ObjectiveTo investigate the correlation between sleep patterns and myopia progression among younger school-age children at a primary school in Changning District of Shanghai, based on the data from the Shanghai Students’ Common Diseases and Health Influencing Factors Monitoring System and a sleep-specific survey, so as to provide data support for myopia prevention and control in this age group. MethodsOne primary school was selected from the common diseases and health influencing factors monitoring system for students in Changning District, Shanghai. A total of 230 first-grade students were included in the study. Myopia and refractive parameters were examined, and sleep patterns were investigated. General demographic characteristics and myopia-related behavior data of the students were also collected. Sleep patterns were evaluated in terms of sleep duration, sleep efficiency, and sleep quality, with the latter assessed using the Chinese version of the Children’s Sleep Habits Questionnaire (CSHQ). Multiple linear regression and binary logistic regression models were used to analyze the association between sleep patterns and myopia progression among these students. ResultsThe results of the regression analyses revealed that the total CSHQ score of the students at baseline survey was (48.85±7.15) points. Their sleep efficiency was (94.49±8.48)%, sleep duration was (9.58±0.93) hours, and the proportion of those with insufficient sleep (<10 hours) was 78.26%. At baseline survey, students’ higher daytime sleepiness scores were associated with lower spherical equivalent (SE) ( β=-0.18, 95%CI: -0.31 to -0.04) and an increased risk of axial length (AL) / corneal radius (CR) ratio >3 (OR=1.52, 95%CI: 1.00 to 2.29), whereas longer sleep duration and higher sleep efficiency were associated with higher SE (β=0.18, 95%CI: 0.05 to 0.32; β=0.17, 95%CI: 0.04 to 0.31, respectively), shorter (AL) (β=-0.15, 95%CI: -0.27 to -0.03; β=-0.13, 95%CI: -0.25 to 0, respectively) and a reduced risk of AL /CR>3 (OR=0.70, 95%CI: 0.51 to 0.96; OR=0.73, 95%CI: 0.53 to 0.99, respectively). At baseline survey, children’s higher propensity for sleep problems (OR=1.70, 95%CI: 1.04 to 2.78), sleep resistance (OR=2.26, 95%CI: 1.36 to 3.75), and sleep anxiety scores (OR=2.15, 95%CI: 1.33 to 3.48) were all associated with an increased risk of AL/CR >3 at follow-up (all P<0.05). Furthermore, higher sleep anxiety scores predicted prolonged AL at follow-up (β=0.03, 95%CI: 0 to 0.05). According to the mixed-effects model, higher daytime sleepiness scores and prolonged sleep duration were independently linked to reduced right-eye SE (β=-0.05, 95%CI: -0.10 to 0, P<0.05) and shorter right-eye AL (β=-0.05, 95%CI: -0.10 to 0, P<0.05). ConclusionIn this school in Shanghai, there are problems of insufficient and poor-quality sleep among young children. Sleep problems such as sleep resistance, delayed sleep onset, sleep anxiety, and daytime sleepiness among children may accelerate the risk of myopia progression, while longer sleep duration and higher sleep efficiency may serve as protective factors against the occurrence and development of myopia.

