Abstract The prevention and control of myopia in Chinese children and adolescents has become a major public health issue. While maintaining increased outdoor activity as a cornerstone intervention, there is an urgent need to explore new complementary approaches that can be effectively implemented in both indoor and outdoor settings. In recent years, environmental spatial frequency has gained increasing attention as one of the key environmental factors influencing the development and progression of myopia. Both animal studies and human research have confirmed that indoor environments lacking mid to high spatial frequency components, often characterized as "visually impoverished", can promote axial elongation and myopia through mechanisms such as disruption of retinal neural signaling, impaired accommodative function, and altered expression of related molecules. Based on the scientific consensus, it is recommended that "enriching of environmental spatial frequency" should be integrated into the myopia prevention and control framework. Following the principles of schoolled organization, family cooperation, community involvement, and student participation, specific measures are put forward in three areas：optimizing school visual settings, improving home spatial environments, and promoting healthy visual behavior. The aim is to create "visually friendly" indoor environments as an important supplement to outdoor activity, thereby providing a novel perspective and strategy for comprehensively advancing myopia prevention and control among children and adolescents.

Objective:To explore the resting-state network(RSN) of college students with high obsessive-compulsive tendency by electroencephalographic (EEG) microstate analysis, with the aim of informing early identification and intervention of obsessive-compulsive disorder (OCD).Methods:From December 2021 to February 2022, a total of 687 college students from Anhui Medical University were investigated by obsessive-compulsive inventory-revised(OCI-R). Thirty students were selected as the high obsessive-compulsive tendency group (OCI-R>25) and thirty-two students were selected as the low obsessive-compulsive tendency group (OCI-R<15), and 4-minute resting-state EEG data were collected for all subjects. The collected EEG data were analyzed to explore the EEG microstate by spectral decomposition, and intergroup differences in different frequency bands were compared separately using Python (v3.9.0) permutation test for independent samples. Additionally, partial correlation analysis was performed between microstate parameters that exhibited significant between-group differences and symptom scale scores, controlling for age, gender and years of education.Results:(1) The scores of self-rating anxiety scale (37.77±6.01 vs 29.75±6.08), the self-rating depression scale (42.97±8.52 vs 32.78±6.61), OCI-R (34.07±7.10 vs 6.25±3.81), and the Padua inventory-Washington State University revision (56.70±12.98 vs 21.22±10.28) in high obsessive-compulsive tendency group were higher than those of the low obsessive-compulsive tendency group( t=5.215-19.401, all P<0.01). (2) EEG microstate analysis revealed that in the theta band, compared to the low obsessive-compulsive tendency group, the high obsessive-compulsive tendency group showed longer duration ((109.05±19.29)ms vs (100.86±12.02)ms) and higher coverage ((23.27±8.39)% vs (19.51±5.41)%) of microstate A, along with a lower occurrence of microstate B ((1.81±0.43)times/s vs (2.02±0.36)times/s), (all P<0.05). In the beta band, compared to the low obsessive-compulsive tendency group, the high obsessive-compulsive tendency group showed higher duration ((84.17±9.08)ms vs (79.52±5.92)ms) and coverage ((20.30±6.91)% vs (17.43±3.36)%) of microstate A (both P<0.05). (3) Correlation analysis showed that, in the theta band, both the duration and coverage of microstate A were positively correlated with the contamination/washing compulsions factor (CWCF) score ( r=0.482, P=0.011; r=0.406, P=0.035, respectively), while the occurrence of microstate B was negatively correlated with CWCF score ( r=-0.430, P=0.025). Conclusion:The duration and coverage of microstate A may be an early warning signal for the development of contamination/washing compulsions symptoms. In addition, the theta and beta bands are sensitive bands for obsessive-compulsive symptoms.

To summarize the nursing experience of 3 patients with severe hypercapnia during the acute exacer-bation of chronic obstructive pulmonary disease(COPD)undergoing extracorporeal carbon dioxide removal(ECCO2R),as well as adjustment of oxygen therapy support strategy and implementation of non-pharmacological airway clearance techniques.Additionally,the nursing focus includes all process nursing of ECCO2R,which covers the key aspects such as catheter selection and placement management,pre-flush setting and bubble handling,dual connection with initial parameter setting for patients,heparin pathway management and bleeding monitoring,observation of thrombosis formation and pressure monitoring during operation and self-examination,evaluation of carbon dioxide removal effi-ciency and implementation of decommissioning tests.After careful treatment and nursing,2 patients recovered and were discharged,and a patient's condition improved and was transferred to the respiratory ward for further treat-ment,and was discharged after 5 days.

