AIM:To investigate the visual development of children under 6 years old in Wuhan, and provide evidence-based support for the formulation and optimization of regional policies for children's eye health care.METHODS:Suresight refractive screener was applied to rapid refractive status examination in 4 989 preschool children under 6 years old in Wuhan City, with results determined according to the manufacturer's age-specific referral criteria. All screened pre-school children completed vision screening and comprehensive ophthalmic examination.RESULTS: A total of 4 989 children under 6 years old were screened out, including 2 641 males and 2 348 females. They were divided into 6 groups according to age: 426 aged from 6-month to 1-year-old, 903 aged >1 to 2 years old, 1 078 aged >2 to 3 years old, 442 aged >3 to 4 years old, 808 aged >4 to 5 years old, and 1 332 aged >5 to 6 years old. The abnormal rate in the 6-month to 1-year-old group was 44.60%, in the >1 to 2 years old group was 26.02%, in the >2 to 3 years old group was 15.58%, in the >3 to 4 years old group was 10.86%, in the >4 to 5 years old group was 21.91%, in the >5 to 6 years old group was 23.27%, and the total refractive abnormal rate for children aged 6 mo to 6 years old was 22.61%. The refractive abnormal rate generally showed a decreasing trend with increasing age(P<0.001); the refractive abnormal rate in boys aged 6-month to 6 years old was 12.33%, and in girls was 10.28%, with no statistically significant difference in the abnormal rate between boys and girls(P>0.05); among children aged 6-month to 6 years old, the abnormal rate of single-eye myopia was 0.98%, of single-eye hyperopia was 5.41%, of single-eye astigmatism was 9.92%, of binocular myopia was 0.98%, of binocular hyperopia was 2.79%, and of binocular astigmatism was 8.14%; the prevalence of astigmatism in children aged 6-month to 1-year-old was 40.38%, in those aged >1 to 2 years old was 19.82%, in those aged >2 to 3 years old was 12.34%, in those aged >3 to 4 years old was 9.05%, in those aged >4 to 5 years old was 18.81%, and in those aged >5 to 6 years old was 16.89%; the prevalence of astigmatism in children aged 6-month to 6 years old was 18.06%. The abnormal rate of astigmatism in the four age groups ranging from 6-month to 4 years old decreased continuously with age(P<0.001). There was no statistically significant difference in the abnormal rate of astigmatism between the >4 to 5 years old group and the >5 to 6 years old group(P>0.05).CONCLUSION:Refractive error has become a common eye disease among preschool children. Through early vision screening, establishing a systematic refractive management file, and early intervention, the best treatment period can be seized to avoid missing it and causing adverse consequences.

Objective To establish a stable and reproducible animal model of abdominal intestinal firearm penetrating injury in a cold high-altitude environment.Methods Twenty landrace pigs were randomly and equally assigned to a low-altitude normal temperature(LN)group and a high-altitude cold(HC)group.The HC group was placed in a cold environment at high altitudes,and the LN group was placed in a normal-temperature environment at low altitudes.They were raised for 48 hours respectively.After anesthesia,they were suspended on the shooting range,and the right lower abdomen of the experimental pigs was shot with a gun.After injury,they were simply bandaged and transported back to the laboratory for observation in the normal temperature environment of the low altitudes.The vital signs and injuries at 0,2,4,8,12 and 24 h and 24 h survival rates of experimental pigs were compared.Laparotomy was immediately performed on the dead pigs and the experimental pigs still alive at 24 h to explore the injuries and observe the pathology of the small intestine and colon.Results The 24 h survival rate of the HC group was 70％,with no statistically significant difference compared to the LN group's 90％(P＞0.05).After the injury,the body temperature of both groups gradually increased.The body temperature of the HC group was significantly higher than the LN group at 0,2,4 and 8 h time points(P＜0.001),and the LN group exceeded the HC group at 24 h(P＜0.05).Both groups showed an initial increase followed by a decrease in heart rate,with the HC group significantly higher than the LN group only at 0 h(P＜0.01),and no statistically significant differences were observed at other time points(P＞0.05).Both groups showed an early increase and later decrease in respiratory rate,with the HC group higher than the LN group at 0,4,8,12 and 24 h(P＜0.05 or P＜0.001).There was no statistically significant difference(P＞0.05)between the HC group and the LN group in small intestine rupture,small intestine contusion,mesenteric injury,colon rupture and wound diameter.The pathology of the small intestine and colon in the HC group showed extensive necrosis and shedding of the mucosa layer,severe congestion and edema of the submucosa,and extensive lymphocyte infiltration.The LN group also showed similar symptoms but to a lesser extent.Conclusion This study established a pig model of abdominal firearm intestinal perforation injury in a cold environment at high-altitudes.The model has strong operability and stable damage,which can provide a reference for subsequent research.