Abstract: Objective　This study aimed to report the application of endoscopic retrograde cholangiopancreatography (ERCP) in patients with hepatic hydatid disease (HHD) in Lhasa, Xizang, and to explore the application value of ERCP in these patients. Methods By reviewing cases of HHD treated with ERCP at Lhasa People's Hospital from June 2019, to August 2023, the patients were divided into three groups based on whether they underwent hepatic hydatid surgery operation and the timing of the surgery. The groups were the preoperative ERCP group (2 cases), postoperative ERCP group (3 cases), and non-operation group (11 cases, 12 times). The study evaluated the application value of ERCP in patients with hepatic echinococcosis. Results A total of 16 patients (17 times) with HHD who underwent ERCP were included in this study (cyst type∶alveolar type=12∶4), with an average age of (54.38±21.93) years and a male-to-female ratio of 1∶1.67. Nine cases (56.25%) had choledocholithiasis, and 5 cases (31.25%) had biliary strictures. In the preoperative ERCP group, all patients underwent endoscopic nasobiliary drainage (ENBD) for acute cholangitis. In the postoperative ERCP group, one case underwent ENBD for postoperative biliary leakage, and two cases underwent ERCP for stone removal due to recurrence of choledocholithiasis after hepatic echinococcosis surgery. In the non-operation group, 6 cases (7 times) underwent ERCP for choledocholithiasis, 3 cases underwent endoscopic biliary drainage for biliary stricture, 1 case underwent endoscopic biliary clearance for the intrabiliary rupture of hepatic hydatid cyst combined with choledocholithiasis, and 1 case underwent ERCP for acute cholangitis caused by a white flat membrane-like material in the biliary tract. ERCP-related complications occurred in one case (5.88%), namely, biliary hemorrhage, which was relieved by conservative therapy. After surgery and ERCP treatment, 8 cases (50.00%) were cured, 5 cases (31.25%) were obviously relieved, and 3 cases (18.75%) were slightly relieved. With a follow-up of (28.56±17.11) months, 13 cases had a good outcome, and 3 cases died at 29, 31, and 44 months after ERCP, respectively. The therapeutic effect was significantly better in patients with cystic echinococcosis compared to patients with alveolar echinococcosis (P<0.05). Conclusions ERCP is safe and effective for the treatment of acute cholangitis, biliary leakage, biliary stricture, choledocholithiasis, and intrabiliary rupture of the hepatic hydatid cyst in patients with HHD.

Osteoporotic fracture is the most major complication of osteoporosis. It is a significant global public health problem which continues to bring serious family and social burden. In order to improve the prevention and treatment of osteoporotic fractures， many countries have carried out new ways of fracture prevention and management， and achieved some results. Prevention mainly aims at those at high risk of fracture， and includes new health education on fracture and the promotion of fall prevention measures. For management， the "Fracture liaison services" mode is mainly applied to the fracture patients， with refined patient management to deal with the fractures that have occurred. This article summarizes the global prevalence of osteoporotic fractures， risk factors， and the current research progress in fracture prevention and management in China and the West.

Objective:To understand the positive rate of 2019 novel coronavirus (2019-nCoV) specific IgG antibody induced by Coronavirus Disease 2019 (COVID-19) inactivated vaccine in healthy population in Xizang Autonomous Region, and evaluate the immune effect of the vaccine.Methods:Serum samples were collected from COIVD-19 vaccine immunized health population without history of 2019-nCoV infection from six prefecture-level cities in Xizang Autonomous Region. The IgG antibody against 2019-nCoV were tested by chemiluminescence method. Then, the positive rate of IgG antibody was analyzed for different immunization histories and age groups.Results:A total of 22 255 participants were enrolled in this survey. After full-access (two doses of vaccine) and booster immunization, the overall positive rate of specific IgG antibody against 2019-nCoV was 96.38%. The positive rate of IgG antibody in the booster immunized population was 97.12%, which was much higher than the 88.38% in the full-access immunization population, the difference is statistically significant ( χ2=381.11, P<0.001). There was a significant differences in the positive rates of specific IgG antibodies in different age groups ( χ2=138.28, P<0.001). Especially in the younger age groups, including less than 10 years old and the 11-20 years age group, the positive rate of specific IgG antibody were 93.44% and 89.03% respectively, which were lower than those in other age groups. Except for Naqu city and the age group ≤ 10 years old, the differences in antibody positivity rates were statistically significant between different age groups in the same region and between the different regions in the same age group for the two populations with different immunization histories ( P<0.05). Conclusions:The COVID-19 inactivated vaccine showed a good immune effect in the healthy population in Xizang Autonomous Region, and the booster immunization helps to increase the positive rate of specific IgG antibody in healthy population.