AIM:To investigate the prevalence of visual impairment and its correction status among junior high school students in Xi'an, so as to provide evidence for the development of targeted myopia prevention and control strategies.METHODS: A stratified cluster sampling design was adopted. From March to May 2025, students in grades 7-9 were recruited from three schools in Xi'an, Shaanxi Province, China: Dongfang Middle School, the Middle School Attached to Xi'an University of Technology, and the Xingqing Campus of the High School Affiliated to Xi'an Jiaotong University. In total, 3 974 students were invited, including 1 726 in grade 7, 1 206 in grade 8, and 1 042 in grade 9. The visual acuity was measured monocularly using a 5 m standard logarithmic visual acuity chart, with the fellow eye occluded; the line corresponding to the smallest optotype that could be correctly identified was recorded as the visual acuity value. Non-cycloplegic autorefraction was performed with a desktop autorefractor to obtain spherical equivalent(SE)values for refractive error screening.RESULTS: This study initially included 3 974 students, of whom 32 did not participate in the vision test, resulting in 3 942 students being included in the final analysis. Among them, 3 067(77.80%)were identified with poor vision. The prevalence of myopia was 81.47%(1 746)in males and 87.55%(1 575)in females(P<0.01). A stratified analysis by grade showed myopia rates of 81.72%(1 386)in junior grade one, 84.47%(1 017)in junior grade two, and 88.10%(918)in junior grade three, demonstrating a significant upward trend with increasing grade level(χ2=19.8484, P<0.01). Among the 3 321 myopic students, 2 287 adopted corrective measures. The rates of full correction, under-correction, and non-correction among all myopic students were 48.15%(1 599), 20.71%(688), and 31.14%(1 034), respectively. The rate of non-correction was significantly higher in male students than in females(32.70% vs 29.40%, χ2=4.2222, P<0.05).CONCLUSION: The findings indicate a high prevalence of visual impairment among junior high school students in Xi'an, coupled with suboptimal spectacle-wearing and full-correction rates. There is an urgent need for collaborative efforts across society, schools, and families to implement effective interventions to slow the onset and progression of myopia in this population.

Objective To explore the non-invasive diagnostic criteria of magnetocardiography (MCG) for coronary microvascular dysfunction (CMVD), and its value in dynamically assessing drug treatment for CMVD. Methods Patients who presented with chest tightness or chest pain at Zhongshan Hospital, Fudan University from September 2024 to March 2025 were consecutively enrolled, and all of whom had non-obstructive coronary arteries on angiography. Using the coronary angiography-derived index of microcirculatory resistance (caIMR) as the gold standard, patients were divided into a normal microcirculation group (caIMR≤40 U) and a CMVD group (caIMR＞40 U). MCG testing was performed using a domestic device (MD-U041001, Mind Medical). Patients in the CMVD group received adenosine treatment and underwent repeat MCG after medication. Differences in MCG parameters between the two groups were analyzed, and a diagnostic model was established. The value of the diagnostic model was analyzed using receiver operating characteristic (ROC) curves. Results A total of 311 patients were included, with 135 in the normal microcirculation group and 176 in the CMVD group. The CMVD group had a significantly higher proportion of males (61.9% vs 47.4%, P＝0.012), and lower high-density lipoprotein cholesterol (HDL-C) levels ([1.16±0.31] mmol/L vs [1.24±0.29] mmol/L, P＝0.029) than the normal group. Eleven MCG parameters showed significant differences between the two groups (P＜0.05), among which increased values of mfm_QR_epav, mfm_RS_epmse, space_zeroRTrot, as well as decreased value of mfm_QR_v1 were independent predictors of CMVD. The diagnostic model based on these 11 MCG parameters yielded an area under the curve (AUC) of 0.688 (95%CI 0.629-0.747). The integrated diagnostic model combining clinical risk factors (male, smoking history, HDL-C) with MCG parameters had an AUC of 0.701 (95%CI 0.643-0.759). After adenosine treatment, patients in the CMVD group showed significant decreases in mfm_QR_epav (P＝0.010), mfm_RS_sad (P＝0.013), and mfm_RS_epmse (P＝0.046). Conclusions The model based on MCG parameters demonstrates good diagnostic ability for CMVD; dynamic changes in MCG parameters following adenosine intervention may serve as potential objective indicators for evaluating microcirculatory treatment efficacy.

