AIM:To investigate the current status and influencing factors of knowledge-attitude-practice in myopia prevention and control among children and adolescents in Ningbo City, thereby providing a scientific basis for formulating targeted prevention strategies.METHODS: Children and adolescents aged 6-12 years old were selected from the medical-school collaborative myopia prevention network in Ningbo City between August 2024 and May 2025 using stratified cluster sampling. Information on myopia prevention knowledge(15 items)and practice(9 items)was collected through questionnaire surveys. Logistic regression models were used to analyze factors influencing myopia occurrence in children and adolescents.RESULTS: A total of 664 children and adolescents aged 6-12 years were enrolled in this study. Participants were divided by age into three groups: 6-7 years old(n=221), 8-9 years old(n=221), and 10-12 years old(n=222). Of the 664 questionnaires distributed, 637 valid questionnaires were returned(201 from the 6-7 age group, 235 from the 8-9 age group, and 201 from the 10-12 age group), yielding an effective response rate of 95.9%. Based on myopia screening results, the non-myopic group comprised 203 participants(31.9%), including 100 males and 103 females, with a mean age of 8.82±1.98 years old. The myopic group comprised 434 participants(68.1%), including 213 males and 221 females, with a mean age of 9.10±1.95 years old. The myopia prevalence rates in the 6-7, 8-9, and 10-12 age groups were 37.8%(76/201), 71.9%(169/235), and 94.0%(189/201), respectively(P<0.001). Regarding the knowledge and practice of myopia prevention, the overall awareness rate in the non-myopic group(59.7%±9.7%)was significantly higher than that in the myopic group(48.7%±8.5%; P<0.001). Additionally, the non-myopic group scored higher on the key practice of “regular eye examinations”(4.27±0.96)compared to the myopic group(4.10±1.05; P<0.05). Logistic regression analysis indicated that age was the primary risk factor for myopia occurrence.CONCLUSION: Age is the dominant factor in the onset of myopia, and there is a phenomenon of “knowledge-practice gap”; the traditional health education model has limitations, and a precise prevention and control system based on developmental patterns should be established.

Objective: To develop a RHCE genotyping assay based on kompetitive allele-specific PCR (KASP) and assess its clinical accuracy for RhCE blood group determination. Methods: KASP primers were designed to interrogate three RHCE loci: the 109 bp insertion/deletion in intron 2, c. 307T>C, and c. 676C>G. A total of 1 194 RhD-positive inpatients from Chengdu were typed by both KASP genotyping and manual tube serology. Discordant samples (n=10) were retested by both methods and further resolved by Sanger sequencing. An additional 377 cases were tested for the c. 48C>G locus to evaluate the predictive accuracy of individual loci and combined locus testing for RhC antigen. Results: Genotyping concordance with serology was 100.0% for both the c. 676C>G locus (RhE/Rhe) and the c. 307T>C locus (Rhc). For RhC prediction using the 109 bp insertion, overall accuracy was 99.7% (1 191/1 194); the 3 discordant cases were confirmed by Sanger sequencing to be false negatives attributable to 109 bp deletion in intron 2. Testing the c. 48C>G allele for RhC prediction yielded 7 false positives, with an accuracy of 98.1% (370/377). RhC antigen status was determined by combining the 109 bp insertion and the c. 48C allele. After excluding 10 samples with inconsistent results between the two loci, the accuracy reached 100% in the remaining 367 samples. When both loci were applied in combination, accuracy reached 100% in the 367 cases with concordant results. Among the 1 194 patients, CCee (45.8%) and CcEe (31.7%) were the most common RhCE phenotypes. The e antigen had the highest positivity rate (92.2%), and the Ce haplotype was the most frequent (66.9%). Conclusion: The KASP-based RHCE genotyping method achieves high accuracy for clinical RhCE typing. Combining the 109 bp insertion/deletion with the c. 48C allele significantly improves RhC antigen prediction compared with either locus alone. This method was applied to RhCE genotyping of 1 194 RhD-positive inpatients in Chengdu, providing local RhCE phenotype and haplotype distribution data to support RhCE-matched transfusion practice.

To compare the performance differences between the multidisciplinary team (MDT) model and the conventional diagnostic and treatment model for lung cancer, and to explore a high-quality development pathway for optimizing lung cancer diagnostic and treatment resources.

