AIM: To analyze the prevalence, severity, types, and correction of astigmatism in children, and provide scientific evidences for the prevention and treatment of refractive errors.METHODS: This cross-sectional study included 29 153 children aged 6-12 years from Xi'an and Lantian County, Shaanxi Province, China. Visual acuity and non-cycloplegic refraction were measured. Astigmatism was defined as an absolute cylindrical power ≥0.5 D in the right eye. Differences in astigmatism severity, type distribution, and refractive correction were analyzed across age, gender, and region.RESULTS:The prevalence of astigmatism increased with age, peaking at 11 years old(62.88%). Boys(57.10%)had a higher prevalence than girls(54.86%), and the municipal areas(58.29%)had a higher prevalence than county areas(51.75%). Mild astigmatism was the most common(63.82%), with moderate astigmatism increasing with age. The highest prevalence of high astigmatism was observed in 11-years-old children(9.68%). Compound myopic astigmatism(59.28%)and mixed astigmatism(25.16%)were the most frequent types. With increasing age, compound myopic astigmatism increased, while simple myopic, simple hyperopic, and compound hyperopic astigmatism decreased. Mixed astigmatism increased from ages 6 to 7, but declined from ages 7 to 12. For astigmatic axis types, with-the-rule astigmatism was the most prevalent(81.06%)and increased with age, peaking at 11 years(85.74%). Against-the-rule astigmatism showed a declining trend, while oblique astigmatism remained relatively stable. Distribution differences in astigmatism types and axes by gender and region were observed. Significant differences in astigmatism severity, types, and axis types across different ages, genders, and regions were observed(all P<0.05). The overall refractive correction rate for children with astigmatism was only 40.18%.CONCLUSION: The overall prevalence of astigmatism among children aged 6-12 years in Shaanxi Province was 56.02%, with higher prevalence observed in boys and in municipal areas. Age, gender, and region significantly influenced the prevalence of astigmatism. Notably, less than half of the children with astigmatism received refractive correction, highlighting the need for increased attention from parents and relevant authorities.

OBJECTIVE To investigate the induction of apoptosis in hepatocellular carcinoma cells by polyphyllin 9 （PP9） through the regulation of the Fas/Fas ligand （FasL） signaling pathway， and its inhibitory effect on the growth of transplanted tumor in nude mice. METHODS Based on the screening of cell lines and intervention conditions， HepG2 cells were selected as the experimental subject to investigate the effects of 2 μmol/L and 4 μmol/L PP9 treatment on cell colony formation activity， apoptosis rate， as well as the protein expressions of Fas， FasL， cleaved caspase-8 and cleaved caspase-3. Additionally， Fas inhibitor KR- 33493 was introduced to investigate the underlying mechanism of PP9’s anti-hepatocellular carcinoma activity. Using HepG2 cell tumor-bearing nude mice model as the object， and 5-fluorouracil （20 mg/kg） as the positive control， the effects of 10 mg/kg PP9 on tumor volume， tumor mass， and the protein expressions of the nuclear proliferation-associated antigen Ki-67 and cleaved caspase-3 in tumor-bearing nude mice were investigated. RESULTS Compared with the control group， 2， 4 μmol/L PP9 significantly decreased the number of clones and the clone formation rate of cells， but significantly increased the apoptosis rate， the protein expressions of Fas， FasL， cleaved caspase-8 and cleaved caspase-3 （P＜0.05 or P＜0.01）. However， the combination of Fas inhibitor KR-33493 could significantly reverse the effect of PP9 on the up-regulation of proteins related to the Fas/FasL signaling pathway （P＜0.01）. Compared with the control group， the tumor volume （on day 27）， mass and protein expression of Ki- 67 in nude mice of the PP9 group were significantly decreased， while the protein expression of cleaved caspase-3 was significantly increased （P＜0.01）. CONCLUSIONS PP9 can induce apoptosis of HepG2 cells by activating the Fas/FasL signaling pathway. Meanwhile， PP9 can also effectively inhibit the growth of transplanted tumors in nude mice.

