AIM:To compare and analyze the effectiveness and safety of reducing the diameter of the back optical zone diameter(BOZD)of orthokeratology lens designed by CRT and VST in controlling the progression of myopia in children and adolescents.METHODS:Retrospective study. The study subjects were 400 myopia patients aged 8-16 years who were admitted to the orthokeratology fitting center of our hospital from June 2019 to May 2022, with 400 eyes(including right eye data analysis). The subjects were divided into CRT-S group(BOZD<6.0 mm), CRT group(BOZD=6.0 mm), VST-S group(BOZD<6.2 mm), VST group(BOZD=6.2 mm)according to the brand of orthokeratology lens and BOZD group, with 100 cases in each group. Uncorrected visual acuity(UCVA), corneal flat K value, axial length, spherical equivalent, and incidence of corneal injury were collected and analyzed at 1 d, 1 wk, 1 and 6 mo, 1 and 2 a, respectively.RESULTS:After wearing lenses for 1 d, the UCVA of the VST-S group improved the fastest, but after 1 wk, all groups reached a good UCVA, and there was no significant difference between groups. The corneal flat K value of the CRT-S group decreased the most after wearing lenses for 6 mo, and there was no significant difference in the corneal flat K value of all groups after 1 year of lens wearing. At each time point, the axial length growth decreased significantly after reducing the BOZD of the same brand of orthokeratology lens. At 6 mo, there was no significant difference in the axial length growth and defocus ring diameter between the CRT-S group and the VST-S group, but at 1 and 2 a, the VST-S group had significantly lower axial length growth and defocus ring diameter than the CRT-S group. The growth of the diopter sphere and spherical equivalent(SE)was significantly reduced when the BOZD of the same brand of orthokeratology lens was reduced at 2 a follow-up. The VST-S group had the smallest changes in the degree of SE and had the best myopia control effect. There was no significant difference in the change value of the diopter cylinder and the incidence of corneal injury among the four groups.CONCLUSION:Reducing the BOZD of the orthokeratology lens can effectively control the growth of the axial length and the progression of myopia degree. The myopia control effect of the VST lens is better than that of the CRT lens after reducing the BOZD. Reducing the BOZD of the orthokeratology lens does not increase the risk of additional corneal injury.

AIM:To compare and analyze the effectiveness and safety of reducing the diameter of the back optical zone diameter(BOZD)of orthokeratology lens designed by CRT and VST in controlling the progression of myopia in children and adolescents.METHODS:Retrospective study. The study subjects were 400 myopia patients aged 8-16 years who were admitted to the orthokeratology fitting center of our hospital from June 2019 to May 2022, with 400 eyes(including right eye data analysis). The subjects were divided into CRT-S group(BOZD<6.0 mm), CRT group(BOZD=6.0 mm), VST-S group(BOZD<6.2 mm), VST group(BOZD=6.2 mm)according to the brand of orthokeratology lens and BOZD group, with 100 cases in each group. Uncorrected visual acuity(UCVA), corneal flat K value, axial length, spherical equivalent, and incidence of corneal injury were collected and analyzed at 1 d, 1 wk, 1 and 6 mo, 1 and 2 a, respectively.RESULTS:After wearing lenses for 1 d, the UCVA of the VST-S group improved the fastest, but after 1 wk, all groups reached a good UCVA, and there was no significant difference between groups. The corneal flat K value of the CRT-S group decreased the most after wearing lenses for 6 mo, and there was no significant difference in the corneal flat K value of all groups after 1 year of lens wearing. At each time point, the axial length growth decreased significantly after reducing the BOZD of the same brand of orthokeratology lens. At 6 mo, there was no significant difference in the axial length growth and defocus ring diameter between the CRT-S group and the VST-S group, but at 1 and 2 a, the VST-S group had significantly lower axial length growth and defocus ring diameter than the CRT-S group. The growth of the diopter sphere and spherical equivalent(SE)was significantly reduced when the BOZD of the same brand of orthokeratology lens was reduced at 2 a follow-up. The VST-S group had the smallest changes in the degree of SE and had the best myopia control effect. There was no significant difference in the change value of the diopter cylinder and the incidence of corneal injury among the four groups.CONCLUSION:Reducing the BOZD of the orthokeratology lens can effectively control the growth of the axial length and the progression of myopia degree. The myopia control effect of the VST lens is better than that of the CRT lens after reducing the BOZD. Reducing the BOZD of the orthokeratology lens does not increase the risk of additional corneal injury.

