AIM:To investigate the visual development of children under 6 years old in Wuhan, and provide evidence-based support for the formulation and optimization of regional policies for children's eye health care.METHODS:Suresight refractive screener was applied to rapid refractive status examination in 4 989 preschool children under 6 years old in Wuhan City, with results determined according to the manufacturer's age-specific referral criteria. All screened pre-school children completed vision screening and comprehensive ophthalmic examination.RESULTS: A total of 4 989 children under 6 years old were screened out, including 2 641 males and 2 348 females. They were divided into 6 groups according to age: 426 aged from 6-month to 1-year-old, 903 aged >1 to 2 years old, 1 078 aged >2 to 3 years old, 442 aged >3 to 4 years old, 808 aged >4 to 5 years old, and 1 332 aged >5 to 6 years old. The abnormal rate in the 6-month to 1-year-old group was 44.60%, in the >1 to 2 years old group was 26.02%, in the >2 to 3 years old group was 15.58%, in the >3 to 4 years old group was 10.86%, in the >4 to 5 years old group was 21.91%, in the >5 to 6 years old group was 23.27%, and the total refractive abnormal rate for children aged 6 mo to 6 years old was 22.61%. The refractive abnormal rate generally showed a decreasing trend with increasing age(P<0.001); the refractive abnormal rate in boys aged 6-month to 6 years old was 12.33%, and in girls was 10.28%, with no statistically significant difference in the abnormal rate between boys and girls(P>0.05); among children aged 6-month to 6 years old, the abnormal rate of single-eye myopia was 0.98%, of single-eye hyperopia was 5.41%, of single-eye astigmatism was 9.92%, of binocular myopia was 0.98%, of binocular hyperopia was 2.79%, and of binocular astigmatism was 8.14%; the prevalence of astigmatism in children aged 6-month to 1-year-old was 40.38%, in those aged >1 to 2 years old was 19.82%, in those aged >2 to 3 years old was 12.34%, in those aged >3 to 4 years old was 9.05%, in those aged >4 to 5 years old was 18.81%, and in those aged >5 to 6 years old was 16.89%; the prevalence of astigmatism in children aged 6-month to 6 years old was 18.06%. The abnormal rate of astigmatism in the four age groups ranging from 6-month to 4 years old decreased continuously with age(P<0.001). There was no statistically significant difference in the abnormal rate of astigmatism between the >4 to 5 years old group and the >5 to 6 years old group(P>0.05).CONCLUSION:Refractive error has become a common eye disease among preschool children. Through early vision screening, establishing a systematic refractive management file, and early intervention, the best treatment period can be seized to avoid missing it and causing adverse consequences.

Objective To analyze the temporal trend of thyroid cancer incidence in China from 1992 to 2021 and evaluate the impact of age,period and cohort on the incidence.Methods Based on the Global Burden of Disease 2021,the trend changes of age-standardized incidence rate(ASIR)of thyroid cancer in China from the period were analyzed,and the obtained data were further analyzed with Joinpoint regression and age-period-cohort analysis.Auto regressive integrated moving average(ARIMA)model was applied to predict the incidence of thyroid cancer in China in the next 20 years.Results The ASIR of thyroid cancer among males was increased from 0.70/100 000 to 2.11/100 000 between 1992 and 2021,with an average annual percent change(AAPC)of 3.93%(95%CI:3.86%～4.00%,P<0.001);For the females,the ASIR was elevated from 1.91/100 000 to 2.87/100 000 in the time,with an AAPC of 1.43%(95%CI:1.36%～1.50%,P<0.001).On the age effect,the overall variation in ASIR among the females was minor,and that in the males reached its peak in the≥85-years-old group,with a rate of 230.51/100 000.Regarding the period effect,the risk of thyroid cancer incidence in the males and females changed with the period and exhibited a temporal increase,and the incidence risk was consistently higher in the males than the females across different periods.Taking the incidence risk during 1992 and 1996 as a reference(RR=1),the males(RR=2.94,95%CI:2.78～3.11)and the females(RR=1.37,95%CI:1.32～1.42)had the highest risk of thyroid cancer in the period from 2017 to 2021.On the cohort effect,the risk of thyroid cancer in both sexes showed an increasing trend with cohort change.When taking the cohort during 1992 and 1996 as a reference(RR=1),the females in the pre-1986 cohort exhibited a higher risk of incidence than the males,but in the post-1996 cohort,the males demonstrated a greater risk of incidence than the females.The males in the 2012-2016 cohort had the highest risk of thyroid cancer when compared to the reference group(RR=2.54,95%CI:1.80～3.57),and the females in the cohort from 1992 to 2016 had higher risk of thyroid cancer than the reference group,though no statistical differences were observed.The ARIMA model prediction analysis found that the ASIR of thyroid cancer in males and females in China would continue to increase from 2022 to 2041,and the ASIR of thyroid cancer in males would reach 2.79/100 000(95%CI:1.96～3.61),and the ASIR of thyroid cancer in females would reach 3.54/100 000(95%CI:3.02～4.06)by 2041.Conclusion Between 1992 and 2021,the ASIR of thyroid cancer in China has exhibited a consistent upward trend,with the females having a higher ASIR than the males.However,the risk of developing thyroid cancer is higher in men who are older and those who were born more recently.In the next 20 years,the incidence of thyroid cancer among both men and women in China is projected to continue to rise,and the situation for prevention and control will be challenging.

