AIM: To investigate the decentration of the treatment zone(TZ)and the early impact on corneal higher-order aberrations(HOAs)induced by orthokeratology(OK)lenses fitted with digital corneal topography.METHODS: A retrospective longitudinal clinical study was conducted on 28 patients(28 right eyes)who were digitally fitted with OK lenses at the Laser Vision Center of Xi'an No.1 Hospital since 2023. Longitudinal measurements were taken at baseline, 1 wk, 1 and 3 mo post-treatment to assess changes in TZ diameter, decentration magnitude and direction. Furthermore, changes in corneal HOAs were observed, and correlations of decentration with each HOAs were also analyzed.RESULTS: The mean age of patients was 10.29±2.00 years, with 15 males and 13 females, and the average baseline spherical equivalent was -2.92±0.94 D. The average TZ diameters at 1 wk, 1, and 3 mo were 3.64±0.58, 3.83±0.57, and 3.69±0.55 mm, respectively, with no statistically significant differences between 1 wk and 3 mo. Horizontal decentration values were -0.43±0.28, -0.38±0.33, and -0.31±0.37 mm after wearing lenses for 1 wk, 1 and 3 mo, respectively, while vertical decentration values were -0.33±0.20, -0.33±0.23, and -0.36±0.23 mm across the same time points. The TZ consistently decentered inferotemporally, and changes in both horizontal and vertical decentration over time were not statistically significant(Fhorizontal=1.416, Phorizontal=0.252; Fvertical=0.126, Pvertical=0.882). Significant increases in total corneal HOAs, coma, and spherical aberration were observed at 5 mm optical zone post-wear(F=45.695, 33.401, and 45.091, all P<0.001). Vertical decentration at 1 wk and 1 mo was negatively correlated with total HOAs and coma(all P<0.05), while horizontal decentration at 3 mo showed a weak negative correlation with spherical aberration(P=0.037).CONCLUSION: Digitally-fitted OK lenses achieved stable TZ diameter by 1 wk post-wear, with minor inferotemporal decentration. Early post-wear corneal total HOAs, coma and sphercal aberration increased significantly, and vertical downward decentration was associated with elevated total HOAs and coma. However, correlations between decentration and HOAs weakened by 3 mo.

Objective To analyze the risk factors for postoperative recurrence in patients with chronic sinusitis and nasal polyps(CRSwNP)treated by endoscopic sinus surgery(ESS),and to construct a predictive model.Methods A retrospective study was conducted on 203 patients with CRSwNP who underwent ESS in the hospital from March 2022 to February 2023.These patients were divided into a recurrence group(n=43)and an non-recurrence group(n=160)based on whether they experienced recurrence after surgery.Clinical data were collected and analyzed using univariate analysis to identify significant differences.Lasso regression was used to screen potential influencing factors.Multivariate logistic regression was employed to analyze the risk factors.A nomogram was constructed for postoperative recurrence model,and the receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the model.Results Single-factor analysis showed that disease duration,Lund-Mackay CT score,SNOT-22 score,EOS,ECP,total IgE,CRP,IL-5,and IL-1β in the recurrence group after ESS were higher than those in the non-recurrence group(P<0.05),while the UPSIT score,CD3+,CD4+,CD8+,and CD4+/CD8+were lower(P<0.05);the proportion of patients with allergic rhinitis,asthma,no preoperative glucocorticoid treatment,and surgery time≥2 hours in the recurrence group after ESS was higher than that in the non-recurrence group(P<0.05).Multivariate logistic regression analysis model showed that disease duration(OR=1.389,95%CI:1.094～1.763,P=0.007),combined asthma(OR=2.997,95%CI:1.065～8.432,P=0.038),Lund-Mackay CT score(OR=1.156,95%CI:1.027～1.301,P=0.016),EOS(OR=1.540,95%CI:1.249～1.898,P<0.001),total IgE(OR=1.005,95%CI:1.000～1.009,P=0.041),and IL-5(OR=1.165,95%CI:1.078～1.260,P<0.001)were risk factors for ESS recurrence.Based on multivariate logistic regression analysis nomogram,the area under the ROC curve(AUC)was 0.9057;the sensitivity 76.74%;the specificity 87.5%;the average absolute error(MAE)of the calibration curve 0.03;the mean square error(MSE)0.00157,and the absolute error at the 0.9 percentile 0.065.Conclusions Disease course,the presence of asthma,Lund-Mackay CT score,EOS,total IgE,and IL-5 are all risk factors for postoperative recurrence in patients with CRSwNP.Moreover,the relevant nomogram model can be used as a reliable tool for assessing the risk of postoperative recurrence in CRSwNP.

