The prevalence of dry eye among children has been progressively increasing each year; however, clinical diagnosis remains challenging due to the unique physiological attributes of the pediatric tear film functional unit, as well as symptoms that are often atypical and clinical signs that differ from those seen in adults. In healthy children, tear secretion is generally greater, the meibomian gland structure is typically more intact, and the meibum composition and physicochemical properties are more favorable for the maintenance of tear film stability. Compared to adults, the etiology of pediatric dry eye is more frequently associated with meibomian gland dysfunction, allergic ocular conditions, orthokeratology lens wear, environmental influences, such as growing screen time, and systemic disorders. Affected children frequently exhibit non-specific symptoms such as excessive blinking or rubbing of the eyes, which may be overlooked due to their limited ability to verbalize discomfort. Clinical signs can include conjunctival hyperemia, decreased tear meniscus height, and corneal epithelial punctate lesions, though these tend to be milder or less distinct compared with adults. Diagnostic requires the use of age-appropriate tear metrics, such as the Schirmer test and tear film breakup time, alongside ocular surface evaluation, with particular attention to features specific to children that distinguish it from dry eye in adults. Going forward, it is essential to establish and validate pediatric-specific diagnostic criteria to improve ocular surface health and maximize visual quality in this vulnerable population.

Keratoconus is a blinding corneal disease that is particularly prevalent among adolescents. Early diagnosis and treatment can significantly reduce visual impairment in advanced stages and improve its prognosis. Based on machine learning and deep learning in keratoconus, Artificial intelligence(AI)mainly involves early screening and diagnosis, severity grading, progression prediction, and outcomes prediction. In this paper, the main applications and research progress of AI in keratoconus in recent years were summarized, and the challenges and future prospects in this field were discussed.

Objective:To analyze the clinical characteristics and prognosis of patients with myelodysplastic syndrome (MDS) with a bone marrow nucleated erythroid cell proportion of greater than or equal to 50% (MDS-E) .Methods:The clinical characteristics and prognostic factors of patients with MDS-E were retrospectively analyzed by collecting the case data of 1 436 newly treated patients with MDS diagnosed in the Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences from May 2014 to June 2023.Results:A total of 1 436 newly diagnosed patients with complete data were included in the study, of which 337 (23.5%) patients with MDS-E had a younger age of onset and lower neutrophil and platelet counts compared with those in patients with an erythroid cell proportion of less than 50% (MDS-NE) (all P<0.05). The proportion of MDS cases with ring sideroblasts (MDS-RS) was higher in the MDS-E group than in the MDS-NE group, and multi-hit TP53 mutations were more enriched in the MDS-E group than in the MDS-NE group (all P<0.05). Among patients with MDS-RS, the frequency of complex karyotypes and the TP53 mutation rate were significantly lower in the MDS-E group than in the MDS-NE group (0 vs 11.9%, P=0.048 and 2.4% vs 15.1%, P=0.053, respectively). Among patients with TP53 mutations, the frequencies of complex karyotypes and multi-hit TP53 mutations were significantly higher in the MDS-E group than in the MDS-NE group (87.5% vs 64.6%, P=0.003 and 84.0% vs 54.2%, P<0.001, respectively). Survival analysis of patients with MDS-RS found that the overall survival (OS) in the MDS-E group was better than that in the MDS-NE group [not reached vs 63 (95% CI 53.3-72.7) months, P=0.029]. Among patients with TP53 mutations and excess blasts, the OS in the MDS-E group was worse than that in the MDS-NE group [6 (95% CI 2.2-9.8) months vs 12 (95% CI 8.9-15.1) months, P=0.022]. Multivariate analysis showed that age of ≥65 years ( HR=2.47, 95% CI 1.43-4.26, P=0.001), mean corpuscular volume (MCV) of ≤100 fl ( HR=2.62, 95% CI 1.54-4.47, P<0.001), and TP53 mutation ( HR=2.31, 95% CI 1.29-4.12, P=0.005) were poor prognostic factors independent of the Revised International Prognostic Scoring System (IPSS-R) prognosis stratification in patients with MDS-E. Conclusion:Among patients with MDS-RS, MDS-E was strongly associated with a lower proportion of complex karyotypes and TP53 mutations, and the OS in the MDS-E group was longer than that in the MDS-NE group. Among patients with TP53 mutations, MDS-E was strongly associated with complex karyotypes and multi-hit TP53 mutations, and among TP53-mutated patients with excess blasts, the OS in the MDS-E group was shorter than that in the MDS-NE group. Age of ≥65 years, MCV of ≤100 fl, and TP53 mutation were independent adverse prognostic factors affecting OS in patients with MDS-E.