Background Individuals may experience significant alterations in sleep hygiene during the major public health emergencies,consequently impacting their sleep quality.Objective To explore the relationship between sleep quality and sleep hygiene among adult residents during the major public health emergencies,so as to provide references for improving the sleep quality of residents during such a period.Methods A sample of 1 364 adult residents were enrolled as the research subjects from February 20 to 29,2020.All participants were asked to complete self-administered questionnaire to obtain basic-demographic information and sleep hygiene.Pittsburgh Sleep Quality Index(PSQI)was applied to assess sleep quality.Residents were classified into poor sleepers with PSQI score≥8 and good sleepers defined as PSQI score<8.Binary Logistic regression analysis was conducted to identify factors associated with sleep quality.Radar chart was used to visualize and compare the sleep hygiene between poor sleepers and good sleepers.Results According to PSQI score,891(65.32%)residents were good sleepers,while 473(34.68%)residents were poor sleepers.Comparison revealed that age(χ2=3.887),past medical history(χ2=27.938),awareness rate of importance of sleeping before major public health emergencies(χ2=4.337),impact of sleep quality on quality of life during the major public health emergencies(χ2=178.138),frequency of staying up late during the major public health emergencies(χ2=139.390),compensatory sleep behaviors(χ2=39.257),impact of sleep problems on daytime functioning(χ2=285.879),change of bedtime(χ2=63.031),sleep latency(χ2=168.672),wake-up time(χ2=59.221),changes in sleep duration(χ2=172.332),time spent in the bedroom(χ2=23.071),and sum of money spent on improving sleep environment(χ2=58.584)yielded statistical difference between poor sleepers and good sleepers(P<0.05 or 0.01).Logistic regression analysis denoted that past medical history(OR=1.680,95%CI:1.185～2.382),negative impact of sleep quality on quality life(OR=4.181,95%CI:2.722～6.422),staying up late 3 to 4 times per week(OR=3.145,95%CI:1.497～6.605),staying up late almost every day(OR=4.271,95%CI:1.970～9.260),negative impact of sleep problems on daytime functioning(OR=7.169,95%CI:5.188～9.907),prolonged sleep latency(OR=2.836,95%CI:2.019～3.982)and shortened sleep duration(OR=3.518,95%CI:2.144～5.772)were risk factors of poor sleep quality.The sum of money spent on improving sleep environment following the major public health emergencies≤500 RMB(OR=0.334,95%CI:0.134～0.830)was related to the incidence rate of poor sleep quality.Radar chart showed that poor sleepers were characterized by extravagant concerns,excessive cleanliness and poor sleep hygiene practices during the major public health emergencies,and poor sleepers were more likely to stay up late due to stress and emotional issues.Conclusion Some residents are facing poor sleep quality during the major public health emergencies,and poor sleep hygiene practice also contributes to poor sleep quality.