OBJECTIVE To screen for GJB2,mitochondrial DNA12S rRNA 1555A>G and SLC26A4 gene mutations in 27 non syndromic hereditary hearing loss families,clarify the genetic causes.METHODS 125 members from 27 deaf families were for questionnaire surveys,audiological examinations,and peripheral blood DNA extraction.The GJB2,SLC26A4,and mitochondrial DNA A1555G coding regions were amplified and directly sequenced.RESULTS Twelve families and 52 individuals were screened for deafness gene mutations,the detection rate in 27 families was 44%(12/27),and the detection rate in all the members was 42%(52/125).The detection rate of gene mutation for GJB2 is 31%(39/125),for SLC26A4 is 6%(8/125),and for mitochondrial DNA1555A>G mutation is 4%(5/125).CONCLUSION GJB2,SLC26A4 and mitochondrial A1555G have a high detection rate in families with hereditary deafness.Mutation screening of these three genes can clarify the genetic causes of most deafness families and can be used as genetic screening targets for hereditary deaf families.

Objective To investigate the changes of anti-Müllerian hormone(AMH),inhibin-B(INHB)and inhibin-A(INHA)levels in boys with cryptorchidism,analyze their clinical application value,and provide labo-ratory data for the diagnosis and treatment of cryptorchidism.Methods A total of 1 310 boys with cryp-torchidism who were hospitalized or visited the outpatient department in the hospital from July 2020 to July 2023 were included in the case group.Another 50 boys who underwent physical examination at the hospital and had no abnormalities in reproductive system development such as testicles were selected as the control group.Venous blood was collected from all the research subjects in a fasting state and placed into biochemical tubes.After centrifuging the serum,the changes in the levels of anti-Müllerian hormone(AMH),Inhibin B(INHB),and Inhibin A(INHA)in the two groups were detected by the chemiluminescence method.The differences between the two groups were analyzed,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of AMH,INHB,and INHA for cryptorchidism.Results The AMH lev-els in boys with cryptorchidism were significantly higher than those in the control group(P＜0.01),while the INHB and INHA levels were significantly lower than those in the control group(P＜0.01).ROC curve analy-sis showed that the area under the curve(AUC)of AMH was 0.65(95％CI:0.56-0.74,P＜0.01).When the Youden index was 26.85％and the cut off value was 37.19 ng/mL,it had relatively good sensitivity(88.85％)but relatively low specificity(38.00％).The AUC of INHB was 0.63(95％CI:0.57-0.70,P＜0.01).When the Youden index was 24.17％and the cut off value was 77.17 pg/mL,it had relatively poor sensitivity(38.17％)but relatively good specificity(86.00％).Both AMH and INHB have certain clinical val-ue in the differential diagnosis of boys with cryptorchidism.The AUC of INHA was 0.81(95％CI:0.79-0.84,P＜0.01).When the Youden index was 75.86％and the cut off value was 5.165 pg/mL,it had a rela-tively good sensitivity(77.86％)and specificity(98.00％).Conclusion The changes in the levels of serum AMH and INHB have certain diagnostic value for boys with cryptorchidism,while INHA has a good diagnos-tic value and can be used as an auxiliary diagnostic indicator for boys with cryptorchidism.

