The 577 nm subthreshold micropulse laser(577 nm SML)is a non-invasive retinal laser treatment technique that selectively acts on the retinal pigment epithelium(RPE), induces heat shock protein expression, regulates inflammatory response, promotes blood retinal barrier repair, downregulates vascular endothelial growth factor(VEGF)levels, improves Müller cell function, promotes retinal metabolism and functional recovery, and avoids thermal damage caused by traditional threshold lasers. In recent years, 577 nm SML has been widely used in the treatment of various fundus diseases, including central serous chorioretinopathy(CSC), diabetes macular edema(DME), macular edema secondary to retinal vein occlusion(RVO-ME), age-related macular degeneration(ARMD), type 2 macular telangiectasia(MacTel2), persistent subretinal fluid after retinal detachment repair, and Irvine-Gass syndrome. Characterized by favorable safety and repeatability, 577 nm SML possesses high clinical application value and serves as a vital adjuvant and complementary strategy for anti-VEGF therapy. This review aims to summarize the therapeutic mechanisms and clinical applications of 577 nm SML in common fundus diseases, and provide a theoretical basis for its further clinical application.

Objective:To analyze the molecular genetic spectrum of children with acute myeloid leukemia(AML),and explore its correlation with clinical characteristics and prognosis.Methods:The clinical and molecular genetic data of 116 children with newly diagnosed AML in Wuhan Children's Hospital from September 2015 to August 2022 were retrospectively analyzed.The Fisher's exact test was used to analyze the correlation of gene mutations with clinical features,and Kaplan-Meier curve was used to analyze the influences of gene mutations on the prognosis.Results:NRAS(22％),KRAS(14.9％),and KIT(14.7％)mutations were the most common genetic abnormalities in 116 children with AML.Children with KIT,CEBPA and GATA2 mutations showed a higher median onset-age than those without mutations(all P＜0.05).Children with FLT3-ITD mutation exhibited a higher white blood cell count at initial diagnosis compared to those without mutations(P＜0.05).Children with ASXL2 mutation had lower platelet count and hemoglobin at initial diagnosis than those without mutations(both P＜0.05).KIT mutations were often co-occurred with t(8;21)(q22;q22).There was no significant relationship between gene mutation and minimal residual disease(MRD)remission rate after the first and second induction therapy(P＞0.05).KIT and NRAS mutations were not associated with prognosis significantly(P＞0.05).The overall survival(OS)rates of children with CEBPA and FLT3-ITD mutations were superior to those without mutations,but the differences were not statistically significant(P＞0.05).The 3-year OS rate of 61 children treated by allogeneic hematopoietic stem cell transplantation was 89.8％,which was significantly higher than 55.2％of those only treated by chemotherapy(P＜0.001).Conclusions:Gene mutations are common in children with AML,and next-generation sequencing can significantly improve the detection rate of gene mutations,which can guide the risk stratification therapy.In addition,FLT3-ITD and KIT mutations may no longer be poor prognostic factors.

