Abstract The prevention and control of myopia in Chinese children and adolescents has become a major public health issue. While maintaining increased outdoor activity as a cornerstone intervention, there is an urgent need to explore new complementary approaches that can be effectively implemented in both indoor and outdoor settings. In recent years, environmental spatial frequency has gained increasing attention as one of the key environmental factors influencing the development and progression of myopia. Both animal studies and human research have confirmed that indoor environments lacking mid to high spatial frequency components, often characterized as "visually impoverished", can promote axial elongation and myopia through mechanisms such as disruption of retinal neural signaling, impaired accommodative function, and altered expression of related molecules. Based on the scientific consensus, it is recommended that "enriching of environmental spatial frequency" should be integrated into the myopia prevention and control framework. Following the principles of schoolled organization, family cooperation, community involvement, and student participation, specific measures are put forward in three areas：optimizing school visual settings, improving home spatial environments, and promoting healthy visual behavior. The aim is to create "visually friendly" indoor environments as an important supplement to outdoor activity, thereby providing a novel perspective and strategy for comprehensively advancing myopia prevention and control among children and adolescents.

ObjectiveTo investigate the correlation between neutrophil-to-lymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， systemic immune-inflammation index （SII） and the severity of intrauterine adhesions （IUA）. MethodsThe retrospective study included 380 patients who underwent transcervical resection of adhesions （TCRA） from December 2019 to March 2025. Based on the American Fertility Society （AFS） classification， patients were divided into mild （n=61）， moderate （n=225）， and severe （n=94） groups. NLR， PLR， and SII were calculated from preoperative blood tests. Statistical analyses included Kruskal-Wallis test and ordinal Logistic regression. ResultsNLR， PLR， and SII were significantly higher in the severe IUA group compared to the mild group （P<0.05）， with SII showing the strongest predictive ability （OR=1.004， P=0.001）. The number of intrauterine procedures was an independent risk factor （OR=1.27/level， P=0.016）. The predictive model ［Logit（P）=-0.676+0.241×operation times+0.004×SII］ effectively identified severe IUA cases. ConclusionInflammatory markers （particularly SII） are correlated with IUA severity and may serve as non-invasive tools for clinical assessment.

BACKGROUND/OBJECTIVES: Unhealthy diets are associated with chronic stress. An allostatic load (AL) is a comprehensive physiological index that measures the chronic stress response of the body. As a healthy dietary pattern, the role of Dietary Approaches to Stop Hypertension (DASH) in the development of an AL during pregnancy remains unclear. This study examined the relationship between the DASH dietary pattern and AL during pregnancy. SUBJECTS/METHODS: This study was a prospective study. From January 2024 to November 2024, 134 pregnant women in the second trimester (23–27 weeks) and third trimester (32–36 weeks) of pregnancy who met the inclusion and exclusion criteria in the obstetrics clinic of a tertiary general hospital in Anhui Province were selected for a questionnaire survey, physical examination, and laboratory examination. The DASH dietary pattern was assessed using the DASH scoring tool, and the total AL score was calculated using nine biomarkers that represent the cardiovascular, metabolic, and immune systems. Logistic regression was used to analyze the relationship between the DASH score and AL. RESULTS: One hundred and thirty-four pregnant women were included in this study. At the second and third trimesters, 41.8% and 37% of pregnant women, respectively, were in the high AL group. The binary logistic regression results showed that the DASH score was negatively correlated with the AL in the unadjusted model (odds ratio [OR], 0.878; 95% confidence interval [CI], 0.807–0.957; P = 0.003) and adjusted model (OR, 0.878; 95% CI, 0.792–0.973; P = 0.013) in the second trimester, the DASH score was negatively correlated with the AL in the unadjusted model (OR, 0.832; 95% CI, 0.758–0.913; P < 0.001) and adjusted model (OR, 0.806; 95% CI, 0.716–0.908; P < 0.001) in the third trimester. CONCLUSION The DASH score was negatively correlated with the AL in pregnant women.A low DASH score may increase the risk of a high AL, which may have adverse effects on physical and mental health.

