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25 April 2021, Volume 20 Issue 02 Previous Issue    Next Issue

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The structure of gut microbiome in idiopathic short stature profiled by 16S rRNA second generation sequencing sequencing LI Lin, AN Jingjing, WANG Junqi, WANG Xinqiong, DONG Zhiya 2021, 20 (02):  149-154.  DOI: 10.16150/j.1671-2870.2021.02.006 Abstract ( 270 )   HTML ( 6 )   PDF (919KB) ( 115 )   Objective: To investigate structural characteristics of gut microbiome in idiopathic short stature (ISS) children and difference in gut microbiome between ISS and healthy children(HC) children, so as to explore the possible mechanism of action of gut microbiome on ISS. Methods: A total of 16 children aging from 4 to 8, including 16 ISS children (ISS group)and 16 HC (control group) were enrolled in the study. Flora of the collected feces were collected, and V3-V4 of bacterial 16S rRNA was sequenced with high-throughput sequencing. Diversity and abundance of gut microbiome between HC and ISS group were compared. Results: The structure of gut microbiome in ISS children were significantly different from HC children. The Chao1 (diversity index) of ISS group were lower than that of HC group (1109.85±435.23 vs. 1485.68±334.51) (P=0.018) as well as Observed_species index(946.98±374.93 vs. 1 217.69±289.66)(P=0.038), indicating decreased relative abundance of gut microbiome in ISS group. It’s also showed that the relative abundances of Faecalibacterium and Eubacterium were significantly lower in ISS group than HC group (P<0.05). In ISS group, both abundances of Faecalibacterium and Eubacterium were positively correlated with height-SDS and insulin-like growth factor 1(IGF1)-SDS（r>0.6, P<0.05）. Conclusions: For ISS, the abundance of gut microbiome decreases and the flora also experiences significant structural changes. Faecalibacterium and Eubacterium may decrease IGF-1 by short-chain fatty acid (SCFA), constituting a possible pathogenic mechanism for ISS. Figures and Tables | References | Related Articles | Metrics

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Clinical features of primary Sjögren syndrome with purpura ZHAO Qian, ZHAO Xiaoqing, DIAO Licheng, SUN Fei, ZHENG Jie, ZHU Xuemei, CAO Hua 2021, 20 (02):  155-160.  DOI: 10.16150/j.1671-2870.2021.02.007 Abstract ( 232 )   HTML ( 8 )   PDF (910KB) ( 60 )   Objective: To study the clinical characteristics of patients with primary Sjögren syndrome(pSS) with purpura. Methods: A total of 101 patients with pSS were enrolled from January 2017 through January 2020 in Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. The patients were divided into 2 groups: pSS with purpura (purpura group, n=15) and without purpura (non-purpura group, n=86). The clinical presentations and laboratory data were compared between the 2 groups. Results: Of the 15 patients with manifestation of purpura (14.9%), 12(80%) were diagnosed as hypergammaglobulinemia purpura and the other 3(20%) were cryoglobulinemia purpura, thrombocytopenic purpura, and pigmented purpuric dermatosis, respectively. Four cases developed purpura prior to the glandular symptoms of dry mouth and eyes, and 11 cases had purpura after presentations of glandular symptoms. Com-paring with the non-purpura group, the pSS patients with purpura group had earlier onset age [(41.6±13.5) years vs. (51.7±11.4) years, P=0.003], higher incidence of lymphoma (2/15 vs. 0, P=0.011); higher serum levels of rheumatoid factor (RF) (P=0.002), erythrocyte sedimentation rate (ESR) (P=0.019), immunoglobulin (Ig) G (P<0.001), γ-globulin (P=0.001), free Ig light (κ) chains (P<0.001), free Ig heavy (λ) chains (P=0.015), and lower levels of compliment components C3 (P=0.011) and C4 (P=0.021). Conclusions: As a common and heterogeneous dermatological manifestation of pSS patients revealed in this study, the diagnosis of pSS should be considered in patients presenting purpura. The pSS patients with purpura with early onset and abnormal laboratory parameters have increased risk of lymphoma and demanded further monitoring. Figures and Tables | References | Related Articles | Metrics

