Objective: To understand the prevalence of myopia among primary and secondary school students in minority areas of Yunnan Province, and to explore the influence of outdoor activities and short-distance use of eyes, so as to provide a basis for early myopia intervention. Methods: In October 2020, the survey was conducted among 1 782 primary and secondary school students in three cities of Yunnan through a multi stage random cluster sampling method. All subjects underwent a questionnaire survey and the visual acuity examination at baseline. The first follow-up was conducted in October 2021 to obtain 1 691 valid samples, and the second follow-up was conducted in May 2023 to obtain 1 367 valid samples. Factors associated with myopia among primary and secondary school students were explored by using generalized estimating equations. Results: The prevalence rates of myopia in 2020, 2021 and 2023 were 52.64%, 61.62% and 69.35%, respectively, showing an increasing trend ( χ 2 trend =91.77, P <0.05). The results of multivariate regression analysis on the generalized estimation equations showed that age at baseline ( OR =1.31), girls ( OR =1.76), Hani ethnicity ( OR =0.75), Bai ethnicity ( OR =0.69), parental myopia ( OR =1.97-2.29), parents often reducing children s exercise time for homework or tutoring ( OR =1.35), less than 1 time or 2-3 times of ball sports per week ( OR =1.27, 1.20 ), reading and writing in the classroom during the break ( OR =1.27), reading in direct sunlight occasionally ( OR =1.20), using only desk lamp for writing at home ( OR =0.71), more than 1 hours of short-distance eye use for a break once ( OR =1.23) were associated with myopia among primary and secondary school students ( P <0.05). Conclusions Outdoor activities and short-distance use of eye among primary and middle school students in minority areas in Yunnan province are suboptimal. Enhancing the related environmental and behavioral factors can effectively mitigate the occurrence and progression of myopia.

Background Indoor air quality directly affects people's health, especially the impact of chemical pollutants in residential indoor air on children and the elderly is more significant. Objective To understand the pollution status of common chemical pollutants in residential indoor air in Shijiazhuang, evaluate the health risks of chemical pollutants to school-age children and the elderly, and provide reference for controlling indoor pollution in residential environment. Methods Using stratified random sampling, a total of 60 households were selected from 2 urban areas and 1 surrounding rural area in Shijiazhuang City, specifically in July 2023 (non-heating season) and December 2023 (heating season), respectively. Relevant data was collected through on-site sampling [including CO, CO₂, PM₁₀, PM_2.5, NO₂, SO₂, O₃, ammonia, formaldehyde, benzene, toluene, xylene, total volatile organic compounds (TVOC), trichloroethylene, and tetrachloroethylene] and survey questionnaires. The pollutant concentrations were evaluated following the Standards for indoor air quality of GB/T 18883-2022, and the inhalation exposure risks of the target population were assessed based on the health risk assessment method. Results In the indoor air of the urban and rural residence in Shijiazhuang City, except for CO, NO₂, SO₂, toluene, and xylene, which did not exceed the standard limits, other pollutants showed varying degrees of exceedance. The non-qualified rates of PM₁₀, PM_2.5, and CO₂ in the urban areas were higher than those in the rural areas (P < 0.05). The seasonal difference analysis showed that the non-qualified rates of PM_2.5, PM₁₀, CO₂, trichloroethylene, and tetrachloroethylene in the urban areas were higher in the heating season than in the non-heating season (P<0.05); the non-qualified rates of ammonia and formaldehyde in the rural areas increased significantly in the non-heating season(P<0.05). The health risk assessment indicated that the maximum hazard quotient (HQ) of tetrachloroethylene for the elderly exceeded 1, while the HQ values for ammonia, formaldehyde, benzene, toluene, xylene, and trichloroethylene remained below 1 for either children or the elderly. For carcinogenic risks, the median carcinogenic risk (CR) of formaldehyde for school-aged children or the elderly fell within the range of 10⁻⁶-10⁻⁴, whereas the median CR values for benzene, trichloroethylene, and tetrachloroethylene were all below 10⁻⁶. Conclusion The primary indoor air pollutants exceeding the national standard limits in residential areas of Shijiazhuang City include CO₂, PM₁₀, TVOC, PM_2.5, formaldehyde, ammonia, trichloroethylene, and tetrachloroethylene. The levels of these pollutants exhibit significant urban-rural and seasonal variations. Special attention should be paid to the non-carcinogenic risk of tetrachloroethylene to the elderly and the carcinogenic risks of formaldehyde to school-age children and the elderly.