Objective To analyze the risk factors for postoperative recurrence in patients with chronic sinusitis and nasal polyps(CRSwNP)treated by endoscopic sinus surgery(ESS),and to construct a predictive model.Methods A retrospective study was conducted on 203 patients with CRSwNP who underwent ESS in the hospital from March 2022 to February 2023.These patients were divided into a recurrence group(n=43)and an non-recurrence group(n=160)based on whether they experienced recurrence after surgery.Clinical data were collected and analyzed using univariate analysis to identify significant differences.Lasso regression was used to screen potential influencing factors.Multivariate logistic regression was employed to analyze the risk factors.A nomogram was constructed for postoperative recurrence model,and the receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the model.Results Single-factor analysis showed that disease duration,Lund-Mackay CT score,SNOT-22 score,EOS,ECP,total IgE,CRP,IL-5,and IL-1β in the recurrence group after ESS were higher than those in the non-recurrence group(P<0.05),while the UPSIT score,CD3+,CD4+,CD8+,and CD4+/CD8+were lower(P<0.05);the proportion of patients with allergic rhinitis,asthma,no preoperative glucocorticoid treatment,and surgery time≥2 hours in the recurrence group after ESS was higher than that in the non-recurrence group(P<0.05).Multivariate logistic regression analysis model showed that disease duration(OR=1.389,95%CI:1.094～1.763,P=0.007),combined asthma(OR=2.997,95%CI:1.065～8.432,P=0.038),Lund-Mackay CT score(OR=1.156,95%CI:1.027～1.301,P=0.016),EOS(OR=1.540,95%CI:1.249～1.898,P<0.001),total IgE(OR=1.005,95%CI:1.000～1.009,P=0.041),and IL-5(OR=1.165,95%CI:1.078～1.260,P<0.001)were risk factors for ESS recurrence.Based on multivariate logistic regression analysis nomogram,the area under the ROC curve(AUC)was 0.9057;the sensitivity 76.74%;the specificity 87.5%;the average absolute error(MAE)of the calibration curve 0.03;the mean square error(MSE)0.00157,and the absolute error at the 0.9 percentile 0.065.Conclusions Disease course,the presence of asthma,Lund-Mackay CT score,EOS,total IgE,and IL-5 are all risk factors for postoperative recurrence in patients with CRSwNP.Moreover,the relevant nomogram model can be used as a reliable tool for assessing the risk of postoperative recurrence in CRSwNP.

Purpose/Significance By integrating clinical and biological sample information,a big data research platform for biologi-cal sample information resources is built to provide one-stop data retrieval,integration and analysis services for researchers,and a data governance system is established,so as to improve the level of hospital clinical research infrastructure construction.Method/Process Common data model and data governance technology are adopted to integrate data sources from different vendors through extraction,trans-formation,loading and other steps to provide a unified data access portal.Result/Conclusion The big data research platform for biologi-cal sample information resources has the advantages of multi-dimensional data screening and rapid integrated analysis,which can pro-vide support for clinical research.