Objective To analyze the epidemiological characteristics and spatiotemporal clustering of varicella in Lu'an City from 2005 to 2023, and to provide a scientific basis for optimizing varicella prevention and control strategies. Methods Data on varicella cases were collected through the Chinese Center for Disease Control and Prevention Information System. Descriptive epidemiology, temporal trend analysis, seasonal analysis, spatiotemporal clustering analysis, and spatial autocorrelation analysis were conducted using QGIS, JoinPoint, SaTScan and GeoDa software. Results The average annual reported incidence rate of varicella in Lu'an City from 2005 to 2023 was 34.55/100,000, showing a trend of initial increase followed by a decrease. The peak incidence occurred from October to January of the following year (RR=1.97, LLR=1743.95, P=0.001). Students aged 0 to 19 was the primary affected group. Spatiotemporal scan analysis revealed four types of spatiotemporal clusters, with the cluster in Jin'an District from October 2017 to December 2023 being particularly prominent (RR=2.87，LLR=1734.15，P<0.001). Spatial autocorrelation analysis indicated significant clustering of varicella cases in the main urban area (Moran's I=0.216，Z=4.786，P=0.003). Conclusion The incidence of varicella in Lu'an City exhibits distinct seasonal and spatial clustering, and schools and kindergartens in the main urban area are the key to varicella prevention and control. It is necessary to enhance the monitoring of disease outbreaks during peak periods and in key areas, and to increase the two-dose vaccination rate for varicella in areas with case aggregation and among key populations.

Objective:To evaluate efficacy of safflower polysaccharide in treatment of thymic atrophy induced by estradiol in mice.Methods:A total of 75 female ICR mice were divided into 5 groups:control group,model group,ubenimex group,SPS high dose group,SPS low dose group.Except for control group,each group was given intraperitoneal injection of estradiol benzoate every other day for 6 times.Treatment group began administration 24 h after the last parenteral administration,once a day for 10 days.Mice were sacrificed 24 hours after the last administration,and body weight,immune organ index,MDA and GST levels in plasma,periph-eral blood cells and T cells changes were observed,thymus tissue was stained by HE staining and TUNEL cell apoptosis staining,and thymus output capacity was detected.Results:Both high and low doses of safflower polysaccharide significantly improved thymus index(P<0.05)in mice,increased leukocytes level in peripheral blood(P<0.05),proportions of CD3+CD4+T,CD3+CD8+T cells(P<0.05)and CD4+T/CD8+T,improved thymus tissue damage.High dose of safflower polysaccharide could significantly reduce apoptosis in thymus tissue and enhance thymus output.Conclusion:Safflower polysaccharide has a certain therapeutic effect on estradiol-induced thymus atrophy in mice.

Vascular dementia is a cognitive impairment caused by cerebrovascular disease.Its pathogen-esis is derived from a series of pathological processes such as low cerebral blood perfusion caused by cere-brovascular damage.Microglia is an important part of the human innate immune system.Under the stimu-lation of different microenvironmental signals,microglia can differentiate into Ml type with pro-inflamma-tory effects and M2 type with anti-inflammatory effects,and produce a variety of cytokines with neurotoxic or neuroprotective effects.In recent years,regulating the polarization of microglia and reducing excessive inflammatory response have become important strategies for the treatment of neurodegenerative diseases.By introducing the main signaling pathways related to microglia polarization and the role of microglia po-larization-mediated neuroinflammation in vascular dementia,this paper clarified the important role of mi-croglia polarization balance in the treatment of vascular dementia and provided new ideas for related clini-cal research.