Cell is the most basic unit of life,and normal metabolism is the key to cell growth and development.Reactive oxygen species(ROS)are important regulators of cell function,and hypoxi-a-inducible factor-1 alpha(HIF-1α)is a ROS receptor,which can activate transient receptor poten-tial vanilloid(TRPV)channel.TRPV is a sensor for temperature,pain,and osmotic pressure.Changes in the environment can induce changes in the activity of TRPV channel,which regulates various physiological and pathological processes of cells through its downstream signaling path-ways.Low temperature plasma can regulate cellular TRPV channel activity through HIF-1α.This article mainly reviews the effect of HIF-1α on cell function through TRPV channel,which has ref-erence significance for future research on various diseases related to TRPV channel and their pre-vention and treatment,as well as provides a new idea for using low temperature plasma technology to treat diseases through regulating TRPV channel.

Objective To analyze the correlation between the poor position of pedicle screw after lumbar internal fixation and the occurrence of postoperative neurological symptoms.Methods The clinical data of patients who underwent lumbar pedicle screw surgery in our hospital from January 2017 to December 2023 were analyzed retrospectively.Record the patient's sex,age,diagnosis,surgical segment,the presence of postoperative neurological complications,the types of neurological complications.According to the postoperative CT,the screw penetration zone and grade were evaluated,and the distribution of different pedicle screw penetration types was recorded.The correlation between different types of pedicle screw penetration and postoperative neurological symptoms was analyzed.Results A total of 184 patients were included,including 80 males and 104 females.Age ranged from 18 to 82 years,with an average of 60.1±14.2 years.35 patients developed new neurological symptoms after operation.The incidence of postoperative neurological symptoms caused by pedicle medial quadrant screw penetration and lower quadrant screw penetration was higher than that of pedicle superior quadrant and lateral quadrant screw penetration.From L1 to L5,the risk of postoperative neurological symptoms caused by screw penetration in the medial quadrant of the pedicle increases gradually.When the penetration distance of pedicle medial quadrant screws in L4 and L5 segments is≥2mm,the risk of postoperative neurological symptoms is high.When the penetration distance of pedicle medial quadrant screws in L1,L2 and L3 segments is greater than 4mm,the risk of postoperative neurological symptoms is high.The distance of pedicle screw penetrating the medial quadrant of pedicle was positively correlated with the incidence of postoperative neurological symptoms(P<0.05).Conclusion The lateral and superior quadrants of the pedicle may be regarded as safety zones for lumbar pedicle screw placement.For the L1～L3 segments,screw penetration depth should not exceed 4 mm;whereas for the L4～L5 segments,the safety threshold must be strictly controlled within 2 mm.

Objective To analyze changes in intestinal microbiota composition and metabolites in mice with nitrous oxide poisoning using 16S rDNA sequencing and metabolomics,and to examine correlations between gut microbes and metabolites in order to explore the mechanisms of nitrous oxide poisoning.Methods C57BL/6 mice were randomly divided into a control group and a nitrous oxide poisoning group(n=6).The poisoning group was exposed to 90,000 ppm nitrous oxide twice daily for 1 h over 28 days,while the control group was exposed to air.Fecal samples were collected 24 h after the last exposure.16S rDNA sequencing was used to analyze structural differences in microbial communities and identify significantly different taxa.Metabolomics analysis was performed to detect changes in fecal metabolites and identify differential metabolites.Correlation analysis was conducted between differential microbiota and metabolites.Results 16S rDNA sequencing showed that the poisoning group had increased microbial abundance compared with controls,while species diversity remained unchanged.Significant differences were observed in gut microbiota structure between groups.Metabolomics identified 112 differential metabolites related to nitrous oxide poisoning,mainly involving the cAMP signaling pathway and sphingolipid metabolism.Spearman correlation analysis revealed a strong association between differential microbiota and differential metabolites.Conclusion Nitrous oxide poisoning alters the structure and metabolic profiles of intestinal microbiota.Changes in microbial abundance affect multiple metabolic pathways,which may be related to damage to the nervous and hematological systems.These findings provide a basis for further research on the mechanisms of nitrous oxide poisoning and for clinical treatment.

