Abstract Prevention and control of myopia requires comprehensive measures. Based on the system established earlier, the system is revised and upgraded. The original system emphasizes comprehensive measures and proposes to focus on both the symptoms and root causes. These measures are summarized into six aspects, three address the root cause measures including health education, glasses optics and visual environment, and three address symptoms measures including eye exercises, physical therapy and drugs. The paper is comprehensively supplemented and analyzes the primary and the secondary, and promotes physical therapy from treating the symptoms to treat both the symptoms and the root causes. These improvement measures will help promote the prevention and control of myopia in children and adolescents.

Objective:To compare the clinical outcomes between percutaneous Kirschner wire leverage plus plaster fixation and elastic intramedullary nailing in the treatment of radial neck fractures in children.Methods:A retrospective study was conducted to analyze the 60 children with radial neck fracture who had been treated by percutaneous Kirschner wire leverage plus plaster fixation at Department of Pediatric Orthopedics, Children's Hospital of Soochow University from January 2016 to July 2023 (set as an internal fixation-free group). They were 30 males and 30 females (34 left and 26 right sides) with an age of (7.7±3.0) years. At the same time, another cohort of 60 patients were chosen as an intramedullary nailing group who had been treated by percutaneous Kirschner wire leverage plus elastic intramedullary nailing and matched in age and gender with those in the internal fixation-free group. The preoperative fracture angulation, operative time, hospitalization time, fracture angulation on the first postoperative day, fracture angulation at 1 month postoperatively, rate of angulation loss after reduction, Mayo elbow performance score (MEPS) at the last follow-up and complications were compared between the 2 groups.Results:There was no significant difference between the 2 groups in their preoperative general data, showing comparability ( P<0.05). The 120 pediatric patients were followed up for (7.5±3.2) months. The operative time [(27.4±15.0) min] and hospitalization time [(3.4±1.9) d] in the internal fixation-free group were significantly shorter than those in the intramedullary nailing group [(45.4±13.5) min and (4.4±1.3) d] ( P<0.05). The preoperative fracture angulation (50.8°±1.9°), fracture angulation on the first postoperative day (11.3°±1.2°), fracture angulation at 1 month postoperatively (12.1°±1.3°), rate of angulation loss after reduction (2.9%±0.5%), and MEPS at the last follow-up [(90.4±2.0) points] in the internal fixation-free group showed no significant differences from those in the intramedullary nailing group [49.5°±1.7°, 11.1°±1.2°, 13.3°±1.5°, 3.9%±1.4%, and (90.2±2.3) points] ( P>0.05). None of the patients in the internal fixation-free group developed pin-tail irritation sign or premature epiphyseal closure after surgery, whereas 3 patients in the intramedullary nailing group developed pin-tail irritation sign and 2 ones premature epiphyseal closure after surgery, showing a significant difference in the complication rate between the 2 groups [0 (0/60) versus 8.3% (5/60)] ( P<0.05). Conclusions:Percutaneous Kirschner wire leverage plus plaster fixation and close elastic intramedullary nailing can both achieve satisfactory outcomes in the treatment of radial neck fractures in children. However, percutaneous Kirschner wire leverage plus plaster fixation needs shorter operative time and hospitalization time, leads to fewer complications, and requires no reoperation to remove internal fixation.

Clinical data of a teenager with slipped capital femoral epiphysis (SCFE) combined with primary hyperparathyroidism (PHPT) treated in the Children′s Hospital of Soochow University in May 2022 were retrospectively analyzed.A girl, aged 13 years and 5 months, had claudication of both lower limbs for 1.5 years, and the symptom was aggravated for 1 month.X-ray examination of the hip joint showed bilateral SCFE.However, the patient had a body mass index of 18.2 kg/m 2 and no trauma, which did not meet the typical characteristics of SCFE.Further ultrasound examination of the parathyroid gland shows parathyroid adenoma.And parathyroid adenoma was considered to cause PHPT, which in turn triggered SCFE.After surgical resection of the PHPT, the patient had a better fusion of the femoral head and femoral neck and improved hip joint function.Therefore, SCFE fixation was not performed.The diagnosis and treatment of this patient indicated that for similar patients with SCFE and PHPT, SCFE may not be treated with internal fixation, if the femoral head and femoral neck have been fused, the hip joint function has improved, and the pain has been relieved after resection of PHPT.In patients with SCFE and PHPT, the management of hyperparathyroidism takes precedence over the treatment of SCFE.Acute and acute-on-chronic slip, with or without PHPT-induced hypercalcemia, should be treated first by SCFE fixation, and excising parathyroid adenoma should be performed simultaneously or as soon as possible.For chronic slip patients who have mild to moderate hypercalcemia and one or more related symptoms, parathyroidectomy should be performed firstly, and then the SCFE fixation should be considered after parathyroid hormone and blood calcium levels become stable.