Objective:To explore the short-term clinical efficacy of arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft for early and middle-stage femoral head necrosis in young and middle-aged patients.Methods:A retrospective study was conducted to analyze the clinical data of the 20 patients with early and middle-stage femoral head necrosis who had been treated by arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft at Orthopaedic Medical Center, Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University from January 2020 to December 2024. There were 12 males and 8 females, with an age of 31 (21, 46) years. The femoral head necrosis was due to hormones in 6 cases, to alcohol in 8 cases, to trauma in 3 cases, and to primary lesions in 3 cases. The International Bone Circulation Research Association staging: stage 2B in 2 cases, stage 2C in 5 cases, stage 3A in 7 cases, stage 3B in 3 cases, and stage 3C in 3 cases. The surgical time, intraoperative blood loss, and incidence of complications during follow-up were recorded in this cohort. The visual analogue scale (VAS) pain score, hip Harris score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in this cohort were compared between pre-surgery, 3 months after surgery, and the last follow-up.Results:In this cohort, the surgical time was 134 (120, 160) minutes, the intraoperative blood loss 275 (250, 300) mL, and the follow-up duration (28.7±8.2) months. At pre-surgery, 3 months after surgery, and the last follow-up, respectively, the VAS pain scores were 6.0 (5.0, 7.0) points, 2.0 (1.0, 3.0) points, and 0.5 (0.0, 1.0) points; the WOMAC scores 45.5 (40.3, 46.8) points, 12.5 (10.5, 14.0) points, and 9.5 (8.3, 10.0) points; the Harris hip scores (58.1±4.8) points, (78.4±4.7) points, and (85.0±6.7) points. There were statistically significant differences in the pairwise comparisons between the 3 time points ( P<0.05). At the last follow-up, the therapeutic effects were evaluated according to the Harris hip score as excellent in 7 cases, as good in 10 cases, and as poor in 3 cases, giving an excellent and good rate of 85.0% (17/20). Two patients developed lower limb intermuscular vein thrombosis after surgery, 2 patients had delayed healing of greater trochanter osteotomy after nail removal, heterotopic ossification occurred in 2 patients, and further collapse of the femoral head occurred in 7 patients. No patient developed complications such as wound infection or nerve injury during the follow-up period. Conclusion:The arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft can lead to good short-term clinical efficacy in the treatment of early and middle-stage femoral head necrosis in young and middle-aged patients, but complications such as femoral head collapse, delayed healing of greater trochanter osteotomy, heterotopic ossification, and lower limb intermuscular vein thrombosis still exist.

OBJECTIVES: Stigma is common among community-dwelling patients with schizophrenia and has a profound negative impact on both psychiatric symptoms and quality of life. This study aims to explore the association between stigma and quality of life in this population and to examine the multiple mediating roles of anxiety and depression symptoms. METHODS: The multi-stage stratified cluster random sampling method was used to select the community-dwelling patients with schizophrenics in Chengdu, Sichuan Province, China. The questionnaire included general demographic characteristics, stigma question, the Generalized Anxiety Disorder-7 (GAD-7) scale, the Patient Health Questionnaire-9 (PHQ-9), and the 12-item Short Form Health Survey (SF-12). The SF-12 was used to measure quality of life, including physical health and mental health dimensions. A multiple mediation model was used to analyse the mediating effects of anxiety and depression symptoms together between stigma and quality of life. RESULTS: A total of 1 087 community patients with schizophrenia were included with a mean age of 50.68±12.73 years; 525 (48.30%) were male. Stigma was reported by 543 patients (49.95%). Anxiety symptoms were present in 292 patients (26.86%), and depression symptoms in 407 patients (37.44%). The physical health quality of life score was 72.01 ± 20.99, and the mental health quality of life score was 71.68 ± 19.38. Multiple mediation analysis showed that stigma directly affected quality of life, and also indirectly affected quality of life through anxiety and depression symptoms. Anxiety and depression jointly mediated 42.26% of the total effect of stigma on physical health quality of life and 47.51% on mental health quality of life. CONCLUSIONS Reducing stigma and preventing anxiety and depression symptoms in community-dwelling patients with schizophrenia can effectively improve their quality of life and support reintegration into society.
Humans ; Quality of Life ; Male ; Depression/psychology* ; Middle Aged ; Social Stigma ; Schizophrenia ; Female ; Anxiety/psychology* ; China ; Surveys and Questionnaires ; Adult ; Schizophrenic Psychology ; Independent Living ; Aged

