OBJECTIVES: To compare the efficacy of toric implantable collamer lens (Toric-ICL) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia correction in patients with moderate to high myopia complicated with astigmatism. METHODS: We retrospectively collected data from 64 patients (aged 18-42 years) with moderate to high myopia complicated with astigmatism (128 eyes) undergoing either Toric-ICL (28 patients/56 eyes) or FS-LASIK (36 patients/72 eyes) at our department between January, 2019 and December, 2020. The changes of uncorrected distance visual acuity (UCVA), spherical equivalent (SE), mean astigmatism correction index (CI), corneal endothelial cell density (ECD) and intraocular pressure (IOP) following the procedures were compared between the two groups. RESULTS: In FS-LASIK group, all the eyes (72/72) achieved an UCVA≥1.0, similar to the rate in Toric-ICL group (55/56 eyes; P=0.2374). The postoperative SE was also comparable between FS-LASIK and Toric-ICL groups [0.43±0.06 D (range: -1.0 to 1.50 D) vs 0.38±0.05 D (range: -0.75 to 1.00 D); P=0.56]. The mean astigmatism CI was significantly higher in FS-LASIK group than in Toric-ICL group (0.8561 vs 0.7176; P<0.0001), and 88.89% of the eyes in FS-LASIK group and 69.64% in Toric-ICL group had postoperative astigmatism ≤0.50 D. No significant changes were observed in postoperative corneal ECD in FS-LASIK group, whereas ECD decreased significantly after the procedure in Toric-ICL group (P=0.0057). The patients undergoing Toric-ICL exhibited no significant changes of postoperative IOP, but the patients receiving FS-LASIK had significantly reduced IOP after the procedure (P<0.001). CONCLUSIONS Although the patients included in Toric-ICL group had higher myopia and astigmatism, Toric-ICL still showed better predictability and efficacy for astigmatic correction in Toric-ICL group. Toric-ICL is an effective and safe equivalent of FS-LASIK for correcting moderate myopia but can be more advantageous for correcting high myopia with astigmatism.
Humans ; Astigmatism/complications* ; Myopia/complications* ; Keratomileusis, Laser In Situ/methods* ; Retrospective Studies ; Adult ; Visual Acuity ; Adolescent ; Young Adult ; Treatment Outcome ; Male ; Lens Implantation, Intraocular/methods* ; Female ; Phakic Intraocular Lenses ; Intraocular Pressure

Objective:To analyze different smoking behaviors and their influencing factors of middle school students in Fujian Province in 2021.Methods:This study was a cross-sectional study based on the data of the National Tobacco Epidemic Survey in Fujian Province in 2021. A multi-stage stratified cluster random sampling method was used to investigate tobacco prevalence among middle school students at 10 monitoring points in Fujian province in 2021. A total of 7 681 subjects were investigated and 7 652 subjects were included in the study. The tobacco prevalence rates of different smoking behaviors were compared and the influencing factors were analyzed by multivariate logistic regression.Results:In 2021, the attempted smoking rate of middle school students in Fujian Province was 15.2%, the current smoking rate was 2.9%, and the regular smoking rate was 1.1%. Among the students with the 14 factors investigated, there were statistically significant differences in smoking behavior rates ( P<0.05). The students with the factor of "good friends smoking" had the highest rate of trying smoking (34.9%) (χ 2=825.65).The students with the factor of " feeling more comfortable with social smoking" had the highest rate of current smoking (16.0%) (χ 2=492.75). The students with the factor of "social smoking makes people more comfortable" had the highest rate of regular smoking (9.0%) ( χ2=334.56) ( P<0.001 for all). The results of multivariate logistic regression analysis showed that the influencing factors of different smoking behaviors were different. Among them, male students, good friends who smoke, students who think that social smoking makes people more comfortable, and not receiving tobacco control information from the media were common risk factors for middle school students to try smoking, smoke currently and smoke frequently. The most significant risk factors for different smoking behaviors were: (1) Attempted smoking rate: good friends smoking (34.9%, OR=3.402); (2) current smoking rate: good friends smoking (9.9%, OR=9.417); (3) regular smoking rate: social smoking makes people more comfortable (9.0%, OR=18.383). Urban students ( OR=0.666) were the protective factor for trying smoking; general high school ( OR=0.424) was a protective factor for smoking. Conclusions:In 2021, middle school students in Fujian Province have three types of smoking behaviors: try smoking, current smoking and frequent smoking. The common main influencing factors are gender, whether good friends smoke, social smoking makes people more comfortable, and whether they have accepted tobacco control messages from the media.