OBJECTIVE To establish the fingerprints of Kangfuyan capsules and carry out chemical pattern recognition analysis，and simultaneously determine the contents of five components so as to promote the quality standard of the drug. METHODS High performance liquid chromatography （HPLC）fingerprints of 11 batches of Kangfuyan capsules （S1-S11）were established by Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition）；identification and attribution analysis of chromatographic peaks were carried out by comparison with the chromatograms of the reference substance and the decoction pieces of single ingredient. SPSS 26.0 and SIMCA 14.1 software were used for cluster analysis and principal component analysis. HPLC method was used to determine the contents of matrine ，phellodendrine chloride ，rutin，forsythoside A and berberine hydrochloride. RESULTS There were 29 common peaks in the fingerprints for 11 batches of samples ，and the similarity was higher than 0.99. A total of 5 chromatographic peaks were identified ，which are matrine （peak 3），phellodendron chloride （peak 14），rutin （peak 20），forsythiaside A （peak 22） and berberine hydrochloride （peak 28）. The results of cluster analysis and principal component analysis showed that S 1-S9 were clustered into one category ，and S 10 and S 11 were clustered into another category. The contents of above 5 components were 29.320 5-60.144 3，0.621 6-1.076 6，1.025 9-2.830 5，2.899 3-6.212 7 and 4.425 1-8.581 6 mg/g， respectively. CONCLUSIONS The established fingerprint and content determination method are stable and reliable ，and can provide reference for the quality control of the preparation in combination with chemical pattern recognition analysis.

Objective To investigate epidemiological characteristics of measles cases and the influencing factors of transmission of measles among floating children in Shenzhen. Methods Descriptive study was conducted in data which were collected from the report system of statutory infectious diseases from 2016 to 2018 in Shenzhen. Case-control study was conducted between 89 cases and relative controls. Results A total of 108 measles cases in floating children were reported from 2016 to 2018, and the incidence trend showed a year-on-year decline( 2trend=68.35, P<0.001). Analysis showed that nosocomial exposure in 7 to 21 days ago(OR=7.80, 95% CI:3.51-17.35, P<0.001), having been to the crowded places(OR=3.37, 95% CI:1.52-7.47, P=0.002), having contact history of fever-rash patients(OR=4.57, 95% CI:1.41-14.84, P=0.007) were influencing factors of transmission of measles among floating children, and immunization at the prescribed time(OR=0.12, 95% CI:0.04-0.32, P<0.001) was a protective factor for measles. Conclusions Vaccination must be strengthened for floating children. Medical institutions should avoid becoming a key place for measles transmission, and need to strengthen health education.