Obesity is a significant risk factor for cancer and is associated with breast cancer metastasis. Nevertheless, the mechanism by which alterations in systemic metabolism affect tumor microenvironment (TME) and consequently influence tumor metastasis remains inadequately understood. Herein, we found that perturbations in circulating metabolites induced by obesity promote metastasis-like phenotypes in breast cancer. Oleoylcarnitine (OLCarn) concentrations were elevated in the serum of obese mice and humans. Administration of exogenous OLCarn induces metastasis-like characteristics in breast cancer cells. Mechanistically, OLCarn directly interacts with the Arg176 site of adenylate cyclase 10 (ADCY10), leading to the activation of ADCY10 and enhancement of cAMP production. Mutations at Arg176 prevent OLCarn from binding to ADCY10, disrupting the ADCY10-mediated activation of cyclic adenosine monophosphate (cAMP) signaling pathway. This activation promotes transcription factor 4 (TCF4)-dependent kinesin family member C1 (KIFC1) transcription, thereby driving breast cancer metastasis. Conversely, the neutralization of both ADCY10 and KIFC1 through knockdown or pharmacological inhibition abrogates the oncogenic effects mediated by OLCarn. Hence, obesity-induced systemic environmental changes lead to the aberrant accumulation of OLCarn within the TME, making it a potential therapeutic target and biomarker for breast cancer.

Ferroptosis, an iron-dependent programmed cell death process driven by reactive oxygen species-mediated lipid peroxidation, is regulated by several metabolic processes, including iron metabolism, lipid metabolism, and redox system. Macrophages are a group of innate immune cells that are widely distributed throughout the body, and play pivotal roles in maintaining metabolic balance by its phagocytic and efferocytotic effects. There is a profound association between the biological functions of macrophage and ferroptosis. Therefore, this review aims to elucidate three key aspects of the unique relationship between macrophages and ferroptosis, including macrophage metabolism and their regulation of cellular ferroptosis; ferroptotic stress that modulates functions of macrophage and promotion of inflammation; and the effects of macrophage ferroptosis and its role in diseases. Finally, we also summarize the possible mechanisms of macrophages in regulating the ferroptosis process at the global and local levels, as well as the role of ferroptosis in the macrophage-mediated inflammatory process, to provide new therapeutic insights for a variety of diseases.
Ferroptosis/physiology* ; Macrophages/metabolism* ; Humans ; Animals ; Iron/metabolism* ; Reactive Oxygen Species/metabolism* ; Lipid Peroxidation/physiology* ; Inflammation/metabolism*