[Purpose]To analyze the trends of cancer incidence and mortality from 1991 to 2020 in Jiashan County of Zhejiang Province,and to predict trends from 2021 to 2035.[Methods]Cancer cases and deaths from 1991 to 2020 in Jiashan County were collected.The crude inci-dence rate and mortality rate,age-standardized rate(ASR)were calculated.The annual percentage change(APC)and average annual percentage change(AAPC)were calculated by Joinpoint model to analyze the trend of cancer incidence and mortality.The age-period-cohort model was used to predict the trends of cancer incidence and mortality from 2021 to 2035 and the estimated annual percentage change(EAPC)was calculated.[Results]The age-standardized incidence rates by Chinese standard population(ASIRC)in Jiashan were 159.06/105,187.25/105,and 254.37/105 during 1991-2000,2001-2010,and 2011-2020,respectively.The trends in young and middle-aged women and people above 65 years old were more predominant.Lung,stomach,colorectal,liver and female breast cancers were major incident cancers for the period from 1991 to 2020.The cancer incidence showed an increasing trend from 1991 to 2020(AAPC=2.17％,P＜0.05)and is expect-ed to continue to increase over 2021 to 2035(EAPC=3.03％,P＜0.05).The age-standardized mor-tality rates by Chinese standard population(ASMRC)in Jiashan were 119.74/105,117.79/105,and 100.11/105 during 1991-2000,2001-2010,and 2011-2020,respectively.Lung,liver,stomach,colorectal,esophageal,and pancreatic cancers were leading causes of cancer deaths from 1991 to 2020.The cancer mortality showed a decreasing trend from 1991 to 2020(AAPC=-1.00％,P＜0.05)and is expected to continue to decline over 2021 to 2035(EAPC=-1.67％,P＜0.05).[Conclusion]The mortality rate from cancers has been gradually declined in Jiashan County,while the incidence rate has increased significantly and will continue to increase in the next 15 years.High incidence of lung cancer,liver cancer,gastric cancer and colorectal cancer makes it crucial to pay close attention to key groups and strengthen the control of risk factors of high inci-dence cancer.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To explore the composition of gut microbiome, the characteristics of virulence factor genes and their relationship with liver metabolic inflammation in overweight or obese children.Methods:A case-control design was conducted. From the children who visited the West China Second University Hospital of Sichuan University for medical or physical examinations between August 2021 and April 2022, a total of 23 obese children (obesity group), 8 overweight children (overweight group), and 22 healthy children (control group) were recruited. The body mass index of children was calculated after anthropometric measurements; metabolic inflammation indexes such as the levels of fasting blood glucose and hepatic function and renal function etc. were detected. The composition and abundance of gut microbiota in the feces of the children were detected by metagenomic sequencing technology and the Shannon index and Simpson index were calculated to assess the α diversity of virulence factor genes. The Wilcoxon rank-sum test was used for pairwise comparison between groups. The Spearman′s rank correlation test was used for correlation analysis, and the Benjamini-Hochberg method was used to correct the P-value of multiple tests. Results:The obese group included 23 children aged 8.5 (6.3, 11.8) years, of whom 9 (39%) were male. The overweight group consisted of 8 children aged 9.2 (5.5, 12.3) years, of whom 4 were male. The control group comprised 22 children aged 5.3 (5.1, 5.4) years, of whom 10 (45%) were male. The obese group exhibited higher levels of alanine aminotransferase (ALT), gamma-glutamyl transferase (γ-GT), globulin, and uric acid compared to those of the control group (all P<0.05), with ALT also higher than that of the overweight group ( P<0.05). The levels of fasting blood glucose, γ-GT, globulin, and uric acid in the overweight group were all higher than those in the control group (all P<0.05). The abundance of Coprococcus A (0.76 (0.00, 3.11) vs. 0.00 (0.00, 0.00), false discovery rate ( FDR)<0.05) and Parasutterella (0.89 (0.08, 1.79) vs. 0.00 (0.00, 0.08), FDR<0.05) in the gut of children in the obese group were both higher than those of the control group. The number of virulence factor genes in the obese group was higher than those of the control group (941 (886, 977) vs. 890 (807, 920), P<0.05). The Simpson index and Shannon index of gut microbial virulence factor genes in the obese group were both higher than those of the control group (0.993 (0.992, 0.993) vs. 0.991(0.990, 0.991), (5.50 (5.46, 5.56) vs. 5.37 (5.30, 5.43), both P<0.01). The abundance of gut microbiota virulence factors genes all showed positive correlations with fasting blood glucose, ALT, γ-GT, and uric acid levels in children (all r>0.3, all FDR<0.05). The abundance of 17 gut microbial virulence factor genes were all positively associated with γ-GT levels (all r>0.3, all FDR<0.05). The virulence factor genes (LpxH, LpxB, LpxK) of lipopolysaccharide were all positively correlated with plasma γ-GT and globulin levels (all r>0.3, all FDR<0.05). Conclusions:Overweight or obese children exhibited elevated liver metabolic-inflammatory markers compared to their normal-weight counterparts. Notably, obese children demonstrated gut microbiota dysbiosis accompanied by enrichment of virulence factor genes, which may promote liver metabolic inflammation through pathways such as lipopolysaccharide biosynthesis.

Objective:To explore the influence of initial high-risk cytogenetic abnormalities on the outcomes of children with acute myeloid leukemia (AML) after post-transplant Cyclophosphamide (PTCy)-based allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:A retrospective cohort study.AML children who underwent PTCy-based allo-HSCT after the first complete remission at Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology between April 2017 and April 2024 were enrolled.Patients were divided into intermediate-risk and high-risk groups based on their initial cytogenetic features.These patients were further divided into complex karyotype, 11q23 rearrangement, and other karyotype groups.Clinical characteristics and survival outcomes were compared among these groups.Measurement and count data were analyzed using Wilcoxon rank-sum/Kruskal-Wallis and χ2 tests, respectively.Survival and risk factor analyses were performed using Kaplan-Meier and Cox proportional hazards methods, respectively. Results:A total of 51 AML children who underwent allo-HSCT were included in this study.The median age at transplantation was 3.2 years and the median follow-up time was 4.6 years.There were 26 cases in the intermediate-risk group and 25 cases in the high-risk group; 8 cases in the complex karyotype group, 14 cases in the 11q23 rearrangement group, and 29 cases in the other karyotype groups.By the end of the follow-up on November 30, 2024, 11 patients relapsed, 8 patients died, and 13 patients developed grades Ⅱ-Ⅳ acute graft-versus-host disease (GVHD).The 3-year overall survival (OS), relapse-free survival (RFS), and grades Ⅱ-Ⅳ acute GVHD-free and relapse-free survival (GRFS) were 84.0% (95% CI: 74.4%-94.8%), 74.5% (95% CI: 63.4%-87.5%), and 58.8% (95% CI: 46.7%-74.0%), respectively.The 3-year OS of the high-risk group was significantly lower than that of the intermediate-risk group (71.8% vs.96.2%, P=0.022), while differences in 3-year RFS and GRFS between the 2 groups were not statistically significant (68.0% vs.80.8%, P=0.400; 52.0% vs.65.4%, P=0.420).The 3-year OS, RFS and GRFS of the complex karyotype group were significantly lower than those of 11q23 rearrangement and other karyotype groups (50.0% vs.85.7%, 93.1%, P=0.009; 37.5% vs.85.7%, 79.3%, P=0.022; 25.0% vs.64.3%, 65.5%, P=0.049).Multivariate analysis showed that a complex karyotype was an independent prognostic factor affecting 3-year OS and GRFS [OS: HR=6.79 (95% CI: 1.13-43.80), P=0.044; GRFS: HR=3.72(95% CI: 1.13-12.20), P=0.030]. Conclusions:High-risk cytogenetic features are significant predictors of survival outcomes in pediatric AML patients undergoing PTCy-based allo-HSCT.