BACKGROUND:The mechanisms underlying the occurrence of pressure injuries are complex,and it is not entirely clear which factors play a central role in the development of pressure injuries and how these factors operate. OBJECTIVE:To investigate the relationship between Piezo-type mechanosensitive ion channel component 1(Piezo1)and the occurrence of pressure injuries. METHODS:(1)Cellular experiment:Human immortalized keratinocytes(HaCaT)were treated with Yoda1,a Piezo1 agonist,at different concentrations.Cell viability,calcium ion influx,Piezo1,and apoptosis-related protein expression were detected.(2)Animal experiment:Twelve Sprague-Dawley rats were randomly divided into a control group and three experimental groups,with three rats in each group.The control group was not subjected to pressure,while in the three experimental groups,magnets with a thickness of 1,2,and 3 mm were used to press on both sides of the rats'back for 1 hour,respectively,to establish the animal models of pressure injuries.After modeling,all traumatic tissues were excised and subjected to hematoxylin-eosin,Masson,immunofluorescence staining and western blot assay. RESULTS AND CONCLUSION:Cellular experiments:The results of live/dead cell staining showed that HaCaT cell apoptosis increased with the increase of Yoda1 concentration(0,2.5,5,and 10 μmol/L),and calcium ion influx increased with the increase of Yoda1 concentration(0,5,and 10 μmol/L),as well as with the prolongation of treatment time.Western blot assay results showed an increase in the expression of BAX,TG2,and PIEZO1 and a decrease in the expression of the expression of Bcl-2 protein in HaCaT cells in 5 and 10 μmol/L Yoda1 groups compared with the control group(0 μmol/L Yoda1).Animal experiments:The results of hematoxylin-eosin and Masson staining showed that the skin structure of the three experimental groups was damaged at the compression site,there was subcutaneous fat liquefaction and necrosis,and collagen was sparse and disorganized,and damage to the skin structure at the compression site was aggravated with the increase of magnet thickness.Immunofluorescence staining and western blot results showed that compared with the control group,the expression of BAX,TG2,Yap1 and PIEZO1 proteins was elevated,and the expression of Bcl-2 proteins was lowered in the three experimental groups.Moreover,the expression of related proteins showed more significant changes with the increase of magnet thickness(pressure).To conclude,skin compression activates PIEZO1,leading to a significant influx of calcium ions.As the pressure increases,this ultimately results in cell apoptosis due to calcium overload.

Geraniin, a polyphenol derived from the fruit peel of Nephelium lappaceum L., has been shown to possess anti-inflammatory and antioxidant properties in the cardiovascular system. The present study explored whether geraniin could protect against an isoproterenol (ISO)-induced cardiac hypertrophy model. Mice in the ISO group received an intraperitoneal injection of ISO (5 mg/kg) once daily for 9 days, and the administration group were injected with ISO after 5 days of treatment with geraniin or spironolactone. Potential therapeutic effects and related mechanisms analysed by anatomical coefficients, histopathology, blood biochemical indices, reverse transcription-PCR and immunoblotting. Geraniin decreased the cardiac pathologic remodeling and myocardial fibrosis induced by ISO, as evidenced by the modifications to anatomical coefficients, as well as the reduction in collagen I/III á1mRNA and protein expression and cross-sectional area in hypertrophic cardiac tissue. In addition, geraniin treatment reduced ISO-induced increase in the mRNA and protein expression levels of interleukin (IL)-6, IL-1β and tumor necrosis factor-α, whereas ISO-induced IL-10 showed the opposite behaviour in hypertrophic cardiac tissue.Further analysis showed that geraniin partially reversed the ISO-induced increase in malondialdehyde and nitric oxide, and the ISO-induced decrease in glutathione, superoxide dismutase and glutathione. Furthermore, it suppressed the ISO-induced cellular apoptosis of hypertrophic cardiac tissue, as evidenced by the decrease in Bcell lymphoma-2 (Bcl-2)-associated X/caspase-3/caspase-9 expression, increase in Bcl-2 expression, and decrease in TdT-mediated dUTP nick-end labeling-positive cells.These findings suggest that geraniin can attenuate ISO-induced cardiac hypertrophy by inhibiting inflammation, oxidative stress and cellular apoptosis.