Objective:To explore the short-term clinical efficacy of arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft for early and middle-stage femoral head necrosis in young and middle-aged patients.Methods:A retrospective study was conducted to analyze the clinical data of the 20 patients with early and middle-stage femoral head necrosis who had been treated by arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft at Orthopaedic Medical Center, Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University from January 2020 to December 2024. There were 12 males and 8 females, with an age of 31 (21, 46) years. The femoral head necrosis was due to hormones in 6 cases, to alcohol in 8 cases, to trauma in 3 cases, and to primary lesions in 3 cases. The International Bone Circulation Research Association staging: stage 2B in 2 cases, stage 2C in 5 cases, stage 3A in 7 cases, stage 3B in 3 cases, and stage 3C in 3 cases. The surgical time, intraoperative blood loss, and incidence of complications during follow-up were recorded in this cohort. The visual analogue scale (VAS) pain score, hip Harris score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in this cohort were compared between pre-surgery, 3 months after surgery, and the last follow-up.Results:In this cohort, the surgical time was 134 (120, 160) minutes, the intraoperative blood loss 275 (250, 300) mL, and the follow-up duration (28.7±8.2) months. At pre-surgery, 3 months after surgery, and the last follow-up, respectively, the VAS pain scores were 6.0 (5.0, 7.0) points, 2.0 (1.0, 3.0) points, and 0.5 (0.0, 1.0) points; the WOMAC scores 45.5 (40.3, 46.8) points, 12.5 (10.5, 14.0) points, and 9.5 (8.3, 10.0) points; the Harris hip scores (58.1±4.8) points, (78.4±4.7) points, and (85.0±6.7) points. There were statistically significant differences in the pairwise comparisons between the 3 time points ( P<0.05). At the last follow-up, the therapeutic effects were evaluated according to the Harris hip score as excellent in 7 cases, as good in 10 cases, and as poor in 3 cases, giving an excellent and good rate of 85.0% (17/20). Two patients developed lower limb intermuscular vein thrombosis after surgery, 2 patients had delayed healing of greater trochanter osteotomy after nail removal, heterotopic ossification occurred in 2 patients, and further collapse of the femoral head occurred in 7 patients. No patient developed complications such as wound infection or nerve injury during the follow-up period. Conclusion:The arthroscopy-assisted surgical dislocation combined with autologous iliac bone graft can lead to good short-term clinical efficacy in the treatment of early and middle-stage femoral head necrosis in young and middle-aged patients, but complications such as femoral head collapse, delayed healing of greater trochanter osteotomy, heterotopic ossification, and lower limb intermuscular vein thrombosis still exist.

Introduction: Ageing is commonly linked with physical inactivity. This review was performed to identify the factors associated with participation in physical activity among older adults in Malaysia. Methods: A systematic review was conducted using five databases; Pubmed, Sagepub, Scopus, Cochrane Library and Science Direct. Observational and intervention studies published between January 2010 and December 2020 were included, with Malaysian older adults aged 55 years and older being the main subject. Results: A total of 9 articles were included in the review. Analysis was guided by the Social Ecological Model for Health Promotion. The review had successfully identified gender, age, education level, health reasons, ethnicity and attitude as intrapersonal factors, social support (friend) and marital status as interpersonal factors, and locality as well as availability of facilities as environmental factors. Conclusions: Physical activity participation among Malaysian older adults were mainly determined by intrapersonal factors, particularly gender, health condition and educational level.

The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.

Objective:To explore the genetic basis of two children with unexplained psychomotor developmental delay and facial dysmorphisms suggestive of Coffin-Siris syndrome (CSS).Methods:A boy and a girl suspected for CSS at the 980th Hospital of the People′s Liberation Army Joint Service Support Force respectively in July 2019 and January 2021, and seven members from their families, were selected as the study subjects. Clinical data and family history of the children were collected, and detailed physical examination was carried out, in addition with laboratory and related auxiliary examinations. Potential variants and copy number variations (CNVs) were detected by whole exome sequencing (WES) and copy number variation sequencing (CNV-seq).Results:Child 1, an 8-month-old female, had featured microcephaly, atrial septal defect, curving of fifth finger/toe, and low limb muscle tone. Child 2 was a 2.5-year-old male with language delay, social impairment, dense hair but no curving of the fifth fingers. Genetic testing revealed that child 1 had loss of heterozygosity for exons 8 to 21 of the ARID1B gene, which was unreported previously. Family verification showed that both of her parents were of the wild type. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG) and American Society of Molecular Pathology (AMP), the variant was rated as pathogenic (PVS1+ PS2+ PM2-supporting). Child 2 was found to harbor a heterozygous c. 4263-6 (IVS17) T>G variant of the ARID1B gene. Transcriptome sequencing confirmed that the variant can affect the normal splicing, resulting in retention of a 5 bp sequence in intron 17. Family verification showed that both of his parents were of the wild type. Based on the guidelines from the ACMG, the variant was rated as pathogenic (PS2+ PM2-supporting+ PP3+ PS3). Conclusion:WES and RNA-seq have confirmed the diagnosis of CSS in both children. Discovery of the novel variants has expanded the spectrum of pathogenic mutations underlying CSS, and provided a basis for the genetic counseling.