AIM: To explore the factors affecting the whole-eye astigmatism after pterygium excision combined with autologous limbal stem cell transplantation.METHODS: A retrospective analysis was conducted on the medical records of 42 patients(42 eyes)with primary pterygium admitted in the ophthalmology department of Xijing Hospital from January 2023 to October 2023. They underwent pterygium excision combined with autologous limbal stem cell transplantation. The maximum invasion depth of pterygium into the cornea was measured with anterior segment optical coherence tomography(AS-OCT)before operation, the length of the pterygium invading cornea, the width of the limbus and the area of the invading cornea were measured during the operation, and three-dimensional values of corneal astigmatism of anterior segment, index of surface variance(ISV), index of vertical asymmetry(IVA), best corrected visual acuity(BCVA)and whole-eye astigmatism were collected before and at 1 mo after surgery. Patients with astigmatism ≤0.50 D or >0.50 D of the whole eye at 1 mo after surgery were assigned to group A and B, respectively. The differences of clinical data before and at 1 mo after surgery between the two groups, and the correlation between pre-operative clinical indicators and whole-eye astigmatism were analyzed. The decision tree algorithm was performed to explore the influencing factors of whole-eye astigmatism at 1 mo postoperatively.RESULTS: The maximum invasion depth of pterygium in the group A was significantly less than that in the group B [80.00(40.00, 180.00)μm vs 175.00(123.00, 190.00)μm, P=0.002]. Preoperative BCVA(LogMAR), whole-eye astigmatism, cornea astigmatism, ISV, IVA and maximum invasion depth of pterygium were positively correlated with whole-eye astigmatism at 1 mo after surgery(rs=0.317, P=0.041; rs=0.545, P<0.001; rs=0.448, P=0.003; rs=0.389, P=0.011; rs=0.382, P=0.013; rs=0.391, P=0.010). The decision tree algorithm screened out two influential factors: the maximum invasion depth of pterygium into the cornea and preoperative whole-eye astigmatism. The risk of whole-eye astigmatism >0.50 D at 1 mo after operation was higher with maximum invasion depth of pterygium into the cornea >95 μm than that with ≤95 μm. Among the patients with whole-eye astigmatism >2.63 D before operation, the probability of residual whole-eye astigmatism >0.50 D was 88.9%, and the predictive model AUC was 0.804.CONCLUSION: The whole-eye astigmatism after pterygium resection is mainly affected by the maximum invasion depth of pterygium into the cornea and preoperative whole-eye astigmatism. When the maximum invasion depth of pterygium into the corneal is >95 μm and the whole-eye stigmatism is >2.63 D before surgery, the patient should receive surgical treatment as soon as possible in order to obtain good clinical benefits.

Objective: To analyze epidemiological trends and changing characteristics of syphilis among students in Yunnan Province from 2005 to 2023, so as to provide evidence for the comprehensive prevention and control of syphilis in schools. Methods: The case data of syphilis among students in Yunnan Province from 2005 to 2023 were obtained from the China Information System for Disease Control and Prevention. The Joinpoint regression model was used to conduct a time trend analysis of the reported incidence rate of syphilis. Results: From 2005 to 2023, a cumulative total of 3 191 cases of syphilis were reported in schools in Yunnan Province(1 248 male cases and 1 943 female cases). The reported incidence rate rose continuously from 0.17/100 000 in 2005 to 8.26/100 000 in 2023, with an average annual percent change (AAPC) of 24.89%( Z =13.18, P <0.01). The reported incidence rate was higher in female students than in male students ( χ 2=229.48, P <0.05). The incidence rates in the primary school, junior high school, senior high school and higher education were 0.21/100 000, 2.42/100 000, 4.45/100 000 and 6.29/100 000 respectively, and the difference was statistically significant (χ 2=3 432.84, P <0.05). The average annual growth rate was the highest in the junior high school stage(AAPC= 30.68% , Z =7.57, P <0.05),followed by the senior high school stage (AAPC=24.28%, Z = 5.70 , P <0.05).The reported incidence rate of primary and secondary syphilis increased from 0.12/100 000 in 2005 to 2.06/ 100 000 in 2023, with an AAPC of 16.86% ( Z = 4.57, P <0.05). Conclusions The overall reported incidence rate of syphilis among students in schools in Yunnan Province shows a sustained upward trend, with the most rapid annual increase observed in junior high schools. Schools should prioritize syphilis education and expand awareness campaigns to curb transmission.