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The ultrasonic features and diagnostic performance of ultrasound for ovarian cystadenofibroma and adenofibroma QIAN Le, JIANG Meijiao, YANG Bowen, CHEN Hui 2021, 20 (02):  161-167.  DOI: 10.16150/j.1671-2870.2021.02.008 Abstract ( 254 )   HTML ( 6 )   PDF (988KB) ( 66 )   Objective: To investigate ultrasonic features of ovarian cystadenofibroma (CAF) and adenofibroma (AF). Methods: Ultrasonic features of 50 cases with ovarian CAF and 7 cases with AF were analyzed, and diagnostic performance of ultrasound was evaluated. Results: According to pathological findings of the CAF cases studied, 46 were benign CAF with 47 tumors identified, and 4 cases were borderline AF. All the seven AF cases were benign with single lesion. Pathologically, most of lesions was serous (53/58, 91.4%). With borderline CAF defined as malignant, the ultrasound differentiated benign from malignant masses of CAF and AF with a sensitivity of 100.0% (95%CI 39.8%-100.0%), specificity of 72.2% (95%CI 58.4%-83.5%), and accuracy of 74.1%. Most benign CAF masses were described as unilocular solid cysts (25/47, 53.2%) with regular morphology (43/47, 91.5%) and well-defined boundaries (46/47, 97.9%). Regular papillary projections (32/47, 68.1%) in CAF lesions manifested no or minimal color Doppler signals（31/32, 96.9%）. The borderline CAF masses were all identified with solid components or papillary projections, which manifested various degree of blood supply. Compared with benign CAF, borderline CAF showed more solid or papillary components [maximum diameter, borderline CAF was 19.5 (18.8-26.3) mm versus benign 8.0 (7.0-13) mm, P=0.002], with higher the maximum diameter ratio of the solid components or papillary projections to the mass [the borderline CAF was 0.35 versus benign CAF 0.15, P=0.033], and there were more blood supply inside the borderline CAF (4/4) than benign CAF (10/35), (P=0.012). Most of the AF masses were described as regular (6/7), well-defined (5/7) solid masses with shadowing identified (4/7). Absent color Doppler signals were recorded in the solid components (6/6). Conclusions: The ultrasound has a sound diagnostic performance for CAF and AF. Benign CAF lesions are mostly described as solid cysts with papillary projection(s) manifesting no or minimal color Doppler signals; borderline CAFs are mostly described as masses with papillary projection(s) and solid component(s) containing varied blood supply. AFs are mostly described as solid masses with shadowing identified and absent color Doppler signals. It is difficult to discriminate benign from borderline CAF, presence of solid components or papillary projections and copious blood supply may indicate borderline CAF. Figures and Tables | References | Related Articles | Metrics

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A comparison of clinicopathologic and ultrasonic features between unifocal and multifocal papillary thyroid carcinoma YANG Yixian, NI Zhongxin, XIA Shujun, ZHOU Wei, ZHAN Weiwei 2021, 20 (02):  168-172.  DOI: 10.16150/j.1671-2870.2021.02.009 Abstract ( 331 )   HTML ( 3 )   PDF (564KB) ( 104 )   Objective: To investigate the difference in the clinicopathologic and ultrasonic features between unifocal and multifocal papillary thyroid carcinomas. Methods: A total of 448 cases with papillary thyroid carcinoma undergone total thyroidectomy were enrolled during Jan. 2007 to Jan. 2019. Patients were divided into two groups which were unifocal tumor group (155 cases) and multifocal tumor group (293 cases). The difference in clinicopathologic and ultrasonic features between two groups were compared using χ2 test and non-parametric tests. Results: The pathological examination revealed that the multifocal tumors presented more microcarcinoma (72% vs 63%, P=0.049), lymph node metastasis （LMN） (56% vs 41%, P=0.004), capsular invasion (10% vs 3%, P=0.009) and less nodular goiter （42% vs 56%, P=0.003） than those of unifocal tumors. Comparing to unifocal tumors, the multifocal tumors occurred more in the middle dorsal and medial lateral side of the thyroid （P=0.029, P=0.008; P=0.002, P=0.011）, and their size measured with three diameters(vertical anteroposterior, left right diameters) was smaller (P=0.004, P=0.001, P=0.023) in ultrasonography. In addition, the multifocal group had less unclear boundary (67% vs 77%, P=0.013), heterogeneous internal echoes (79% vs 88%, P=0.009), calcification (50% vs 63%, P=0.010) and pos-terior echo change （18% vs 28%, P<0.008） than the unifocal group. Conclusions: The multifocal tumors have more LNM and capsular invasion, presenting more aggressive clinicopathological features, which means active management may be required. The ultrasonic imaging shows multifocal tumors tend to locate in the middle dorsal and medial lateral side of the thyroid and the size of them are smaller, which makes it easy to lead to the missed diagnosis or misdiagnosis. Therefore, more attention should be given to it in clinical practice. Figures and Tables | References | Related Articles | Metrics