Objective:To detect the pathogen and clinically diagnose for a suspected case of Neisseria meningitidis with positive blood culture result, and assess the risk of disease transmission among the community. Methods:Blood sample was collected for Neisseria meningitidis isolation and culture. Pathogen identification and serogroup typing were conducted by colony morphology, Gram staining, biochemical tests, latex agglutination test, slide agglutination test, and nucleic acid testing. The susceptibility to 12 antibiotics was also tested. Epidemiological investigation was conducted on the case, and epidemic control measures were also implemented. Results:Through various detection, the suspected case was diagnosed as Neisseria meningitidis invasive infection. The isolated strain belonged to group Y serotype, type 767 (multilocus sequence typing), and the ST167 clonal complex. The strain was sensitive to nine antibiotics, including penicillin, ampicillin, and meropenem. It exhibited intermediate sensitivity to ciprofloxacin and levofloxacin, and resistance to methicillin/sulfamethoxazole. Close contacts of the case and environmental testing results were negative. Conclusions:The case is confirmed to be an invasive infection caused by group Y Neisseria meningitidis, the ST167 clonal complex. Epidemiological investigation shows a relatively low risk of epidemic transmission. Continuous monitoring and surveillance are necessary for further assessment.

Objective To analyze the disease burden and change trend of breast cancer mortality among Chinese women from 2013 to 2021.Methods The indicators of breast cancer-related mortality (MR),age-standardized mortality rate (ASMR),deaths,and urban-rural deaths in the Chinese Cause of Death Surveil-lance Dataset from 2013 to 2021 were collected and collated,and the trend changes of MR,ASMR,and years lost in life of premature death (YLL) were analyzed,annual percentage change (APC) was used for trend a-nalysis,and Fisher substitution test was used to compare APC in different regions.Results From 2013 to 2021,a total of 88112 cases of breast cancer died,with an average annual MR of 7.56/100000 and an ASMR of 6.34/100000.From 2013 to 2021,the MR rate of breast cancer (APC=2.12%,t=5.414,P<0.001),MR in rural areas (APC=2.84%,t=7.581,P<0.001),and YLL in rural areas (APC=1.61%,t=3.588,P=0.009) showed an upward trend in China.MR at 40-<45 years old showed a downward trend (APC=-2.76%,t=-4.689,P=0.002),and at 70-<75 years old (APC=1.41%,t=2.494,P=0.041),75-<80 years old (APC=3.05%,t=3.690,P=0.008),and 80-<85 years old (APC=1.82%,t=2.909,P=0.023).There was a statistically significant difference in APC between MR and ASMR in urban and rural areas (P<0.001).There was no significant difference in the trend of other indicators (P>0.05).Conclusion From 2013 to 2021,the disease burden of breast cancer mortality in Chinese women showed an upward trend,and the comprehensive prevention and treatment of breast cancer should be strengthened to reduce the risk of breast cancer death.

Bluetongue virus is an arbovirus that seriously harms ruminants such as sheep,this study aims to investigate the molecular mechanism of bluetongue virus infection and host cell interferon antiviral immune response.The study was conducted to characterize the mRNA expression of inter-feron pathway genes by real-time fluorescence quantitative PCR,as well as Western blot analysis of MDA5,TRAF3,RIG-Ⅰ,and TBK1 protein expression in BHK-21 cells induced by BTV with a multiplicity of infections(MOI)of 1 for 18,24,and 36 h.The results showed that the most pro-nounced changes in the expression of interferon signaling pathway genes were observed at 24 h of induction,the gene mRNA expression levels of the IFN-α,IFN-β,RIG-Ⅰ,TBK1,MDA5,VISA,and TRAF3 genes were upregulated.However,the mRNA expression levels of IKKε and TRAF6 genes were downregulated.At the protein level,MDA5 and TBK1 proteins were upregulated while RIG-1 and TRAF3 proteins were downregulated,which showed that BTV infection induces a typeⅠ interferon immune response in BHK-21 cells.This study lays the foundation for further exploring the antiviral immunity mechanism of IFN-Ⅰ signaling pathway regulatory genes in host cells infected with BTV infection.