Objective:To explore the chain mediation role of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness.Methods:From February to March 2024, a convenience sampling method was used to select 763 nurses from ClassⅢ Grade A hospitals in Wenzhou as research subjects. Data were collected using a General Information Questionnaire, the Occupational Embeddedness Scale for Nurses (OESN), the Nursing Professional Values Scale-Revised (NPVS-R), the Nurses' Career Planning Questionnaire (NCPQ), and the Career Success Scale for Nurses (CSSN). Pearson correlation analysis was performed to examine the correlations among the scores of OESN, NPVS-R, NCPQ, and CSSN. The AMOS 21.0 software was used to construct a structural equation model to explore the chain mediation role of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness.Results:A total of 763 questionnaires were collected, with 749 valid responses, resulting in an effective recovery rate of 98.17%. The average scores for the 749 nurses were as follows: OESN (60.29±7.65), NPVS-R (108.99±11.82), NCPQ (42.98±4.44), CSSN (73.57±8.34). All four scale scores were positively correlated with each other ( P<0.05). The chain mediation effect of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness was established, with the total indirect effect accounting for 46.04% (0.302/0.656) of the total effect and the chain mediation effect of career development planning and career success accounting for 10.21% (0.067/0.656) . Conclusions:The level of occupational embeddedness among nurses needs further improvement. Nurses' professional values not only directly influence their level of occupational embeddedness but also affect their career development planning, which in turn impacts their career success, ultimately exerting an indirect effect on occupational embeddedness. Nursing managers should strengthen nurses' professional values, assist them in formulating clear career development plans, and provide timely feedback and recognition of career success.

Objective To investigate the current situation of knowledge,belief,and practice of grass-root health workers during war injury rescue in marine corps,so as to provide a basis for targeted training of war injury rescue.Methods From March to May 2023,382 grass-root health workers were selected by convenience sampling method as research subjects,and a self-designed questionnaire was used for the survey.Results The average scores of knowledge,attitude,and behavior items related to war injury rescue were 3.78±0.94,4.55±0.64,and 3.50±1.08,respectively.Multiple linear regression analysis showed that military rank,workplace,and training experience were the main influence factors for the knowledge,belief,and practice of health workers in war injury rescue(P<0.05).Conclusion Grass-root health workers in the marine corps have a positive attitude towards war injury rescue,but their knowledge and practice are relatively weak.It is necessary to carry out targeted and graded training for them.

OBJECTIVE: To explore the clinical feature and genetic etiology of a patient with normosmic idiopathic hypogonadotropic hypogonadism (nIHH) due to variant of CHD7 gene. METHODS: A patient who had presented at Anhui Provincial Children's Hospital in October 2022 was selected as the study subject. Clinical data of the patient was collected. The patient and his parents were subjected to trio-whole exome sequencing. Candidate variant was verified by Sanger sequencing and bioinformatic analysis. RESULTS: The patient had featured delayed development of secondary sexual characteristics but normal olfactory function. Genetic testing revealed that he has harbored a c.3052C>T (p.Pro1018Ser) missense variant of the CHD7 gene, for which both of his parents were of the wild type. The variant has not been recorded in the PubMed and HGMD databases. Analysis of amino acid sequences suggested that the variant site is highly conserved, and the variant may affect the stability of protein structure. Based on the guidelines from the American College of Medical Genetics and Genomics, the c.3032C>T variant was classified as a likely pathogenic (PS2+PM2_Supporting+PP2+PP3+PP4). CONCLUSION The delayed development of secondary sexual characteristics of the patient may be attributed to the c.3052C>T (p.Pro1018Ser) variant of the CHD7 gene. Above finding has expanded the variation spectrum of the CHD7 gene.
Child ; Humans ; Male ; Amino Acid Sequence ; Computational Biology ; DNA Helicases/genetics* ; DNA-Binding Proteins/genetics* ; Genetic Testing ; Genomics ; Hypogonadism/genetics* ; Mutation