With the increasing emphasis on the bio-psycho-social medical model, significant progress has been made in patient-reported outcomes. Now, through a comprehensive analysis and synthesis of literature within the field, this study explores the advancements in the application of patient-reported outcomes in clinical research on lymphoma. The intention is to provide valuable references for future related studies.

ObjectiveTo explore and analyze the influencing factors of myopia among the primary and middle school students, and to provide an evidence for the prevention and control of myopia in students through the combination of scientific use in electronic products and adherence improvement to outdoor activities. MethodsStratified cluster sampling method was used to select 4 schools in Jiading District, in which all the students in grades 3‒5 of primary school and grades 7‒9 of middle school were enrolled into the study for a questionnaire survey and refraction examination. The χ² test was used to compare the data between the myopic and non-myopic group. Logistic regression analysis was used to analyze the influencing factors of myopia. ResultsThe total myopia detection rate among the primary and middle school students in the industrial zone of Jiading District was 62.8%, with a detection rate of 46.9% for primary school students and 75.6% for middle school students, respectively. Logistic regression analysis showed that middle school (OR=3.639, 95%CI=3.045‒4.349, P<0.001), female students (OR=1.278, 95%CI=1.081‒1.510, P=0.004), the frequency of school desks and chairs was adjusted>1 semester (OR=1.227, 95%CI=1.031‒1.461, P=0.021), the length of time spent on extracurricular tutorial classes for main courses ≥1 hour in a week (OR=1.205,95%CI=1.009‒1.440, P=0.040), parents reduced the length of time that their children spent on exercise (OR=1.205, 95%CI=1.009‒1.440, P=0.040), and parental myopia (OR=2.611, 95%CI=2.157‒3.160, P<0.001) were associated with myopia among the primary and middle school students in the industrial zone of Jiading District. ConclusionThe detection rate of myopia among students in Jiading District was relatively high. More attention should be paid to the effect of school desks and chairs’ adjustment frequency, the length of time spent on extracurricular tutorial classes for main courses, electronic screen exposure time on students’ vision, so as to prevent and slow down the occurrence and development of myopia.

AIM:To investigate the differences in clinical features and therapeutic effects of the tea tree oil wipes combined with deep massages of the meibomian glands for different age groups of patients with demodex blepharitis.METHODS:The clinical data of 146 patients(292 eyes)diagnosed with demodex blepharitis, hospitalized in Department of Ophthalmology, Xijing Hospital from January 2023 to October 2023, was collected in this retrospective study, and the patients were divided into group A(64 cases with 128 eyes)aged ≤45 years old and group B(82 cases with 164 eyes)aged >45 years old according to different ages. The differences in total numbers of binocular mites, Schirmer I tests, symptom and sign scores before, and at 1 and 3 mo after the treatment of the tea tree oil wipes combined with deep massages of the meibomian glands were analyzed between the two groups.RESULTS: Before the treatments, the total number of the mites in the group A [7(6, 8)] was lower than that in the group B [8(7, 9.25); P<0.05]. The dry eye score in the group A [6(6, 7)] was lower than that in the group B [11(10, 12); P<0.001], and the ocular surface irritation symptom score in the group A [10(9, 11)] was higher than that in the group B [6(6, 7); P<0.001]. Both groups experienced a decrease in mite counts and improvement in symptoms and signs scores at 1 mo after treatment, and there was still a degree of improvement in all clinical indicators, with patients in the group B showing a further reduction in mite counts [-1(-3, 0)] even after the treatment was continued for 3 mo.CONCLUSION:The total numbers of mites in patients of older than 45 years old were higher than those in patients of ages younger than 45, and older patients have more serious dry eyes, with less serious symptoms of ocular surface irritation. The treatment can effectively reduce the number of mites in patients of different ages with demodex blepharitis, but the outcomes of Schirmer I tests do not change after the treatment. Longer treatment duration provide sustained clinical benefits.