Objective To explore the effect of endoscopic retrograde appendicitis therapy on inflammatory reaction,oxidative stress and immune level in patients with acute appendicitis.Methods 82 patients with acute appendicitis who were treated from January 2020 to September 2023,and divided into control group(41 cases)and treatment group(41 cases).The grouping method was random number table method.The control group was given laparoscopic appendectomy,and the treatment group was given endoscopic retrograde appendicitis therapy.Both groups observed that the patients were discharged from hospital and were followed up for 1 week.The operation-related indexes,levels of inflammatory factors[serum procalcitonin(PCT),soluble intercellular adhesion molecule-1(sICAM-1),lipoxin A4(LXA4),soluble P-selectin(sP-s)and C-reactive protein(CRP)],oxidative stress[serum superoxide dismutase(SOD)and malondialdehyde(MDA)]and immune function[immunoglobulin M(IgM)and immunoglobulin G(IgG)]before and 24 h after operation,score of pain before operation,12 h and 24 h after operation and complications(during the study period)were compared between the two groups.Results Compared with the control group,the amount of bleeding in the treatment group was relatively less,and the time of lying on bed,hospitalization,anal exhaust and body temperature returning to normal after operation were relatively shorter,the differences were statistically significant(P＜0.05).Compared with pre-operation,the levels of serum sICAM-1,LXA4 and sP-s in both groups decreased at 24 h after operation,while the level of serum PCT and CRP increased,the treatment group was significantly lower than the control group(P＜0.05).Compared with pre-operation,the levels of serum SOD,IgM and IgG in the two groups decreased at 24 h after operation,but the levels in the treatment group were relatively higher,while the levels of serum MDA all increased,which was lower in the treatment group(P＜0.05).Compared before operation,the scores of pain in the two groups showed a downward trend from 12 and 24 h after operation,and compared with the control group,the scores of pain in the treatment group were relatively lower(P＜0.05).During the study period,compared with 26.83%in the control group,the total incidence of complications in the treatment group was 7.32%,which was relatively lower(P＜0.05).Conclusion Endoscopic retrograde appendicitis therapy for acute appendicitis can effectively reduce patients'oxidative stress and inflammatory reaction,protect their immune function,shorten patients'postoperative recovery time,relieve their pain and reduce the incidence of postoperative complications.

Objective:To investigate the effect of taxifolin on cartilage damage in osteoarthritis(OA)rats by regulating Sonic hedgehog(Shh)/Gli family zinc finger protein 1(Gli1)signaling pathway.Methods:Rats were randomly separated into control group,OA group,taxifolin group,Shh activator(purmorphamine)group and taxifolin+purmorphamine group,with 12 rats in each group.Except for control group,rats in all other groups were used to construct OA models by the improved Hulth method.After successful modeling,medication treatment began once a day for 4 weeks.Changes in knee joint swelling and maximum range of motion in rats were detected.Saffranine O-solid green staining was applied to detect pathological changes in knee joint cartilage tissue and to perform the Osteoarthritis Research Society International(OARSI)score.ELISA was applied to detect levels of IL-1β,TNF-α and IL-10 in tissue.Immunohistochemical staining was applied to detect expressions of ADAMTS-5 and MMP-13 in knee joint cartilage tissue.Western blot was applied to detect expressions of Shh and Gli1 proteins in knee joint cartilage tissue.Results:Compared with control group,cartilage surface of rats in OA group was damaged,cartilage erosion occurred,and cells were greatly reduced,knee joint swelling,OARSI score,levels of IL-1β and TNF-α in knee cartilage tissue,percentages of ADAMTS-5 and MMP-13 positive cells,Shh and Gli1 protein expressions were elevated,the maximum range of motion and level of IL-10 in knee cartilage tissue were decreased(P<0.05).Compared with OA group,damage to cartilage surface,cartilage erosion and cell reduction were alleviated in taxifolin group,knee joint swelling,OARSI score,levels of IL-1β and TNF-α in knee cartilage tissue,percentages of ADAMTS-5 and MMP-13 positive cells,Shh and Gli1 protein expressions were decreased,while the maximum range of motion and level of IL-10 in knee cartilage tissue were increased,the trend of changes in corresponding indicators in purmorphamine group was opposite to that in taxifolin group(P<0.05).Compared with taxifolin group,pathological damage to knee joint cartilage tissue in taxifolin+purmorphamine group was intensified,knee joint swelling,OARSI score,levels of IL-1β and TNF-α in knee cartilage tissue,percentages of ADAMTS-5 and MMP-13 positive cells,Shh and Gli1 protein expressions were increased,the maximum range of motion and level of IL-10 in knee carti-lage tissue were decreased(P<0.05).Conclusion:The improvement mechanism of taxifolin on cartilage damage in OA rats may be related to the inhibition of the Shh/Gli1 signaling pathway.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.