Objective To evaluate the therapeutic efficacy for surgical treatments among patients with hepatic cystic echinococcosis in Gansu Province from 2006 to 2023, so as to provide insights into optimization of the diagnosis and treatment strategies against hepatic cystic echinococcosis. Methods The demographic and clinical data of all echinococcosis cases included in central government fiscal transfer payment program for echinococcosis control and undergoing surgical treatments in Gansu Province from 2006 to 2023 were captured. Hepatic cystic echinococcosis patients with complete medical records and follow-up data were included in the study, and patients’ characteristics, including hospital where patients received diagnosis and treatment, methods of case identification, year of surgery, classification of lesions, number of lesions, size of lesions, course of disease, surgical methods, and post-surgical follow-up data. The cure and recurrence of hepatic cystic echinococcosis were evaluated according to the Guidelines for Management of Echinococcosis Patients in the Central Government Fiscal Transfer Payment Program, and the cure and recurrent rates were calculated. Results Data were collected from 1 686 surgical patients with hepatic cystic echinococcosis. According to the inclusion and exclusion criteria, 1 222 hepatic cystic echinococcosis patients undergoing surgical treatments were included during the period from 2006 to 2022, including 1 166 cured patients (95.42%) and 88 patients with postsurgical recurrence (7.20%), and the cure rate of surgical treatments appeared a tendency towards a rise among patients with hepatic cystic echinococcosis from 2008 to 2022 (χ²_trend = 19.39, P < 0.05). The cure rates of hepatic cystic echinococcosis were 100% (177/177), 94.81% (128/135) and 94.62% (861/910) among patients detected through regular physical examinations, screened by the central government fiscal transfer payment program for echinococcosis control, and those who passively sought healthcare services, respectively (χ² = 9.95, P < 0.05). The cure rates of hepatic cystic echinococcosis were 95.96% (1 046/1 090) among patients with a disease course of 2 years and less and 90.90% (120/132) among patients with a disease course of over 2 years (χ² = 6.87, P < 0.05), and there were significant differences in the cure rates among patients with hepatic cystic echinococcosis in terms of number of lesions (χ² = 24.44, P < 0.05) and surgical methods (P < 0.05). The cure rate of hepatic cystic echinococcosis patients was significantly higher following initiation of the central government fiscal transfer payment program for echinococcosis control (96.06%, 1 096/1 141) than before the program (86.42%, 70/81) (χ² = 16.06, P < 0.05), and the cure rate of hepatic cystic echinococcosis patients was significantly higher in designated hospitals (96.48%, 741/768) than in non-designated hospitals (93.37%, 366/392) (χ² = 5.78, P < 0.05). The median follow-up period was 4 (interquartile range, 7) years among 1 222 hepatic cystic echinococcosis patients undergoing surgical treatments. The recurrent rate of hepatic cystic echinococcosis appeared a tendency towards a decline from 2008 to 2022 (χ²_trend = 36.86, P < 0.05), with a reduction from 23.08% (9/39) in 2008 to 1.85% (1/54) in 2021, and the post-surgical recurrence rate of hepatic cystic echinococcosis was lower following initiation of the central government fiscal transfer payment program for echinococcosis control (5.87%, 67 / 1 141) than before the program (25.93%, 21/81) (χ² = 45.51, P < 0.05). In addition, the post-surgical recurrence rate of hepatic cystic echinococcosis was higher in non-designated hospitals (10.46%, 41/392) than in designated hospitals (5.60%, 43/768) (χ² = 9.12, P < 0.05), and there was a significant difference in the post-surgical recurrence rate among patients with hepatic cystic echinococcosis in terms of surgical methods (P < 0.05), with the highest recurrence rate (11.54%) seen among patients undergoing percutaneous fine-needle aspiration of cyst fluids-based surgical procedures (P < 0.05). Conclusion Since the initiation of the central government fiscal transfer payment program for echinococcosis control in Gansu Province in 2006, an increase in the surgical cure rate and a reduction in the recurrence of hepatic cystic echinococcosis had been found among patients with hepatic cystic echinococcosis, indicating a high overall therapeutic efficacy.

