AIM: To observe related influence of eye-use behaviors on the onset and progression of myopia among primary school student in Minhang district, Shanghai under the background of “double reduction”, and evaluate the impact of eye-use habit and behavior on the myopia development in children and adolescents.METHODS:A stratified cluster sampling method was adopted to select study subjects for longitudinal observation. Random sampling was conducted among grade 1-4 students from three primary schools in Minhang District, Shanghai from September to December 2021 after the implementation of the “double reduction” policy, with a 2-year observation period. Annual vision screenings were performed to obtain uncorrected visual acuity, non-cycloplegic refraction data, and spherical equivalent(SE). Biometric measurements were taken to acquire axial length(AL)and corneal curvature(CR). Questionnaires were administered to investigate the eye-use behaviors of participants. Taking myopia ≤-0.50 D as the diagnostic criterion, myopia incidence were calculated. SE and AL changes were used to evaluate myopia progression. Logistic regression analysis was employed to identify risk factors for myopia, and analyze the relationship between eye-use behaviors and myopia development or progression.RESULTS:A total of 2 986 children complete a follow-up for 2 a. The baseline prevalence of poor vision was 32.74%, increasing to 38.92% and 43.73% at 1 and 2 a follow-up, respectively, demonstrating a yearly upward trend. Taking uncorrected visual acuity combined with non-cycloplegic refraction as clinical screening criteria for myopia, the incidence was 24.72%, 27.60%, and 29.64% at baseline, 1, and 2 a follow-ups, respectively. These showed no statistical significant difference compared to the diagnostic standard of cycloplegic refraction SE(23.98%, 27.03%, and 29.17%; all P>0.05). Logistic regression analysis found that daily outdoor and sleep duration were protective factors against myopia(OR=0.54, 0.84, all P<0.05), while age, parental myopia, duration of offline education, online education, electronic device usage, and poor visual posture were identified as risk factors(OR=2.72, 1.54, 1.72, 1.12, 1.47, 1.26, all P<0.001). Further analysis of myopia progression in baseline myopic children over 2 a revealed that age, parental myopia, baseline SE, duration of offline/online education, electronic device usage, and poor visual posture may contribute to rapid myopia progression.CONCLUSION:Under the background of “double reduction”, the eye-use behavior among primary school students in Minhang District, Shanghai has an important impact on the occurrence and development of myopia. In order to effectively prevent and control myopia, it is necessary to further strengthen the education and guidance of eye-use behavior.

The application of artificial intelligence (AI) in medicine has attracted extensive attention. AI-assisted endoscopic diagnosis is the hot spot of research. The operation of digestive endoscopy is completed by endoscopists in clinical settings, and the diagnosis is completed by endoscopists' eyes along with pathological biopsy findings. It is essentially a process of continuously accumulating experience and gradually perfecting. AI-assisted endoscopic diagnosis is expected to improve the detection rate of digestive tract lesions and reduce missed diagnosis effectively. This article reviewed the role and progress in research on application of AI in endoscopic diagnosis of digestive system diseases.

ObjectiveTo investigate the status of health literacy of child rearing among caregivers of 0‒3 year-old children and analyze its determinants in Minhang District， Shanghai to provide scientific evidence for further promoting health literacy of caregivers. MethodsThe caregivers of 0‒3 year-old children were randomly selected and investigated using a questionnaire of health literacy in 13 community health care centers of Minhang District from March 2020 to April 2021. ResultsA total of 2819 valid questionnaires were collected. The total score of health literacy of child rearing for caregivers were 159.2±23.1 （full score being 200.0）. The score of physical health literacy and mental health literacy were 80.0±10.2 and 79.1±15.1， respectively （full score being 100.0）. The proportions of health literacy in the caregivers were： scarce 3.1%， insufficient 7.6%， good 47.2%， and excellent 42.1%. The multivariate ordinal Logistic regression model showed the following were independent determinants： always （OR=5.90） or often （OR=3.55） choosing information from professional approach like hospital to guide children rearing，mother （OR=4.98） or father （OR=3.95） being caregivers， easy access to children rearing information （OR=4.50）， mother education degree being master and above （OR=3.10） or junior college， undergraduate （OR=2.14）， father education degree being junior college， undergraduate （OR=1.59） or master and above （OR=1.53）， single child （OR=1.37）， household registration being Shanghai （OR=1.37）. All caregivers with the above factors showed more superior health literacy. ConclusionThe level of health literacy of child rearing among caregivers of 0‒3 year-old children in Minhang District has a good level of health literacy. Targeted health education should be strengthened for caregivers of children in the future.