OBJECTIVE： To evaluate the efficacy and safety of apremilast in the treatment of moderate-to-severe plaque psoriasis systematically. METHODS： Retrieved from PubMed， Embase， Cochrane Library， VIP， CNKI and CBM， RCTs about apremilast or apremilast combined with other drugs （trial group） versus placebo （control group） in the treatment of moderate- to-severe plaque psoriasis were collected. Meta-analysis was conducted by using Rev Man 5.3 statistical software after literature screening， data extraction and quality evaluation with bias risk evaluation tool of Cochrane System Evaluator Manual 5.1.0. RESULTS： Totally 7 studies were included， involving 2 332 patients. Results of Meta-analysis showed that case number of psoriasis assessment and severity index （PASI） decreased by 75％ （PASI 75％） [OR＝6.44，95％CI（4.90，8.45），P＜0.000 01]， PASI 90％ [OR＝8.13， 95％CI（4.65， 14.22）， P＜0.000 01] and sPGA 0 or 1 [OR＝3.89，95％CI（3.00，5.05），P＜0.000 01]， the incidence of ADR [OR＝1.87，95％CI（1.44，2.43）， P＜0.000 01] in trial group were significantly more or higher than control group. Subgroup analysis by apremilast dose showed that case number of 20 mg PASI 75％ [OR＝4.72，95％CI（2.77，8.05），P＜0.000 01]， 30 mg PASI 75％ [OR＝7.05，95％CI（5.13，9.69），P＜0.000 01]， 20 mg PASI 90％ [OR＝4.27，95％CI（1.80，10.09），P＝0.001]， 30 mg PASI 90％ [OR＝11.11，95％CI（5.27，23.43），P＜0.000 01]， 20 mg sPGA 0 or 1 [OR＝2.82，95％CI（1.51，5.26），P＝0.001]， 30 mg sPGA 0 or 1 [OR＝4.13，95％CI（3.10，5.50），P＜0.000 01]， the incidence of 30 mg ADR [OR＝1.94，95％CI（1.51，2.49），P＜0.000 01] in trial group were significantly more or higher than control group. There was no statistical significance in the incidence of serious ADR [OR＝1.27，95％CI（0.77，2.07），P＝0.35] or case number of ADR leading to withdrawal [OR＝1.48，95％CI（1.00，2.20），P＝0.05] between 2 groups. CONCLUSIONS： Apremilast is effective for moderate-to-severe plaque psoriasis in dose-dependent manner and improve the quality of life， but increase the incidence of ADR.

To analyze the clinical characteristics of juvenile gout,101 gout patients in Affiliasted First Hospital of Wanan Medical College from 2016 January to Decemder were divided into juvenile group (≤ 20 years,n=41) and adult group (＞20 years,n=60),the clinical data and related biochemical tests were collected.The body mass index (BMI),fasting blood glucose (FBG),TC,TG,uric acid,urea nitrogen,creatinine,cystatin C,glomerular filtration rate (GFR) and C-reactive protein (CRP),the first gout position,the duration of disease,the family history,the number of involved joints and the tophi were compared between two groups.Compared with the adult group,the juvenile group had significantly higher BMI [(25.6± 1.3) vs.(22.8± 1.0),t=-12.51)],TC [(5.55±0.51) vs.(5.07±0.54),t=-4.44),TG [(2.04±0.32) vs.(1.83±0.39),t=-2.92),uric acid[606.0 (541.0,641.0) vs.502.5 (447.5,542.2),Z=-5.65land C-reactive protein[68.0(57.0,83.5) vs.46.0 (36.0,59.8),Z=-4.64],while lower FBG [(4.83±0.68) vs.(5.74± 1.23),t=4.31)] and the number of involved joints[1(1,1) vs.2(1,4),Z=5.45].The GFR was higher in the juvenile group [(140.4± 31.0) vs.(77.7±22.5),t=-ll.81,P＜0.001)],while the urea nitrogen [6.3 (5.8,6.9) vs.7.6 (6.8,8.4),Z=5.89],creatinine [65.1 (56.2,75.1) vs.87.4 (78.5,98.4),Z=7.18] and cystatin C[1.0(0.9,1.1) vs.1.9(1.5,2.0),Z=7.66]were lower than those in adult group(all P＜0.01).The incidence of the first metatarsophalangeal joint involvement and the ankle joint involvement had no statistical difference between two groups (x2=3.434,P＞0.05).The proportion of family history of gout was higher in juvenile group (x2=6.174,P＜0.05)but the proportion of tophi was lower (x2=16.564,P＜0.01) than those in adult group.The characteristics of juvenile gout are significantly different with those of adult gout patients,so the juvenile patients should be managed differently from the adult patients.