Objective:To develop an intelligent recognition and precise segmentation technique using ultrasonic images，and to enhance diagnostic efficiency and accuracy.Methods:A total of 1，430 patients diagnosed with uterine fibroids through transvaginal ultrasonography at the Maternal and Child Health Hospital of Guangming from November 2020 to October 2024 were retrospectively included. Ultrasonic images were manually annotated by two experienced physicians and reviewed by a senior expert. The Mask DINO deep learning model was used for lesion segmentation，and the segmentation results were optimized using ellipse fitting technology. Model performance was evaluated using the Dice coefficient，intraclass correlation coefficient（ICC），mean absolute error（MAE），and measurement accuracy.Results:In the test set of 286 cases，the average Dice coefficient of model prediction was 0.992，indicating extremely high segmentation accuracy. The average accuracy of lesion identification by the model was 0.909，with 241 correctly identified samples，19 basically correct samples，and 26 incorrect samples. In terms of long and short axis measurements，the ICC of the model's direct predictions were 0.871（short axis）and 0.784（long axis），with MAE of 0.436 cm（short axis）and 0.508 cm（long axis）. After optimization with ellipse fitting，the ICC increased to 0.893（short axis）and 0.866（long axis），and the MAE decreased to 0.191 cm（short axis）and 0.274 cm（long axis），the measurement accuracy improved significantly.Conclusions:The intelligent recognition and precise segmentation technique for uterine fibroids based on ultrasonic images constructed in this study performed excellently in lesion segmentation and measurement，it can significantly improve the efficiency and accuracy of diagnosis.

Objective:To investigate the efficacy and safety of sentinel lymph node dissection in the treatment of early cervical cancer.Methods:This study used a prospective study design. A total of 122 patients with early cervical cancer who received treatment at Jinhua Maternal & Child Health Care Hospital form June 2022 to June 2024 were included in this study. These patients were divided into an observation group and a control group ( n = 61/group) using a random number table method. In the observation group, sentinel lymph node resection instead of systematic lymphadenectomy was performed, while in the control group, systematic lymphadenectomy was performed. Perioperative indicators, postoperative lymph node pathology results, complications, and postoperative tumor recurrence rates were compared between the two groups. Additionally, sentinel lymph node imaging results were evaluated in the observation group. Results:After treatment, the surgical time, duration of pelvic drainage tube retention, duration of catheter retention, postoperative hospital stay, number of lymph nodes dissected, and time to postoperative bowel function recovery in the observation group were (178.33 ± 8.29) minutes, (7.19 ± 1.38) days, (11.73±2.57) days, (8.09±1.34) days, (12.48 ± 2.63), and (2.28 ± 0.69) days, respectively. These values were significantly shorter or lower than those in the control group [(239.41 ± 9.83) minutes, (9.74 ± 1.75) days, (12.88 ± 2.76) days, (9.53 ± 1.47) days, (133.27 ± 11.43) mL, (26.18 ± 2.27), (3.12 ± 0.98) days, t = 37.10, 8.94, 2.38, 5.65, 30.80, 5.47, all P < 0.05]. There were no statistically significant differences in postoperative pathological results between the two groups ( χ2 = 2.03, 0.12, both P > 0.05). The overall incidence of perioperative complications in the observation group was significantly lower than that in the control group [1.46% (1/61) vs. 8.19% (5/61), χ2 = 5.55, P < 0.05). Conclusions:Sentinel lymph node resection can significantly enhance the perioperative outcomes of patients with cervical cancer and reduce the incidence of complications. Additionally, there were no recurrences of cervical cancer during the follow-up period. Therefore, sentinel lymph node resection is a safe and feasible procedure.

