目的 分析高原地区3~6年级学生屈光状态及屈光参数之间的关系。方法 2023年9月,采用随机抽样方法选取林芝市波密县某两所小学3~6年级535名学生进行校园筛查。计算并记录裸眼远视力（UCVA）,非睫状肌麻痹电脑验光下散光及其轴位、等效球镜（SE）、眼轴（AL）、角膜曲率半径（CR）和眼轴/角膜曲率半径轴率比（AL/CR）。采用SPSS 22.00统计软件分析数据。结果 3~6年级学生AL和AL/CR大体趋势为随年级升高而增长,SE随年级升高而降低。3~6年级学生总体筛查性近视患病率为29.91%,且3~6年级筛查性近视患病率分别为20.35%、25.53%、30.53%和51.38%。总体散光患病率为51.59%,其中顺规散光、逆规散光及斜轴散光分别占90.22%、7.61%及2.17%。视力不良者约40.37%。以非睫状肌麻痹验光SE≤-0.50 D同时UCVA<5.0作为筛查性近视的诊断,AL/CR诊断筛查性近视的灵敏度为0.656、特异度为0.887和Youden指数为0.534,曲线下面积（AUC）为0.802,优于AL评估（AUC=0.764）。结论 高原地区3~6年级学生的筛查性近视患病率随年级升高而快速增长,且散光患病率较高,视力不良者较多。AL／CR值对筛查性近视监测具有一定的临床意义。

Objective To analyze the relationship between refractive status and refractive parameters of students in grades three-six in plateau area．Methods In September,2023,a random sampling method was used to select 535 students from grades three-six of two primary schools in Bomi County,Nyingchi City,for school screening．Distance uncorrected visual acuity（UCVA）,astigmatism and its axis position,equivalent spherical（SE）,axial length（AL）,corneal radius（CR）,and axial length/corneal radius ratio（AL/CR）were calculated and recorded．The data was analyzed using the statistical software SPSS 22.00. Results The general trend of AL and AL/CR for grade three-six students was increased with grade increasing,while SE decreased with grade increasing．The overall prevalence of screening myopia was 29.91%,and the prevalence of screening myopia in grades three to six was 20.35%,25.53%,30.53% and 51.38%,respectively．The overall prevalence rate of astigmatism was 51.59%,including 90.22%,7.61% and 2.17% for astigmatism with the rule,astigmatism against the rule and oblique astigmatism,respectively．About 40.37% of the students had poor vision．Screening myopia was diagnosed using non-cycloplegic optometry with SE ≤-0.50 D combined with UCVA<5.0．The sensitivity and specificity of AL/CR for screening myopia were 0.656 and 0.887,respectively,with a Youden index of 0.534 and an area under the curve（AUC）of 0.802．This was superior to the AL evaluation,which had an AUC of 0.764．Conclusions The prevalence of screening myopia increased rapidly with the increase of grade in grade 3 to 6 in plateau area．And there were high prevalence of astigmatism and more poor vision．AL/CR value has a certain clinical significance in the monitoring of screening myopia．

目的 探讨眼底豹纹斑密度（FTD）及视盘旁萎缩弧（PPA）与眼轴长（AL）的相关性,为眼底定量化在儿童近视防控的应用提供科学依据。方法 本研究随机抽取广州市荔湾区两所小学三年级学生作为研究对象,在校园视力筛查的过程中同时采集AL、CR和眼底彩照。使用AI软件对眼底彩照进行量化分析,量化指标包括不同区域和范围的FTD及PPA面积大小,根据眼轴长度分为三组：A组（AL<23 mm）;B组（23 mm≤AL<24 mm）;C组（24 mm≤AL）。结果 共有398例右眼被纳入统计分析,年龄范围8~11岁,中位数是9岁,男性人数占55.1％。三组组间AL、AL/CR和SE比较均有统计学差异（P<0.05）。A组与B组相比,FTD在后极部整体范围、黄斑中心3 mm区域、黄斑中心3 mm区域上方区域具有统计学差异（P<0.05）,C组与B组相比,PPA面积及FTD在后极部整体范围、视盘为中心4.5 mm范围、黄斑为中心直径3 mm和6 mm范围均具有统计学差异（P<0.05）,Spearman相关性分析表明,AL与PPA（r=0.443）和FTD（r=0.322）呈正相关（P<0.001）。亚组相关性分析表明,A组仅黄斑为中心直径3 mm上方范围FTD与AL呈正相关（P=0.028）,B组PPA、黄斑中心直径3 mm及其上方范围FTD与AL呈正相关（P<0.05）,C组仅PPA与AL呈正相关（P=0.005）。结论 眼底定量对于儿童近视防控具有潜在价值,PPA和FTD与AL呈正相关性,不同区域和范围FTD与AL相关性具有一定差异性,黄斑中心直径3 mm范围及其上方范围与眼轴相关性最强。FTD在短眼轴阶段就可以作为生物标记物预测近视严重程度,而PPA主要在长眼轴阶段体现生物标记物的作用。

