第二版国际近视研究学会近视防控白皮书解读

全球近视率居高不下,儿童青少年近视发病率不断攀升。近视进展会影响个人视力、视力相关生活质量和生产力,高度近视及其相关眼部并发症亦会加剧家庭和社会负担。因此,针对近视的机制、相关并发症与防控方法亟需进一步探究。国际近视研究学会(IMI)于2021-04发布了第二版近视防控白皮书,内容包括近视临床实践反思、近视的影响、近视的危险因素、近视进展过程中的调节与双眼视觉、病理性近视、近视防控及年度汇编。第二版白皮书在第一版白皮书的基础上增加了对上千篇文章和重要的会议摘要的研究,突出了近视防控相关的最新研究和进展。本文对上述第二版近视防控白皮书的内容进行简要汇总和解读,包括近视概述、近视影响、危险因素、近视进展过程中的调节与眼结构改变以及近视防控,以期对近视防控的临床和科研工作有所帮助。

Long-term potentiation-based screening identifies neuronal PYGM as a synaptic plasticity regulator participating in Alzheimer's disease

Synaptic dysfunction is an important pathological hallmark and cause of Alzheimer's disease(AD).High-frequency stimulation(HFS)-induced long-term potentiation(LTP)has been widely used to study synaptic plasticity,with impaired LTP found to be associated with AD.However,the exact molecular mechanism underlying synaptic plasticity has yet to be completely elucidated.Whether genes regulating synaptic plasticity are altered in AD and contribute to disease onset also remains unclear.Herein,we induced LTP in the hippocampal CA1 region of wildtype(WT)and AD model mice by administering HFS to the CA3 region and then studied transcriptome changes in the CA1 region.We identified 89 genes that may participate in normal synaptic plasticity by screening HFS-induced differentially expressed genes(DEGs)in mice with normal LTP,and 43 genes that may contribute to synaptic dysfunction in AD by comparing HFS-induced DEGs in mice with normal LTP and AD mice with impaired LTP.We further refined the 43 genes down to 14 by screening for genes with altered expression in pathological-stage AD mice without HFS induction.Among them,we found that the expression of Pygm,which catabolizes glycogen,was also decreased in AD patients.We further demonstrated that down-regulation of PYGM in neurons impaired synaptic plasticity and cognition in WT mice,while its overexpression attenuated synaptic dysfunction and cognitive deficits in AD mice.Moreover,we showed that PYGM directly regulated energy generation in neurons.Our study not only indicates that PYGM-mediated energy production in neurons plays an important role in synaptic function,but also provides a novel LTP-based strategy to systematically identify genes regulating synaptic plasticity under physiological and pathological conditions.

Data mining analysis of Professor Liu Shangyi＇s prescription characteristics in clinical medicine for the treatment of cancer patients with stomachache

目的：分析国医大师刘尚义教授治疗肿瘤患者胃痛的临床用药特点.方法：收集2014年1月到2016年7月就诊于刘尚义教授国医堂门诊癌症见胃痛的患者资料,采用关联规则阿Apriori算法、复杂系统熵聚类等无监督数据挖掘方法,探讨刘尚义教授治疗肿瘤患者胃痛的临床用药特点.结果：对筛选出的120例处方进行分析,确定处方中药物使用频次,药物之间的关联规则,挖掘出4个核心组合和2个新方.治疗后的胃痛症状分级明显低于治疗前,差异具有统计学意义（P〈0.001）.结论：刘教授治疗肿瘤患者胃痛以活血散结、祛湿止痛为主.

Ocular development in children with unilateral congenital cataract and persistent fetal vasculature

AIM: To investigate the ocular development of patients who had unilateral congenital cataract(CC) combined with persistent fetal vasculature(PFV).METHODS: This cross-sectional, observational study included patients who had unilateral CC and PFV and those with isolated unilateral CC.Axial length(AL), keratometry, anterior chamber depth(ACD), lens thickness, and vitreous length were obtained.The ocular biometric parameters of the affected eyes of patients with CC and PFV were compared with the fellow eyes and with the affected eyes of patients with isolated CC.RESULTS: A total of 110 patients were included and divided into 4 groups: group 1(18 patients with CC and PFV, <24 mo), group 2(22 patients with CC and PFV, ≥24 mo), group 3(35 patients with CC, <24 mo), and group 4(35 patients with CC, ≥24 mo).The ALs of the affected eyes were shorter than those of the fellow eyes in group 1(20.02±1.06 vs 20.66±0.63 mm, P=0.025).While the ALs of the affected eyes were longer than those of the fellow eyes in group 2(23.18±2.00 vs 22.31±1.06 mm, P=0.044) and group 4(22.64±1.80 vs 22.02±1.01 mm, P=0.033).The keratometries of the affected eyes were steeper than those of the fellow eyes in group 2(44.78±1.66 vs 43.83±1.38 D,P=0.041) and group 4(43.76±1.91 vs 43.34±1.46 D, P=0.043).No difference of ACDs between two eyes was found in all groups(all P>0.05).CONCLUSION: Compared with the fellow eyes, the ALs of the eyes with unilateral CC and PFV are shorter in patients younger than 24 mo and longer in those older than 24 mo;the keratometries of the eyes with unilateral CC and PFV are steeper in patients older than 24 mo and similar with those younger than 24 mo.These findings provide further understanding of ocular development in patients with both CC and PFV.

