AIM: To investigate the correlation of degree of myopia in adolescents with axial length, corneal curvature and axial ratio.METHODS: Cross-sectional study. A total of 246 adolescents(492 eyes)aged 8-18 years consecutively enrolled for orthokeratology lens fitting at the Fifth Affiliated Hospital of Zhengzhou University between 2021 and 2023 were included based on random sampling method, with 447 eyes finally included due to the elimination of 45 eyes that did not meet the inclusion criteria. Biometric measurements under scotopic conditions assessed axial length(AL), corneal radius of curvature(CR), and AL/CR ratio. Cycloplegic refraction determined spherical equivalent(SE), classifying eyes into mild(216 eyes)or moderate(231 eyes)myopia groups. Furthermore, the correlation of degree of myopia with AL, CR and AL/CR was analyzed by multiple linear regression analysis.RESULTS: A statistically significant difference in myopia severity was observed between the 8-12-year-old and 13-18-year-old age groups(all P<0.001). There were statistically significant differences between mild and moderate groups in SE, AL and AL/CR(all P<0.001). Linear regression analysis revealed significant negative correlations of SE with AL and AL/CR(r=-0.531, -0.598, all P<0.001). The areas under the ROC curve(AUC)for predicting moderate myopia were 0.812(95% CI: 0.773-0.852)for AL/CR combined with gender and age, 0.800(95% CI: 0.759-0.841)for AL/CR alone, 0.726(95% CI: 0.680-0.773)for AL alone, and 0.548(95% CI: 0.494-0.601)for CR alone. The optimal AL/CR cut-off value for predicting moderate myopia was 3.189(sensitivity: 0.632, specificity: 0.852), suggesting its potential as a clinical threshold.CONCLUSION: In adolescents with mild-to-moderate myopia, AL/CR, AL, and SE showed significant negative correlations. The combination of AL/CR with gender and age demonstrated the highest diagnostic accuracy for SE. AL/CR shows independent predictive value for myopia degree in adolescents, irrespective of refractive status.

AIM: To study the degree of astigmatism, axial distribution and axial symmetry pattern of binocular astigmatism in primary and secondary school students aged 7-18 years with myopia.METHODS:A total of 239 cases(478 eyes)of primary and secondary school students aged 7-18 years who underwent keratoplasty for myopia correction at the Fifth Affiliated Hospital of Zhengzhou University from 2020 to 2022 were randomly selected, and optometry was performed under ciliary muscle paralysis and was statistically analyzed.RESULTS:Astigmatism degree: 0.25 to 1.00 D accounted for 78.5%, 1.25 to 2.00 D accounted for 17.1%, and >2.00 D accounted for 4.4%. The axial distribution of astigmatism: 86.6% was astigmatism with the rule, 5.9% was astigmatism against the rule, and 7.5% was oblique astigmatism; both genders and different astigmatism degrees were dominated by astigmatism with the rule, and there were differences with the other two axes(both P<0.05). Axial symmetry pattern of astigmatism: the median axial difference in astigmatism between the direct symmetry model and the mirror symmetry model was 7° and 10°, respectively, with no statistical significance in both models(P=0.158), and there was no difference between the two in gender, degree of astigmatism, and axial distribution of astigmatism, but in the age group of 7-12 years old, the difference between the axial astigmatism of the direct symmetry model and the mirror symmetry model was statistically significant(P=0.027).CONCLUSION:The axial distribution of binocular astigmatism in myopic primary and middle school students is mostly astigmatism with the rule; the degree of astigmatism is more common from 0.25 to 1.0 D; however, there is no tendency for axial symmetry pattern of astigmatism.

Objective:To evaluate the immunogenicity, safety, and immune persistence of the sequential booster with the recombinant protein-based COVID-19 vaccine (CHO cell) in healthy people aged 18-84 years.Methods:An open-label, multi-center trial was conducted in October 2021. The eligible healthy individuals, aged 18-84 years who had completed primary immunization with the inactivated COVID-19 vaccine 3 to 9 months before, were recruited from Shangyu district of Shaoxing and Kaihua county of Quzhou, Zhejiang province. All participants were divided into three groups based on the differences in prime-boost intervals: Group A (3-4 months), Group B (5-6 months) and Group C (7-9 months), with 320 persons per group. All participants received the recombinant COVID-19 vaccine (CHO cell). Blood samples were collected before the vaccination and after receiving the booster at 14 days, 30 days, and 180 days for analysis of GMTs, antibody positivity rates, and seroconversion rates. All adverse events were collected within one month and serious adverse events were collected within six months. The incidences of adverse reactions were analyzed after the booster.Results:The age of 960 participants was (52.3±11.5) years old, and 47.4% were males (455). The GMTs of Groups B and C were 65.26 (54.51-78.12) and 60.97 (50.61-73.45) at 14 days after the booster, both higher than Group A′s 44.79 (36.94-54.30) ( P value<0.05). The GMTs of Groups B and C were 23.95 (20.18-28.42) and 27.98 (23.45-33.39) at 30 days after the booster, both higher than Group A′s 15.71 (13.24-18.63) ( P value <0.05). At 14 days after the booster, the antibody positivity rates in Groups A, B, and C were 91.69% (276/301), 94.38% (302/320), and 93.95% (295/314), respectively. The seroconversion rates in the three groups were 90.37% (272/301), 93.75% (300/320), and 93.31% (293/314), respectively. There was no significant difference among these rates in the three groups (all P values >0.05). At 30 days after the booster, antibody positivity rates in Groups A, B, and C were 79.60% (238/299), 87.74% (279/318), and 90.48% (285/315), respectively. The seroconversion rates in the three groups were 76.92% (230/299), 85.85% (273/318), and 88.25% (278/315), respectively. There was a significant difference among these rates in the three groups (all P values <0.001). During the sequential booster immunization, the incidence of adverse events in 960 participants was 15.31% (147/960), with rates of about 14.38% (46/320), 17.50% (56/320), and 14.06% (45/320) in Groups A, B, and C, respectively. The incidence of adverse reactions was 8.02% (77/960), with rates of about 7.50% (24/320), 6.88% (22/320), and 9.69% (31/320) in Groups A, B, and C, respectively. No serious adverse events related to the booster were reported. Conclusion:Healthy individuals aged 18-84 years, who had completed primary immunization with the inactivated COVID-19 vaccine 3 to 9 months before, have good immunogenicity and safety profiles following the sequential booster with the recombinant COVID-19 vaccine (CHO cell).