Objective To investigate the correlation between fundus tessellated density（FTD）and peripapillary atrophy（PPA）with axial length（AL）,providing a scientific basis for the application of fundus quantification in the prevention and control of myopia in children．Methods This study randomly selected third-grade students from two primary schools in Liwan District,Guangzhou City,as research subjects．Axial length（AL）,corneal radius（CR）,and fundus color photographs were collected simultaneously during the school vision screening process．AI software was utilized to perform quantitative analysis on the fundus color photographs,with quantification indicators including the area size of PPA and FTD in different regions and ranges．Subjects were divided into three groups based on axial length：Group A（AL<23 mm）;Group B（23 mm≤AL<24 mm）;Group C（AL≥24 mm）．Results A total of 398 right eyes were included in the statistical analysis,with an age range of 8 to 11,a median age of 9,and 55.1% were male．There were significant statistical differences in AL,AL/CR,and spherical equivalent（SE）among the three groups（P<0.05）．Compared with Group B,Group A showed significant statistical differences in FTD in the overall posterior pole,the 3 mm diameter area centered on the fovea,and the superior area of the 3 mm foveal center（P<0.05）．Compared with Group B,Group C showed significant differences in PPA area and FTD in the overall posterior pole,the 4.5 mm diameter area centered on the optic disc,and the 3 mm and 6 mm diameter areas centered on the fovea（P<0.05）．Spearman correlation analysis indicated that AL was significantly positively correlated with PPA（r=0.443）and FTD（r=0.322）（P<0.001）．Subgroup correlation analysis showed that in Group A,only the FTD in the superior area of the 3 mm diameter centered on the fovea was significantly positively correlated with AL（P=0.028）．In Group B,PPA and FTD in the 3 mm diameter and superior area centered on the fovea were significantly positively correlated with AL（P<0.05）．In Group C,only PPA was significantly positively correlated with AL（P=0.005）．Conclusions Fundus quantification holds potential value for the prevention and control of myopia in children．PPA and FTD show significant positive correlations with AL,with varying degrees of correlation in different regions and ranges of FTD with AL．The 3 mm diameter area centered on the fovea and its superior area have the strongest correlation with the eye axis．FTD can serve as a biomarker to predict the severity of myopia in the early stages of eye axis elongation,while PPA primarily manifests as a biomarker in the later stages of elongation．

目的 探讨Reversine对人肝星状细胞系LX-2凋亡的影响。方法 设对照组和Reversine干预组,其中Reversine干预组分为7个浓度,分别为1,5,10,20,40,80,120 μg/mL,CCK-8法检测Reversine对LX-2增殖的影响,选取最佳浓度。将细胞重悬在加入5 μL FITC-Annexin V和5 μL PI,用流式细胞仪进行了凋亡率分析,免疫荧光检测凋亡蛋白bcl-2及caspase 3。结果 Reversine可促进LX-2细胞凋亡,随着Reversine浓度增加,LX-2的凋亡可呈剂量依赖关系,其中10 μg/mL为最佳浓度,LX-2细胞的bcl-2蛋白的表达显著下降而cleaved-caspase 3的表达显著上升。结论 Reversine可通过促进caspase-3蛋白活化、抑制bcl-2蛋白表达的方式诱导LX-2凋亡。

目的 探讨胰腺神经鞘瘤的临床特点和诊治方法。方法 总结并回顾性分析我院肝胆外科收治的胰腺神经鞘瘤患者1例及文献报道的71例患者临床资料。结果 共计72例胰腺神经鞘瘤患者纳入总结和分析。患者平均年龄54岁(范围17～89岁),其中女性40例(56%)。临床表现包括上腹痛、体重减轻,或体检偶然发现胰腺肿物。肿瘤平均大小6.1 cm(1～20 cm)。肿瘤位于胰头部29例(40%)、胰体/尾部32例(44%),沟突部6例(8%)。肿瘤表现为实性肿物27例(38%)、囊性28例(39%)、囊实性10例(14%)。2例通过术前超声内镜下穿刺活检病理确诊,其余均为手术后标本病理诊断证实。手术治疗行胰十二指肠切除术23例、局部剜除术16例、胰体尾切除术15例、胰腺中段切除1例。5例 (7%) 患者术后病理为恶性神经鞘瘤,恶性组肿瘤大小明显大于良性组[(13.8±6.2)cm vs (5.6±4.1)cm,P=0.0004)]。手术切除患者术后随访3～65月,均无肿瘤复发、转移及患者死亡。结论 胰腺神经鞘瘤临床表现缺少特异性,术前诊断困难,肿瘤大小与良恶性具有明显相关性,手术治疗可取得良好效果。