Objective To investigate the characteristics of peripheral blood in the treatment of aplastic anemia(AA)with Bushen Shengxue Method and Yiqi Yangxue Method combined with Western medicine.Methods Totally 492 AA patients who were treated in 19 centers including Xiyuan Hospital China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected,and were randomized into three groups:161 cases in the Bushen Shengxue group,164 cases in the Yiqi Yangxue group,and 167 cases in the control group.All three groups were orally administered cyclosporine and androgens.Bushen Shengxue group was given Bushen Shengxue Granules,Yiqi Yangxue group was given Yiqi Yangxue Granules,and the control group was given placebo(half dosage of Bushen Shengxue granules).The general data,overall efficacy,and peripheral blood at the 1st month,the 4th month,and 6th month after treatment were analyzed.Results The total effective rate of Bushen Shengxue group was 98.8％(159/161),which was significantly higher than that of Yiqi Yangxue group(79.9％)and the control group(61.7％),with statistical significance(P＜0.001);The total effective rate of Yiqi Yangxue group was significantly higher than that of the control group(P＜0.001).Compared with before treatment,the hemoglobin(HGB)levels of all three groups of patients significantly increased after treatment(P＜0.001,P＜0.01),and the platelet levels of Bushen Shengxue group and the control group significantly increased after treatment(P＜0.001);after treatment,the HGB levels in the three groups were ranked from high to low as the Bushen Shengxue group,Yiqi Yangxue group and the control group(P＜0.01).25％of patients had HGB levels exceeding 20％of baseline values,Bushen Shengxue group took 1 month,while Yiqi Yangxue group and control group took 4 months;25％of patients had an increase in HGB levels exceeding 50％of the baseline value,Bushen Shengxue group took 6 months,while Yiqi Yangxue group and control group took more than 6 months.At 6 months,the number of patients with HGB elevation exceeding 20％and 50％of baseline values in Bushen Shengxue group was higher than that in Yiqi Yangxue group and the control group(P＜0.05,P＜0.001).25％of patients had white blood cell elevation exceeding 50％of the baseline value,Bushen Shengxue group took 4 months,Yiqi Yangxue group took 6 months,and the control group took more than 6 months.25％of patients showed an increase in platelet levels exceeding 100％of the baseline value,Bushen Shengxue group took 4 months,while Yiqi Yangxue group and control group took 6 months;at 6 months,the number of patients in Bushen Shengxue group and Yiqi Yangxue group with platelet elevation exceeding 20％of the baseline value was significantly higher than that in the control group(P＜0.01,P＜0.05).Conclusion Bushen Shengxue method combined with Western medicine intreating AA is better than the method of Yiqi Yangxue method combined with Western medicine.In terms of improving HGB,it is reflected in shortening the recovery time and increasing the number of beneficiaries,and the dosage can affect the recovery time and the number of beneficiaries at the same time;in terms of improving white blood cell and platelet,it is reflected in shortening the recovery time,and the dosage can affect the recovery time.