Intellectual disability (ID) is a kind of neurodevelopmental disorder with high clinical and genetic heterogeneity, which seriously endangers the physical and mental health of children. Its etiology is complex, many genetic and environmental factors can participate in the pathogenesis, and metabolic disorders are one of the important etiology. Targeted assays such as plasma amino acids and acylcarnitine and urinary organic acids are of limited use in helping to diagnose and manage these patients. Non-targeted metabolomics has become a tool to explore changes in the metabolites of organisms and a means to study possible biomarkers of such diseases. In recent years, metabolomics technology has made some progress in the etiology and mechanism of ID, providing new ideas and methods for its early recognition, treatment and improvement of prognosis. This paper reviews the progress of non-targeted metabolomics in ID.

Objective:To observe the influence of antibacterial photodynamic therapy combined with scaling and root planning(SRP)on the periodontal condition,oral flora and C-reactive protein(CRP),prostaglandin E2(PGE2),and interleukin-8(IL-8)in gingival crevicular fluid of patients with chronic periodontitis.Methods:102 patients with chronic periodontitis who were admitted to Fengdu County People's Hospital of Chongqing from January 2023 to October 2024 were prospectively selected,they were divided into control group(received SRP treatment,51 cases)and study group(received antibacterial photodynamic therapy combined with SRP treatment,51 cases)according to random number table method.The clinical efficacy,periodontal condition,oral flora,oral health impact profile-14(OHIP-14)scores,and CRP,PGE2 and IL-8 levels in gingival crevicular fluid between two groups were compared.Result:The clinical total effective rate of the study group was higher than that of the control group(P＜0.05).Clinical attachment loss(CAL),gingival index(GI),probing depth(PD),bleeding index(BI),aggregated bacilli with release lines,fusobacterium nucleatum,porphyromonas gingivalis,OHIP-14 score,CRP,PGE2 and IL-8 levels in gingival crevicular fluid 4 weeks after treatment and 12 weeks after treatment in the study group were lower than those in the control group(P＜0.05).Conclusion:Antibacterial photodynamic therapy combined with SRP can effectively improve the periodontal condition,oral flora and CRP,PGE2,IL-8 levels in gingival crevicular fluid of patients with chronic periodontitis,and enhance clinical efficacy.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

[Purpose]To analyze the trends of cancer incidence and mortality from 1991 to 2020 in Jiashan County of Zhejiang Province,and to predict trends from 2021 to 2035.[Methods]Cancer cases and deaths from 1991 to 2020 in Jiashan County were collected.The crude inci-dence rate and mortality rate,age-standardized rate(ASR)were calculated.The annual percentage change(APC)and average annual percentage change(AAPC)were calculated by Joinpoint model to analyze the trend of cancer incidence and mortality.The age-period-cohort model was used to predict the trends of cancer incidence and mortality from 2021 to 2035 and the estimated annual percentage change(EAPC)was calculated.[Results]The age-standardized incidence rates by Chinese standard population(ASIRC)in Jiashan were 159.06/105,187.25/105,and 254.37/105 during 1991-2000,2001-2010,and 2011-2020,respectively.The trends in young and middle-aged women and people above 65 years old were more predominant.Lung,stomach,colorectal,liver and female breast cancers were major incident cancers for the period from 1991 to 2020.The cancer incidence showed an increasing trend from 1991 to 2020(AAPC=2.17％,P＜0.05)and is expect-ed to continue to increase over 2021 to 2035(EAPC=3.03％,P＜0.05).The age-standardized mor-tality rates by Chinese standard population(ASMRC)in Jiashan were 119.74/105,117.79/105,and 100.11/105 during 1991-2000,2001-2010,and 2011-2020,respectively.Lung,liver,stomach,colorectal,esophageal,and pancreatic cancers were leading causes of cancer deaths from 1991 to 2020.The cancer mortality showed a decreasing trend from 1991 to 2020(AAPC=-1.00％,P＜0.05)and is expected to continue to decline over 2021 to 2035(EAPC=-1.67％,P＜0.05).[Conclusion]The mortality rate from cancers has been gradually declined in Jiashan County,while the incidence rate has increased significantly and will continue to increase in the next 15 years.High incidence of lung cancer,liver cancer,gastric cancer and colorectal cancer makes it crucial to pay close attention to key groups and strengthen the control of risk factors of high inci-dence cancer.