ObjectiveTo investigate the current situation of personality traits and job satisfaction of pediatric therapists in Jiangsu province, and to explore the correlation between them and the related factors of job satisfaction. MethodsFrom June, 2021 to February, 2022, random cluster sampling method was adopted after field investigating several pediatric hospitals and institutions in Jiangsu. Online questionnaires were sent out to pediatric therapists in different settings in eleven cities in Jiangsu. The questionnaires included Minnesota Satisfaction Questionnaire (MSQ), Eysenck Personality Questionnaire-Revised Short Scale for Chinese (EPQ-RSC) and self-made scale of demographic characteristics and working status. ResultsAll of the questionaires were taken back, in which 165 were valid (83.33%). Among the three dimensions of psychoticism, extraversion and neuroticism, the intermediate type accounted for 66.06%, 38.79% and 40.00%, respectively. The overall satisfaction of job was (3.80±0.55), the internal satisfaction was (3.88±0.53), and the external satisfaction was (3.59±0.69). There was significant difference in the satisfaction among different types of work institution, monthly incomes, levels of parental support and neuroticism (P < 0.05). Multiple linear regression showed that the internal satisfaction and overall satisfaction were related with neuroticism, monthly income and parental support (P < 0.05), while external satisfaction was related with the neuroticism and parental support (P < 0.05). The level of neuroticism was negatively correlated with the internal satisfaction, the external satisfaction and overall satisfaction (|r| > 0.337, P < 0.001), and the level of extraversion was postively correlated with the external satisfaction (r = 0.155, P < 0.05). ConclusionThe job satisfaction of pediatric therapists is fine in Jiangsu, and is ralated with the level of neuroticism, the monthly income and the level of parental support. The levels of neuroticism and extraversion correlate with the job satisfaction.

Objective To construct human yippee-like 5(YPEL5) gene eukaryotic expression recombinant plasmid and to express in esophageal carcinoma EC9706 cells .Methods The cDNA from human normal tissue was taken as a template and amplified to YPEL5 gene coding sequence with 366 bp in length .Then this se-quence was inserted into the multiple cloning site areas of eukaryotic expression vector pCDH-CD513B for ob-taining the eukaryotic expression vector pCDH-CD513B-Flag-YPEL5 .After the bacterial colony PCR identifi-cation ,it was sent to the corporation for testing the sequence .The successfully constructed recombinant plas-mid was transfected into human esophageal carcinoma EC9706 cells .The expression of PEL5 gene in EC9706 cells was detected by QRT-PCR and Western Blot .Results The YPEL5 gene segment with 366 bp in length was successfully amplified .pCDH-CD513B-Flag-YPEL5 recombinant plasmid was obtained by double enzyme digestion ,connection ,conversion and screening .The gene sequencing identification showed that the inserted gene sequence in recombinant plasmid was consistent with that in the GenBank .After 2 d of transfecting into EC9706 cells ,the QRT-PCR and Western Blot revealed that YPEL5 gene expression was significantly up-reg-ulated .Conclusion The pCDH-CD513B-Flag-YPEL5 eukaryotic expression vector is successfully constructed and is expressed in esophageal squamous cancer cell line EC9706 ,thus which lays a foundation for studying its function in the progression of esophageal cancer .