Purpose: Dual anti–human epidermal growth factor receptor 2 (HER2) drugs have become the standard regimen for neoadjuvant systemic treatment (NST) to HER2-positive breast cancer patients. However, the efficacy varies greatly among patients with different HER2 protein expression levels. Materials and Methods: A total of 575 HER2-positive breast cancer patients from multiple centers throughout China from 2013 to 2022 were retrospectively analyzed. We compared clinicopathological features in different HER2 immunohistochemistry classes (HER2 2+/in situ hybridization [ISH] + or HER2 3+), and their difference in response to NST and survival with single or dual anti-HER2 drugs. Drug sensitivity assays were used to evaluate different efficacy of anti-HER2 drugs in vitro. Results: Compared to HER2 3+ subgroup, the HER2 2+/ISH+ group had a higher proportion of hormone receptor–positive status (48.7% vs. 76.1%, p < 0.001), more HER2 protein loss after NST, lower pathological complete response (pCR) rate (46.07% vs. 16.24%, p < 0.001), and tended to have worse disease-free survival (DFS). In HER2 2+/ISH+ patients, treated with pertuzumab and trastuzumab in combination had no significant improvement in pCR (19.12% vs. 12.24%, p=0.287) and DFS (p=0.908) than using alone. Drug sensitivity assay showed poor efficacy with dual anti-HER2 drugs in HER2 2+/ISH+ cell lines; however, fam-trastuzumab deruxtecan drugs had a satisfactory effect. Conclusion Owing to the differences in clinicopathological features and treatment efficacy, we considered the HER2 2+/ISH+ group to be a distinct subtype and defined it as the HER2-moderate–positive subgroup. In this subgroup, dual anti-HER2 drugs did not exert significant improvement in pCR and DFS. Therefore, treatment optimization is warranted, with antibody-drug conjugate drugs as potential options.

Lung cancer ranks first in morbidity and mortality among malignant tumors in China. Low-dose computed tomography (LDCT), as the primary screening method, faces increasingly prominent challenges of false positives and overdiagnosis associated with its high sensitivity. In recent years, the integration of artificial intelligence (AI) and three-dimensional reconstruction technology has provided a novel approach to addressing these challenges. This review highlights how AI and three-dimensional reconstruction contribute to improving image quality, enabling precise identification of pulmonary nodules and intelligent risk stratification, optimizing dynamic follow-up strategies, and assisting in preoperative planning, thereby driving the transformation of the LDCT screening paradigm. Meanwhile, current technical limitations and future directions are also discussed.

AIM:To compare and analyze the effectiveness and safety of reducing the diameter of the back optical zone diameter(BOZD)of orthokeratology lens designed by CRT and VST in controlling the progression of myopia in children and adolescents.METHODS:Retrospective study. The study subjects were 400 myopia patients aged 8-16 years who were admitted to the orthokeratology fitting center of our hospital from June 2019 to May 2022, with 400 eyes(including right eye data analysis). The subjects were divided into CRT-S group(BOZD<6.0 mm), CRT group(BOZD=6.0 mm), VST-S group(BOZD<6.2 mm), VST group(BOZD=6.2 mm)according to the brand of orthokeratology lens and BOZD group, with 100 cases in each group. Uncorrected visual acuity(UCVA), corneal flat K value, axial length, spherical equivalent, and incidence of corneal injury were collected and analyzed at 1 d, 1 wk, 1 and 6 mo, 1 and 2 a, respectively.RESULTS:After wearing lenses for 1 d, the UCVA of the VST-S group improved the fastest, but after 1 wk, all groups reached a good UCVA, and there was no significant difference between groups. The corneal flat K value of the CRT-S group decreased the most after wearing lenses for 6 mo, and there was no significant difference in the corneal flat K value of all groups after 1 year of lens wearing. At each time point, the axial length growth decreased significantly after reducing the BOZD of the same brand of orthokeratology lens. At 6 mo, there was no significant difference in the axial length growth and defocus ring diameter between the CRT-S group and the VST-S group, but at 1 and 2 a, the VST-S group had significantly lower axial length growth and defocus ring diameter than the CRT-S group. The growth of the diopter sphere and spherical equivalent(SE)was significantly reduced when the BOZD of the same brand of orthokeratology lens was reduced at 2 a follow-up. The VST-S group had the smallest changes in the degree of SE and had the best myopia control effect. There was no significant difference in the change value of the diopter cylinder and the incidence of corneal injury among the four groups.CONCLUSION:Reducing the BOZD of the orthokeratology lens can effectively control the growth of the axial length and the progression of myopia degree. The myopia control effect of the VST lens is better than that of the CRT lens after reducing the BOZD. Reducing the BOZD of the orthokeratology lens does not increase the risk of additional corneal injury.

