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 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.

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 compare the differences of baseline characteristics of patients with myelodysplastic syndrome(MDS)who achieved platelet(PLT)response after arsenic-containing TCM compounds combined with Western medicine treatment.Methods Totally 72 MDS patients were selected from 12 outpatient departments and wards,such as Xiyuan Hospital,China Academy of Chinese Medical Sciences,Dongfang Hospital,Beijing University of Chinese Medicine from October 2021 to October 2024.Among them,45 patients received arsenic-containing TCM compounds combined with Western medicine treatment,27 patients received Western medicine treatment.The blood routine[white blood cell(WBC)count,hemoglobin,PLT,neutrophil count],TCM syndrome scores,safety indicators,and adverse events were observed before and after three courses of treatment.The efficacy of all patients was evaluated,and the baseline characteristics of patients who achieved PLT response in the arsenic-containing TCM compounds group and the Western medicine treatment group were compared.Results Comparing the differences of baseline characteristics of the two groups,it was found that the patients who achieved PLT response in the arsenic-containing TCM compounds group were compared with those in the Western medicine treatment group:Age<60 years old(P=0.038),longer disease duration(P=0.012),lower WBC(P=0.017),lower reticulocyte percentage(P=0.037),lower blood urea nitrogen(P=0.046),lower high-density lipoprotein cholesterol(P=0.014),and lower N-terminal pro-B-type natriuretic peptide(P=0.034),abnormal electrocardiogram(P=0.013),high blasts(P=0.009),grade 0 reticular fiber staining(P<0.01),normal chromosome karyotype(P<0.01),gene mutation(P<0.01)and high TCM syndrome scores(P=0.013)were found.Conclusion Arsenic-containing TCM compounds consisting of Qinghuang Powder and Bushen Jianpi Decoction combined with Western medicine is used to treat MDS.Patients with age<60 years old,long disease duration,low WBC count,low reticulocyte percentage,low blood urea nitrogen,low high-density lipoprotein cholesterol,low N-terminal pro-B-type natriuretic peptide,abnormal electrocardiogram,high blasts,grade 0 reticular fiber staining,normal chromosome karyotype,gene mutation and high TCM syndrome score are more likely to obtain PLT response.

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.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.

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 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 investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.