AIM: To investigate the features of retinal peripheral defocus and its associated variables in unilateral myopia. METHODS: This cross-sectional study included consecutive anisometropic myopic patients who visited Center for Optometry and Visual Science from August 2023 to March 2025 in Guangxi Zhuang Autonomous Region. Eyes were classified based on spherical equivalent(SE)and uncorrected visual acuity(UCVA): myopic eyes(SE ≤-0.50 D, UCVA <0.2 LogMAR)and contralateral normal eyes(SE ≥-0.25, UCVA ≥0 LogMAR). Total relative defocus value(TRDV)across the visual field, RDV at 15°, 30°, and 45°(RDV-15, RDV-30, RDV-45), and quadrant-specific RDV(superior/RDV-S, inferior/RDV-I, temporal/RDV-T, nasal/RDV-N)were compared between groups.RESULTS: This study enrolled 81 anisometropic patients(81 myopic eyes, 81 contralateral normal eyes). The cohort comprised 42 males and 39 females, 47 patients aged 8-12 y and 34 patients aged 13-17 y(mean age: 11.8±2.4 y). Myopic eyes demonstrated significantly higher values in TRDV, RDV-30, RDV-45, RDV-I, RDV-S, RDV-N, and RDV-T versus contralateral normal eyes(all P<0.001). RDV-15 showed no significant difference between groups in either 8-12-year-olds or 13-17-year-olds(both P>0.05). Among 13-17-year-olds, RDV-S also exhibited no intergroup difference(P>0.05). All other parameters differed significantly across both age strata(all P<0.05). In myopic eyes, age positively correlated with TRDV(r=0.31, P=0.005), RDV-30(r=0.33, P=0.002), RDV-45(r=0.32, P=0.004), and RDV-N(r=0.37, P<0.001). In contralateral eyes, scotopic pupil diameter negatively correlated with TRDV(r=-0.25, P=0.03), RDV-45(r=-0.25, P=0.02), RDV-S(r=-0.29, P=0.008), and RDV-N(r=-0.27, P=0.014). And age positively correlated with RDV-N(r=0.30, P= 0.006), axial length positively correlated with RDV-T(r=0.30, P=0.006). CONCLUSION: The peripheral defocus of unilateral myopic eyes varies from that of their contralateral normal counterparts. The former presents hyperopic defocus, which augments with age, while the latter displays myopic defocus, which accentuates with the increase of the scotopic pupil size.

Breast cancer prevention and treatment have become major issues that urgently need to be addressed in the field of global public health. As a key pathological transitional stage in the progression of breast cancer， preneoplastic breast cancer （PBC） carries a significant risk of clinical transformation. Effective intervention in the progression of PBC is of great clinical significance in preventing the occurrence of breast cancer. Pathological studies have shown that abnormal angiogenesis is a key mechanism driving the transformation of PBC into breast cancer. Vascular endothelial growth factor （VEGF）， as a core regulatory molecule that promotes angiogenesis， plays a pivotal role in this process. The malignant transformation of PBC is closely associated with the abnormal activation of the VEGF-mediated pro-angiogenic network. Although modern medicine has achieved certain therapeutic effects through surgery and endocrine therapy， clinical limitations such as invasiveness， drug resistance， and adverse reactions still exist. Recent studies have demonstrated that the VEGF signaling system mediates the phosphatidylinositol 3-kinase-protein kinase B （PI3K/Akt） signaling pathway and the mitogen-activated protein kinase （MAPK） pathway. In addition， the hypoxia-inducible factor-1α （HIF-1α）/VEGF signaling pathway and the delta-like ligand 4 （DLL4）/Notch receptor 1 （Notch1） signaling pathway， together with other pathways， form a complex regulatory network that plays a central role in angiogenesis during PBC. Traditional Chinese medicine （TCM）， characterized by multi-component synergy， multi-pathway regulation， and high safety， demonstrates significant advantages in inhibiting pathological angiogenesis and blocking PBC progression by targeting the VEGF signaling pathway. From the perspective of VEGF pathway regulation， this paper systematically reviews the latest research progress on TCM in inhibiting angiogenesis and intervening in PBC， and discusses its mechanisms and application value in the early prevention and treatment of PBC， with the aim of providing references for optimizing clinical intervention strategies for PBC.