Objective:To explore the clinical, imaging, and pathological features of glottic squamous cell carcinoma of the larynx and their relationship with prognosis. Methods:A retrospective analysis was conducted on the clinical, imaging, and pathological data of 130 patients with glottic squamous cell carcinoma of the larynx who were treated at the First People's Hospital of Yinchuan and the General Hospital of Ningxia Medical University from January 2018 to March 2023. Imaging examinations （CT and MRI） were used to evaluate the lesion boundary clarity, density, enhancement nature, and enhancement degree. Postoperative pathological examination was used to determine the pathological nature, immunohistochemistry, etc. Statistical methods such as χ² test, Spearman correlation analysis, multivariate logistic regression analysis, and Kaplan-Meier method were used to analyze the data. Results:Among the 130 patients, 127 were male and 3 were female, with an average age of （61.92±9.595） years. There was a correlation between clinical, imaging, and pathological features. Multivariate analysis showed that heterogeneous MRI density （OR=12.414;P=0.019） and squamous cell carcinoma as a subtype were correlated. The initial symptom of non-hoarseness （HR=6.045;P=0.010） and unclear MRI boundary （HR=12.559; P=0.029） were independent risk factors for poor prognosis in patients with glottic squamous cell carcinoma of the larynx. Conclusion:There is a correlation between the clinical, imaging, and pathological features of patients with glottic squamous cell carcinoma of the larynx, and they can affect prognosis. The initial symptom of non-hoarseness and unclear MRI boundary of the tumor are independent risk factors for poor prognosis.
Humans ; Laryngeal Neoplasms/diagnosis* ; Prognosis ; Male ; Female ; Retrospective Studies ; Middle Aged ; Carcinoma, Squamous Cell/diagnosis* ; Magnetic Resonance Imaging ; Glottis/pathology* ; Tomography, X-Ray Computed ; Aged

Objective:To investigate the impact of limonin(LIM)on the necrotic apoptosis of myocardial cells in rats with myocardial infarction(MI)by regulating the receptor-interacting protein 1(RIP1)/receptor-interacting protein 3(RIP3)/mixed-lineage kinase domain-like protein(MLKL)signaling pathway.Methods:A total of 60 Sprague-Dawley rats were randomly divided into sham-operation group(Sham group),MI model group(Model group),low-dose LIM group(LIM-L group,25 mg/kg LIM),high-dose LIM group(LIM-H group,50 mg/kg LIM),and high-dose LIM+RIP1 inhibitor Nec-1 group(LIM-H+Nec-1 group,50 mg/kg LIM+0.6 mg/kg Nec-1),with 12 rats in each group.A rat model of MI was established by ligation of the coronary artery.The changes of cardiac func-tion were examined for each group;HE staining was used to observe the pathological changes of myocardial tissue;the 2,3,5-triphen-yltetrazolium chloride-Evans blue method was used to measure myocardial infarct area;the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling method was used to observe the necrotic apoptosis of myocardial cells;quantitative real-time PCR and Western blot were used to measure the expression levels of mRNAs and proteins associated with the RIP1/RIP3/MLKL signaling pathway and the expression of apoptosis-related proteins.Results:Compared with the Sham group,the Model group had significant re-ductions in left ventricular ejection fraction,left ventricular systolic pressure,and the expression level of B-cell lymphoma-2(Bcl-2)in myocardial tissue(all P<0.001)and significant increases in left ventricular end-systolic volume,left ventricular end-diastolic pres-sure,left ventricular end-diastolic volume,myocardial infarct area,cell apoptosis rate,the mRNA and protein expression levels of RIP1,RIP3,and MLKL in myocardial tissue,and the protein expression levels of Bcl-2 associated X protein and cysteinyl aspartate-specific proteinase 3 in myocardial tissue(all P<0.001),as well as swelling and disordered arrangement of myocardial cells with ne-crosis and massive inflammatory cell infiltration on HE pathological sections.Compared with the Model group,the LIM-H group showed reverse changes in the above indicators(RIP1 mRNA:P=0.002,RIP3 mRNA:P=0.008,and the other indexes P were all<0.001),with alleviations of myocardial histopathological injury and inflammatory cell infiltration.Nec-1 promoted the effect of LIM in alleviating the necrotic apoptosis of myocardial cells in MI rats.Conclusion:LIM may alleviate the necrotic apoptosis of myocardial cells in MI rats by downregulating the RIP1/RIP3/MLKL signaling pathway.