Objective:To analyze different smoking behaviors and their influencing factors of middle school students in Fujian Province in 2021.Methods:This study was a cross-sectional study based on the data of the National Tobacco Epidemic Survey in Fujian Province in 2021. A multi-stage stratified cluster random sampling method was used to investigate tobacco prevalence among middle school students at 10 monitoring points in Fujian province in 2021. A total of 7 681 subjects were investigated and 7 652 subjects were included in the study. The tobacco prevalence rates of different smoking behaviors were compared and the influencing factors were analyzed by multivariate logistic regression.Results:In 2021, the attempted smoking rate of middle school students in Fujian Province was 15.2%, the current smoking rate was 2.9%, and the regular smoking rate was 1.1%. Among the students with the 14 factors investigated, there were statistically significant differences in smoking behavior rates ( P<0.05). The students with the factor of "good friends smoking" had the highest rate of trying smoking (34.9%) (χ 2=825.65).The students with the factor of " feeling more comfortable with social smoking" had the highest rate of current smoking (16.0%) (χ 2=492.75). The students with the factor of "social smoking makes people more comfortable" had the highest rate of regular smoking (9.0%) ( χ2=334.56) ( P<0.001 for all). The results of multivariate logistic regression analysis showed that the influencing factors of different smoking behaviors were different. Among them, male students, good friends who smoke, students who think that social smoking makes people more comfortable, and not receiving tobacco control information from the media were common risk factors for middle school students to try smoking, smoke currently and smoke frequently. The most significant risk factors for different smoking behaviors were: (1) Attempted smoking rate: good friends smoking (34.9%, OR=3.402); (2) current smoking rate: good friends smoking (9.9%, OR=9.417); (3) regular smoking rate: social smoking makes people more comfortable (9.0%, OR=18.383). Urban students ( OR=0.666) were the protective factor for trying smoking; general high school ( OR=0.424) was a protective factor for smoking. Conclusions:In 2021, middle school students in Fujian Province have three types of smoking behaviors: try smoking, current smoking and frequent smoking. The common main influencing factors are gender, whether good friends smoke, social smoking makes people more comfortable, and whether they have accepted tobacco control messages from the media.

Objective:To develop an intelligent recognition and precise segmentation technique using ultrasonic images，and to enhance diagnostic efficiency and accuracy.Methods:A total of 1，430 patients diagnosed with uterine fibroids through transvaginal ultrasonography at the Maternal and Child Health Hospital of Guangming from November 2020 to October 2024 were retrospectively included. Ultrasonic images were manually annotated by two experienced physicians and reviewed by a senior expert. The Mask DINO deep learning model was used for lesion segmentation，and the segmentation results were optimized using ellipse fitting technology. Model performance was evaluated using the Dice coefficient，intraclass correlation coefficient（ICC），mean absolute error（MAE），and measurement accuracy.Results:In the test set of 286 cases，the average Dice coefficient of model prediction was 0.992，indicating extremely high segmentation accuracy. The average accuracy of lesion identification by the model was 0.909，with 241 correctly identified samples，19 basically correct samples，and 26 incorrect samples. In terms of long and short axis measurements，the ICC of the model's direct predictions were 0.871（short axis）and 0.784（long axis），with MAE of 0.436 cm（short axis）and 0.508 cm（long axis）. After optimization with ellipse fitting，the ICC increased to 0.893（short axis）and 0.866（long axis），and the MAE decreased to 0.191 cm（short axis）and 0.274 cm（long axis），the measurement accuracy improved significantly.Conclusions:The intelligent recognition and precise segmentation technique for uterine fibroids based on ultrasonic images constructed in this study performed excellently in lesion segmentation and measurement，it can significantly improve the efficiency and accuracy of diagnosis.