Objective:To investigate the effect of pelvic packing on the control of intractable postpartum hemorrhage after emergency perinatal hysterectomy (EPH).Methods:Eleven cases with complete clinical data of pelvic packing due to failure of hemostasis after EPH were collected to evaluate the outcome, complications, hospital stay of pregnant women, and to analyze the factors affecting the effect of pelvic packing. The cases included patients who were admitted to the Third Affiliated Hospital of Guangzhou Medical University after pelvic packing treatment in the other hospital due to continuous bleeding after EPH or who were referred to our hospital for pelvic packing treatment due to continuous bleeding after EPH from January 2014 to August 2021.Results:The median gestational week of 11 pregnant women was 38.3 weeks(38.0-39.9 weeks) , and the methods of termination of pregnancy were cesarean section in 7 cases (7/11) and vaginal delivery in 4 cases (4/11). The median time between postpartum hemorrhage and pelvic tamponade was 10 hours (5-57 hours), the median amount of bleeding was 8 500 ml(4 800-15 600 ml) , the median number of pelvic tamponade was 3 pieces (2-7 pieces), and the median retention time of gauze pad was 6.0 days (3.0-6.0 days). The median frequency of laparotomy in this pregnancy was 3 times (2-3 times), with a maximum of 4 among the 11 cases, the first pelvic packing was successful in hemostasis in 9 cases, and the final successful treatment in all of the 11 cases. All parturients had hemorrhagic shock (11/11) and disseminated intravascular coagulation (11/11) before pelvic packing. Other common complications were multiple organ dysfunction syndrome (9/11), cardiac arrest (4/11), deep vein thrombosis (3/11), septic shock (3/11), and intestinal obstruction (1/11). All parturients took out the gauze after the coagulation function returned to normal and there was no active bleeding. The recovery time of coagulation function in 11 cases was 3 days (3-5 days), the retention time of gauze pad was 6 days (3-6 days), the median length of stay in intensive care unit was 14 days (11-26 days), and the median total length of stay was 22 days (16-49 days).Conclusions:Pelvic packing could be used as a temporary strategy for intractable postpartum hemorrhage after EPH, which provides a key time for injury control resuscitation for patients with unstable vital signs. This technology provides an opportunity for referral to superior medical institutions and further treatment.

Objective:To explore the prognostic value of the maximum standardized uptake value reduction proportion (ΔSUVmax%) on 18F-fluorodeoxyglucose (FDG) positron emission tomography combined with computed tomography (PET/CT) imaging, Deauville scores and C-myc gene rearrangement for the prediction of diffuse large B-cell lymphoma (DLBCL) in early chemotherapy. Methods:A total of 83 primary patients with pathologically confirmed DLBCL admitted in Shanxi Provincial Cancer Hospital from September 2010 to December 2016 underwent 18F-FDG PET/CT 1 week before and after early chemotherapy. The patients underwent post-chemotherapy examinations between 17 to 21 days after one cycle ( n=34) or two cycles ( n=49). The region of interest (ROI) was drawn and the ΔSUVmax% was calculated. Deauville 5-point scale was used to score the PET/CT imaging in early chemotherapy. Fluorescence in situ hybridization (FISH) was used to detect C-myc gene rearrangement. The follow-up time was from 36 to 111 months. The primary end-point of the study was progression-free survival (PFS). Receiver operating characteristic (ROC) analysis, χ2 test, Spearman correlation analysis, Log rank test, and Cox regression analysis were used to analyze the data. Results:Of 83 DLBCL patients, 19 progressed during the follow-up period. The optimal cut-off value of ΔSUVmax% for predicting tumor progression in early chemotherapy was 62.59%, and the Deauville score was taken as 5. The differences in sensitivity, specificity, and accuracy between the two methods were not statistically significant ( P>0.05). The ΔSUVmax% were negatively correlated with C-myc gene rearrangement and the Deauville scores ( rs= -0.889, -0.862, P<0.001). However, the Deauville scores was positively correlated with the C-myc gene rearrangement ( rs=0.781, P<0.001). The median PFS were 59 months and 16 months in ΔSUVmax%≥62.59% ( n=57) and ΔSUVmax%<62.59% ( n=26), respectively, with significant difference ( P<0.001). The median PFS for the Deauville score <5 subgroup (61 cases) and =5 subgroup (22 cases) was 59.0 and 15.0 months, respectively, with statistically significant differences ( P<0.001). The median PFS for patients with C-myc rearrangement subgroup (62 cases) and without rearrangement subgroup (21 cases) was 59.0 and 15.0 months, respectively, with statistically significant differences ( P<0.001). The median PFS for ΔSUVmax%<62.59% and Deauville score=5 subgroup, ΔSUVmax%<62.59% and C-myc rearrangement subgroup, Deauville score=5 and C-myc rearrangement subgroup were 15.5 months, 15 months and 13.5 months, respectively, with statistically significant differences ( P<0.001). Conclusion:ΔSUVmax%, Deauville score and C-myc gene rearrangement in early chemotherapy are all associated with PFS in DLBCL patients, and the combination of the two has a good predictive value for the prognosis of DLBCL