Objective To understand the potential types and influencing factors of motor system symp-toms in breast cancer patients with endocrine therapy.Methods The convenience sampling method was used to select 505 breast cancer patients with endocrine therapy in a class 3A hospital of Zhejiang Province from January 2021 to August 2023 as the research subjects.The self-designed general information questionnaire and the motor system subscale in the Breast Cancer Endocrine Symptom Assessment Scale were used to investi-gate the patients,and the latent profile analysis(LPA)was performed.The t test,x2 test and rank sum test were adopted to conduct the univariate analysis on the influencing factors of different latent categories.The variables with statistical significance in the single factor analysis adopted the binary logistic regression for con-ducting multivariate analysis.Results A total of 553 questionnaires were distributed,and 505 valid question-naires were recovered with an effective recovery rate of 91.32％.The research subjects conducted LPA.The motor system symptoms could be divided into the two potential categories of the pain and stiffness group(n=116)and slight influence group(n=389).The binary logistic regression results showed that the medication time and medication type were the potential category factors affecting the motor system symptoms(P＜0.05).Conclusion There are classification characteristics of motor system symptoms in breast cancer patients with endocrine therapy.The medical and nursing staff should early identify the patients with pain and stiffness,and understand the symptoms of motor system and clinical detection results at regular intervals.

An increasing number of studies have shown that there is a close relationship between Alzheimer's disease(AD)and diabetes mellitus(DM).Traditional Chinese medicine holds that"kidney yin deficiency"is the common pathogenesis of these two diseases,while modern medicine believes that their pathogenesis involves abnormal aggregation of amyloid proteins,insulin deficiency and resistance,inflammatory response,oxidative stress,and autophagy,among others.The well-known traditional Chinese medicine formula Liuwei Dihuang Pills plays a significant role in the treatment of these two diseases with the same therapeutic approach.Therefore,this article will explore the connection between Liuwei Dihuang Pills and the treatment of AD and DM from different aspects;analyze the common etiology and pathogenesis of AD and DM,and explain the mechanism of prevention and treatment of Liuwei Dihuang Pills,with the aim of providing new ideas and methods for the integrated traditional and Western medicine prevention and treatment of AD and DM in the future.

BACKGROUND:Currently,artificial corneas used for full-thickness transplantation lack biological activity and mechanical adaptability.Composite artificial corneas face interface issues between the corneal button and surrounding components.OBJECTIVE:To prepare an integrated artificial cornea with peptide enhancement,matched mechanical strength to natural cornea,and excellent transparency via in situ ultraviolet light curing of decellularized porcine cornea.METHODS:Non-ionic decellularization reagent Triton X-100 combined with ultrasonic freeze-thawing and super nucleases was utilized to prepare decellularized porcine cornea.Hydroxyethyl methacrylate monomer and photoinitiator were introduced into the decellularized porcine cornea simultaneously.Ultraviolet light with a filter was used to cover the peripheral region except for the central area,where polymerization was initiated using 275 nm ultraviolet light.After removal of unreacted monomers and initiators,the central optical zone was obtained.Similarly,the posterior lamellar layer was polymerized to form the hydrophobic barrier zone.Finally,REG active polypeptide was introduced to obtain in situ integrated full-layer artificial cornea.The physical properties,mechanical properties,transparency,degradation properties and in vivo and in vitro biocompatibility of artificial cornea were characterized.RESULTS AND CONCLUSION:(1)An optical region with the co-existence of polymer and collagen fibers was constructed in situ using hydroxyethyl methacrylate in the central region of decellularized porcine cornea.Under scanning electron microscopy,the upper surface of the artificial cornea was rough and irregular,with obvious concave and convex structure,and the lower surface was relatively smooth.The artificial cornea had mechanical properties close to those of natural cornea.The transparency of the optical zone reached 80%of that of the natural cornea.After soaking in PBS aseptic solution containing collagenase,it could preserve the solidified optical region and hydrophobic barrier zone,and maintain the basic structure of cornea.The artificial cornea had good cytocompatibility,could provide a suitable adhesion and growth environment for cells,was conducive to the migration and adhesion of corneal epithelial cells,promoted the growth of vascular endothelial cells and the formation of new blood vessels,and promoted the epithelialization process.The artificial cornea had good biocompatibility and safety after 12 weeks of subcutaneous implantation in SD rats,and could reduce the acute inflammatory reaction at the initial stage of implantation.(2)The results show that the integrated full-layer artificial cornea prepared by the experiment has the potential as a full-layer artificial cornea scaffold.

