目的   探讨出生胎龄＜37周早产儿发生败血症时的临床特征及其不良结局的危险因素。方法   收集2020年1月—2023年12月安徽医科大学第一附属医院本部新生儿科收治出生胎龄＜37周且发生败血症早产儿的临床资料；根据败血症发生时间分为早发型败血症（EOS）49例，晚发型败血症（LOS）150例；根据是否出现不良结局，分为结局不良组90例，结局良好组109例。分析EOS和LOS败血症的临床特征，并采用多因素Logistic回归分析早产儿败血症出现不良结局的危险因素。结果  早产儿败血症中EOS患儿出生胎龄更小，生后1 min Apgar评分更低，孕母羊水污染、胎膜早破≥18 h发生率较LOS更高（P＜0.05）；早产儿败血症临床表现无特异性，但LOS患儿休克发生率更高（P＜0.05）；早产儿易发生革兰阴性菌感染，合并先天性心脏病（OR=2.490，P＜0.05）、出生胎龄＜30周（OR=4.851，P＜0.05）、出生体质量小于1 500 g（OR=4.169，P＜0.05）是早产儿败血症发生不良结局的危险因素。结论  早产儿败血症临床表现无特异性，更易发生革兰阴性菌感染，出生胎龄越小、体质量越低发生不良结局的风险更高。

       Objective  To analyze the clinical characteristics and  risk factors of adverse outcomes of  sepsis in premature infants with gestational age ＜ 37 weeks．Methods  Clinical data of preterm infants ＜ 37 weeksof gestational age admitted to the Department of Neonatology of the First Affiliated Hospital of Anhui Medical University from January 2020 to December 2023 were collected．According to the timing of sepsis，49 cases with early-onset sepsis（EOS）and 150 cases with late-onset sepsis（LOS）were diagnosed．According to the outcome，90 cases were divided into the adverse outcome group and 109 cases were good outcome group．The clinical characteristics of EOS and LOS were analyzed，and the risk factors of adverse outcomes were analyzed by multivariate logistic regression．Results The gestational age of EOS infants was smaller at birth，the 1 minute Apgar score was lower ，and the incidence of amniotic fluid contamination and premature rupture of membranes ≥18h were higher than those in LOS infants（P＜0.05）．The clinical manifestations of sepsis in premature infants were not specific，but the incidence of shock was higher in LOS children（P＜0.05）．Preterm infants were more likely to develop gram-negative bacterial infection，congenital heart disease（OR=2.490，P＜0.05），gestational age ＜30 weeks（OR=4.851，P＜0.05），and birth weight ＜ 1 500 g（OR=4.169，P＜0.05）were identified as significant risk factors for adverse sepsis outcomes in preterm infants．Conclusions The clinical manifestations of septicemia in preterm infants are non-specific，and they are more likely to suffer from gram-negative bacterial infection．The younger the gestational age and lower the birth weight of preterm infants，the higher the risk of adverse outcomes after sepsis．

       目的   探讨非肌层浸润性膀胱癌患者初次经尿道膀胱肿瘤电切术的复发情况及危险因素。方法   以93例非肌层浸润性膀胱癌患者进行研究，2018年1月至2022年1月西藏自治区人民政府驻成都办事处医院泌尿外科医院收治采取经尿道膀胱肿瘤电切术，术后随访24个月，复发22例，未复发71例，比较复发与未复发基础情况、不同肿瘤直径、不同肿瘤分期、分级、数量、是否带蒂、灌注化疗方式等特征患者的复发情况，对具有统计学意义的因素，采取非条件Logistic多因素回归分析，明确术后复发的危险因素。结果   肿瘤分期T1期者的复发率为32.08%，高于Ta期者15.50%，肿瘤分级为高级别者的复发率为53.33%，高于低级别者17.95%，肿瘤多发者的复发率为35.71%，高于单发者的13.73%，肿瘤不带蒂者的复发率为38.71%，高于肿瘤带蒂者的16.13%，常规灌注化疗患者的复发率为29.85%，高于术后即刻+灌注化疗患者的7.69%，比较差异均有统计学意义（χ ² 分别为6.648、4.836、6.872、6.166、5.834、5.902，P分别为0.010、0.027、0.008、0.013、0.015、0.024）。肿瘤分期T1期、肿瘤分级为高级别、肿瘤多发、常规灌注化疗为非肌层浸润性膀胱癌行初次经尿道膀胱肿瘤电切术的术后复发的危险因素（P＜0.05）。结论   非肌层浸润性膀胱癌患者初次采取经尿道膀胱肿瘤电切术容易因为临床分期为T1期、肿瘤分级为高级别、肿瘤多发及常规灌注等出现复发，应采取针对性干预措施，改进灌注化疗方式，降低复发率。