Objective To analyze the clinical efficacy and safety of photodynamic therapy(PDT)com-bined with CO2 laser in treating vaginal intraepithelial neoplasia(VaIN)to provide reference for the treatment scheme of the patients with VaIN.Methods A total of 80 patients with definitely diagnosed VaIN by colpo-scopic biopsy in Henan University People's Hospital from June 2022 to February 2023 were selected and di-vided into the PDT combined CO2 laser group and CO2 laser group by the random number table method,40 cases in each group.The follow up lasted for 6 months.The cure rate,negative conversion rate of human papillomavir-us(HPV),adverse reactions,recurrence and progression were compared between the two groups.Results After 3,6 months of treatment,the cure rates of VaIN in the PDT combined CO2 laser group were 77.50％and 82.50％,respectively,which in the CO2 laser group were 75.00％and 70.00％respectively,and the differ-ences between the two groups were not statistically significant(P＞0.05).There was no statistically signifi-cant difference in the cure rates of low-grade squamous intraepithelial lesion(LSIL)and high-grade squamous intraepithelial lesion(HSIL)after 3,6 months of treatment between the two groups(P＞0.05).There was no statistically significant difference in the negative conversion rate of HPV after 3 months of treatment be-tween the PDT combined with CO2 laser group and CO2 laser group(71.79％vs.56.41％,P＞0.05).How-ever,after 6 months of treatment,the negative conversion rate of HPV in the PDT combined CO2 laser group was significantly higher than that in the CO2 laser group(82.05％vs.58.97％,P＜0.05).In the CO2 laser group,one case experienced vaginal bleeding during treatment process,two cases appeared mild vaginal wall adhesion.No obvious adverse reaction was observed in the PDT combined with CO2 laser group.After 6 months of treatment,there was no case with progression of lesion in both groups;there were one case(3.23％)of relapse in the PDT combined CO2 laser group and three cases(10.00％)of relapse in the CO2 laser group,and the difference was not statistically significant(P＞0.05).Conclusion PDT combined with CO2 laser for treating VaIN has a high cure rate and HPV clearance rate,which is a safe and effective method for treating VaIN.

Objective:To investigate the factors influencing the occurrence of esophageal stenosis after endoscopic radiofrequency ablation (RFA) for total or near total circumferential early esophageal cancer and precancerous lesions.Methods:Between November 2018 and April 2022, 37 patients who underwent RFA for early esophageal squamous cell carcinoma or intraepithelial neoplasia at Zhongda Hospital, Southeast University were included in a case-control study, and were divided into two groups based on the occurrence of postoperative esophageal stricture: the group with postoperative esophageal stenosis (case group, n=15) and the group without postoperative esophageal stenosis (control group, n=22). The differences in general information, endoscopic findings, and surgical procedures between the two groups were analyzed. Results:There was no significant difference in gender ( P=0.708), age ( t=1.106, P=0.413), smoking or drinking ( P=0.329), preoperative pathology ( P=0.194), circumferential situation ( P=1.000), Paris type ( P=0.379), lesion length ( t=-0.825, P=0.927), ablation length ( t=-0.134, P=0.723), ablation times ( P=0.306), or interval between each ablation ( P=0.500) between the two groups; however, there was significant difference in invasion depth between the two groups ( P=0.021). Conclusion:For total or near total circumferential early esophageal cancer and precancerous lesions, the depth of lesion infiltration may affect the occurrence of esophageal stenosis after RFA. The likelihood of esophageal stenosis may rise with increased infiltration depth, suggesting a need for further research to validate these findings.

Objective:To investigate the clinical value of combined detection of serum immunoglobulin G (IgG), T-frame protein 21 (TBX21), and microRNA-335 (miR-335) in the diagnosis of lupus nephritis (LN).Methods:Ninety-five patients with LN treated in our hospital from January 2021 to January 2023 were selected as the observation group, while ninety-five healthy individuals were selected as the control group. Based on the systemic lupus erythematosus disease activity index (SLEDAI) score at admission, the LN patients were divided into two subgroups: the active LN group (51 cases, SLEDAI score > 4) and the stable LN group (44 cases, SLEDAI score = 0 - 4). The levels of serum IgG, TBX21, and miR-335 were compared between the two groups, and the levels of serum IgG, TBX21, miR-335, blood urea nitrogen (BUN), serum creatinine (Scr), complement C3, complement C4, and SLEDAI score were compared between the two groups. The correlations of serum IgG, PTX3, and miR-335 levels with BUN, Scr, complement C3, complement C4, and SLEDAI scores were analyzed. The diagnostic value of serum IgG, TBX21, and miR-335 in LN was evaluated.Results:Compared with the control group, the levels of serum IgG, TBX21, and miR-335 in the observation group were higher on admission (all P < 0.05). The serum levels of IgG, TBX21, and miR-335 in patients with the active stage were higher than those in patients with the stable stage on admission (all P < 0.05). On admission, the BUN, Scr, and SLEDAI scores of patients in the active stage were higher than those in the stable stage, and the levels of complement C3 and C4 were lower than those in the stable stage (all P < 0.05). The levels of serum IgG, TBX21, and miR-335 on admission were positively correlated with BUN, Scr, and SLEDAI scores and negatively correlated with complement C3 and C4 levels (all P < 0.05). The area under the curve (AUC) of the combination of serum IgG, TBX21, and miR-335 levels in the diagnosis of LN was greater than that of single detection ( P < 0.05). Conclusions:Serum IgG, TBX21, and miR-335 are closely related to disease activity and can be used as reference indicators for the diagnosis and prediction of LN in clinical practice, enabling the development of early targeted treatment plans.