AIM:To compare and analyze the effectiveness and safety of reducing the diameter of the back optical zone diameter(BOZD)of orthokeratology lens designed by CRT and VST in controlling the progression of myopia in children and adolescents.METHODS:Retrospective study. The study subjects were 400 myopia patients aged 8-16 years who were admitted to the orthokeratology fitting center of our hospital from June 2019 to May 2022, with 400 eyes(including right eye data analysis). The subjects were divided into CRT-S group(BOZD<6.0 mm), CRT group(BOZD=6.0 mm), VST-S group(BOZD<6.2 mm), VST group(BOZD=6.2 mm)according to the brand of orthokeratology lens and BOZD group, with 100 cases in each group. Uncorrected visual acuity(UCVA), corneal flat K value, axial length, spherical equivalent, and incidence of corneal injury were collected and analyzed at 1 d, 1 wk, 1 and 6 mo, 1 and 2 a, respectively.RESULTS:After wearing lenses for 1 d, the UCVA of the VST-S group improved the fastest, but after 1 wk, all groups reached a good UCVA, and there was no significant difference between groups. The corneal flat K value of the CRT-S group decreased the most after wearing lenses for 6 mo, and there was no significant difference in the corneal flat K value of all groups after 1 year of lens wearing. At each time point, the axial length growth decreased significantly after reducing the BOZD of the same brand of orthokeratology lens. At 6 mo, there was no significant difference in the axial length growth and defocus ring diameter between the CRT-S group and the VST-S group, but at 1 and 2 a, the VST-S group had significantly lower axial length growth and defocus ring diameter than the CRT-S group. The growth of the diopter sphere and spherical equivalent(SE)was significantly reduced when the BOZD of the same brand of orthokeratology lens was reduced at 2 a follow-up. The VST-S group had the smallest changes in the degree of SE and had the best myopia control effect. There was no significant difference in the change value of the diopter cylinder and the incidence of corneal injury among the four groups.CONCLUSION:Reducing the BOZD of the orthokeratology lens can effectively control the growth of the axial length and the progression of myopia degree. The myopia control effect of the VST lens is better than that of the CRT lens after reducing the BOZD. Reducing the BOZD of the orthokeratology lens does not increase the risk of additional corneal injury.

Objective To investigate the effect of extracorporeal diaphragmatic pacing(EDP)on wea-ning patients undergoing mechanical ventilation after acute Stanford type A aortic dissection(ATAAD)sur-gery.Methods A total of 80 patients who underwent ATAAD surgery and required mechanical ventilation in the cardiac intensive care unit(CCU)of our hospital from October 2023 to October 2024 were selected as the study subjects.They were randomly divided into a control group and an intervention group using a random number table method,with 40 patients in each group.Both groups of patients received conventional clinical drug therapy,mechanical ventilation support,and rehabilitation exercises after surgery.The intervention group additionally underwent EDP therapy on this basis.The clinical data,mechanical ventilation time,weaning out-comes,oxygenation index,tidal volume,and changes in diaphragm function parameters were compared be-tween two groups of patients.Results Compared with the control group,the intervention group had a shorter mechanical ventilation time[77.00(59.00,133.63)h]vs.54.50(49.00,105.25)h],offline success rate(72.5％vs.90.0％),oxygenation index[202.90(178.63,240.05)mmHg vs.236.50(196.00,293.75)mm-Hg],higher tidal volume[(496.00±111.95)mL vs.(563.23±133.98)mL],with a statistically significant difference(P＜0.05).Compared with the control group,diaphragmatic excursion(DE)of both sides[11.90(8.50,16.50)mm vs.15.30(12.20,19.80)mm;12.60(10.80,14.90)mm vs.14.70(11.43,19.20)mm]and diaphragmatic thickening fraction(DTF)of left and right side[21.75％(17.53％,27.13％)vs.26.30％(21.10％,32.40％);24.00％(17.68％,29.35％)vs.28.30％(22.43％,33.40％)]of the intervention group were higher,and the differences were statistically significant(P＜0.05).Conclusion EDP can enhance the function of the diaphragm in patients,shorten the duration of mechanical ventilation,improve the success rate of wea-ning,and improve the weaning outcomes of mechanically ventilated patients after ATAAD surgery.