OBJECTIVE:To systematically review the efficacy of Compound danshen dripping pill or Compound danshen tablets for chronic hepatitis B complicated with hepatic fibrosis,and to provide evidence-based reference for clinical treatment.METHODS:Retrieved from PubMed,Cochrane Library,EMBase,Medline,Wanfang database,VIP,CJFD and CBM database,randomized controlled trials (RCTs) about Compound danshen dripping pills or tablets combined with entecavir(trial group) vs.entecavir alone (control group) for chronic hepatitis B complicated with hepatic fibrosis were collected.Meta-analysis was performed by using Rev Man 5.3 statistical software after data extraction and quality evaluation according to Cochrane systematic evaluation manual 5.1.0.RESULTS:A total of 9 RCTs were enrolled,including 714 patients.The results of Meta-analysis showed that ALT [SMD=-0.44,95％CI(-0.86,-0.01),P=0.04],HA [SMD=-1.53,95％CI(-2.28,-0.79),P＜0.001],LN [SMD=-0.93,95％CI(-1.41,-0.46),P＜0.001],CⅣ [SMD=-1.38,95％CI(-2.13,-0.63),P＜0.001] and PCⅢ [SMD=-1.42,95％ CI (-1.60,-1.23),P＜0.001] of trial group were significantly lower than those of control group;HBV-DNA negative rate [OR=3.73,95 ％ CI (2.14,6.49),P ＜ 0.001] was significantly higher than control group,with statistical significance.CONCLUSIONS:Compound danshen dripping pills or tablets can not only improve liver function and liver fibrosis in chronic hepatitis B patients with hepatic fibrosis,but also improve the antiviral effect.

Box-Behnken design-response surface methodology was used to optimize the transformation from chlorogenic acid to neochlorogenic acid.Based on single factor experiments,the experiment design were developed by box-benhnhen central composite design with causal factors of the reaction temperature,time and PH to neochlorogenic acid.The optimum transformation conditions were as follow:reaction temperature at 107℃,reaction time of 60 min,the PH of 4.72.Under the optimum extraction technology conditions,the productivity of neochlorogenic acid was 64.20％.Neochlorogenic acid was isolated and purified.The determination and characterization of neochlorogenic acid was detected by HPLC,1H-NMR,13C-NMR and ESI-MS.The results showed that the content of neochlorogenic acid reached to 98.78％ and the yield of 87.37％.

BACKGROUND:Mechanical, inflammatory, and biochemical factors, particularly matrix metaloproteinases and reactive oxygen lead to chondrocyte degeneration in osteoarthritis. Curcumin has been shown to be a potent antioxidant; however, its protective effects against chondrocyte degeneration in osteoarthritis remain unclear.
OBJECTIVE:To investigate the potential molecular mechanisms underlying the protective effects of curcumin on articular cartilage of osteoarthritis in rats.
METHODS:A total of 30 Sprague-Dawley rats were used and randomly divided into model group (positive control,n=15) and normal group (negative control,n=15). Rat models of traumatic osteoarthritis were established, and then cartilage cels were isolated from articular cartilage and culturedin vitro. Chondrocytes were treated with curcumin (curcumin group) or PDTC (an inhibitor of nuclear factor-kappa B) for 24 hours. The expression level of nuclear factor-kappa B P65 in nucleus and cytoplasm in chondrocytes were determined by western blot assay and immunofluorescence. Moreover, mRNA expressions of type II colagen, matrix metaloproteinase-1 and -13 were analyzed using RT-qPCR.
RESULTS AND CONCLUSION: Nuclear factor-kappa B P65 protein was mainly expressed in nucleus, but few in cytoplasm in positive control group; the reversed results were found in the curcumin group. Nuclear translocation of nuclear factor-kappa B P65 was observed mainly in nucleus in the positive control group; however, that was observed mainly in cytoplasm in the negative control, curcumin, and PDTC groups. Matrix metaloproteinase-1 and -13 mRNA expressions were significantly decreased, while type II colagen mRNA expression was significantly increased in the curcumin group compared with the positive control group. These findings indicated that curcumin protect chondrocytes against degeneration through inhibiting the activation of nuclear factor-kappa B signaling pathway, suppressing nuclear translocation of nuclear factor-kappa B P65 and inhibiting the expressions of matrix metaloproteinase-1 and -13, which are responsible for upregulation of type II colagen expression.