Objective:To explore the prognostic value of the maximum standardized uptake value reduction proportion (ΔSUVmax%) on 18F-fluorodeoxyglucose (FDG) positron emission tomography combined with computed tomography (PET/CT) imaging, Deauville scores and C-myc gene rearrangement for the prediction of diffuse large B-cell lymphoma (DLBCL) in early chemotherapy. Methods:A total of 83 primary patients with pathologically confirmed DLBCL admitted in Shanxi Provincial Cancer Hospital from September 2010 to December 2016 underwent 18F-FDG PET/CT 1 week before and after early chemotherapy. The patients underwent post-chemotherapy examinations between 17 to 21 days after one cycle ( n=34) or two cycles ( n=49). The region of interest (ROI) was drawn and the ΔSUVmax% was calculated. Deauville 5-point scale was used to score the PET/CT imaging in early chemotherapy. Fluorescence in situ hybridization (FISH) was used to detect C-myc gene rearrangement. The follow-up time was from 36 to 111 months. The primary end-point of the study was progression-free survival (PFS). Receiver operating characteristic (ROC) analysis, χ2 test, Spearman correlation analysis, Log rank test, and Cox regression analysis were used to analyze the data. Results:Of 83 DLBCL patients, 19 progressed during the follow-up period. The optimal cut-off value of ΔSUVmax% for predicting tumor progression in early chemotherapy was 62.59%, and the Deauville score was taken as 5. The differences in sensitivity, specificity, and accuracy between the two methods were not statistically significant ( P>0.05). The ΔSUVmax% were negatively correlated with C-myc gene rearrangement and the Deauville scores ( rs= -0.889, -0.862, P<0.001). However, the Deauville scores was positively correlated with the C-myc gene rearrangement ( rs=0.781, P<0.001). The median PFS were 59 months and 16 months in ΔSUVmax%≥62.59% ( n=57) and ΔSUVmax%<62.59% ( n=26), respectively, with significant difference ( P<0.001). The median PFS for the Deauville score <5 subgroup (61 cases) and =5 subgroup (22 cases) was 59.0 and 15.0 months, respectively, with statistically significant differences ( P<0.001). The median PFS for patients with C-myc rearrangement subgroup (62 cases) and without rearrangement subgroup (21 cases) was 59.0 and 15.0 months, respectively, with statistically significant differences ( P<0.001). The median PFS for ΔSUVmax%<62.59% and Deauville score=5 subgroup, ΔSUVmax%<62.59% and C-myc rearrangement subgroup, Deauville score=5 and C-myc rearrangement subgroup were 15.5 months, 15 months and 13.5 months, respectively, with statistically significant differences ( P<0.001). Conclusion:ΔSUVmax%, Deauville score and C-myc gene rearrangement in early chemotherapy are all associated with PFS in DLBCL patients, and the combination of the two has a good predictive value for the prognosis of DLBCL

Vascular cognitive impairment (VCI) is a clinical syndrome with impairment of at least one cognitive domain caused by vascular risk factors or cerebrovascular diseases, and its pathogenesis is not completely clear so far. Microglia are innate immune cells in the brain. They participate in many processes such as neuroinflammation, synaptic pruning, myelin regeneration, neurogenesis and connection. They are associated with the occurrence and development of various neurological diseases such as cerebral infarction, Alzheimer's disease, Parkinson's disease, and autism. Recent studies have shown that microglia play an important role in the development of VCI. This article reviews the role of microglia in VCI.