AIM:To investigate the differences in the effectiveness of different types of defocus spectacles highly aspherical lenslets technology(HAL)and defocus incorporated multiple segments(DIMS) compared with conventional single-vision spectacles(SVS)in the prevention and control of myopia in children, and to analyze related influencing factors based on a random forest model.METHODS:A retrospective analysis was conducted on 190 myopic children(380 eyes)who attended the Ophthalmology Department of the Third People's Hospital of Chengdu between June 2022 and December 2023. According to the types of spectacle correction, patients were divided into three groups: SVS(84 cases, 168 eyes), HAL(58 cases, 116 eyes), and DIMS(48 cases, 96 eyes), all data from the right eye were selected for analysis, with a follow-up period of 12 mo. General information and changes in spherical equivalent(SE)and axial length(AL)were observed and compared among the three groups. A random forest model combined with Logistic regression analysis was used to identify factors influencing the effectiveness of treatment, and the predictive performance of these factors was evaluated using receiver operating characteristic(ROC)curves.RESULTS:There was no statistical significance in the general characteristics among the three groups of patients before wearing lenses(P>0.05). Both the HAL and DIMS groups showed better control of SE progression and AL changes compared to the SVS group, and the HAL group demonstrated superior control effect compared to the DIMS group(all P<0.05). The random forest model indicated that the lowest mean out-of-bag estimation error rate, which was 0.1988, was achieved when the number of variables was 3, and the top 3 influencing factors were AL, spectacle-wearing age, and uncorrected visual acuity. Multivariate Logistic regression analysis revealed that AL was a protective factor for the effectiveness of defocus spectacles, while spectacle-wearing age and uncorrected visual acuity were risk factors. The area under the curve(AUC)values for predicting the effectiveness of defocus spectacles were 0.802, 0.747, and 0.720 for AL, spectacle-wearing age, and uncorrected visual acuity, respectively.CONCLUSION:The HAL group demonstrated better effectiveness in myopia prevention and control compared to the DIMS and SVS groups. AL, spectacle-wearing age, and uncorrected visual acuity were identified as independent factors influencing the effectiveness of defocus spectacles.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

  Objective  To study the demographic and clinical characteristics, correlation of genotype and phenotype and treatment of Blau syndrome to facilitate early diagnosis and timely treatment of Blau syndrome.  Methods  Seventy-two patients with Blau syndrome from 11 centers from May 2006 to April 2022 were retrospectively analyzed, and their general information, clinical data, laboratory examination and treatment medication were collected.  Results  The distribution of patients with Blau syndrome was uniform in geographical north and south of China, and there was no obvious gender bias. The mean age of onset was (14.30±12.81) months, and the age of diagnosis was (55.18±36.22) months. 35% of patients with Blau syndrome happened before 1 year old, and all patients developed before 5 years old. 87.50% (63/72) had granulomatous arthritis, 65.28% (47/72) had rash, 36.11% (26/72) had ocular involvement, 27.78% (20/72) had fever, and 15.28% (11/72) had pulmonary involvement. Arthritic manifestations of Blau syndrome were most at risk, followed by rash, ocular involvement, and fever.The first 25 months of the disease, the risk of developing a rash was the greatest. The risk of developing arthritis was the greatest between 25 months and 84 months. The main mutations were p.R334Q and p.R334W, and patients with p.R334Q mutation had relatively high incidence of fever (35.71%[5/14] vs. 14.29%[1/7], P=0.43) and ocular involvement (42.86%[6/14]vs. 28.57%[2/7], P=0.51). There was a relatively high incidence of rash (85.71%[6/7] vs. 64.29%[9/14], P=0.59) in patients with the p.R334W mutation. Forty-five patients(62.50%)were treated with a combina-tion of glucocorticoid and methotrexate. Twenty-two patients were treated with tumor necrosis factor antagonist in addition to glucocorticoid and methotrexate.  Conclusions  The risk of different clinical manifestations of Blau syndrome from high to low was arthritis, followed by rash, ocular involvement and fever. The main treatment was glucocorticoid combined with methotrexate, to which biological agents could be added.

Objective To study the intervention effect of systematic nutrition combined with rhythmic exercise on patients with abnormal liver metabolism. Methods According to the theory of system nutrition and health rhythm kinematics, selected 56 subjects with abnormal liver metabolism were selected, and the combined intervention of system nutrition and rhythm movement was conducted regularly every day for 3 consecutive months using the techniques such as liver transient elastography (FibroScan) and bioelectric whole body health scanning system (DDFAO). Results Compared with the pre-intervention period, the liver fat attenuation, liver hardness and liver functional activity of the subjects were significantly improved after intervention. Conclusion The systematic nutrition combined with rhythmic exercise significantly reduced the risk of abnormal liver metabolism in subjects, which may play an important role in preventing liver diseases and promoting the recovery of liver function.