Serine/arginine-rich splicing factor 6 (SRSF6) is a member of the serine and arginine-rich (SR) protein family,and it plays a crucial regulatory role in RNA splicing.Dysregulation of SRSF6 ex-pression or function can lead to aberrant alternative splicing of certain genes,and contribute to the devel-opment and progression of inflammatory diseases,including tumors,diabetes,and pleural fibrosis.How-ever,the role of SRSF6 in inflammation remains unclear.In this study,we found that the expression of inflammatory factors,including tumor necrosis factor-α(TNF-α) and cyclooxygenase-2 (COX-2),was induced by lipopolysaccharides (LPS) .Concurrently,both the levels of SRSF6 mRNA and protein ex-pression significantly increased with prolonged LPS stimulation (P<0.05) .Furthermore,we investigated the change of SRSF6 expression on the expression of inflammatory factors.The results showed that upreg-ulation of SRSF6 enhanced the expression of LPS-induced inflammatory factors (P<0.05),while down-regulation of SRSF6 inhibited their expression (P<0.05) .Additionally,the activation of the nuclear fac-tor-κB (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways was suppressed by SRSF6 knockdown (P<0.05),indicating that SRSF6 is involved in regulating inflammatory responses in macrophages.Myeloid differentiation factor 88 (MyD88) is a key adaptor protein in the TLR4 signaling pathway,with its splicing isoforms MyD88-L and MyD88-S exerting pro-inflammatory and anti-inflamma-tory effects,respectively.Analysis of RNA-binding protein database and RNA immunoprecipitation showed that SRSF6 binds to MyD88 mRNA.Splicing analysis indicated that downregulation of SRSF6 promoted the expression of the anti-inflammatory MyD88-S mRNA isoform (P<0.01) .Moreover,knock-down of MyD88-S could rescue the expression of inflammatory factors suppressed by SRSF6 downregula-tion.These findings suggest that SRSF6 regulates MyD88 alternative splicing in macrophages,thereby af-fecting the activation of inflammatory signaling pathways and the expression of inflammatory factors.This study provides a foundation for further elucidating the role of SRSF6 in inflammatory diseases.

Objective:To evaluate the clinical characteristics and risk factors of infections occurring during hospitalization in patients with multiple myeloma (MM) treated with new generation therapies (including immuno-modulatory drugs,proteasome inhibitors and monoclonal antibodies).Methods:The clinical data were collected from 155 patients with multiple myeloma who were treated in Shanxi Bethune Hospital from March,2017 to March,2022 and were retrospectively analyzed.For this study,the following therapies were considered to be new generation therapies:lenalidomide,pomadomide,bortezomib,ixazomib,daratumumab. The clinical characteristics and risk factors of infection were analyzed.Results:A total of 155 patients were included in this study.The median follow-up time was 20 months.Of 155 patients with MM,242 infection episodes were identified.Among the 242 infections,the incidence of clinically defined infection (CDI)was the highest (186,76.86％),followed by microbiologically defined infection (MDI)in 50 cases (20.66％),and fever at unknown focus (FUF)in 6 cases (2.48％).35 cases (14.46％)of bacteria,10 cases (4.13％)of viruses,and 5 cases (2. 07％)of fungi were clearly infected.The most common site of infection was the lower respiratory tract in 90 cases (37.19％),the upper respiratory tract in 83 cases (34.30％),and the digestive tract in 27 cases (11.16％).All-cause mortality was 8.39％(13/155).In univariate analysis,there was a higher correlation between ISS stage Ⅲ,the number of treatment lines ≥2,frail and infected patients with multiple myeloma.In multivariate analysis,ISS stage Ⅲ(OR=2.96,95％CI:1.19-7.40,P=0.02),the number of treatment lines ≥2 (OR=2.91,95％CI:1.13-7.51,P=0.03)and frail (OR=3.58,95％CI:1.44-8.89,P=0. 01)were risk factors for infection in patients with multiple myeloma in the era of new drugs.Conclusion:Patients with multiple myeloma treated with new agents are prone to bacterial infection during hospitalization.ISS stage Ⅲ,lines of therapy(≥2)and frail were associated with high risk for infection.

