In recent years, the global prevalence of myopia has continued to rise. In China, myopia shows a trend toward widespread prevalence, earlier onset, and greater severity, and high myopia poses a serious threat to adolescent ocular health. Orthokeratology is currently one of the most effective clinical interventions for slowing myopia progression, yet its exact mechanisms of action have not been fully elucidated. Focusing on the various hypotheses proposed in the literature, this review summarizes the role of peripheral retinal defocus, choroidal thickness and blood flow, higher-order aberrations, accommodation, and biomechanics in myopia control with orthokeratology lenses. Specifically, the induction of peripheral myopic defocus through the reverse-geometry design of orthokeratology lenses constitutes the core mechanism by which axial elongation is slowed. After lens wear, choroidal thickening and increased blood perfusion improve the nutritional supply to the outer retina and inhibit scleral remodeling. Increases in higher-order aberrations, such as spherical aberration and coma, expand the depth of focus and reduce accommodative lag. Improvements in accommodative function and alterations in corneal biomechanics also act synergistically. These mechanisms are interrelated and act in a cascading manner to jointly inhibit axial elongation. This review aims to provide a theoretical basis for a deeper understanding of the mechanisms of orthokeratology lenses and to offer clinical references for individualized lens fitting, optimized lens design, and future research on myopia prevention and control.

The rationale for the design of control groups in tuina clinical trial is the foundation for rigorously validating the effectiveness and safety of this therapy. This article reviewed the current state of the design of tuina placebo in control groups of clinical trials， pointed out the necessity of setting up tuina placebo in clinical trials of tuina， analyzed the challenges in implementing blinding of tuina manipulation， and concluded that tuina placebo is still challenged by the placebo effect， the diversification of tuina manipulation but the lack of standardization， and the difficulty of implementing blinding due to the high level of public awareness of tuina. This article also summarized the design of placebo manipulation in three types of clinical trials， including spinal manipulation， acupressure， and paediatric tuina， and proposed four strategies for designing placebo tuina manipulation-controlling placebo effects， developing operational standards for placebo tuina manipulation， ensuring the rigor of blinding implementation， and applying new technologies to enhance the standardization and blinding capacity of placebo tuina methods. So the article is aimed at improving the methodological quality of tuina clinical trial designs， and promoting the standardization and scientificity of tuina clinical trial design.

Objective: To detect the expression of nuclear transcription factor OCT-4 in laryngeal squamous cell carcinoma (LSCC) and its relationship with CD44, and to explore the relationship between OCT-4 and the cancer stem cells and its significance in tumors. Methods: Sixty-nine specimens of laryngeal surgical resection were selected from LSCC patients from January 2008 to December 2012 in Lanzhou General Hospital of Lanzhou Military Region. Another 18 cases of normal laryngeal mucosa tissues were selected as control. OCT-4, CD44 and OCT-4⁺ CD44⁺ cells were observed by using tissue microarray, immunohistochemistry staining and immunohistochemical double staining techniques, and the relationship between their pathological features, such as expression intensity, distribution, cell morphology and clinical parameters were analyzed to explore the clinicopathological significance of CD44⁺ OCT-4⁺ cells. Results: The percentage of CD44-positive cells in LSCC was significantly higher than that in normal laryngeal mucosa tissues [(63.62±8.76)% vs. (13.61±5.81)%, P < 0.001]. The percentage of OCT-4-positive cells in LSCC was (50.44±10.84)%, while it was not expressed in normal laryngeal mucosa tissues (P < 0.001). In LSCC, the expression of OCT-4 was significantly lower than that of CD44 (P < 0.001); the coexpression rate of these two molecules was (5.07±2.90)%. The percentage of CD44-positive cells in poorly differentiated LSCC was significantly higher than that in the well-differentiated group [62.78% (8.22%) vs. 28.62% (30.45%), P < 0.05]. The percentage of OCT-4-positive cells in poorly differentiated LSCC was significantly higher than that in the well-differentiated group [49.89% (13.12%) vs. 33.00% (20.00%), P < 0.05]. In the cancer stem cells, the percentage of OCT-4⁺ CD44⁺ cells in poorly differentiated carcinoma group was also significantly higher than that in the well-differentiated carcinoma group (P < 0.01), the lower the degree of differentiation, the higher the expression level of OCT-4. In LSCC poorly differentiated group, the expressions of OCT-4 and CD44 showed no significant difference between different T stages, but the percentage of OCT-4⁺ CD44⁺ cells elevated with T stage increasing (P < 0.05). The expression of OCT-4 in patients with lymph node metastasis was significantly higher than that in patients without lymph node metastasis (P < 0.01). Conclusions The expressions of OCT-4 and CD44 are associated with the malignant biological behaviors of LSCC closely. OCT-4 may be a valuable marker of tumor stem cells of LSCC.

Objective To understand the laboratory testing current situation of ABO hemolytic disease of the newborn(ABO-HDN)in Chizhou area,and to analyze the test results of serological three indexes tests in order to provide the basis for clinical diag-nosis.Methods The ABO blood group identification and serological three indexes tests(direct antiglobulin test,free antibody test, antibody release test)were performed by using microcolumn gel method.Results A,B,O and AB blood groups were 29.13%, 31.09%,37.82% and 1.96%;the total positive rate of ABO-HDN was 22.41%(80/357),the positive rates of ABO-HDN in A and B blood groups were 38.46% (40/104)and 36.04% (40/111 )respectively;the occurrence rate of ABO-HDN had no statistical difference between blood group A and B (P >0.05);the positive rates of the direct antiglobulin test,free antibody test and antibody release test were 1.96%(7/357),4.76%(17/357)and 22.41%(80/357)respectively.Conclusion The serological three indexes tests are the main basis for the diagnosis of ABO-HDN,the antibody release test shows the highest positive rate.If clinically consid-ering HDN,the newborns should conduct the ABO-HDN screening as early as possible for clarifying the diagnosis and performing the early treatment.