Objective:To compare the efficacy and safety of irradiation-incorporated and chemotherapy only-based myeloablative conditioning regimens in haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for patients with high-risk myeloid malignancies.Methods:This study retrospectively collected clinical data from 63 high-risk acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) patients who underwent haplo-HSCT at the Fifth Medical Center of the Chinese PLA General Hospital from January 2015 to December 2019. These patients were classified into the irradiation ( n = 17) and chemotherapy ( n = 46) groups based on different conditioning regimens. The differences between the two groups were compared in terms of hematopoietic reconstitution, cumulative incidence of acute/chronic graft-versus-host diseases (aGVHD and cGVHD), non-relapse mortality (NRM), relapse rate (RR), overall survival (OS), and disease-free survival (DFS), followed by the analysis of prognostic factors. Results:The median follow-up time for the irradiation and chemotherapy groups was 78.5 and 72.3 months, respectively. The median time for neutrophil engraftment was 14.0 days in the irradiation group and 14.5 d in the chemotherapy group, and for platelet engraftment was 15.0 and 13.0 d, respectively. As a result, the two groups showed no statistically significant differences in hematopoietic reconstitution ( P > 0.05). The cumulative incidence of aGVHD and cGVHD was higher in the irradiation group compared to the chemotherapy group, yet showing no statistically significant differences ( P > 0.05). Specifically, the cumulative incidence of grade Ⅱ-Ⅳ aGVHD within 100 d was 29.4% and 21.7% for the irradiation and chemotherapy groups, respectively. The cumulative incidence of grade Ⅲ-Ⅳ aGVHD was 23.5% and 13.0%, respectively. The cumulative incidence of severe cGVHD within five years was 11.8% in the irradiation group and 8.7% in the chemotherapy group. In terms of long-term survival, the cumulative 5\|year RR and NRM were 20.2% and 28.4% in the irradiation group, 5.9% and 23.9% in the chemotherapy group, respectively, showing no statistically significant differences ( P > 0.05). The 5-year DFS and OS rates were 73.9% and 47.7% in the irradiation group, and 81.1% and 54.4% in the chemotherapy group, respectively, without statistically significant differences ( P > 0.05). Notably, the irradiation group manifested more favorable DFS and OS survival curves compared to the chemotherapy group. The survival curves indicate that the irradiation-incorporated regimen exhibited better trends in OS, DFS, and cGVHD-free relapse-free survival (GRFS). However, multivariate analysis did not reveal that irradiation conditioning is an independent prognostic factor affecting survival [ HR = 0.532 (0.163-1.735), 0.370 (0.091-1.516), 0.683 (0.248-1.882), P > 0.05]. Conclusions:In haplo-HSCT for high-risk myeloid malignancies, the irradiation-incorporated conditioning regimen demonstrates lower RR and NRM, higher DFS and OS, and potentially superior survival outcomes compared to the chemotherapy only-based regimen. Therefore, the irradiation-incorporated conditioning regimen may be preferentially considered in haplo-HSCT.

Objective To establish an animal model of anterior displacement of the temporomandibular joint disc in rabbits and ob-serve the pathological changes of condylar cartilage under stress by using HE staining,immunohistochemical staining and immunofluo-rescence staining.Methods Thirty adult New Zealand white rabbits were randomly divided into a Sham operation group and four ex-perimental groups,with six rabbits in each group.The Sham operation group underwent a sham operation,while the experimental groups were used to establish an animal model of anterior displacement of the temporomandibular joint disc.The experimental groups were further divided into a model group(no postoperative treatment),a 2-APB(TRPM7 inhibitor)group,a PDTC(NF-κB specific inhibitor)group,and a Diclofenac group.Two weeks after the operation,the experimental animals were sacrificed,and pathological sections of the condylar cartilage were made.HE staining was used to observe the pathological changes of the condylar cartilage,and immunohistochemical staining and immunofluorescence staining were used to observe the expression of NF-κB and its inflammatory fac-tors.Results ① HE staining showed that the pathological changes of the condylar cartilage were obvious at the 2nd week.Compared with the 2-APB group,PDTC group,and Diclofenac group,the pathological changes in the model group were more obvious.② Immu-nohistochemical staining showed that the expression of TRPM7,NF-κB,IL-1,IL-6,TNF-α and MMP-3 in the model group was higher than that in the sham operation group.After treatment with 2-APB,PDTC or diclofenac,the expression of TRPM7,NF-κB,IL-1,IL-6,TNF-α and MMP-3 decreased.③ Immunofluorescence staining showed that the expression of NF-κB in the model group was higher than that in the sham operation group.After treatment with 2-APB,PDTC or diclofenac,the expression of NF-κB decreased.Conclu-sion ① Under stress,the condylar bone undergoes early remodeling,and the apoptosis of condylar chondrocytes increases with the extension of loading time within a certain period.② Diclofenac,2-APB and PDTC can all reduce the apoptosis of condylar cells,and inflammatory factors also play an important role in the apoptosis of condylar chondrocytes.