Objective:To investigate the effect of mindfulness-based cognitive therapy on the sense of personal control and illness perception of young and middle-aged patients after percutaneous coronary intervention (PCI), so as to provide theoretical and practical guidance for the psychological care of patients after PCI.Methods:A randomized controlled trial was conducted. From January 2022 to December 2023, young and middle-aged patients after PCI admitted to the Department of Cardiology, Qinhuai Medical District, Eastern Theater Command General Hospital of the Chinese People′s Liberation Army were selected as the research subjects by convenient sampling method, patients were divided into the experimental group and the control group by the random number table method. The control group was given routine nursing, and the experimental group was given mindfulness-based cognitive therapy on the basis of routine nursing. The Personal Mastery Scale (PMS), Cardiac Self-Efficacy Questionnaire (CSEQ), and Brief Illness Perception Questionnaire (BIPQ) were used to evaluate personal sense of control, self-efficacy, and illness perception before and after the intervention respectively.Results:A total of 80 young and middle-aged patients after PCI were included. There were 40 cases in the control group, including 25 males and 15 females, aged (49.43 ± 5.55) years old. There were 40 cases in the experimental group, including 19 males and 21 females, aged (49.03 ± 4.19) years old. Before the intervention, there was no statistically significant difference in the PMS, CSEQ and BIPQ scores between the two groups of patients (all P>0.05). After the intervention, the PMS, CSEQ scores of the patients in the experimental group were (23.03 ± 2.54), (45.85 ± 8.16) points respectively, which were higher than (21.95 ± 2.28), (39.05 ± 8.78) points in the control group, the BIPQ score of the patients in the experimental group was(39.63 ± 8.12) points, which was lower the (45.45 ± 8.64) points in the control group, the differences were statistically significant ( t=-2.00, -3.59, 3.11, all P<0.05). Conclusions:Mindfulness-based cognitive therapy can effectively improve the sense of personal control and self-efficacy of young and middle-aged patients after PCI, reduce the sense of threat to the disease.

Purpose To compare the 5.0T gradient echo coronary magnetic resonance angiography(CMRA)using compressed sensing(CS)acceleration technology(5.0TCS-CMRA)vs.3.0T gradient echo-CMRA(3.0TCS-CMRA)using CS.Materials and Methods Twenty-five healthy volunteers aged 23 to 30 years from December 16,2023 to January 14,2024 at Peking Union Medical College Hospital,Chinese Academy of Medical Sciences were prospective enrolled in this study.The interval between 3.0TCS-CMRA and 5.0TCS-CMRA was within two weeks.3.0TCS-CMRA used T2 preparation and 5.0TCS-CMRA did not use T2 preparation.The image quality scores,coronary artery length,signal-to-noise ratio(SNR)and contrast-to-noise ratio between coronary blood and adjacent myocardium or tissue(CNRmyo-blood)were evaluated.Results On 5.0TCS-CMRA,the SNR and CNRmyo-blood of the proximal right coronary artery(RCA)in 25 healthy volunteers were significantly higher than those of 3.0TCS-CMRA(SNR:318.07±94.06 vs.223.81±51.19,t=-5.609,P<0.001;CNRmyo-blood:212.75±91.44 vs.149.70±59.53,Z=-3.619,P<0.001),while the SNR and CNRmyo-blood of proximal left anterior descending coronary artery(LAD)and left circumflex coronary artery(LCX)were not significantly higher than those of 3.0TCS-CMRA(SNR:315.52±102.49 vs.306.35±92.85,t=-0.627,P=0.536;289.72±88.79 vs.272.87±84.68,t=-1.226,P=0.232;CNRmyo-blood:135.83±93.53 vs.203.94±74.30,t=4.132,P<0.001;117.66±79.63 vs.161.60±78.91,t=3.127,P=0.005).The length of the three coronary arteries measured by 5.0TCS-CMRA was significantly shorter than that of 3.0TCS-CMRA[RCA:(126.04±31.54)mm vs.(137.20±29.93)mm,t=2.911,P=0.008;LAD:(122.68±24.63)mm vs.(134.24±23.38)mm,Z=-3.026,P=0.002;LCX:(57.07±26.70)mm vs.(68.27±24.02)mm,t=2.552,P=0.018].There was no significant difference in the scanning time required between 3.0TCS-CMRA and 5.0TCS-CMRA[(8.60±2.84)min vs.(8.30±2.32)min,Z=-0.183,P=0.855].The image scores of the three major coronary arteries of 5.0TCS-CMRA were significantly lower than those of 3.0TCS-CMRA(RCA:2.52±0.59 vs.3.16±0.69,Z=-3.258,P=0.001;LAD:2.72±0.74 vs.3.24±0.66,Z=-2.540,P=0.011;LCX:2.44±0.71 vs.3.00±0.87,Z=-2.462,P=0.014).Conclusion In the absence of T2 preparation,5.0TCS-CMRA can still show obvious advantages in the SNR and CNRmyo-blood of proximal RCA compared with 3.0TCS-CMRA,which suggests the application potential of 5.0TCS-CMRA.In the future,a suitable T2 preparation pulse or potential alternative may significantly improve the performance of the 5.0TCS-CMRA.