Objective:To investigate the role of miR-146a in the pathogenesis of systemic juvenile idiopathic arthritis (sJIA) and its clinical significance.Methods:This article is a prospective clinical cohort study.Twenty-six patients with sJIA (14 cases of initial active group and 12 cases of stable group), 15 patients with multijoint juvenile idiopathic arthritis (JIA) and 15 patients with oligojoint JIA diagnosed in the Department of Rheumatology and Immunology of Anhui Provincial Children′s Hospital from June 2018 to December 2020 were enrolled.Twenty healthy controls from the out-patient clinic were also recruited.The expression level of miR-146a in peripheral blood mononuclear cells (PBMCs) of research objects was detected by real-time fluorescence quantitative polymerase reaction (qPCR), and the serum levels of interleukin (IL) - 6, tumor necrosis factor (TNF) - α and IL-1β in sJIA patients and healthy controls were detected by enzyme-linked immunosorbent assay.The expression levels of miR-146a in PBMCs and cytokines among different groups were compared by analysis of variance. Pearson correlation analysis was used to analyze the correlation of the relative expression level of miR-146a in PBMCs with clinical inflammatory indexes and serum cytokines in sJIA patients. Results:(1) The expression level of miR-146a in PBMCs of early sJIA patients was significantly higher than that in the multijoint JIA group and oligojoint JIA group (8.77±3.15 vs.4.40±1.59, 2.55±1.15, t=6.27, 14.23; all P<0.05). The expression level of miR-146a in PBMCs of sJIA active patients was significantly higher than that in sJIA stable patients (8.77±3.15 vs.3.63±1.37, t=10.27, P<0.05). There was no significant difference in the expression level of miR-146a between the sJIA stable group and healthy control group ( P>0.05). (2) The expression levels of IL-1β, IL-6 and TNF-α were significantly higher in sJIA active patients group than those in sJIA stable group[(58.56±17.47) ng/L vs.(26.32±10.54) ng/L, (73.72±11.16) ng/L vs.(23.20±9.12) ng/L, (70.93±19.97) ng/L vs.(24.25±9.49) ng/L, all P<0.05]. There was no significant difference in the expression levels of IL-1β, IL-6 and TNF-α between the sJIA stable group and healthy control group(all P>0.05). (3)The expression of miR-146a in PBMCs of sJIA patients was positively correlated with serum ferritin levels, platelets, erythrocyte sedimentation rates, C-reactive proteins, IL-1β, IL-6 and TNF-α( r=0.542, 0.433, 0.329, 0.306, 0.333, 0.342, 0.319, all P<0.05). Conclusions:miR-146a may be involved in the inflammatory process of sJIA disease.miR-146a can well distinguish sJIA from multijoint JIA and oligojoint JIA.TNF-α, IL-1β and IL-6 are involved in sJIA inflammatory responses.

OBJECTIVE: To investigate the clinical characteristics and genetic basis for a child with Keppen-Lubinsky syndrome (KPLBS). METHODS: Trio-whole exome sequencing (Trio-WES) was carried out for the proband and her parents. Candidate variant was verified by Sanger sequencing and bioinformatic analysis. RESULTS: The child has featured peculiar facies including large eyes, alar hypoplasia, microretrognathia, premature aging appearance in addition with growth delay and mental retardation. Trio-WES has identified that she has carried a de novo variant of the KCNJ6 gene, namely c.460G>C (p.Gly154Arg). The variant has not been recorded in the database. Prediction of protein structure indicated that the variant may affect the potassium ion selective filtration structure channel in the transmembrane region of KCNJ6 protein, which may result in up regulation of the function of the channel. CONCLUSION The de novo c.460G>C (p.Gly154Arg) variant of the KCNJ6 gene probably underlay the KPLBS in this child. Above finding has enriched the genotypic and phenotype spectrum of this syndrome.
Cataract ; China ; Female ; G Protein-Coupled Inwardly-Rectifying Potassium Channels/genetics* ; Humans ; Hypogonadism/congenital* ; Intellectual Disability/genetics* ; Mutation ; Whole Exome Sequencing