Objective To investigate the related risk factors for dyed cornea of orthokeratology, and to analyze the related risk factors, and to determine the independent risk factors, Provide evidence for intervention measures. Methods The clinical date were investigated for 990 patients with fitting orthokeratology lens between may.2014 and may.2016 in our hospital,through access to medical records, follow-up visit,questionnaire investigation to find out the cause of orthokeratology adverse reactions, the related risk factors were analyzed by univariate and multivariate Logistic regression analysis, using SPSS17.0 statistical processing. Results The incidence rate of dyed cornea of orthokeratology lens fitting in was 14.55%(144 in 990 patients); the single factor analysis found gender, age, region, refraction, lens position, family members, no significant difference . Eye disease combined (χ2= 28.73, P＜0.01), Schirmer I test (χ2=17.68, P＜0.01), lens activity (χ2=67.1, P＜0.01), Lens deposit(χ2=64.29, P＜0.01), lens wearing time (χ2=43.25, P＜0.01), health habits (χ2=38.01, P＜0.01) and water resources (χ2=3.81, P＜0.05), the difference was statistically significant; Logistic Logistic regression analysis found that Schirmer I test ( OR=4.126, P=0.003), lens activity ( OR=1.733, P=0.104), Lens deposit( OR=3.723, P=0.038), lens wearing time ( OR=5.034, P=0.002), health habits ( OR=6.544, P=0.002) and water resources ( OR=7.501, P=0.002) were independent risk factors for adverse reactions of orthokeratology. Conclusions Intervention measures that improve the fitting technology, complete removal of lens depositthe, Control wearing time, improve the health behaviors of the patients with the habit, use saline and professional cleaning are of great significance to reduce the incidence of adverse reactions of orthokeratology.

Objective To explore the risk factors for adverse reaction of Ortho-K lens so as to provide a reference for formulating targeted intervention measures.Methods From May 2014 to May 2016, retrospective analysis was used to clinical data from 990 patients with Ortho-K lens of Hankou Hospital, Wuhan Aier Eye Hospital. The reasons for adverse reaction of Ortho-K lens were found out through consulting medical record, telephone follow-up or asking and the related risk factors were analyzed.Results Among 990 patients with Ortho-K lens, there were 144 of them with adverse reaction with 14.55％ for the incidence. Single factor analysis showed that there were statistical differences in history of ocular disease, schirmer tests, mobility of eyeglass, sediment of eyeglass, time of wearing glasses, health habit, cleaning solution for eyeglass among patients with Ortho-K lens (χ2=28.73,17.68,67.1,64.29,43.25,38.01,3.81;P<0.05). Multivariate Logistic regression analysis revealed that the independent risk factors for adverse reaction of Ortho-K lens included secretion of tears, mobility of eyeglass, sediment of eyeglass, time of wearing glasses, health habit and cleaning solution.Conclusions The major factors for adverse reaction of Ortho-K lens are schirmer tests, mobility of eyeglass, sediment of eyeglass, time of wearing glasses, health habit and cleaning solution. Hospitals should constantly optimize the process, improve optometry technology, promote healthy behaviors of patients to make them form a good living and health habit as well as eye care habit, strengthen education and guidance to ensure patients master correct cleaning and disinfection methods, effectively control time of wearingglasses. We recommend the 0.9％ sodium chloride solution and professional cleaning solution to deal with eyeglass and nursing devices.

Nitidine is a benzophenanthridine alkaloid derived from Zanthorulum nitidum (Roxb .) DC root .Research shows that nitidine displays rich biological activities ,such as anti-tumor ,anti-inflammatory ,anti-malaria and etc .This paper reviewed the progress of the total synthesis methods for nitidine and recent research on bioactivities .

Objective Study configuration inversion of C-2-hydroxy in lycorine to provide a foundation for semi-synthesis of asiaticumine B .Methods Use instrumental analyses to explore the C-2-hydroxy configuration through oxidation and reduc-tion reactions .Results Accomplished configuration inversion of C-2-hydroxy in lycorine with 49% yield .Conclusion We identified a convenient and efficient method for the configuration inversion of C 2-hydroxy in lycorine .