Objective To investigate the expression levels of platelet activating factor and rhythm nuclear receptor Rev-erbα in patients after ischemic stroke on different onset times.Methods A total of 158 patients after ischemic stroke admitted from June 2022 to May 2023 were divided into four groups according to the onset time T1(0-6 o'clock),T2(6-12 o'clock),T3(12-18 o'clock),and T4(18-24 o'clock).Matched to the ischemic stroke groups,126 patients hospitalized at the same time with non-ischemic stroke were divided into four groups.General data and serum samples of the subjects were collected,and the expression levels of CD62P,CD40L and Rev-erbα were detected with enzyme-linked immunosorbent assay(ELISA).Results The expressions of platelet activating factor CD62P,tumor necrosis factor CD40L,and rhythm nuclear receptor Rev-erbα in T2 group after ischemic stroke were significantly higher than that in the other groups(P＜0.05),whilst no significant difference were observed in other three groups(P＞0.05).The expression of CD62P,CD40L and rev-erbα in ischemic stroke groups were significantly higher than that in control groups.Conclusion The expression levels of the rhythm nuclear receptor Rev-erbα,CD62P,and CD40L in ischemic stroke groups is higher than that in control groups,and the expression of these cytokines is more significant in T2 group(i.e.early in the morning)than other time slot.On the other hand,the expressions of CD62P and CD40L are consistent with Rev-erbα on the time slots,indicating a clear correlation.It is indicated Rev-erbα and platelet activation play a key role on attacking of ischemic stroke.

Objective To investigate the vasodilatory effect of luteolin on isolated denuded-endothelium rat thoracic aorta(DRTA)vascular rings,and the mechanistic role of the Kv7 ion channel.Methods The tension of DRTA vascular rings was measured using an ex vivo tissue perfusion muscle-tone detection system.DRTA vascular rings were pre-contracted with 60 mmol/L KCl or 0.3 μmol/L U46619,and the effect of luteolin on vascular-ring relaxation was observed at 1,3,10,30,100 and 300 μmol/L.The effects of 4-AP,XE-991,and ML213 on luteolin-induced vasodilation were also observed.The effect of luteolin on KCNQ1-KCNQ5 expression in the thoracic aorta was detected by real-time fluorescence quantitative polymerase chain reaction.Expression levels of Kv7.1 and Kv7.4 proteins in the DRTA were detected by Western blot.Results(1)The luteolin-induced maximum vasodilation rates in DRTA pre-contracted with 60 mmol/L KCl and 0.3 μmol/L U46619 were(97.67±8.51)％and(98.42±9.76)％,respectively.The vasodilation effect was concentration-dependent(P＜0.05).(2)4-AP(3 mmol/L)significantly reduced the vasodilatory effect of luteolin on DRTA vascular rings at 10,30,and 100 μmol/L(P＜0.05),and XE-991(3 μmol/L)significantly reduced the effect of luteolin at 30 and 100 μmol/L(P＜0.05),while ML213(1 μmol/L)significantly enhanced the vasodilatory effect of luteolin at 3,10,and 30 μmol/L(P＜0.05).(3)The relative gene expression levels of each subtype of Kv7 channel in normal DRTA were KCNQ1＞KCNQ5＞KCNQ4＞KCNQ3＞KCNQ2,with KCNQ1 being the most highly expressed.(4)Luteolin significantly enhanced the expression levels of KCNQ1 at 3,10,30,and 100 μmol/L,KCNQ2 at 1,3,10,30,and 100 μmol/L(P＜0.05),KCNQ3 at 3,10,30,and 100 μmol/L,and KCNQ4 at 10,30,and 100 μmol/L(P＜0.05),but did not significantly enhance the expression of KCNQ5 at 1,3,10,30,or 100 μmol/L(P＞0.05).(5)Luteolin significantly increased the expression of Kv7.1 protein in DRTA at 3,10,30,and 100 μmol/L(P＜0.05)and the expression of Kv7.4 at 10,30,and 100 μmol/L(P＜0.05).Conclusions Luteolin-induced dilation of DRTA vascular rings may be related to the enhanced gene expression of KCNQ1-4 and increased expression of Kv7.1 and Kv7.4 channel proteins.