       Objective  To investigate the  relapse and  risk factors of non-muscular invasive bladder cancer after primary transurethral resection．Methods  A total of 93 patients with non-muscular invasive bladder cancer were selected for study．They were received by the hospital from January 2018 to January 2022 and underwent transurethral resection．After 24 months of follow-up，22 patients recurred，and 71 patients did not recur．The recurrence of patients with different tumor diameter，tumor stage，grade，numbers，pedicel or not，and infusion chemotherapy methods were compared．For the statistically significant factors，unconditional logistic regression analysis was used to determine the independent risk factors for recurrence．Results  The recurrence rate in T1 stage of tumor was 32.08% higher than that in Ta stage，which was 15.50%．The recurrence rate in high stage was 53.33% higher than that in low stage，which was 17.95%．The recurrence rate in multiple tumor patients was 35.71% higher than that in single tumor patients，which was 13.73%．The no-pedicle tumor recurrence rate was 38.71% higher than that with pedicle，which was 16.13%．The recurrence rate in patients receiving conventional infusion chemotherapy was 29.85% higher than that in patients receiving immediate postoperative infusion chemotherapy，which was 7.69%．The differences were statistically significant（χ ² =6.648、4.836、6.872、6.166、5.834、5.902，P=0.010、0.027、0.008、0.013、0.015、0.024）．The independent  risk factors of recurrence after primary transurethral resection were tumor stage T1，high grade tumors，multiple tumors，routine perfusion chemotherapy as non-muscular invasive bladder cancer（P＜0.05）．Conclusions  The  patients with  non-muscular invasive bladder cancer taking transurethral resection for the first time are prone to recurrence because of the clinical stage of T1，tumor grade of high grade，multiple tumors and routine perfusion．Targeted intervention measures  should be taken to improve the perfusion chemotherapy method to reduce the recurrence rate．

      近视是一种常见的屈光不正状态，也是全球范围内普遍存在的视觉健康问题，其特征是在眼部调节放松的状态下，平行光线经眼的屈光系统折射后聚焦在视网膜前，导致视远模糊。近视通常在儿童期发生和发展，但在成年期仍可继续发生和发展。本综述对已发表的关于成年人近视发生和进展的文献进行总结，描述成年人近视的流行病学特征，包括近视率、近视发病率、近视进展率及其近视特征（屈光度及眼轴），总结成年人近视发病和进展的危险因素。了解成年人近视的发展特点和管理方式对于近视防控实践具有重要意义。

   Myopia is a common refractive error and a universal visual health problem in the world. It is characterized by the fact that parallel light rays refract through the refractive system of the eye and focus in front of the retina when the eye accommodatior is relaxed, resulting in distant blurred vision. Myopia usually occurs and develops in childhood, but can continue to occur and develop in adulthood. This review summarizes the published literature on the occurrence and progression of myopia in adults, describes the epidemiological characteristics of myopia in adults, including myopia rate, myopia incidence rate, myopia progression rate, and myopia characteristics（diopter and ocular axis） ; and summarizes the  risk factors for the occurrence and progression of myopia in adults. Understanding the developmental characteristics and management methods of adult myopia is of great significance for myopia prevention and control practice.