Objective:To observe the development of elevated body temperature during surgical correction under different general anesthesias in the pediatric patients with congenital ptosis.Methods:Sixty American Society of Anesthesiologists Physical Status classification Ⅰ pediatric patients with blepharoptosis of both sexes, aged 2-10 yr, undergoing elective surgery for blepharoptosis correction, were divided into total intravenous anesthesia group(TIVA group) and combined intravenous-inhalational anesthesia group(CIIA group) using a random number table method, with 30 cases in each group. Anesthesia was induced with intravenous propofol 1-2 mg/kg, cisatracurium 0.15-0.25 mg/kg and fentanyl 2-3 μg/kg in both groups, and then the patients were endotracheally intubated. Anesthesia was maintained with intravenous infusion of propofol 50-200 μg·kg -1·min -1 and remifentanil 0.2-0.05 μg·kg -1·min -1 in TIVA group and with intravenous infusion of propofol 25-75 μg·kg -1·min -1 and remifentanil 0.2-0.5 μg·kg -1·min -1 and inhalation of 1%-1.5% sevoflurane in CIIA group. After completion of anesthesia induction, the nasopharyngeal temperature was continuously monitored until the end of surgery, and the occurrence of elevation in intraoperative body temperature (≥37.5 ℃) was recorded. Results:The incidence of elevated body temperature was 20% and 40% in TIVA group and CIIA group, respectively. Body temperature ≥39.0 ℃ did not occur in two groups. There was no significant difference in the incidence of elevated body temperature and constituent ratio of degree of elevation in body temperature between the two groups ( P>0.05). Conclusions:When total intravenous anesthesia and combined intravenous-inhalational anesthesia are used in the surgery for blepharoptosis correction in the pediatric patients with congenital ptosis, concurrent mild hypothermia is a non-small probability event, but it is safe to evaluate it in terms of the occurrence of malignant hyperthermia.

SGP-2 was an acidic polysaccharide with good hypoglycemic activity isolated from Sarcandra glabra (Thunb.) Nakai in the previous study. This study used the laser particle size analysis, transmission electron microscopy (TEM) and atomic force microscopy(AFM) analysis techniques to analyze the advanced structure of SGP-2 in the deionized water and Na2SO4 solution and discuss the structure-activity relationship between the advanced structural characterizations and the α-glucosidase inhibition activities of SGP-2 and its derivative in vitro.Results showed that SGP-2 presented aggregates and spheres in the deionized water.AFM analysis showed that the diameter of SGP-2 was 33 nm and the height was 1.84 nm, whereas compact spherical conformations with high degrees of branching were observed in 0.05 mol/L Na2SO4 solution and SGP-2 had smaller particle size in saline solution compared with that in water.SGP-2 treated by 0.5 mol/L urea and dialysis at the concentration of 1 000 μg/mL showed 98.8% inhibition activity of that from untreated SGP-2. The inhibition rate of short rod conformation with branches reached 83.3% when the temperature rose up to 140 °C, and the α-glucosidase inhibition activity was even higher than that of untreated SGP-2 under the same condition; while SGP-2 with the tangled glycan chains under the condition of carboxyl group reduced had much lower inhibition activity.Therefore, the spherical structure or the short rod conformation with branches played an important role in the activity of SGP-2. This research provides a theoretical basis for further study of structure-function relationship between the advanced structure and activity of polysaccharides.