 42.7 D, t=-7.84, P<0.01; 1.1 D vs 1.01 D, t=-2.14, P=0.03; 2.97 vs 2.96, t=3.32, P=0.02). Boys had higher AL, height, weight and BMI than girls (23.47 mm vs 23.02 mm, t=13.77, P<0.01; 1.34 m vs 1.33 m, t=3.02, P=0.03; 32 kg vs 29.5 kg, t=7.82, P<0.01; 17.4 vs 16.52, t=10.36, P<0.01). LASSO regression was used to screen the 3 physical parameter variables (height, weight, and BMI) to determine that height was the best physical parameter variable for AL/CR. After adjusting for confounders, it was shown that in the low age group (6-9 years), there was a significant positive correlation between children′s height and AL/CR ( b=0.174, 95% CI: 0.106 to 0.241, P<0.001), whereas in the high age group (10-13 years), there was no correlation between children′s height and AL/CR ( b=0.086, 95% CI:-0.038 to 0.21, P=0.174). Conclusion:There was a positive correlation between height and myopia growth in the lower age group of children in Shihezi area, Xinjiang Uyghur Autonomous Region; there was no correlation between height and myopia growth in the higher age group.

Six new ent-abietane diterpenoids, abientaphlogatones A-F (1-6), along with two undescribed ent-abietane diterpenoid glucosides, abientaphlogasides A-B (7-8) and four known analogs were isolated from the aerial parts ofPhlogacanthus curviflorus (P. curviflorus). The structures of these compounds were determined using high-resolution electrospray ionization mass spectrometry (HR-ESI-MS), one-dimensional and two-dimensional nuclear magnetic resonance (NMR) spectroscopy, electronic circular dichroism (ECD) spectra, and quantum chemical calculations. Notably, compounds 5 and 6 represented the first reported instances of ent-norabietane diterpenoids from the genus Phlogacanthus. In the β-hematin formation inhibition assay, compounds 2, 4, 7-10, and 12 displayed antimalarial activity, with IC₅₀ values of 12.97-65.01 μmol·L^-1. Furthermore, compounds 4, 5, 8, and 10 demonstrated neuroprotective activity in PC12 cell injury models induced by H₂O₂ and MPP⁺.
Abietanes/pharmacology* ; Antimalarials ; Hydrogen Peroxide ; Biological Assay ; Plant Components, Aerial

ObjectiveTo determine the complications of hypertension among local residents in Minhang district of Shanghai， and provide scientific evidence for key preventive intervention. MethodsWe retrieved the data from the electronic health records， in which hypertensive patients were included for community-based management， in Minhang district of Shanghai from January 1st， 2014 to December 31st， 2018. A total of 38 599 hypertensive patients who had not had hypertension related clinical symptom when included in the electronic health records were enrolled in our study. Chi-square test and Cochran-Mantel-Haenszel test were used to determine the complications of hypertension. ResultsThe incidence proportion of complications was 10.77%， of which cerebrovascular damage was the highest （7.44%）， followed by cardiac damage （3.55%） and peripheral vascular damage （0.81%）. The incidence proportions in patients aged 18‒59， 60‒69， 70 and above were 5.53%， 9.61% and 16.19%， respectively. There was significant difference in the incidence proportions of complications among age groups （χ²=668.670， P<0.05）. Cochran-Mantel-Haenszel test showed that in the hypertensive patients aged 60‒69， the incidence proportion of complications in females was lower than that in males （χ²=5.937， P<0.05）. However， in those aged above 70， the incidence proportion of complications in females was higher than that in males （χ²=11.619， P<0.05）. ConclusionIn patients with hypertension， the incidence proportions of cardiovascular and cerebrovascular diseases remains relatively high in Minhang district of Shanghai. Additionally， both age and gender have influence on the incidence of complications.

The construction of elderly care needs assessment system is conducive to realize the reasonable matching between care services and needs of the elderly， and to promote the effective allocation of pension resources. It is the basis and premise of the development of long-term care insurance system. Questions such as "Who is responsible for the assessment？ Who can apply for the assessment？ What is the assess tool？ How to pay the assessment fee？" are the core issues that need to be addressed in the construction of the evaluation system. This study compared the current situation of the elderly care needs assessment systems in China， the Netherlands， Germany， Japan and the United States from four aspects： assessment subject， assessment object， assessment cost source， and assessment tools’ dimensions. It has been a trend to entrust a third party for the evaluation work in pilot cities in China. Compared with foreign countries， domestic appraisers’ discipline and professional background are simpler. In foreign countries， the evaluation objects of elderly care needs are more extensive； the legal and financial support system of needs evaluation is more mature； and the evaluation dimensions are more objective and comprehensive. Based on this study， we suggest China to establish a national unified elderly care needs assessment system， cultivate professional assessment teams， expand the coverage of care needs assessment objects， improve the standards of assessment objects and assessment dimensions， and improve the law and financial support regulations related to needs assessment.

