With the development of science and technology, electronic devices have become an inevitable part of our daily life and work. There has been an increase of interest in the use of various video display terminals(VDT). The ocular surface is the first barrier of the visual system to resist the damage of the external environment. In recent years, the number of patients with dry eye has consistently increased with the excessive use of VDT. Blue light produced by VDT, with wavelengths ranging from 400 to 500 nm, has a high energy in visible light. Therefore, blue light may also be an important risk factor for dry eye. In particular, the outbreak of COVID-19 has left people worldwide suffering from increased blue light, which promotes further research into dry eye caused by blue light emitted from VDT. In this review, we summarize the recent studies on the role of blue light produced by VDT in dry eye to provide reference for future related research.

Background Under the background of global warming, research on association between ambient temperature and risk of injury is needed. Objective To examine the effect of temperature on injury in Bao'an district, Shenzhen and identify the sensitive population, thereby providing a scientific basis for formulating prevention and control strategies and measures of injury. Methods The injury reports from the Injury Surveillance System and the meteorological data of Bao'an District between 2018 to 2022 were collected. The meteorological data were sourced from the fifth generation of the European Centre for Medium-Range Weather Forecasts (ECMWF) land reanalysis data. Based on time-stratified case-crossover design, conditional logistic regression combined with distributed lag nonlinear model was used to evaluate the exposure-response association between ambient temperature and injury. The stratified analyses were further conducted by gender, age, and causes of injury. Results A total of 156205 injury cases were collected from the injury surveillance sentinel hospitals in Bao'an District of Shenzhen from 2018 to 2022, and the median of daily average temperature during the same period was 20.0 ℃. The exposure-response curve showed that the risk of injury was positively correlated with temperature. The linearized analysis revealed that each 1°C increase in temperature was associated with a 1.05% (95%CI: 0.68%, 1.42%) rise in injury risk (ER). Notably, the effect was greater in females (ER=1.31%, 95%CI: 0.67%, 1.94%) than males (ER=0.92%, 95%CI: 0.47%, 1.37%). Among age groups, adults ＞60 years faced the highest risk (ER=1.91%, 95%CI: −0.36%, 4.24%). The top three temperature-associated injury risks were sharp instrument injuries (ER=2.19%, 95%CI: 1.16%, 3.22%), animal injuries (ER=1.71%, 95%CI: 0.86%, 2.56%), and blunt injuries (ER=071%, 95%CI: −0.08%, 1.51%). The impact of temperature on unintentional injuries (ER=1.11%, 95%CI: 0.72%, 1.49%) was higher than that on intentional injuries (ER=0.43%, 95%CI: −0.85%, 1.72%). Severe injuries (ER=2.20%, 95%CI: −3.09%, 7.77%) were more affected by temperature than mild injuries (ER=1.00%, 95%CI: 0.58%, 1.43%) and moderate injuries (ER=1.15%, 95%CI: 0.42%, 1.89%). Conclusion The increase in ambient temperature associates with injury occurrence, and the impact of temperature exhibits obvious heterogeneity among different populations, indicating that targeted intervention measures should be taken for different populations and types of injuries.

Background Air pollution is a major public health concern. Air Quality Health Index (AQHI) is a very important air quality risk communication tool. However, AQHI is usually constructed by single-pollutant model, which has obvious disadvantages. Objective To construct an AQHI based on the joint effects of multiple air pollutants (J-AQHI), and to provide a scientific tool for health risk warning and risk communication of air pollution. Methods Data on non-accidental deaths in Yunnan, Guangdong, Hunan, Zhejiang, and Jilin provinces from January 1, 2013 to December 31, 2018 were obtained from the corresponding provincial disease surveillance points systems (DSPS), including date of death, age, gender, and cause of death. Daily meteorological (temperature and relative humidity) and air pollution data (SO₂, NO₂, CO, PM_2.5, PM₁₀, and maximum 8 h O₃ concentrations) at the same period were respectively derived from China Meteorological Data Sharing Service System and National Urban Air Quality Real-time Publishing Platform. Lasso regression was first applied to select air pollutants, then a time-stratified case-crossover design was applied. Each case was matched to 3 or 4 control days which were selected on the same days of the week in the same calendar month. Then a distributed lag nonlinear model (DLNM) was used to estimate the exposure-response relationship between selected air pollutants and mortality, which was used to construct the AQHI. Finally, AQHI was classified into four levels according to the air pollutant guidance limit values from World Health Organization Global Air Quality Guidelines (AQG 2021), and the excess risks (ERs) were calculated to compare the AQHI based on single-pollutant model and the J-AQHI based on multi-pollutant model. Results PM_2.5, NO₂, SO₂, and O₃ were selected by Lasso regression to establish DLNM model. The ERs for an interquartile range (IQR) increase and 95% confidence intervals (CI) for PM_2.5, NO₂, SO₂ and O₃ were 0.71% (0.34%–1.09%), 2.46% (1.78%–3.15%), 1.25% (0.9%–1.6%), and 0.27% (−0.11%–0.65%) respectively. The distribution of J-AQHI was right-skewed, and it was divided into four levels, with ranges of 0-1 for low risk, 2-3 for moderate risk, 4-5 for high health risk, and ≥6 for severe risk, and the corresponding proportions were 11.25%, 64.61%, 19.33%, and 4.81%, respectively. The ER (95%CI) of mortality risk increased by 3.61% (2.93–4.29) for each IQR increase of the multi-pollutant based J-AQHI , while it was 3.39% (2.68–4.11) for the single-pollutant based AQHI . Conclusion The J-AQHI generated by multi-pollutant model demonstrates the actual exposure health risk of air pollution in the population and provides new ideas for further improvement of AQHI calculation methods.