Objective:To investigate the clinical effect of subcutaneous tunnel transfer of forehead thin skin flap supplied by cutaneous branch of supratrochlear artery in repairing skin defect around eyebrow.Methods:From June 2017 to June 2019, 15 patients with eyebrow skin lesion were treated with the aforementioned method at the Plastic Surgery Department of the 2nd Affiliated Hospital of Harbin Medical University. Inclusion criteria: (1)The skin defect area ranged from 1.5 cm×2.0 cm to 2.0 cm×3.0 cm.(2)There was no redness, swelling, skin ulceration, pruritus or pain in the lesions. Based on the patient’s medical history and clinical manifestations before surgery, the lesions were preliminarily diagnosed as benign lesions, and the surrounding tissues of the lesions were good without inflammatory reaction. (3) All patients were treated with tumor resection and repair with thin flap supplied by the cutaneous branch of the supracrochlear artery. (4) Clear consciousness, no intellectual or cognitive impairment, informed consent to this study and willing to cooperate with postoperative follow-up. Patients with other serious systemic diseases were excluded. A thin frontal flap supplied by the cutaneous branch of the supratrochal artery was designed near the hairline of the forehead. The size and shape of the flap should be similar to the size of the lesion. During the operation, the frontal flap was elevated, and the subcutaneous pedicle contained the cutaneous branch of the supratrochlea artery, and the flap was transferred to repair the defect wound through the subcutaneous tunnel. After the operation, the skin flap survival was evaluated by observing the skin flap color and other indicators, and the scar was evaluated by the Vancouver Score Scale(VSS).Results:A total of 15 patients were included, including 2 males and 13 females, aged 12-44 years, and the defect range was 1.5 cm×2 cm-2 cm×3 cm. The flap survived well after operation. In 2 cases, the incision was infected after operation, and the incision healed well after receiving anti-inflammatory treatment and daily dressing change. Local epidermal necrosis occurred in 5 cases, dressing was changed on time, and blood scab was formed. After blood scab shedding, 3 cases had no obvious pigmentation, and 2 cases had mild pigmentation. After 12 months of follow-up, the VSS score was 0-4.All patients were satisfied with the postoperative effect.Conclusions:The thin frontal skin flap can be applied to repair the skin defect around the eyebrow by subcutaneous tunnel transfer. It can be completed in one stage. The scar in the donor area of the flap is hidden, and there is no deformation of the eyebrow and inner canthus, and the survival rate of the flap is high.

Objective:To investigate the clinical effect of subcutaneous tunnel transfer of forehead thin skin flap supplied by cutaneous branch of supratrochlear artery in repairing skin defect around eyebrow.Methods:From June 2017 to June 2019, 15 patients with eyebrow skin lesion were treated with the aforementioned method at the Plastic Surgery Department of the 2nd Affiliated Hospital of Harbin Medical University. Inclusion criteria: (1)The skin defect area ranged from 1.5 cm×2.0 cm to 2.0 cm×3.0 cm.(2)There was no redness, swelling, skin ulceration, pruritus or pain in the lesions. Based on the patient’s medical history and clinical manifestations before surgery, the lesions were preliminarily diagnosed as benign lesions, and the surrounding tissues of the lesions were good without inflammatory reaction. (3) All patients were treated with tumor resection and repair with thin flap supplied by the cutaneous branch of the supracrochlear artery. (4) Clear consciousness, no intellectual or cognitive impairment, informed consent to this study and willing to cooperate with postoperative follow-up. Patients with other serious systemic diseases were excluded. A thin frontal flap supplied by the cutaneous branch of the supratrochal artery was designed near the hairline of the forehead. The size and shape of the flap should be similar to the size of the lesion. During the operation, the frontal flap was elevated, and the subcutaneous pedicle contained the cutaneous branch of the supratrochlea artery, and the flap was transferred to repair the defect wound through the subcutaneous tunnel. After the operation, the skin flap survival was evaluated by observing the skin flap color and other indicators, and the scar was evaluated by the Vancouver Score Scale(VSS).Results:A total of 15 patients were included, including 2 males and 13 females, aged 12-44 years, and the defect range was 1.5 cm×2 cm-2 cm×3 cm. The flap survived well after operation. In 2 cases, the incision was infected after operation, and the incision healed well after receiving anti-inflammatory treatment and daily dressing change. Local epidermal necrosis occurred in 5 cases, dressing was changed on time, and blood scab was formed. After blood scab shedding, 3 cases had no obvious pigmentation, and 2 cases had mild pigmentation. After 12 months of follow-up, the VSS score was 0-4.All patients were satisfied with the postoperative effect.Conclusions:The thin frontal skin flap can be applied to repair the skin defect around the eyebrow by subcutaneous tunnel transfer. It can be completed in one stage. The scar in the donor area of the flap is hidden, and there is no deformation of the eyebrow and inner canthus, and the survival rate of the flap is high.