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Color Doppler ultrasound and magnetic resonance imaging in prenatal diagnosis of pernicious placenta previa and pernicious placenta previa with placenta accreta: clinic value and analysis of missed diagnosis SUN Tiantian, YE Baoying, YANG Yu, NIU Jianmei 2021, 20 (02):  173-177.  DOI: 10.16150/j.1671-2870.2021.02.010 Abstract ( 200 )   HTML ( 4 )   PDF (800KB) ( 159 )   Objective: To explore the detection efficacy of ultrasound(US) and magnetic resonance imaging(MRI) for pernicious placenta previa(PPP) and PPP with placenta accreta, and analyze the causes for missed diagnosis. Methods: A total of 134 pregnancies with pernicious placenta treated at the International Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine during January 2015 to December 2019 were enrolled. All the pregnancies underwent US and MRI, and image characteristics of both were retrospectively analyzed. Findings of US and MRI were compared with the results of intraoperative and postoperative pathological examination, and detection efficacy of US and MRI for PPP was assessed. Results: For PPP, US identified 124 out of 134 cases, with a detection rate of 92.5%, and 10 cases were missed because of obesity(2 cases), intestine gas interference(1 case), placenta position (placenta covering lateral or posterior wall of the uterus)(2 cases) and multi-causes(more than 2 causes, 2 cases). MRI recognized 126 out of 134 cases, with a detection rate of 94%, and 8 cases were missed because of placenta position and complicated surrounding structure. With combined use of US and MRI, 128 cases were recognized and 6 cases were missed. For PPP with placenta accreta, 73 cases were diagnosed by US in 80 patients, with a sensitivity of 91.25%, and 7 cases were missed for obesity (1 case), intestine gas interference (1 case), placenta position (1 case) and complicated surrounding structure (4 cases); 75 cases were diagnosed by MRI, and 5 cases were missed. US combined with MRI could recognized 75 out of 80 PPP with placenta accreta, and 5 cases were missed because of non-obvious placental thickening, lack of blood sinuses in posterior or inner of placenta, and complicated anatomical structure. US detection for PPP was in good consistency with that of MRI(Kappa>0.8). Conclusions: Color Doppler US and MRI have good diagnostic efficacy for PPP and PPP with placenta accreta, and US is still the preferred method for prenatal diagnosis because of its low costs and convenience. MRI can be used as a supplementary method when US diagnosis is not clear. Figures and Tables | References | Related Articles | Metrics

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Study on application of nutritional risk screening in hospitalized patients with chronic heart failure SHENG Hong, ZHANG Andi 2021, 20 (02):  178-183.  DOI: 10.16150/j.1671-2870.2021.02.011 Abstract ( 225 )   HTML ( 3 )   PDF (655KB) ( 46 )   Objectives: To assess the incidence of nutritional risk in hospitalized patients with chronic heart failure（CHF） using nutritional risk screening 2002 scale(NRS 2002) and analyze the relationship between CHF and NRS 2002. Methods: A prospective study was conducted in patients with CHF admitted at the Department of Cardiology. NRS 2002 was performed to assess nutritional risk of the patients. Nutrition related body mass index(BMI), hemoglobin, prealbumin, albumin, triglyceride, total cholesterol, renal function and CHF-related biomarker pro-brain-type natriuretic peptide (pro-BNP) were measured, and correlation of above mentioned indices with NRS 2002 was analyzed. All the patients were followed-up for six months, and readmission due to heart failure(HF) was counted. Results: A total of 165 patients were included in the study. When patients with NRS 2002 score ≥3 were regarded as having nutritional risk,the incidence of nutritional risk in the hospitalized patients with CHF was 50.3%. In patients with nutritional risk,patients aged 60 years and older accounted for 73.5%, higher than that in patients without(P<0.05). Compared with NRS 2002 score<3 group, percentage of patients with Ⅲor Ⅳcardiac function by New York Heart Association (NYHA) in NRS 2002 score≥3 group was significantly higher (P<0.05), while levels of BMI, albumin, prealbumin, hemoglobin, cholesterol and eGFR were lower (P<0.05). Spearman rank correlation test showed that NRS 2002 score was negatively correlated with BMI, pro-BNP, albumin, proalbumin, hemoglobin, triglyceride, cholesterol (P<0.05), while was positively correlated with age and NYHA grade (P<0.05). The NRS 2002 score, pro-BNP and albumin levels differed significantly between patients with different NYHA grades (P<0.05). However, there was no statistically significant difference in readmission rate between NRS 2002 score≥3 group and <3 group (P=0.496). Conclusions: The incidence of nutritional risk in hospitalized patients with CHF is as high as 50.3%.NRS 2002 is suitable for nutritional risk screening in patients with CHF during hospitalization,and can be used as part of the overall assessment of the patients. Figures and Tables | References | Related Articles | Metrics