Primers and probes were designed based on the conserved regions of Senecavirus A(SVA),foot-and-mouth disease virus(FMDV),and porcine teschovirus(PTV)and used to devel-op a TaqMan fluorescent quantitative PCR method for detecting the above-mentioned three viru-ses.The triplex fluorescent quantitative PCR system was developed using recombinant positive plasmids containing conserved sequences of the three viruses as templates.After optimizing the conditions,the specificity,sensitivity,repeatability,standard curve,and mixed infection model were evaluated,and the constructed triplex fluorescent quantitative PCR was used for clinical detection.The results showed that this method could specifically detect SVA,FMDV and PTV without cross-reactivity with other pathogens with the minimal detection concentrations for SVA,FMDV,and PTV as low as 1X101 copies/μL,respectively.The coefficients of variation within and between groups were less than 5％.Furthermore,none of the three viruses were detected in 126 samples.The above results indicate that this method is highly specific,sensitive,and stable,making it suit-able for clinical detection.

Objective To determine the pathogenicity of a novel mutation(c.109_111del)in DKC1 gene of an adult patient,and to analyze the clinical phenotype,immunophenotype and telomere length,so as to provide clues for early clinical identification and diagnosis.Methods The clinical data and peripheral blood samples of the patient were collected for genetic testing and family analysis.The lymphocyte subsets of the patient were detected by Flow cytometry,and the telomere length of the patient and healthy controls were detected by Flow-FISH.Results The main clinical manifestations of the patient were mucocutaneous triad,bone marrow failure and infection.The telomere length of lymphocytes in the patient was significantly shorter than that of healthy controls of the same age,and the absolute value and percentage of lymphocyte subsets were abnormal.Conclusion The clinical manifestations of DC patients are diverse.Flow-FISH detection of telomere length is helpful for early diagnosis of DC patients.

Momordica antiviral protein 30 kD(MAP30)is a type Ⅰ ribosome-inactivating protein(RIP)with antibacterial,anti-HIV and antitumor activities but lacks the ability to target tumor cells.To in-crease its tumor-targeting ability,the arginine-glycine-aspartic(RGD)peptide and the epidermal growth factor receptor interference(EGFRi)peptide were fused with MAP30,which was named ELRL-MAP30.The efficiency of targeted therapy for triple-negative breast cancer(TNBC)MDA-MB-231 cells,which lack the expression of estrogen receptor(ER),Progesterone receptor(PgR)and human epidermal growth factor receptor-2(HER2),is limited.In this study,we focus on exploring the effect and mecha-nism of ELRL-MAP30 on TNBC MDA-MB-231 cells.First,we discovered that ELRL-MAP30 significant-ly inhibited the migration and invasion of MDA-MB-231 cells and induced MDA-MB-231 cell apoptosis.Moreover,ELRL-MAP30 treatment resulted in a significant increase in Bax expression and a decrease in Bcl-2 expression.Furthermore,ELRL-MAP30 triggered apoptosis via the Fak/EGFR/Erk and Ilk/Akt signaling pathways.In addition,recombinant ELRL-MAP30 can inhibit chicken embryonic angiogenesis,and also inhibit the tube formation ability of human umbilical vein endothelial cells(HUVECs),indica-ting its potential therapeutic effects on tumor angiogenesis.Collectively,these results indicate that ELRL-MAP30 has significant tumor-targeting properties in MDA-MB-231 cancer cells and reveals potential ther-apeutic effects on angiogenesis.These findings indicate the potential role of ELRL-MAP30 in the targeted treatment of the TNBC cell line MDA-MB-231.