Objective To explore the levels and clinical significance of serum myeloid-related protein 8/14(MRP8/14)and galectin(Gal)-13 in patients with acute exacerbation of chronic obstructive pulmonary dis-ease(AECOPD).Methods A total of 103 AECOPD patients who were admitted to the hospital from Febru-ary 2021 to February 2024 were collected as AECOPD group,and were divided into mild group(n=37),mod-erate group(n=45),severe group(n=21)according to the degree of disease,and the patients also were di-vided into good prognosis group(n=66)and poor prognosis group(n=37)according to prognosis of 28 d of admission to the hospital.During the same period,a total of 70 patients with stable chronic obstructive pulmo-nary disease(SCOPD)were selected as SCOPD group,and 70 healthy individuals who underwent the physical examination were selected as control group.Serum MRP8/14 and Gal-13 levels were measured by enzyme-linked immunosorbent assay,and lung function was examined by lung function detection instrument.Pearson product moment correlation or Spearman rank correlation was used to analyze correlation between serum MRP8/14,Gal-13 and degree of disease,lung function indexes in the AECOPD patients.Multivariate Logistic regression was used to analyze the factors influencing poor prognosis in the AECOPD patients.Receiver oper-ating characteristic curve was used to assess predictive value of serum MRP8/14 and Gal-13 for poor prognosis in the AECOPD patients.Results Compared with the control group,serum MRP8/14 and Gal-13 levels were increased in the AECOPD group and the SCOPD group(P＜0.05),and serum MRP8/14 and Gal-13 levels in the AECOPD group were higher than those in the SCOPD group(P＜0.05).Compared with the control group,first second forced expiratory volume(FEV1),percentage of FEV1 to expected value(FEV1％),forced vital capacity(FVC),percentage of FVC to expected value(FVC％)and FEV1/FVC were decreased in the AECOPD group and the SCOPD group(P＜0.05),and FEV1,FEV1％,FVC,FVC％,and FEV1/FVC in the AECOPD group were lower than those in the SCOPD group(P＜0.05).Serum MRP8/14 and Gal-13 levels in the AECOPD patients were positively correlated with degree of disease(P＜0.05),and negatively correlated with FEV1,FEV1％,FVC,FVC％,FEV1/FVC(P＜0.05).Age,MRP8/14 and Gal-13 were risk factors for poor prognosis in the AECOPD patients(OR=1.390,1.586,1.471,P＜0.05),and FEV1/FVC was a protec-tive factor for poor prognosis in the AECOPD patients(OR=0.752,P＜0.05).The area under the curve of serum MRP8/14,Gal-13 and the combination of the two for predicting poor prognosis in AECOPD patients were 0.850,0.846 and 0.931,respectively.The predictive value of the combination of the two was greater than that of single indicator,respectively(Z=1.866,1.881,P＜0.05).Conclusion The expression of serum MRP8/14 and Gal-13 are up-regulated in AECOPD patients,which are closely correlate with degree of disease and lung func-tion.Early combined detection of two indicators could predict the prognosis in AECOPD patients.

Objective To investigate the serum levels of CC chemokine ligand 23(CCL23)and sulfony-lurea receptor 1(SUR1)in patients with acute cerebral hemorrhage(ACH)and their predictive value for prognosis.Methods A total of 97 patients with ACH admitted to the hospital from May 2020 to May 2023 were collected as the case group.According to the National Institutes of Health Stroke Scale(NIHSS)score,the patients were divided into mild group(n=26),moderate group(n=41)and severe group(n=30).Ac-cording to the prognosis at 6 months after treatment,the patients were divided into a good prognosis group(n=71)and a poor prognosis group(n=26).During the same period,70 healthy physical examination people were randomly selected as the control group.The serum levels of CCL23 and SUR1 were detected by enzyme-linked immunosorbent assay.Spearman rank correlation analysis was used to analyze the correlation between serum CCL23,SUR1 levels and disease severity.Multivariate Logistic regression was used to analyze the rela-tionship between serum CCL23 and SUR1 levels and poor prognosis of ACH patients.The receiver operating characteristic curve was used to evaluate the predictive value of serum CCL23 and SUR1 for poor prognosis of ACH patients.Results Compared with the control group,the serum levels of CCL23 and SUR1 were in-creased in the case group(P＜0.05).Compared with the mild group,the moderate group and severe group had significant increases in the serum levels of CCL23 and SUR1(P＜0.05),and the severe group had a more significant increase than the moderate group(P＜0.05).Serum CCL23 and SUR1 levels were positively corre-lated with the severity of the disease(rs=0.672,0.634,P＜0.05).Compared with mild patients,the risk of poor prognosis increased in moderate and severe patients,with OR of 1.432(95％CI:1.125-1.822)and 1.863(1.322-2.625),respectively.Elevated serum CCL23 and SUR1 levels were risk factors for poor prog-nosis in ACH patients,OR were 1.513(95％CJ:1.206-1.901)and 1.439(95％CI:1.096-1.890)respec-tively.The area under the curve of serum CCL23,SUR1 and their combination in predicting poor prognosis of ACH patients were 0.839,0.823 and 0.911,respectively.The combined predictive value of the two indicators was higher than that of single index(Z=1.664,1.958,P=0.012,0.008).Conclusion The serum levels of CCL23 and SUR1 are up-regulated in ACH patients,which are related to the severity and prognosis of ACH.Early combined detection of CCL23 and SUR1 can assist clinical judgment and predict the risk of poor prognosis.