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Prospective study on relationship between legumain and early neurological deterioration in patients with acute large artery atherosclerotic stroke RONG Tianyi, HUA Yun, CHEN Deyan, HE Min 2021, 20 (02):  184-189.  DOI: 10.16150/j.1671-2870.2021.02.012 Abstract ( 187 )   HTML ( 1 )   PDF (617KB) ( 55 )   Objective: To investigate the correlation between legumain(LGMN) and early neurological deterioration（END） in patients with acute large artery atherosclerotic（LAA） stroke. Methods: Patients with acute LAA stroke admitted at the Department of Neurology, Shidong Hospital of Yangpu District in Shanghai from January 2016 to December 2018 were enrolled. Serum levels of LGMN and other related laboratory indices were tested in the patients. END was defined as an increase of at least 2 points in repeated National Institutes of Health Stroke Scale (NIHSS) score within the first 72 h of hospitalization. According to whether the patients had END or not, they were divided into END group and non-END group. Multivariable logistic regression model was used to detect the independent risk factors for END. Receiver operator characteristic (ROC) curve was used to analyze the value of LGMN in predicting the occurrence of END. Results: A total of 334 patients were included, and 78 patients (23.4%) had END (END group), while the other 256 patients were of the non-END group. Univariate analysis showed that the incidence of accompanied disease (hypertension, diabetes, hyperlipidemia), vulnerable plaque formation, systolic blood pressure on admission, level of LGMN, fasting blood glucose, glycated hemoglobin, hypersensitive C-reactive protein, NIHSS score on admission in END group were statistically higher than those in non-END group (all P<0.05). The serum LGMN level was significantly lower in moderate (7.05 μg/L) and occlusion (6.80 μg/L) groups than in severe stenosis group (8.66 μg/L) (P<0.05). Multivariate logistic regression analysis showed that increased level of LGMN (OR=1.309,95% CI 1.188-1.441,P<0.001) was the independent risk factors for the occurring of END; other risk factors included vulnerable plaque formation, high systolic blood pressure on admission, high glycated hemoglobin and NIHSS score on admission. ROC curve analysis showed that the area under the curve of LGMN for predicting END was 0.715 (95% CI: 0.663-0.763, P<0.001), with an optimal cut-off value of 6.73 μg/L. Conclusions: Increased level of LGMN is an independent risk factor for END in patients with LAA stroke, which may be used as a biomarker for predicting END in patients with the disease. Figures and Tables | References | Related Articles | Metrics