Objective·To explore the effect of intermittent theta burst stimulation(iTBS)targeting the left dorsolateral prefrontal cortex(DLPFC)on reducing craving in alcohol-dependent patients during the withdrawal period,as well as its impact on patients'emotions and cognitive functions.Methods·A total of 41 inpatients with alcohol dependence in the withdrawal period were recruited from the Addiction Department of Mental Health Center,Shanghai Jiao Tong University School of Medicine,and randomly assigned to the experimental group(20 patients)and the control group(21 patients).Both groups received routine inpatient treatment for alcohol-dependence.The experimental group received real iTBS stimulation targeting the left DLPFC on the basis of routine inpatient treatment,while the control group received sham stimulation with the same parameters.The intervention course lasted for 2 weeks,with a total of 10 sessions.The Visual Analogue Scale(VAS),Beck Depression Inventory(BDI),and Beck Anxiety Inventory(BAI)were used to measure the craving,anxiety,and depression of the patients before and after the intervention.The behavioral tasks of the detection task(DET),identification task(IDN),two back task(TWOB),the Groton maze learning task(GML),and international shopping list task(ISL)in the CogState software package were used to assess the cognitive processing speed,attention/vigilance,working memory,spatial problem-solving/error monitoring ability,and verbal learning and memory of the patients before and after the intervention.Results·Repeated measures ANOVA showed that the time effect[F=126.713,P＜0.001,partial η2(ηp2)=0.765]and interaction effect(F=7.080.P=0.011,ηp2=0.154)of the VAS scores in the two groups of patients were statistically significant.The time effect(F=9.114,P=0.004,ηp2=0.189),group effect(F=5.557,P=0.024,ηp2=0.125),and interaction effect(F=4.977,P=0.032,η2=0.113)of the TWOB score were all statistically significant.Only the time effects of BDI(F=45.273,P＜0.001,ηp2=0.578),BAI(F=31.432,P＜0.001,ηp2=0.473),GML(F=8.993,P=0.005,ηp2=0.209),and ISL(F=26.657,P＜0.001,ηp2=0.439)scores were statistically significant.There were no statistically significant effects of time,group,or interaction on the DET and IDN scores.Simple effect analysis showed that the VAS score of the real stimulation group was lower than that of the sham stimulation group after the intervention(F=8.805,P=0.005,ηp2=0.184),and the TWOB score of the real stimulation group was higher than that of the sham stimulation group(F=11.293,P=0.002,ηp2=0.225).Conclusion·Combining iTBS with routine inpatient treatment can enhance the efficacy of reducing alcohol craving in alcohol-dependent patients during the withdrawal period,and improve their working memory.

Objective:To investigate the differences in protein profile expression in serum samples from children with corona virus disease 2019（COVID-19）related encephalopathy and to explore the underlying mechanisms.Methods:From December 1,2022 to January 31,2023,28 children with COVID-19 who were admitted to the Department of Pediatric Intensive Medicine at Shandong Provincial Hospital Affiliated to Shandong First Medical University were collected,including 21 patients with encephalopathy(COVID-19 with encephalopathy group) and seven patients without encephalopathy(COVID-19 without encephalopathy group).Three children from each group were selected for serum proteomic analysis using tandem mass spectrometry labeling proteomics technology.Proteins were considered significantly different if the fold change was >1.2 or <0.8，with P<0.05.Bioinformatics analysis，including Gene Ontology and Kyoto Encyclopedia of Genes and Genomes Pathway Enrichment were performed on differentially expressed proteins.Protein-protein interaction networks were analyzed using the STRING database.Selected proteins were further validated by enzyme-linked immunosorbert assay. Results:A total of 41 differentially expressed proteins were identified between the two groups.Among these，14 proteins were upregulated and 27 proteins were downregulated in COVID-19 patients with encephalopathy compared to those without encephalopathy.Bioinformatics analysis revealed that these proteins were primarily enriched in critical signaling pathways，including complement and coagulation regulation，neutrophil degranulation and activation，and platelet degranulation.Enzyme-linked immunosorbert assay validation confirmed significant differences in key coagulation-regulating proteins(von willebrand factor upregulated，serpin family F member 2 downregulated in COVID-19 patients with encephalopatly）between the two groups.Conclusion:Coagulation dysfunction may play a role in the development of COVID-19 associated encephalopathy in children，providing valuable insights for future research.

Objective To explore the application effect of 3D printed individualized model in the treatment of complex ankle fractures(AF).Methods Patients with complex AF admitted to our hospital from July 2021 to October 2022 were selected and divided into the control group and the observation group using a random number table method,with 50 cases in each group.Patients in the control group were received minimally invasive reduction and internal fixation,while these in the observation group were given minimally invasive reduction and internal fixation under the guidance of 3D printed individualized model.The surgical conditions,ankle joint reduction,stress indicators[norepinephrine(NE)and angiotensin Ⅱ(AngⅡ)],ankle function and postoperative complications were compared between the two groups.Results There were 2 patients in the observation group and 3 patients in the control group were lost to follow-up 12 months after surgery.Compared with the control group,the observation group showed a decrease in the intraoperative blood loss,shortened surgical time,hospitalization time,and weight-bearing activity time,and an increase in the anatomical reduction rate(P<0.05).The observation group had lower serum levels of NE and AngⅡ 1 and 3 days after surgery(P<0.05)and higher Kofoed score and American Orthopedic Foot and Ankle Society(AOFAS)scores 1,6,and 12 months after surgery(P<0.05),as well as lower incidence of postoperative complications(P<0.05)than those in the control group.Conclusion For the treatment of complex AF,3D printed individualized model assisted the formulation of minimally invasive reduction and fixation surgical plans before surgery can shorten surgical time,reduce stress injury,decrease the risk of complications,and simultaneously increase the anatomical reduction rate and improve ankle joint function,thereby accelerating postoperative recovery of patients.