Objective:In order to effectively educate students on tooth defect diseases and restoration techniques, the teaching and research team at the School of Stomatology of Qingdao University developed an integrated course operative dentistry. This course is specifically designed to align with the undergraduate curriculum reform requirements of "Three Early, Two Multiple and One Integration".Methods:The teaching practice of operative dentistry was conducted with the stomatology undergraduates of grade 2020 and 2021. The course group redesigned the curriculum by reorganizing teaching content, rebuilding teaching resources, reconstructing teaching mode, and reshaping the evaluation system. Evaluation of the curriculum design included test scores, satisfaction questionnaires, and teacher self-evaluation. Statistical analysis was performed using SPSS 27.0 software, including independent sample t-tests for numerical variables and Fisher's exact test or Wilcoxon rank sum test for categorical variables. Results:Through the integrated course learning, 92.68% (38/41) of the students of grade 2020 and 97.44% (38/39) of the students of grade 2021 can basically or completely master various dental defect repair schemes and understand the importance of preserving natural tooth. 82.93% (34/41) of the students of grade 2020 and 100.00% (39/39) of the students of grade 2021 could basically or completely master the key points of various dental defect restorations.Conclusions:Through the practice of teaching, it has been confirmed that the integrated course of operative dentistry is beneficial to students' mastering the knowledge and skills of dental defect diseases and their restoration in a more comprehensive way, and is conducive to the cultivation of clinical thinking, hands-on ability and the patient-centered, comprehensive problem-solving thinking, which is in line with the guidance on the innovation and development of medical education.

Objective:To explore the resting-state network(RSN) of college students with high obsessive-compulsive tendency by electroencephalographic (EEG) microstate analysis, with the aim of informing early identification and intervention of obsessive-compulsive disorder (OCD).Methods:From December 2021 to February 2022, a total of 687 college students from Anhui Medical University were investigated by obsessive-compulsive inventory-revised(OCI-R). Thirty students were selected as the high obsessive-compulsive tendency group (OCI-R>25) and thirty-two students were selected as the low obsessive-compulsive tendency group (OCI-R<15), and 4-minute resting-state EEG data were collected for all subjects. The collected EEG data were analyzed to explore the EEG microstate by spectral decomposition, and intergroup differences in different frequency bands were compared separately using Python (v3.9.0) permutation test for independent samples. Additionally, partial correlation analysis was performed between microstate parameters that exhibited significant between-group differences and symptom scale scores, controlling for age, gender and years of education.Results:(1) The scores of self-rating anxiety scale (37.77±6.01 vs 29.75±6.08), the self-rating depression scale (42.97±8.52 vs 32.78±6.61), OCI-R (34.07±7.10 vs 6.25±3.81), and the Padua inventory-Washington State University revision (56.70±12.98 vs 21.22±10.28) in high obsessive-compulsive tendency group were higher than those of the low obsessive-compulsive tendency group( t=5.215-19.401, all P<0.01). (2) EEG microstate analysis revealed that in the theta band, compared to the low obsessive-compulsive tendency group, the high obsessive-compulsive tendency group showed longer duration ((109.05±19.29)ms vs (100.86±12.02)ms) and higher coverage ((23.27±8.39)% vs (19.51±5.41)%) of microstate A, along with a lower occurrence of microstate B ((1.81±0.43)times/s vs (2.02±0.36)times/s), (all P<0.05). In the beta band, compared to the low obsessive-compulsive tendency group, the high obsessive-compulsive tendency group showed higher duration ((84.17±9.08)ms vs (79.52±5.92)ms) and coverage ((20.30±6.91)% vs (17.43±3.36)%) of microstate A (both P<0.05). (3) Correlation analysis showed that, in the theta band, both the duration and coverage of microstate A were positively correlated with the contamination/washing compulsions factor (CWCF) score ( r=0.482, P=0.011; r=0.406, P=0.035, respectively), while the occurrence of microstate B was negatively correlated with CWCF score ( r=-0.430, P=0.025). Conclusion:The duration and coverage of microstate A may be an early warning signal for the development of contamination/washing compulsions symptoms. In addition, the theta and beta bands are sensitive bands for obsessive-compulsive symptoms.

