Background Axial myopia is the most common type of myopia. However, due to the high incidence of myopia in Chinese children, few studies estimating the physiological elongation of the ocular axial length (AL), which does not cause myopia progression and differs from the non-physiological elongation of AL, have been conducted. The purpose of our study was to construct a machine learning (ML)-based model for estimating the physiological elongation of AL in a sample of Chinese school-aged myopic children. Methods In total, 1011 myopic children aged 6 to 18 years participated in this study. Cross-sectional datasets were used to optimize the ML algorithms. The input variables included age, sex, central corneal thickness (CCT), spherical equivalent refractive error (SER), mean K reading (K-mean), and white-to-white corneal diameter (WTW). The output variable was AL. A 5-fold cross-validation scheme was used to randomly divide all data into 5 groups, including 4 groups used as training data and one group used as validation data. Six types of ML algorithms were implemented in our models. The best-performing algorithm was applied to predict AL, and estimates of the physiological elongation of AL were obtained as the partial derivatives of ALpredicted-age curves based on an unchanged SER value with increasing age. Results Among the six algorithms, the robust linear regression model was the best model for predicting AL, with a R2 value of 0.87 and relatively minimal averaged errors between the predicted AL and true AL. Based on the partial derivatives of the ALpredicted-age curves, the estimated physiological AL elongation varied from 0.010 to 0.116 mm/year in male subjects and 0.003 to 0.110 mm/year in female subjects and was influenced by age, SER and K-mean. According to the model, the physiological elongation of AL linearly decreased with increasing age and was negatively correlated with the SER and the K-mean. Conclusions The physiological elongation of the AL is rarely recorded in clinical data in China. In cases of unavailable clinical data, an ML algorithm could provide practitioners a reasonable model that can be used to estimate the physiological elongation of AL, which is especially useful when monitoring myopia progression in orthokeratology lens wearers.

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Treatment failure of surgically treated gastric cancer is attributed to the spread of gastric cancer cells into the abdominal cavity and lymphatic or hematogenic canals. In the present study, local injection of mitomycin C bound to activated carbon (M-CH) combined with i.p. hyperthermic hypo-osmolar infusion (IPHHOI) was intraoperatively administered to prevent lymph node recurrence and peritoneal recurrence of gastric cancer. Between April 1998 and August 1999, 79 patients with advanced gastric cancer were allocated randomly to two groups. Forty patients underwent M-CH plus IPHHOI combined with surgery (M-CH1+IPHHOI group) and the remaining 39 underwent surgery alone (control group). Lymph node and peritoneal recurrence were significantly decreased in the M-CH1+IPHHOI group compared to that in the control group (p<0.05). The 1- and 2-year survival rates for the M-CH1+IPHHOI group were 91.2 and 72.1%, and those for the control group were 78.9 and 45.5%. The M-CH1IPHHOI group reaped a significant survival benefit (p=0.0352) compared to the control group. Although this study was conducted randomly for a small number of patients and short time, compared with the control group, the M-CH1+IPHHOI group had a beneficial effect in preventing lymph node recurrence and peritoneal recurrence after curative gastrectomy for advanced gastric cancer.