ObjectiveTo explore the effect of interaction of hypertension and abdominal obesity on morbidity of diabetes and to provide the scientific bases for preventing diabetes. MethodsA total of 11 914 people who took the physical examination in 2019 were examined with cluster sampling method for the interaction analysis. The data was collected by physical measurements and laboratory tests. SPSS 16.0 and interaction models were used for data analysis. ResultsIn the subjects there were 75.19% with abdominal obesity， 47.99% with hypertension， 16.26% with diabetes， and 39.42% had abdominal obesity plus hypertension. Multivariate logistic regression analysis showed， after adjusting gender and age， the abdominal obesity（OR=1.29， 95%CI：1.14‒1.46） and hypertension （OR=2.93， 95%CI： 2.63‒3.26） were related to high risk of diabetes. There was no multiplicative interaction effect between abdominal obesity and hypertension （OR=0.98，95%CI： 0.76‒1.27）. The additive interaction was significant between abdominal obesity and hypertension with RERI=0.53（95%CI：0.09‒0.98）， AP=0.14（95%CI：0.02‒0.26）， and SI=1.24（95%CI：1.01‒1.52）. ConclusionThere is a synergistic effect on morbidity of diabetes between abdominal obesity and hypertension. The improvement of weight and control of blood pressure could prevent significantly the diabetes.

ObjectiveTo explore the cumulative incidence of diabetes mellitus and its influencing factors among the diabetes mellitus high-risk groups in Minhang District of Shanghai, and to provide a basis for the development of community-based diabetes mellitus early prevention and treatment strategies in Shanghai. MethodsThe data of this study were collected from the screening project of diabetes mellitus high-risk groups in Minhang District of Shanghai, which was carried out from 2016‒2017. A total of 12 278 people were screened, of which 10 442 were at high risk based on the results of blood glucose diagnosis except those with diabetes. People diagnosed with abnormal fasting blood glucose, impaired fasting blood glucose and abnormal glucose tolerance were classified into the abnormal blood glucose group, and those with normal fasting blood glucose were classified into the normal blood glucose group. In 2023, the cumulative incidence of diabetes mellitus in the 2 groups was followed up, furthermore, the influencing factors of diabetes mellitus were analyzed. ResultsA total of 8 774 cases within the high-risk groups were followed up in 2023, of which 808 cases progressed to diabetes. Of the 8 774 cases, the cumulative incidence of diabetes mellitus in the abnormal blood glucose group (n=2 163) was 16.37% (354/2 163), and that in the normal blood glucose group (n=6 611) was 6.87% (454/6 611), and the difference in cumulative incidence of diabetes mellitus between the 2 groups was statistically significant (χ²=175.88, P<0.001). A history of impaired glucose regulation (OR=2.828, 95%CI: 2.177‒3.675), family history of type 2 diabetes (OR=1.294, 95%CI: 1.047‒1.600), hypertension (OR=1.268, 95%CI: 1.083‒1.485), dyslipidemia (OR=1.205, 95%CI: 1.003‒1.448), overweight/obesity (OR=1.526, 95%CI: 1.300‒1.792) were positively correlated with the cumulative incidence of type 2 diabetes, while female gender (OR=0.785, 95%CI: 0.675‒0.914) and sedentary lifestyle (OR=0.506, 95%CI: 0.374‒0.685) were negatively correlated with the cumulative incidence of type 2 diabetes. ConclusionBlood glucose monitoring should be strengthened in diabetes mellitus high-risk groups with an impaired glucose regulation history, a family history of type 2 diabetes, hypertension, and dyslipidemia, so as to achieve early detection of diabetes. Timely intervention measures should be taken for high-risk population with unhealthy lifestyle or overweight/obesity.

Objective:To retrospectively characterize the perinatal birth defects in the latest 5 years in Minhang District of Shanghai， and provide the evidence to improve the preventive strategies. Methods:The data of perinatal birth defects was retrieved from “Shanghai information reporting system for children with birth defects and disabilities” ，which was recorded by five sentinel hospitals in Minhang District from January 2014 to December 2018. Average proportion of perinatal birth defects in the recent 5 years， annual variation， comparison with municipal data in the same period， difference between registered population and migrant population， difference between male and female， and common birth defects were determined. Results:The average proportion of perinatal birth defects in the recent 5 years was determined to be 6.24‰， which increased from 5.32‰ in 2014 to 7.90‰ in 2018. It was lower than the municipal proportion in Shanghai with an average of 11.02 ‰ （from 9.7 ‰ in 2014 to 14.00 ‰ in 2018）. The proportion was higher in resident population （9.15‰） than that in migrant population （5.57‰）. In addition， the proportion was higher in male infants （6.81‰） than that in female infants （5.59‰）. The first two common defects were congenital heart disease and polydactyly， while cleft lip and cleft lip with palate showed a decreasing trend. Conclusion:In the recent 5 years， the proportion of birth defect increases， which is consistent with the whole city. There remain challenges in the maternal and children healthcare.