Objective To compare the efficacy and safety of defocus incorporated soft contact lenses(DISC)and orthokeratology(Ortho-K)for myopia control in children aged 8～15 years,and to further investigate the influence of dif-ferent baseline age and spherical equivalent(SE)on the treatment effect.Methods A retrospective cohort study was conducted,involving 197 myopic children(197 eyes)aged 8～15 years who were fitted with contact lenses at the Depart-ment of Ophthalmology,Xi'an People's Hospital(Xi'an Fourth Hospital)from May to September 2023.They were divid-ed into the DISC group(97 cases)and the Ortho-K group(100 cases).After 12 months of continuous follow-up,the chan-ges in axial length(AL)at 3,6,and 12 months after lens wear were compared between the two groups.Subgroup analysis was then performed:participants were divided into a younger subgroup(8～10 years)and an older subgroup(11～15 years)based on pre-wear age,and into a low myopia subgroup(-1.00～-3.00 D)and a moderate myopia subgroup(-3.25～-6.00 D)based on pre-wear SE.The AL changes at 3,6,and 12 months after wearing DISC or Ortho-K were com-pared between groups within these subgroups.Meanwhile,the incidence of conjunctivitis,incidence of corneal staining,corneal endothelial cell density,and corneal thickness were compared between the two groups at 12 months after lens wear.Results Inter-group comparisons showed:The change in AL in the DISC group at 3 months after lens wear was significantly lower than that in the Ortho-K group,and the difference was statistically significant(P＜0.05);at 6 and 12 months after lens wear,the differences in AL change between the two groups were not statistically significant(both P＞0.05).Subgroup analysis by age and SE showed:In the younger subgroup and the low myopia subgroup,the AL change in the DISC group at 3 months after lens wear was significantly lower than that in the Ortho-K group,and the differences were statistically significant(both P＜0.05),but these differences disappeared at 6 and 12 months after lens wear(all P＞0.05);in the older subgroup and the moderate myopia subgroup,the differences in AL change between the two groups at 3,6,and 12 months after lens wear were not statistically significant(all P＞0.05).At 12 months after lens wear,there were no statistically significant differences in the incidence of conjunctivitis,incidence of corneal staining,corneal endothe-lial cell density,or corneal thickness between the DISC and Ortho-K groups(all P＞0.05).Conclusion DISC demon-strates superior myopia control efficacy in the short term(3 months)for younger children and those with low myopia,but its medium-term(6 months)and long-term(12 months)efficacy converges with that of Ortho-K.Furthermore,the long-term safety of DISC is not significantly different from that of Ortho-K.

Objective To compare the efficacy and safety of defocus incorporated soft contact lenses(DISC)and orthokeratology(Ortho-K)for myopia control in children aged 8～15 years,and to further investigate the influence of dif-ferent baseline age and spherical equivalent(SE)on the treatment effect.Methods A retrospective cohort study was conducted,involving 197 myopic children(197 eyes)aged 8～15 years who were fitted with contact lenses at the Depart-ment of Ophthalmology,Xi'an People's Hospital(Xi'an Fourth Hospital)from May to September 2023.They were divid-ed into the DISC group(97 cases)and the Ortho-K group(100 cases).After 12 months of continuous follow-up,the chan-ges in axial length(AL)at 3,6,and 12 months after lens wear were compared between the two groups.Subgroup analysis was then performed:participants were divided into a younger subgroup(8～10 years)and an older subgroup(11～15 years)based on pre-wear age,and into a low myopia subgroup(-1.00～-3.00 D)and a moderate myopia subgroup(-3.25～-6.00 D)based on pre-wear SE.The AL changes at 3,6,and 12 months after wearing DISC or Ortho-K were com-pared between groups within these subgroups.Meanwhile,the incidence of conjunctivitis,incidence of corneal staining,corneal endothelial cell density,and corneal thickness were compared between the two groups at 12 months after lens wear.Results Inter-group comparisons showed:The change in AL in the DISC group at 3 months after lens wear was significantly lower than that in the Ortho-K group,and the difference was statistically significant(P＜0.05);at 6 and 12 months after lens wear,the differences in AL change between the two groups were not statistically significant(both P＞0.05).Subgroup analysis by age and SE showed:In the younger subgroup and the low myopia subgroup,the AL change in the DISC group at 3 months after lens wear was significantly lower than that in the Ortho-K group,and the differences were statistically significant(both P＜0.05),but these differences disappeared at 6 and 12 months after lens wear(all P＞0.05);in the older subgroup and the moderate myopia subgroup,the differences in AL change between the two groups at 3,6,and 12 months after lens wear were not statistically significant(all P＞0.05).At 12 months after lens wear,there were no statistically significant differences in the incidence of conjunctivitis,incidence of corneal staining,corneal endothe-lial cell density,or corneal thickness between the DISC and Ortho-K groups(all P＞0.05).Conclusion DISC demon-strates superior myopia control efficacy in the short term(3 months)for younger children and those with low myopia,but its medium-term(6 months)and long-term(12 months)efficacy converges with that of Ortho-K.Furthermore,the long-term safety of DISC is not significantly different from that of Ortho-K.