Objective:To investigate the efficacy and safety of sentinel lymph node dissection in the treatment of early cervical cancer.Methods:This study used a prospective study design. A total of 122 patients with early cervical cancer who received treatment at Jinhua Maternal & Child Health Care Hospital form June 2022 to June 2024 were included in this study. These patients were divided into an observation group and a control group ( n = 61/group) using a random number table method. In the observation group, sentinel lymph node resection instead of systematic lymphadenectomy was performed, while in the control group, systematic lymphadenectomy was performed. Perioperative indicators, postoperative lymph node pathology results, complications, and postoperative tumor recurrence rates were compared between the two groups. Additionally, sentinel lymph node imaging results were evaluated in the observation group. Results:After treatment, the surgical time, duration of pelvic drainage tube retention, duration of catheter retention, postoperative hospital stay, number of lymph nodes dissected, and time to postoperative bowel function recovery in the observation group were (178.33 ± 8.29) minutes, (7.19 ± 1.38) days, (11.73±2.57) days, (8.09±1.34) days, (12.48 ± 2.63), and (2.28 ± 0.69) days, respectively. These values were significantly shorter or lower than those in the control group [(239.41 ± 9.83) minutes, (9.74 ± 1.75) days, (12.88 ± 2.76) days, (9.53 ± 1.47) days, (133.27 ± 11.43) mL, (26.18 ± 2.27), (3.12 ± 0.98) days, t = 37.10, 8.94, 2.38, 5.65, 30.80, 5.47, all P < 0.05]. There were no statistically significant differences in postoperative pathological results between the two groups ( χ2 = 2.03, 0.12, both P > 0.05). The overall incidence of perioperative complications in the observation group was significantly lower than that in the control group [1.46% (1/61) vs. 8.19% (5/61), χ2 = 5.55, P < 0.05). Conclusions:Sentinel lymph node resection can significantly enhance the perioperative outcomes of patients with cervical cancer and reduce the incidence of complications. Additionally, there were no recurrences of cervical cancer during the follow-up period. Therefore, sentinel lymph node resection is a safe and feasible procedure.

ObjectiveTo conduct a systematic comparative study on wild and cultivated Codonopsis pilosula（CP） from three aspects， including characters， microscopy， and contents of primary and secondary metabolites. MethodWild and cultivated CP samples were collected， their characters were measured using vernier caliper， tape measure and balance， the paraffin sections were stained with safranin-fixed green dyeing， and their microstructure were observed under the optical microscope. The content of alcohol-soluble extracts in wild and cultivated CP was determined according to the method for determination of extract under CP in the 2020 edition of Chinese Pharmacopoeia， the starch content was determined by anthrone colorimetry， the content of total polysaccharides was determined by kit method， Fiber analyzer was used to determine the content of fiber components， and ultra performance liquid chromatography（UPLC） was used to determine the content of monosaccharides， disaccharides and some secondary metabolites. Multivariate statistical analysis methods such as principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） were employed to screen key differential components between wild and cultivated CP on the basis of variable importance in the projection（VIP） value>1 and P<0.05. ResultIn terms of morphological characteristics， the "lion's head-like" shape， longitudinal wrinkles， and circumferential wrinkles below the root cap of wild CP were more pronounced in wild CP compared to the cultivated ones. Regarding transverse sectional features， wild CP had more fissures on the outer side of the cortex and a larger duramen. Under microscopic examination， wild CP had more stone cells， a larger proportion of xylem， and the presence of cork cells arranged in rings in the xylem， while cultivated CP has a larger proportion of phloem， smaller vessel diameters， and a more loosely arranged vascular system. In terms of primary metabolites， the contents of 45% ethanol-soluble extract and total polysaccharides in cultivated CP were significantly higher than those in the wild ones（P<0.05）， the contents of lignin， hemicellulose， cellulose， fructose and glucose in wild CP were significantly higher than those in the cultivated ones（P<0.05）， while sucrose content in the cultivated CP was significantly higher than that in the wild ones（P<0.05）. Concerning secondary metabolites， the contents of tryptophan and tangshenoside Ⅰ in cultivated CP were significantly higher than those in the wild ones（P<0.05）， whereas the contents of lobetyolinin， lobetyol and atractylenolide Ⅲ in wild CP were significantly higher than those in the cultivated ones（P<0.05）. ConclusionThere are significant differences between wild and cultivated CP in terms of morphological characteristics， microscopic features and chemical composition. Glucose， fructose， sucrose， tangshenoside Ⅰ， tryptophan and cellulose components are the key differential components between wild and cultivated CP. Wild CP contains more polyacetylenes and fructose， whereas cultivated CP has higher levels of tangshenoside Ⅰ and sucrose， with noticeably lower cellulose content. These distinctions may be related to their growth conditions， growth years and cultivation techniques. Based on the results of this study， it is recommended to increase polyacetylenes and the content ratio of fructose to sucrose as an indicators to characterize different production methods of CP， in order to guide the high-quality production of CP.