Objective:To analyze the characteristics of child cases admitted to accidental injury and provide reliable basis for the prevention of accidental injury.Methods:The clinical data of children admitted to Hunan Children′s Hospital aged 0-18 due to accidental injuries from January 1, 2018 to December 31, 2021 were retrospectively analyzed. The type of accidental injury and characteristic factors such as prognosis, gender, age, time, and location of the child were analyzed.Results:A total of 9 049 children with accidental injury were admitted, accounting for 3.72%(9 049/33 697) of the total number of hospitalized children. The top three types of accidental injuries were falls/drop (3 695 cases), foreign bodies/suffocation (2 639 cases) and traffic accidents (1 165 cases), accounting for 82.87%(7 499/9 049). There were 8 760 cases (96.81%) of improvement and recovery, 178 cases (1.97%) of disability, and 111 cases (1.23%) of unhealed/dead. Among the accidental injuries, 5 833 cases (64.46%) were boys and 3 216 cases (35.54%) were girls, and the incidence ratio was 1.81∶1. There was significant difference between boys and girls in the composition ratio of the type of accidental injury such as falls/falls, foreign bodies/suffocation, poisoning, sharp object injury, drowning ( χ2 values were 3.90-20.56, all P<0.05). Among the accidental injuries, the children aged 1 to<3 years had higher accidental injuries than the other age groups (3 263 cases, accounting for 36.06%), and the composition ratio of accidental injuries in different age groups was different ( χ2 values were 12.98-573.97, all P<0.05). Among the accidental injuries, the accidental injuries occurred in the second quarter and the third quarter were higher than those in the other two quarters (4 892 cases, accounting for 54.06%), and the composition ratio of accidental injuries such as falls/falls, foreign bodies/suffocation, burn and scald, drowning occurred in different quarters was different ( χ2 values were 10.79-18.88, all P<0.05). In the case of accidental injuries, the family was the most likely place of accidental injury, with different types of accidental injuries occurring in different places ( χ2 values were 10.08-2 186.54, all P<0.05). Conclusions:Children′s unintentional injuries are most likely to occur in boys aged 1-<3 years, and fall/fall is the main injury type. Traffic accidents are the most important unintentional injury type leading to children′s unhealed/dead. Different injury types were related to child gender, age, quarter, and place of occurrence.Due to the differences in the occurrence mechanism and injury mode of accidental injuries in different countries and regions, and the majority of accidental injuries can be prevented, targeted preventive measures should be taken according to the characteristics of children′s accidental injuries in different regions, and a comprehensive prevention system for children′s accidental injuries should be constructed to ensure children′s safety.