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Fibroblastic connective tissue nevus in children: a case report and literature review WEI Ruoqu, YU Hong, YAO Zhirong 2021, 20 (02):  190-194.  DOI: 10.16150/j.1671-2870.2021.02.013 Abstract ( 206 )   HTML ( 3 )   PDF (724KB) ( 104 )   Objective: To analyze the clinic-pathological features, immunohistochemical phenotype and differential diagnosis of a child with fibroblastic connective tissue nevus（FCTN）. Methods: A 2-year-old girl developed bright red sclerotic plaque on her right thigh with clear boundary and irregular shape. Biopsy was performed on the lesion, and the pathological tissues were stained with HE and immunohistochemistry. The immunohistochemical phenotypes for differential diagnosis were analyzed along with literature review. Results: Histologically, the lesion was composed of bundles of bland spindle cells of fibroblastic/myofibroblastic lineage irregularly branching within the reticular dermis and along fibrous septa in the subcutis, without affecting the adnexal structures. The dermal adipocytes were entrapped by tumor cells, and elastic fibers were fragmented and decreased. Immunohistochemically, cells of FCTN were positive for CD34, and weak positive for SMA（smooth muscle actin） locally, while negative for S100, des, and low index of Ki-67(1%). Among the 45 cases reported, it was found that the patients generally had an early onset age (median 10 years old), and FCTN occured mostly in children’s trunk, head and neck, with painless spots or nodules as primary presentations. The clinic-pathological features and immunohistochemical phenotype of the patient described hereby were consistent with cases previously reported. Conclusions: FCTN is a rare variant of nevus of connective tissue, which could differentiate into myofibroblast and mechanocyte cells. Immunohistochemically, CD34 is usually positive and SMA is weakly positive in spindle cells. The FCTN should be differentiated with soft tissue tumor, such as dermatofibrosarcoma protuberans,congenital infantile fibrosarcoma and rhabdomyosarcoma. Figures and Tables | References | Related Articles | Metrics

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Effects of macrophages depletion on lipopolysaccharide-induced renal and extra-renal inflammatory response in mice AN Xiaoning, WEI Zhaonan, SHEN Yan, SHI Hao, ZHANG Wen, CHEN Yongxi 2021, 20 (02):  195-200.  DOI: 10.16150/j.1671-2870.2021.02.014 Abstract ( 378 )   HTML ( 9 )   PDF (1046KB) ( 119 )   Objective: To study the effect of macrophages depletion through selective colony-stimulating factor 1(CSF 1) receptor inhibitor GW2580 on inflammatory response induced by lipopolysaccharide(LPS) in mice. Methods: Nine male mice were divided equally into three groups and sacrificed on the 0th, 4th and 7th day after administration of GW2580 (160 mg/kg), respectively. The single cell suspension of spleen were prepared and subjected to flow cytometry assay, the percentage of macrophages in spleen cells at each time point was measured and the depletion efficiency of GW2580 on macrophages was evaluated. Another 9 mice were divided into normal control group, LPS group and GW2580+LPS group with 3 mice in each group. The normal control group were sacrificed without any treatment, the mice in LPS group were sacrificed 16 hours after intraperitoneal injection of LPS, and the mice in GW2580+LPS group were injected with LPS intraperitoneally after administration of GW2580 intragastrically for 1 week and sacrificed 16 hours later. Enzyme linked immunosorbent assay (ELISA) was used to determine the level of tumor necrosis factor-alpha (TNF-α) expression in serum of mice. The creatinine in blood and urinary protein were measured and the histological changes of kidney tissue were compared among the 3 groups. Results: The GW2580 significantly reduce the number of macrophages in the spleen of mice, and the percentages of macrophages in total spleen cells were 7.42%, 4.78% and 3.50% on 0 th, 4 th and 7 th day (P<0.05) after GW2580 administration. LPS raised the level of TNF-α in LPS group (126.4±16.47 pg/mL) (1 pg/mL=1 ng/L) significantly, while the GW2580+LPS and normal control group were below the detection limit of 31.3 pg/mL(P<0.05). Compared with LPS group, GW2580+LPS group had lower level of TNF-α and less renal pathological injury with less inflammatory cells infiltration and alleviated vacuolar degeneration of kidney tubules. Conclusions: GW2580 could reduce the level of the TNF-α by depleting macrophages, alleviating renal injury caused by LPS -induced inflammation. Figures and Tables | References | Related Articles | Metrics