Objective:To compare the clinical efficacy and complications of intra-arterial chemotherapy (IAC) and intravenous chemotherapy (IVC) for unilateral advanced retinoblastoma (RB).Methods:A retrospective clinical study. From January 2020 to January 2021, 40 patients (40 eyes) unilateral group cT2 RB patients diagnosed at Baoding Children’s Hospital and Beijing Children’s Hospital were recruited in this study. There were 22 males (22 eyes) and 18 females (18 eyes). All were monocular. All the patients were assigned to two groups according to different treatment modalities they received: IVC group and IAC group. There were 26 eyes and 14 eyes, respectively. When the tumor invades the optic nerve, choroid, sclera, anterior chamber and iris, enucleation was performed. The globe salvage rate, tumor extraocular metastasis rate, solid tumor control rate, treatment-related complications and pathological high-risk factors after enucleation were observed. The globe salvage rate and solid tumor control rate were compared between the groups by chi square test.Results:The globe salvage rate of IAC group and IVC group were 88.5% (23/26) and 50.0% (7/14), respectively. Solid tumor control of IAC group and IVC group were 84.6% (22/26) and 42.9% (6/14), respectively. There were statistically significant differences in globe salvage rate and solid tumor control between the two groups ( χ 2=7.18, 7.56; P<0.05). Compared with IVC group, IAC group had less systemic complications, mild ocular and periocular side effects. Among 26 cases in IAC group and 14 cases in IVC group, 3 and 7 cases underwent enucleation respectively. The results of pathological examination showed that there were 2 cases and 3 cases with pathological high-risk factors in the two groups, respectively. During the follow-up period, 2 cases in IAC group had extraocular metastasis, there was no extraocular metastasis in IVC group. Conclusion:Compared with IVC, IAC has the advantages of high tumor control rate, high globe salvage rate, less and mild complications, however, there is still tumor recurrence.

Objective:To investigate the effect of Zhitong-Rusheng Decoction on wound healing and serum fibronectin (FN) and epidermal growth factor (EGF) levels after anal fistula operation. Methods:A total of 102 patients after anal fistula operation in our hospital from March 2018 to March 2020 were randomly divided into control group (51 cases) and observation group (51 cases) according to the random number table method. The control group was treated with conventional western treatment, while the observation group was treated with Zhitong-Rusheng Decoction on the basis of control group. The two groups were treated for 3 weeks. The clinical symptoms were scored before and after treatment, and the levels of serum FN and EGF were detected by ELISA. The wound healing time, hematochezia disappearance time, wound longitudinal diameter and wound area before and after treatment were observed. The clinical efficacy was evaluated after treatment. Results:The total effective rate was 98.0% (50/51) in the observation group and 72.6% (37/51) in the control group, with significant difference between the two groups ( χ2=13.209, P<0.01). After treatment, the pain degree score, wound exudation score and granulation morphology score of the observation group were significantly lower than those in the control group ( t=15.448, 21.424, 28.641, P<0.001). After treatment, the wound healing time [(6. 04 ± 1.20) d vs. (9.42 ± 1.58) d, t=12.166] and the disappearance time of hematochezia [(15.72 ± 2.86) d vs. (19.95 ± 4.33) d, t=6.862] of the observation group were significantly shorter than thosse of the control group( P<0.01). After treatment, the wound longitudinal diameter [(1.89 ± 0.31) cm vs. (2.82 ± 0.54) cm, t=10.666] and wound area [(3.26 ± 0.54) cm 2vs. (4.98 ± 1.10) cm 2, t=10. 024] of the observation group were significantly less than those in the control group ( P<0.01). The serum FN [(2.92 ± 0.50) mg/L vs. (2.45 ± 0.39) mg/L, t=5.293], EGF [(7.03 ± 1.44) μg/L vs. (5.47 ± 1.03) μg/L, t=6.293] of the observation group were significantly higher than those in the control group ( P<0.01). Conclusion:Zhitong-Rusheng Decoction on the basis of conventional treatment on patients after anal fistula operation has a good efficacy, which is conducive to wound healing, reducing clinical symptoms, and improving serum levels of FN and EGF.