Objective:To investigate the clinical effects of anterior cage inserting for old thoracolumbar fractures with kyphosis through facet joint approach.Methods:A retrospective analysis was conducted on 32 patients with old thoracolumbar fractures complicated with kyphosis admitted from January 2018 to December 2019, including 14 males and 18 females. The average age was 47.3±13.1 years (range, 26-70 years). Thoracolumbar injury classification (TLICS) scores of patients with initial injury were 3-5 points, with an average of 4.0 points. After 6.3±2.9 months (range, 3-16 months) conservative treatment, intractable thorax and lumbar or back pain still existed. Anterior cage inserting via articular protrusion was performed in 15 cases and posterior screw placement and bone grafting fusion of injured vertebrae was performed in 17 cases. Preoperative sagittal Cobb angle was 27.0°±3.9° and 26.8°±4.6° in the anterior cage inserting group and fixation on fractured vertebrae group ( t=0.07, P=0.946), respectively. Sagittal vertical axis (SVA) was 4.2±1.8 cm and 4.1±2.1 cm ( t=0.14, P=0.887), respectively. The number of patients with ASIA impairment scale (AIS) of the anterior cage inserting group before surgery was 1 in grade C, 4 in grade D and 10 in grade E. However, the number of that in fixation on fractured vertebrae group was 2 in grade C, 2 in grade D and 13 in grade E. There was no significant difference between the two groups (χ 2=1.34, P=0.520). Results:All 32 patients were followed up for 12.2±3.1 months in the anterior cage inserting group and 12.0±3.3 months in fixation on fractured vertebrae group. The operative duration of the anterior cage inserting group and fixation on fractured vertebrae was 128±24.5 min and 123±40.6 min ( t=0.42, P=0.681). The intraoperative blood loss was 485±12.6 ml and 478±16.3 ml ( t=0.13, P=0.894), respectively. At the last follow-up, the improvement rate of VAS score of the anterior cage inserting group was higher than that of fixation on fractured vertebrae group (90%±10% vs. 75%±20%, t=3.17, P=0.004). The height of anterior margin of injured vertebra in the two groups was increased by 1.02±0.10 cm and 0.29±0.14 cm, the change rate of anterior cage inserting group was higher than that of fixation on fractured vertebrae group (67.1%±31.5% vs. 19.0%±14.9%, t=16.29, P<0.001). The sagittal Cobb angle of the anterior cage inserting group was significantly lower than that of fixation on fractured vertebrae group (7.4°±1.5° vs. 11.6°±2.5°, t=-5.85, P<0.001). The SVA of anterior cage inserting group was lower than that of fixation on fractured vertebrae group (1.1±0.6 cm vs. 1.6±0.6 cm, t=2.35, P=0.025). There were 15 patients in AIS grade E in the anterior cage inserting group, while 1 patient in grade D and 16 patients in grade E in fixation on fractured vertebrae group without significant difference between the two groups (χ 2=0.83, P=0.706). Conclusion:The treatment of old thoracolumbar fractures with kyphosis through facet joint approach and anterior fixation could achieve satisfied effects and could relieve pain symptoms of thoracolumbar and back, compared with posterior fusion for injured vertebra with nail and bone grafting.

Objective:To investigate the changing characteristics and stages of balloon pressures in treatment of trigeminal neuralgia by percutaneous balloon compression (PBC), and explore the relations of balloon pressures at different stages with postoperative facial numbness and pain recurrence.Methods:A prospective analysis was performed. Thirty-two patients with primary trigeminal neuralgia, admitted to our hospital from May 2019 to May 2020, were chosen. During surgery, a manometer was connected with computer manometry software to continuously monitor the balloon pressure changes; pear-shaped stage and maintenance stage were named during the balloon pressure changes. The facial numbness occurrence and pain recurrence were assessed by Barrow Institute of Neurology (BNI) facial numbness and pain intensity scales. Robust evaluation method referred to American Institute for Clinical and Laboratory Standardization (CLSI) C28-A2 document was used to determine the reference ranges of balloon pressures at the pear-shaped stage, maintenance stage and whole-process stage (pear-shaped stage+maintenance stage). Spearman rank correlation test was used to analyze the correlations of balloon pressures at the pear-shaped stage, maintenance stage and whole-process stage with facial numbness 24 h and 12 months after surgery, and pain recurrence 6 and 12 months after surgery.Results:Among the 32 patients, pain relief was found in 31 patients and lateral numbness was found in 30 patients 24 h after surgery. Pain recurred 12 months after surgery in 2 patients. The reference ranges of pressure at pear-shaped stage, maintenance stage and whole-process stage were (157.2-128.5) kPa, (136.10-117.9) kPa and (141.9-119.9) kPa, respectively. The pressures at pear-shaped stage, maintenance stage and whole process stage were positively correlated with facial numbness 24 h and 12 months after surgery ( P<0.05); there were negative correlations between pressures at pear-shaped stage and whole-process stage and pain recurrence 6 months after surgery ( P<0.05); pressures at pear-shaped stage, maintenance stage and whole-process stage were negatively correlated with pain recurrence 12 months after surgery ( P<0.05). Conclusion:The lower the balloon pressure during PBC, the more likely it would have pain recurrence after surgery; and the higher the pressure, the more likely it would have facial numbness after surgery; the efficacy of PBC can be maximized when the balloon pressures maintains at adequate ranges ([157.2-128.5] kPa at the pear-shaped stage, [136.1-117.9] kPa at the maintenance stage and [141.9-119.9] kPa at the whole-process stage).