Convergence insufficiency intermittent exotropia (CI-IXT) is a subtype of intermittent exotropia.Surgery remains the most commonly used treatment.Improved unilateral lateral rectus recession-medial rectus resection (I-RR), slanted or nonslanted bilateral medial rectus resection (BMRs) and bilateral slanted lateral rectus recession (S-BLRc) are the commonly used modalities for surgical treatment.These treatment modalities have been able to correct distance and near exotropia and simultaneously reduce the near-distance difference.The clinical application of slanted or nonslanted BMRs is limited due to exodrift over time.I-RR and S-BLRc are widely used in clinics for patients with CI-IXT because of better long-term outcomes.A good knowledge of the different indications of each procedure and its appropriate application can lead to good clinical results.This article reviews recent advances in the surgical management of CI-IXT.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

Objective:To analyze the clinical efficacy and learning curve for robot-assisted cortical bone trajectory (CBT) screw fixation performed by surgeons with different seniority in the treatment of lumbar degenerative disease.Methods:The clinical data of 91 lumbar degenerative disease patients underwent robot-assisted CBT screw fixation from August 2020 to December 2022 in Beijing Shijitan Hospital, Capital Medical University were retrospectively analyzed. Among them, 48 patients underwent surgery performed by the same senior surgeon (senior group), with a total of 234 CBT screws were placed; while 43 patients underwent surgery performed by the same junior surgeon (junior group), with a total of 206 CBT screws were placed. The surgical related indexes, functional improvement score, lower back pain and lower limb radiation pain scores, acceptable nail insertion rate, non invasion rate of facet joints and incidence of postoperative complications were compared between two groups. The functional improvement score was evaluated using the Japanese Orthopaedic Association (JOA) score, the pain score was evaluated using visual analog score (VAS). The cumulative sum (CUSUM) method was used to depict the learning curve with "single screw placement time" as the observation index.Results:There were no statistical difference in incision length, operation time, intraoperative blood loss and postoperative hospital stay between two groups ( P>0.05). The least squares means of JOA scores 1, 3 and 6 months after surgery in both groups increased significantly compared to baseline, while the least squares means of lower back pain VAS and lower limb radiation pain VAS decreased significantly compared to baseline; there were no statistical differences between two groups ( P>0.05). There were no statistical difference in acceptable nail insertion rate, non invasion rate of facet joints and incidence of postoperative complications between two group ( P>0.05). The CUSUM learning curves were fitting well and the inflection point for senior surgeon corresponded to 18 cases, while it was reached after performing surgery on 21 cases for junior surgeon. Conclusions:Robot-assisted CBT screw fixation performed by surgeons with different seniority could achieve similar clinical outcomes for treating lumbar degenerative disease. The senior surgeons are able to complete the initial learning stage faster than the junior surgeons, but there is not much difference in the number of surgeries performed the learning curve.

Purpose To investigate the expression of chromogranin A(CgA)in gastroenteropancreatic neuroendo-crine neoplasms(GEP-NENs)and its relationship with clinicopathological features.Methods The clinicopathological data of GEP-NENs diagnosed in the Department of Pathology,Beijing Chao-yang Hospital,Capital Medical University from May 2011 to December 2024 were retrospectively analyzed.Immunohistochemical staining was applied to evaluate the expression of CgA,and the patients were divided into CgA(+)group and CgA(-)group.Differences in clinico-pathological features between the 2 groups were compared.Results The age of 229 patients ranged from 21 to 89 years,with an average age of 54.4 years.The most common primary site was the rectum(56.8％,130/229),fol-lowed by the stomach(16.6％,38/229),pancreas(14.4％,33/229),small intestine(6.1％,14/229),and colon(6.1％,14/229).There were 206 cases of single lesion and 23 cases of multiple lesions(number of tumors ≥2).There were 153 cases of G1(66.8％),29 cases of G2(12.7％),7 cases of G3(3.1％),and 40 cases of neuroendocrine carcinoma(NEC,17.5％).The positive rates of CgA in G1,G2,G3,and NEC groups were 37.2％,75.8％,71.4％,and 65.0％,respectively,with statistically significant differences(P＜0.001).The positive rates of CgA in T1,T2,T3,and T4 were 37.2％,83.3％,75.9％,and 57.7％,respectively,with statistically significant differences(P＜0.001).There were significant differences in age,vascular invasion,lymph node metasta-sis,and number of tumors between CgA(+)group and CgA(-)group(P＜0.001),but there was no significant difference in sex,tumor location,Syn,and CD56 expression between the two groups(P=0.595,P=0.098,P=0.173,P=0.557).Conclusion Immunohistochemical antibody CgA is a useful marker for GEP-NENs.CgA positiv-ity may be a poor prognostic factor for GEP-NENs patients.