Objective To analyse the risk factors associated with spontaneous intestinal perforation (SIP) in extremely premature infants/extremely low birth weight infants. Method From January 2015 to December 2018, infants with gestational age (GA)<28 weeks or birth weight (BW)<1000 g admitted to our neonatal intensive care unit were enrolled to the retrospective nested case-control study.The clinical data of SIP infants (SIP group) and infants with the same GA but without SIP (control group) were randomly selected and compared. Multivariable Logistic regression was used to analyse the risk factors of SIP. Result A total of 409 extremely premature infants/extremely low birth weight infants were born during the study period. Among them, 25 SIP infants and 55 controls were enrolled. The incidence of SIP in infants with GA 22～25 weeks was 11.8％(16/136), which is higher than infants with GA 26～27 weeks (2.0％, 5/247) (χ2=16.057, P<0.001). The incidence of SIP in infants with BW 400～749 g was 13.0％(14/108), which is higher than infants with BW 750～999 g (3.4％, 8/236) (χ2=11.343, P=0.001). Multivariate Logistic regression analysis showed that twins (OR=4.153, 95％CI 1.392～12.384, P=0.011), umbilical veins catheterization (OR=15.942, 95％CI 1.026～247.789, P=0.048) and ibuprofen use within 3 days after birth (OR=15.387, 95％CI 1.519～155.883, P=0.021) were independent risk factors of SIP. Conclusion The smaller the GA and BW, the higher the incidence of SIP. Twins,umbilical veins catheterization and ibuprofen use early after birth may be independent risk factors of SIP.

Objective To investigate the clinical and genetic features of juvenile-onset Huntington disease (HD).Methods The clinical data of members from one juvenile-onset HD family,admitted to our hospital in February 2015,were collected,and the family pedigree tree was drawn.Peripheral venous blood of volunteers of this family was extracted to pursue IT15 genetic test.Results The pedigree tree indicated that HD was autosomal dominant inheritance.There were 3 patients in this family,2 of them died,and 2 were juvenile-onset HD.Clinical manifestations of these patients were characterized by dystonia,dysarthria,ataxia and cognitive dysfunction.Among 7 participants who pursued genetic test,4 were normal,and 3 carried expanded alleles,whose cytosine-adenine-guanine trinucleotide (CAG) repeat number was 59,60,and 57,respectively.Conclusions (1) The clinical manifestations of juvenile-onset HD are characterized by dystonia,dysarthria,ataxia and cognitive dysfunction;juvenile-onset HD has rapid progression.(2) The phenomenon called "anticipation" is found in this family.

Hematologic Neoplasms ; Hepatitis E virus ; Humans

Objective To observe the mid-term effectiveness of percutaneous lumbar puncture and injection of medical ozone and collagenase in treating lumbar disc herniation.Methods CT-guided percutaneous lumbar puncture and medical ozone injection into the intervertebral disc was performed in 78 patients with lumbar disc herniation, which was confirmed by imaging study or clinical manifestations.After 2-4 days, neucleolysis was carried out.Collagenase 12 000 U was injected via the anterior epidural space onto the surface or into the inside of the prominence of the protruded disc.Results The clinical results were evaluated in 6-25 months after the procedure.Of 78 patients treated with this technique, the result was excellent in 58(74.3%), good in 16(20.5%) and poor in 4(5.1%).Symptoms returned in 12 cases in 2 months after the procedure, and the reappeared symptoms were relieved in 9 of them within 2 months without giving any treatment.In 3 cases the symptoms disappeared after repeated injection of medical ozone.No serious complications occurred.Conclusion Percutaneous lumbar puncture and injection of medical ozone combined with collagenase is an effective, safe and minimally-invasive therapy for lumbar disc herniation.

Objective To determine the effects of pre-operative chemotherapy on p53 expression and apoptosis in lung cancer.Methods 42 patients with lung cancer were divided into pre-opreative chemotherapy group (n=14) and control group (n=28) without preoperative chemotherapy.Method of immunohistochemistry was used to detect the expression of p53 . Terminal deoxynucleotidyl transferase nick end labeling (TUNEL) was used to detect the apoptotic cells.Results The positive rate of p53 expression were as follows;53 5% for control group,64 3% for prechemotherapy group,64 3% for postchemotherapy group respectively;the apoptosis indexes were 6 3?1 9 for control group,7 3?1 6 for prechemotherapy group,14 5?4 6 for postchemotherapy group.Conclusions The preoperative chemotherapy can induce apoptosis in lung cancer ,but can not affect p53 expression .