Quality of life in adult intermittent exotropia and the risk factors

AIM: To study the quality of life of adult patients with intermittent exotropia(IXT) in China and analyze the factors affecting the quality of life in IXT patients.METHODS: Total y 109 cases of normal eye(control group), 77 cases of IXT(IXT group) and 115 cases of strabismus control group(except IXT) were collected. The quality of life of the patients was assessed by Chinese version of adult strabismus patient’s quality of life scale(CAS-20). The differences of general characteristics, visual function and quality of life were analyzed, and the effects of individual factors and visual function on quality of life of patients with IXT were analyzed.RESULTS: The IXT group had a high proportion of patients with family history, low proportion of patients with amblyopia compared with strabismus control group. The proportion with normal near and far stereopsis of IXT group were lower than that of normal control group. The best corrected visual acuity of IXT group was higher than that of strabismus control group, but lower than the control group. In addition, the median strabismus degree in IXT group was higher than that in other strabismus control group. The median psychosocial scores and median visual function scores of the IXT group was lower than that of the normal control group, but not different from strabismus control group. Occupation status, course of disease, far stereopsis and near stereopsis significantly affected the quality of life in IXT patients.CONCLUSION: Adult IXT patients in China have a certain proportion of family history and lower quality of life, The main factors affecting the quality of life of IXT patients is stereopsis, course of disease and occupation status.

The effect of Supplementing Qi and Nourishing Yin combined with chemotherapy for lung cancer： a meta-analysis

目的：明确益气养阴法联合化疗是否较单纯使用化疗治疗肺癌在增效、减毒等方面更有优势.方法：从网络数据库中检索2013年1月至2017年1月期间以中医益气养阴为治法联合化疗方案对比单纯化疗治疗肺癌并且运用了随机对照试验研究的国内外文献,然后采用RevMan5.3.5软件对搜集的文献质量进行评价、筛选.结果：成功筛选符合系统评价的文献10篇,总病例691例,治疗组共369例（益气养阴中药＋化疗）,对照组322例（单纯化疗）.Meta分析结果显示治疗组在改善肺癌临床症状方面具有显著统计学差异（P〈0.001）,在实体瘤情况方面、在生活质量改善情况方面、在不良反应发生情况方面两组对比均有显著统计学差异（P〈0.001）.结论：益气养阴法联合化疗能显著改善中晚期肺癌患者的临床症状,减少因化疗引起的毒副反应,提高患者生活质量.

Traditional Chinese medicine combined with chemotherapy in the treatment ofliver cancer： a meta-analysis

目的：基于Meta分析软件分析中医药联合化疗治疗原发性肝癌的临床疗效.方法：从网络数据库（MEDLINE、EMBASE、PUBMED、万方数据库、中国知网、中国维普数据库）中检索中医药联合化疗治疗肝癌的随机对照实验（RCT）中英文文献.检索年限为2011年1月至2017年7月.将最终纳入的文献进行一般资料与结局指标的提取,并对文献进行质量评价,绘制森林图.结果：共纳入16个RCT研究,共涉及1873例,其中治疗组共949例（化疗＋中药）,对照组924例（单纯化疗）.Meta分析结果提示中医药联合化疗治疗原发性肝癌在提高患者近期疗效、改善患者腹水程度、改善患者生活质量、缓解放化疗毒副作用等方面具有疗效具有优势,差异有统计学意义（P〈0.0001）.结论：中医药联合化疗治疗原发性肝癌有助于提高患者近期疗效、改善患者生活质量、缓解放化疗毒副作用.

Compositional study of δ-NbN film by Auger electron microscopy

The chemical stoichiometry on the surface of superconducting δ-NbN thin films is of great importance for their application.Here,we fabricated the δ-NbN thin films on SiO2/Si substrate by DC sputtering method.The film was characterized using X-ray diffraction(XRD) and atomic force microscopy(AFM).Transport properties were measured to reveal the field dependent superconducting transition temperature.Both XRD and electrical measurement show high crystallinity of δ-NbN phase.A homogeneous and smooth surface morphology was measured by AFM.Auger electron spectroscopy(AES) was applied to analyze the composition along the depth of the film.The evolution of Auger peak profile,heights and nitride stoichiometry at the film surface is discussed.The current study provides a more thorough understanding of complex chemical compositions of δ-NbN thin films.