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Survey of risk factors of coronary heart disease in elderly patients with coronary angiography and establishment of relevant diagnostic model WU Jie, FENG Yuanyuan, REN Yan, CAO Jiumei 2021, 20 (02):  201-206.  DOI: 10.16150/j.1671-2870.2021.02.015 Abstract ( 169 )   HTML ( 3 )   PDF (606KB) ( 52 )   Objective: To investigate the major risk factors for coronary heart disease (CHD) in elderly patients (≥75 years old) using coronary angiography and develop relevant diagnostic model. Methods: Retrospective analysis was conduc-ted on 548 elderly patients with suspected diagnosis of CHD(≥75 years old) underwent coronary angiography (CAG) treatment in Ruijin Hospital from June 2018 to December 2019. According to CAG results, the patients were divided into two groups :CHD group and control group. The risk factors were analyzed by multivariate Logistic regression, and the predictive value of these factors for the occurrence of CHD in the elderly was evaluated by receiver operator characteristic curve (ROC curve). Results: There were 408 cases in the CHD group and 140 cases in the control group based on results of CAG. The multivariate Logistic regression analysis after baseline analysis showed that elevated level of troponin I(OR=6.828, 95%CI:3.834-12.160, P<0.001), carotid plaque formation(OR=3.440, 95%CI: 1.780-6.650, P<0.001), elevated level of HbA1c(OR=1.532, 95%CI: 1.182-1.987, P=0.001) and white blood cell (WBC) counts (OR=1.187, 95%CI: 1.027-1.371, P=0.021) were risk factors for elderly patients with CHD, While female(OR=0.329, 95%CI: 0.201-0.538, P<0.001), elevated level of direct bilirubin(OR=0.800, 95%CI: 0.679-0.942, P=0.008) and elevated level of hemoglobin(OR=0.976, 95%CI: 0.960-0.992, P=0.003) were protective factors for CHD in elderly patients. The area under the curve of the ROC curve model established with above 7 factors for recognizing CHD in elderly patients was 0.825(P<0.05), with a good diagnostic performance. Conclusions:Unlike the risk factors established among the whole population, such as diabetes, high blood pressure, smoking, hyperlipidemia, obesity and high homocysteine, the increased level of troponin I and carotid artery plaque formation are major risk factors for CHD in the elderly. However, the female gender are potential protective factors for CHD. The corresponding diagnostic model is of certain value for identifying high-risk patients from patients suspected of CHD, and may help reduce excessive and unreasonable use of CAG. Figures and Tables | References | Related Articles | Metrics

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Changes of ocular biometric parameters in children with low to moderate myopia after wearing orthokeratology lenses WU Yanlin, LIU Jiacheng, CHEN Yanwei, JIANG Siyu, HU Qiwei, LIAO Huaping, SUN Yue 2021, 20 (02):  207-212.  DOI: 10.16150/j.1671-2870.2021.02.016 Abstract ( 206 )   HTML ( 2 )   PDF (697KB) ( 75 )   Objective: To observe the changes of ocular biometric parameters in childrenwith low to moderate myopia after wearing orthokeratology lenses. Methods: A total of 80 children with low to moderate myopia at the Ophthalmology Department of Ruijin Hospital were enrolled. Children were randomly divided into 2 groups: orthokeratology lens group (n=40) and spectacles (n=40) group. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), and lens thickness (LT) of children in the 2 groups were measured by Lenstar 900 at baseline, 6 months and 12 months after wearing orthokeratology lenses or spectacles, and differences in data between the 2 groups were analyzed with independent t tests. Results: There were no statistically significant differences in AL, CCT, ACD, and LT between the 2 groups at baseline. The incremental AL in the orthokeratology group was lower than that in the spectacles group at both 6 months [(0.08±0.08) mm vs (0.16±0.13) mm, t=-4.859, P<0.001] and 12 months [(0.18±0.11) mm vs (0.35±0.14) mm, t=-3.723, P<0.001). For children in the orthokeratology group, after six monthsof lens wearing, the CCT and ACD decreased by 4.65 μm and 0.02 mm (t=-6.205, P<0.001; t=-3.699, P<0.001), respectively, while LT increased by 0.02 mm (t=3.133, P<0.001), which were significantly different from those of spectacles group. After twelve months of lens wearing, the CCT and ACD decreased by 5.03 μm and 0.01 mm (t=-9.456, P<0.001; t=-3.171, P<0.001), respectively, and the LT increased by 0.04 mm (t=4.125, P<0.001), which were significantly different from those of spectacles group. During the follow-up, slight punctate exfoliation of corneal epithelium occurred in 3 children in orthokeratology lens group,with an incidence of 7.5%. Conclusions: Orthokeratology wearing could slow down axial elongation in children with low to moderate myopia, decrease CCT and ACD, and increase LT. For children wearing lens, adverse effects of punctate exfoliation of corneal epithelium should be paid attention to. Figures and Tables | References | Related Articles | Metrics