Objective:To analyze the feasibility and safety of microsurgical anastomosis for obstructive azoospermia (OA) patients with prior intracytoplasmic sperm injection (ICSI) failure.Methods:From September 2015 to May 2020, the data of 20 OA patients with previous ICSI-assisted pregnancy failure admitted to the Department of Andrology, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The characteristics of seminal tract microsurgical reconstruction were summarized, and the postoperative recurrence rate and clinical pregnancy rate were calculated.Results:Vasal obstruction was found in 8 patients and epididymal obstruction in 12 patients during microscopically reconstructed seminal tract. Among the patients with vasal obstruction, 1 patient developed OA after trauma and underwent laparoscopic-assisted right vasovasostomy (VV). Totally 7 patients developed OA after juvenile bilateral hernia, among whom 6 patients underwent further laparoscopic-assisted VV and 1 patient underwent vasovasostomy and epididymal cross anastomosis. Of the 8 patients who underwent VV, 6 achieved postoperative patency, and 2 couples achieved natural pregnancy. Patients with epididymal obstruction underwent microscopic vasoepididymostomy (VE), and 6 out of 12 patients achieved postoperative pregnancy, while 3 couples achieved natural pregnancy. No significant complications occurred in all patients during and after operation.Conclusion:Microsurgical anastomosis is an effective remedy for patients with OA after ICSI pregnancy failure, which can help patients achieve natural pregnancy.

Objective:To analyze the feasibility and safety of microsurgical anastomosis for obstructive azoospermia (OA) patients with prior intracytoplasmic sperm injection (ICSI) failure.Methods:From September 2015 to May 2020, the data of 20 OA patients with previous ICSI-assisted pregnancy failure admitted to the Department of Andrology, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The characteristics of seminal tract microsurgical reconstruction were summarized, and the postoperative recurrence rate and clinical pregnancy rate were calculated.Results:Vasal obstruction was found in 8 patients and epididymal obstruction in 12 patients during microscopically reconstructed seminal tract. Among the patients with vasal obstruction, 1 patient developed OA after trauma and underwent laparoscopic-assisted right vasovasostomy (VV). Totally 7 patients developed OA after juvenile bilateral hernia, among whom 6 patients underwent further laparoscopic-assisted VV and 1 patient underwent vasovasostomy and epididymal cross anastomosis. Of the 8 patients who underwent VV, 6 achieved postoperative patency, and 2 couples achieved natural pregnancy. Patients with epididymal obstruction underwent microscopic vasoepididymostomy (VE), and 6 out of 12 patients achieved postoperative pregnancy, while 3 couples achieved natural pregnancy. No significant complications occurred in all patients during and after operation.Conclusion:Microsurgical anastomosis is an effective remedy for patients with OA after ICSI pregnancy failure, which can help patients achieve natural pregnancy.

Objective:To know the status of knowledge， attitude and behavior related to sexual and reproductive health in high school students in three regions of East China， and to provide a reference for adolescent reproductive health education. Methods:From August to October in 2019， 614 high school students were invited from 6 high schools in Jiading District and Yangpu District， Shanghai and Taicang City， Jiangsu to participate in this study. We conducted an anonymous self-questionnaire survey using structured questionnaires based on adolescent reproductive health knowledge and literacy. Results:The male to female ratio of all high school students in the study was 1∶1.25， and the average age was （16.1±0.9） years old. The score of pregnancy and abortion knowledge was the lowest among the reproductive health knowledge scores， and the differences among the three regions were statistically significant （P=0.002）. Male high school students （P<0.001）， students in the school with reproductive health education base （P=0.008） and students who wanted to obtain reproductive health education （P=0.002） were more acceptable to premarital sex. The high school students obtained adolescent health knowledge mainly through the internet or mobile phones， and had a demand for reproductive health related services. Conclusion:High school students in the three regions have a more open attitude towards premarital sex， but have a poor grasp of correct and efficient contraceptive knowledge. Responsible departments need to strengthen the health education of relevant knowledge， and at the same time to find new forms of education to effectively improve the level of adolescent reproductive health.