Objective:To understand the prevalence of tobacco use in middle school students in Fujian in 2019 and 2021, explore the influencing factors associated with tobacco use and provide data support for tobacco control intervention.Methods:Two surveys were conducted in middle school students selected through multi-stage stratified clustering random sampling from 10 counties (districts) of Fujian in 2019 and 2021, and χ2 test was used to examine the differences in prevalence of tobacco use between two years, and multiple logistic regression analysis models were used to analyze the factors associated with the tobacco use. Results:The current smoking rate was 2.9% in middle school students in Fujian in 2021, lower than that in 2019 (4.3%). The rate of smoking attempt was higher in 2021 (15.2%) than in 2019 (13.4%). The rate of passive smoking exposure at home, indoor public place, outdoor public place and public transport in 2021 (51.1%) was lower than in 2019 (62.8%), the differences were significant (all P<0.001). In 2021, being vocational school student, passive smoking exposure, believing that smoking is an attractive behavior, believing that smoking is helpful for social contact and seeing other people smoking, including close friends and teachers, were positive associated with tobacco use. Students who believed that passive smoke is harmful and smoking is difficult to quit had lower current smoking rate and smoking attempt rate, respectively. Conclusions:Although the current smoking rate declined in middle school students in Fujian, the smoking attempt rate increased. We should strengthen the establishment of smoke-free campus, health education about tobacco use control to protect adolescents from the harm of tobacco use.

Objective:To identify the characteristics of the bone marrow immune microenvironment associated with long-term survival in multiple myeloma (MM) patients.Methods:In the follow-up cohort of patients with newly diagnosed MM and who received “novel agent induction therapy and subsequent autologous stem cell transplantation and immunomodulator maintenance therapy” in the First Affiliated Hospital of Sun Yat-sen University, a cross-sectional study was carried out between August 2019 and May 2020. Using NanoString technology, the RNA expression of 770 bone marrow immune-related markers was compared between 16 patients who had progression-free survival ≥5 years and 5 patients with progressive disease. Among the 16 patients who achieved long-term survival, 9 achieved persistent minimal residual disease (MRD) negative while the other 7 had persistent positive MRD. The functional scores of each kind of immune cells were calculated based on the expression level of characteristic genes, so as to indirectly obtained the proportion of each immune cell subset. The Mann-Whitney U test and the Kruskal Wallis test were used for statistical analysis. Results:The proportion of neutrophils was significantly higher in long-surviving MM patients than in patients with progressive disease [functional scores, 13.61 (13.33, 14.25) vs. 12.93 (12.58, 13.38); Z=2.31, P=0.021]. Among long-surviving patients, those who were MRD-positive had a significantly greater number of mast cells compared with those who were MRD-negative [functional scores, 7.09 (6.49, 8.57) vs. 6.03 (5.18, 6.69); H=2.18, P=0.029]. Compared with patients with progressive disease, four genes (CTSG, IFIT2, S100B, and CHIT1) were significantly downregulated and six (C4B, TNFRSF17, CD70, IRF4, C2, and GAGE1) were upregulated in long-surviving patients. Among long-surviving patients, only gene CMA1 was significantly upgraded, 10 genes (ISG15, OAS3, MX1, IFIT2, DDX58, SIGLEC1, CXCL10, IL1RN, SERPING and TNFSF10) were significantly downregulated in the MRD-positive group compared with that in the MRD-negative group, the first 5 of which are related to the interferon response pathway. Conclusions:The increased neutrophil and mast cell numbers may be related to long-term survival in MM. Interferon signaling activation may be a key bone marrow immune profiling feature for MRD-negative, long-surviving patients with MM.