Objective:To identify the risk factors for delayed gastric emptying in patients scheduled for elective caesarean section.Methods:One hundred and five patients, aged≥18 yr, at≥37 week gestation, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective caesarean section from August 2023 to February 2024, who followed the preoperative fasting guidelines, were collected. Based on the quantitative and qualitative ultrasound assessments of the gastric antrum, patients were divided into 2 groups: delayed gastric emptying group, as defined by Perlas A score of grade 2 or the presence of solid contents or gastric volume/weight >1.5 ml/kg, and non-delayed gastric emptying group, as defined by Perlas A score < grade 2 and gastric volume/weight ≤1.5 ml/kg. The variables of which showed statistically significant differences in the intergroup comparison would enter the logistic regression analysis to stratify the risk factors for delayed gastric emptying before elective caesarean section.Results:There were 41 parturients (39.0%) showed delayed gastric emptying before elective caesarean section. According to the results of multifactorial logistic regression analysis, the gastroesophageal reflux disease( OR=5.313, 95% confidence interval 1.013-27.878, P=0.048) was an independent risk factor for delayed gastric emptying in the patients who underwent elective caesarean section. Conclusions:Gastroesophageal reflux disease is an independent risk factor for delayed gastric emptying in the patients scheduled for elective caesarean section.

Objective:To investigate the application value of ultrasound technology in transurethral enucleation and resection of the prostate(TUERP).Methods:This study included 78 BPH patients admitted in our hospital from June 2021 to June 2023,aged 70.68±8.63 years and with the indication of surgery.We randomly divided them into two groups to receive TUERP(the control group,n=39)and ultrasound-assisted TUERP(the US-TUERP group,n=39).We statistically analyzed and compared the rele-vant parameters obtained before and after operation between the two groups.Results:No statistically significant differences were ob-served in the operation time and bladder irrigation time between the two groups(P>0.05).More glandular tissues were removed but less intraoperative bleeding and fewer perioperative complications occurred in the US-TUERP group than in the control.Compared with the baseline,IPSS,postvoid residual urine volume(PVR),quality of life score(QOL)and maximum urinary flow rate(Qmax)were significantly improved in both groups at 1 and 3 months after surgery,even more significantly in the US-TUERP than in the control group(P<0.05).Conclusion:US-TUERP helps achieve complete resection of the hyperplastic prostatic tissue along the surgical capsule at the anatomical level,with a higher safety,fewer perioperative complications,and better therapeutic effects.

Objective:To evaluate the safety and efficiency of China-made Toumai Robot-assisted laparoscopic radical prosta-tectomy(LRP).Methods:This study included 40 cases of PCa treated from January 2023 to May 2023 by robot-assisted LRP with preservation of the bladder neck and maximal functional urethral length,15 cases with the assistance of Toumai Robot(the TMR group)and the other 25 with the assistance of da Vinci Robot as controls(the DVR group).We recorded the docking time,laparo-scopic surgery time,vesico-urethral anastomosis time,intraoperative blood loss and postoperative urinary continence,and compared them between the two groups.Results:Operations were successfully completed in all the cases.No statistically significant differ-ences were observed between the TMR and DVR groups in the docking time(6 min vs 5 min,P＞0.05)or intraoperative blood loss(200 ml vs 150 ml,P＞0.05).The TMR group,compared with the DVR group,showed a significantly longer median laparoscopic surgery time(146 min vs 130 min,P＜0.05)and median vesico-urethral anastomosis time(19 min vs 16 min,P＜0.05).There were no statistically significant differences between the TMR and DVR groups in the rates of urinary continence recovery immediately af-ter surgery(60.0％[9/15]vs 64.0％[16/25],P＞0.05)or at 1 month(80.0％[12/15])vs(76.0％[19/25],P＞0.05),3 months(93.3％[14/15])vs(92.0％[23/25],P＞0.05)and 6 months postoperatively(100％[15/15])vs(96％[24/25],P＞0.05).Conclusion:China-made Toumai? Robot surgical system is safe and reliable for laparoscopic radical prosta-tectomy,with satisfactory postoperative recovery of urinary continence.