The clinical phenotype heterogeneity of epilepsy patients with ADGRV1 gene mutation is significant, ranging from self limiting febrile seizures to developmental epileptic encephalopathy, even causing sudden epileptic death. A case of infantile epileptic spasms syndrome with a novel heterozygous variant of the ADGRV1 gene c.4100C>A (p.Thr1367Lys) was reported in this article. The site of this variant had not been reported yet, and the clinical manifestations of the child mainly included epileptic spasms (first onset at 4 months old), mild growth and development delay, highly irregular video electroencephalogram, and effective treatment with adrenocorticotropic hormone.

Objective:To analyze the clinical phenotypes and genetic features of a child with developmental and epileptic encephalopathy due to compound heterozygous variants in the ALG14 gene, and to improve clinicians′ understanding of the ALG14 gene and its associated disorders. Methods:Clinical data of a child with developmental and epileptic encephalopathy caused by ALG14 gene variants, who visited Linyi People′s Hospital on September 9, 2019, were collected and followed up. Whole exome sequencing (WES) and Sanger sequencing were applied to genetically detect the child and her parents, SWISS-MODEL software was used to perform 3D modeling of proteins for the screened ALG14 gene variants, and the literature was reviewed to summarize the clinical phenotypes and genetic characteristics of patients associated with ALG14 gene. Results:The proband, a 17-year-old female, presented with focal seizures and generalized tonic-clonic seizures, generalized developmental delay, cranial magnetic resonance imaging showing no significant abnormalities, and video-electroencephalogram showing widespread low-amplitude fast rhythms. The WES results showed that the affected child carried compound heterozygous variants c.243A>G (p.Ile81Met) and c.103delG(p.Glu35SerfsTer7) (NM_144988) in the ALG14 gene, and Sanger sequencing validation showed that they were derived from her father and mother with normal clinical phenotype, respectively, and the above loci had not been reported domestically or internationally. 3D modeling revealed that the p.Ile81Met variant resulted in a change in the coding amino acid at position 81, and alteration of the stability and hydrophobicity of the protein, which may affect the protein function; the p.Glu35SerfsTer7 variant resulted in early truncation of the peptide chain, loss of a large number of amino acid fragments, and significant alteration of the protein structure. According to the American College of Medical Genetics and Genomics and the Association for Molecular Pathology, p.Ile81Met was a variant of undetermined clinical significance (PM2+PM3+PP3), and p.Glu35SerfsTer7 was a likely pathogenic variant (PVS1+PM2+PP3). A total of 5 papers were retrieved reporting 13 cases related to ALG14 gene variants (including the present case), 4 cases with pure heterozygous variants, 9 with compound heterozygous variants, involving 11 variant types, all inherited from the parents, of which 9 being missense variants, 1 being shifted code variant, and 1 being intronic deletion variant. The main clinical phenotypes included epileptic seizure (11/13), hypotonia (10/13), craniofacial malformations (8/13), growth disorders (3/13), and behavioral abnormalities (2/13). Conclusions:This article reports the first case of ALG14 gene related developmental and epileptic encephalopathy in a child at home and abroad, characterized by focal seizures, generalized tonic-clonic seizures, and global developmental delay. The compound heterozygous variants c.243A>G (p.Ile81Met) and c.103delG(p.Glu35SerfsTer7) may be the genetic cause of this child, enriching the clinical phenotype and variation spectrum related to this gene.