To summarize the nursing experience of 3 patients with severe hypercapnia during the acute exacer-bation of chronic obstructive pulmonary disease(COPD)undergoing extracorporeal carbon dioxide removal(ECCO2R),as well as adjustment of oxygen therapy support strategy and implementation of non-pharmacological airway clearance techniques.Additionally,the nursing focus includes all process nursing of ECCO2R,which covers the key aspects such as catheter selection and placement management,pre-flush setting and bubble handling,dual connection with initial parameter setting for patients,heparin pathway management and bleeding monitoring,observation of thrombosis formation and pressure monitoring during operation and self-examination,evaluation of carbon dioxide removal effi-ciency and implementation of decommissioning tests.After careful treatment and nursing,2 patients recovered and were discharged,and a patient's condition improved and was transferred to the respiratory ward for further treat-ment,and was discharged after 5 days.

Objective:In order to effectively educate students on tooth defect diseases and restoration techniques, the teaching and research team at the School of Stomatology of Qingdao University developed an integrated course operative dentistry. This course is specifically designed to align with the undergraduate curriculum reform requirements of "Three Early, Two Multiple and One Integration".Methods:The teaching practice of operative dentistry was conducted with the stomatology undergraduates of grade 2020 and 2021. The course group redesigned the curriculum by reorganizing teaching content, rebuilding teaching resources, reconstructing teaching mode, and reshaping the evaluation system. Evaluation of the curriculum design included test scores, satisfaction questionnaires, and teacher self-evaluation. Statistical analysis was performed using SPSS 27.0 software, including independent sample t-tests for numerical variables and Fisher's exact test or Wilcoxon rank sum test for categorical variables. Results:Through the integrated course learning, 92.68% (38/41) of the students of grade 2020 and 97.44% (38/39) of the students of grade 2021 can basically or completely master various dental defect repair schemes and understand the importance of preserving natural tooth. 82.93% (34/41) of the students of grade 2020 and 100.00% (39/39) of the students of grade 2021 could basically or completely master the key points of various dental defect restorations.Conclusions:Through the practice of teaching, it has been confirmed that the integrated course of operative dentistry is beneficial to students' mastering the knowledge and skills of dental defect diseases and their restoration in a more comprehensive way, and is conducive to the cultivation of clinical thinking, hands-on ability and the patient-centered, comprehensive problem-solving thinking, which is in line with the guidance on the innovation and development of medical education.

Objective To investigate the correlation of human epididymis protein 4(HE4)with proteinuria in patients with type 2 diabetes mellitus(T2DM).Methods A total of 147 T2DM patients from January 2020 to July 2023 in Jiujiang NO.l People's Hospital were enrolled in observation group.According to the severity of proteinuria,observation group was divided into three groups:Normal albuminuria group(101 cases),microalbuminuria group(25 cases),and massive albuminuria group(21 cases).50 healthy examinees with gender and age matching during the same period were selected as control group.HE4 levels and clinical indicators in each group were compared and analyzed.Correlation between HE4 and proteinuria was analyzed by using univariate and multivariate linear regression.Results The correlation network diagram reveals that HE4 functions was a pivotal node linking serum albumin,urinary microalbumin,urinary microalbumin-to-creatinine ratio(UACR),and renal function biomarkers.Compared to control group,HE4 levels significantly elevated in observation group(P＜0.01).Both univariate and multivariate linear regression analysis demonstrate a positive correlation between HE4 and UACR.Logistic regression analysis shew that after adjusting for confounding factors including age,gender,estimated glomerular filtration rate(eGFR),albumin(ALB),blood urea nitrogen(BUN),serum creatinine(SCr),uric acid(UA),lactate dehydrogenase(LDH)etc.elevated HE4 levels was a risk factor for proteinuria(OR=1.110,95％CI:1.005-1.226).Conclusion Elevated HE4 levels in patients with T2DM is positivly correlated with UACR.Increase its level increases the risk of proteinuria in T2DM patients.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.