Three-dimensional(3D)printing technology,which is based on computer aided design,presents innovative solutions for clinical surgical treatments and is increasingly being utilized in clinical settings.By integrating medical-image processing software and a 3D printer with customized materials,physicians can efficiently fabricate a 3D model layer by layer,thus realizing the reconstruction of human-body models with specific objectives.These models vividly showcase the anatomical structures,fracture types,and rupture severity,thereby facilitating doctors in understanding the fracture being examined.Beyond serving as a mere demonstration tool,the physi-cal model assists doctors in designing personalized implants and selecting customized surgical guide plates and fixation screws.Surgeons can improve the surgical accuracy and efficacy by refining the surgical plan via preoperative simulation operations.This article presents a summary of the application of computer-simulation surgery in conjunction with 3D printing technology in various complex surgeries.Addi-tionally,the significant potential applications of 3D printing technology in the clinical orthopedics field are discussed.

Objective:To explore the association between healthy lifestyle and co-morbidity of overweight/obesity and myopia in adolescents.Methods:Based on the Shanghai Municipal Dynamic Cohort of Student Common Diseases, we used the group-based trajectory model (GBTM) to establish a model for the development of adolescents' healthy lifestyle trajectories aged 11-14 years and the Cox proportional hazard regression model to assess the effects of different healthy lifestyles on the co-morbidity of overweight/obesity and myopia in adolescents.Results:A total of 2 331 adolescents were included in the analysis. The average follow-up time was 1.87 years, with age of (11.44±0.45) years at the initial follow-up, among 1 106 boys and 1 225 girls. During the 2-year follow-up period, the incidence rates of overweight/obesity, myopia, and co-occurrence of overweight/obesity and myopia were 25.9%, 77.0%, and 13.7%, respectively. GBTM identified 3 healthy lifestyles: the unhealthy group (7.3%), the relatively healthy group (50.2%), and the healthy group (42.5%). The risk of overweight/obesity was lower in the relatively healthy group than in the unhealthy group ( HR=0.694, 95% CI: 0.508-0.947). There was no statistically significant association between the GBTM lifestyle subgroups and myopia ( P>0.05). The risk of co-occurrence of overweight/obesity and myopia was lower in both relatively healthy group and healthy group than in the unhealthy group (relatively healthy group: HR=0.515, 95% CI: 0.348-0.763; healthy group: HR=0.571, 95% CI: 0.384-0.849). Sensitivity analyses showed this result to be stable for myopia, overweight/obesity and myopia co-morbidities. Conclusion:Persistent unhealthy lifestyle increases the risk of overweight/obesity and myopia co-occurrence in adolescents.