Objective To analyze clinical presentation, diagnosis, treatment options, and outcome of pancreatic schwannoma. Methods A retrospective study of clinical data of a case in our hospital and 71 cases reported in literature with pancreatic schwannoma. Results 72 cases were analysed. The mean age was 54 years (range 17-89 years), with 56 % of patients being female. Mean tumor size was 6.1 cm (range 1-20 cm). Tumor location was the head (29 cases), body and tail (32 cases), and uncinate process (6 cases). 27 cases exhibited solid tumors and 28 cases exhibited cystic tumors. Treatment included pancreaticoduodenectomy (23 cases), distal pancreatectomy (15 cases), enucleation (16 cases). 5 cases (7%) were malignant schwannoma. Tumor size of malignant group was significant larger than benign group (13.8±6.2 cm vs 5.6±4.1 cm,P=0.0004). There was no local recurrence metastasis,or death at the follow-up after operation (range 3-65 months). Conclusion The clinical manifestations of pancreatic schwannoma are lack of specificity and preoperative diagnosis remains difficulty. The tumor size was significantly related to classification of malignant or benign. Pancreatic schwannoma has satisfactory prognosis with surgical treatment.

      目的   分析高原地区3～6年级学生屈光状态及屈光参数之间的关系。方法  2023年9月，采用随机抽样方法选取林芝市波密县某两所小学3～6年级535名学生进行校园筛查。计算并记录裸眼远视力（UCVA），非睫状肌麻痹电脑验光下散光及其轴位、等效球镜（SE）、眼轴（AL）、角膜曲率半径（CR）和眼轴/角膜曲率半径轴率比（AL/CR）。采用SPSS 22.00统计软件分析数据。结果  3～6年级学生AL和AL/CR大体趋势为随年级升高而增长，SE随年级升高而降低。3～6年级学生总体筛查性近视患病率为29.91%，且3～6年级筛查性近视患病率分别为20.35%、25.53%、30.53%和51.38%。总体散光患病率为51.59%，其中顺规散光、逆规散光及斜轴散光分别占90.22%、7.61%及2.17%。视力不良者约40.37%。以非睫状肌麻痹验光SE≤-0.50 D同时UCVA＜5.0作为筛查性近视的诊断，AL/CR诊断筛查性近视的灵敏度为0.656、特异度为0.887和Youden指数为0.534，曲线下面积（AUC）为0.802，优于AL评估（AUC=0.764）。结论   高原地区3～6年级学生的筛查性近视患病率随年级升高而快速增长，且散光患病率较高，视力不良者较多。AL／CR值对筛查性近视监测具有一定的临床意义。

      Objective  To analyze the  relationship  between  refractive  status and  refractive  parameters of  students in grades three-six in plateau area．Methods  In September，2023，a random sampling method was used to select 535 students from grades three-six of two primary schools in Bomi County，Nyingchi City，for school screening．Distance uncorrected visual acuity（UCVA），astigmatism and its axis position，equivalent spherical（SE），axial length（AL），corneal radius（CR），and axial length/corneal radius ratio（AL/CR）were calculated and recorded．The data was analyzed using the statistical software SPSS 22.00．Results  The general trend of AL and AL/CR for grade three-six students was increased with grade increasing，while SE decreased with grade increasing．The overall prevalence of screening myopia was 29.91%，and the prevalence of screening myopia in grades three to six was 20.35%，25.53%，30.53% and 51.38%，respectively．The overall prevalence rate of astigmatism was 51.59%，including 90.22%，7.61% and 2.17% for astigmatism with the rule，astigmatism against the rule and oblique astigmatism，respectively．About 40.37% of the students had poor vision．Screening myopia was diagnosed using non-cycloplegic optometry with SE ≤-0.50 D combined with UCVA＜5.0．The sensitivity and specificity of AL/CR for screening myopia were 0.656 and 0.887，respectively，with a Youden index of 0.534 and an area under the curve（AUC）of 0.802．This was superior to the AL evaluation，which had an AUC of 0.764．Conclusions  The prevalence of screening myopia increased rapidly with the increase of grade in grade 3 to 6 in plateau area．And there were high prevalence of astigmatism and more poor vision．AL/CR value has a certain clinical significance in the monitoring of screening myopia．