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.

Objectives:To evaluate the outcomes of cochlear implantation in prelingually deafened late-implanted patients with regular cochlear implant use and to analyze the influencing factors of rehabilitation effects.Methods:This before-after self-controlled study design included 60 subjects, comprising 36 males and 24 females, who had received cochlear implantation at Chinese PLA General Hospital. Post-implantation, all patients demonstrated continuous and regular use of cochlear implants (≥8 hours daily). Rehabilitation outcomes were evaluated by using the Categories of Auditory Performance scale (CAP), Meaningful Auditory Integration Scale (MAIS), Speech Intelligibility of Rating scale (SIR), Meaningful Use of Speech Scale (MUSS) and speech recognition score (SRS) in 2018 and 2023. 9 potential risk factors were analyzed by univariate analysis with SPSS 25.0. The influencing factors associated with outcomes were evaluated through multivariate logistic regression.Results:Longitudinal data of 60 participants followed-up in 2018 and 2023 were analyzed. The average duration of cochlear implant use for all patients was (11.3±3.0) years. The mean score of CAP, SIR and MUSS improved significantly over time. The mean CAP score before surgery was (1.0±0.9). From 2018 to 2023, the mean CAP score improved from (5.1±1.4) to (5.9±1.6), with a statistical significance ( P<0.01); the mean SIR score before surgery was (1.3±0.5), and the mean SIR score improved from (2.7±1.1) to (3.2±1.3), with a statistical significance ( P<0.01); the mean MUSS score increased from (16.8±9.7) to (21.1±10.9) between the two follow-ups, with a statistical significance ( P<0.01); the MAIS was only initiated in the 2023 follow-up, with a mean score of (31.0±10.2). The speech recognition score for monosyllabic words increased from (23.9±16.0)% to (25.2±13.0)%, with no statistically significant difference ( P=0.66). Preoperative residual hearing significantly predicted rehabilitation outcomes at univariate analysis ( P<0.05), but the statistical significance was lost at multivariate analysis ( P>0.05). Age at implantation was identified as an independent predictive factor by both univariate and multivariate analysis (Hazard Ratio, 0.88; 95% Confidence Interval 0.79-0.97; P=0.014). The cut-off point for predicting further rehabilitation effects was 19.2 years old. In the correlation analysis of different scales, the CAP score was positively correlated with the total score of MAIS. So were the SIR score and the total score of MUSS. Conclusions:For prelingually deafened late-implanted patients with regular CI use, there was still potential for further improvement of auditory and speech abilities even after 10 years post-implantation. Age at implantation was an independent predictive factor and the cut-off point was 19.2 years old.

Objective To explore the prescription and preparation technology of compound Bupleurum suppository and draft its quality standard.Methods The volatile oil of Bupleurum was extracted by steam distillation,and the compound Bupleurum-based suppository was prepared by mixing the volatile oil with taurine using the melting method.The quality standard of the preparation was formulated according to the quality inspection items of the general rule 0107 of the Pharmacopoeia of the People's Republic of China(2020 Edition,Volume IV);The contents of n-hexanoic acid and n-heptanoic acid in the preparation were determined by gas chromatography-mass spectrometry(GC-MS).The content of taurine in the preparation was determined by high-performance liquid chromatography(HPLC).Results The optimized distillation time of the volatile oil was 1.5 h,The linear ranges of n-hexanoic acid,n-heptanoic acid and taurine are 23.175 0-115.875 0 μg·mL-1(R2=0.999 4),4.590 0-68.850 0 μg·mL-1(R2=0.998 9)and 15-125 μg·mL-1(R2=0.999 6),respectively.The average recoveries are 99.83%,101.96%,98.89%with RSDs of 2.84%,1.36%,2.88%,respectively.The RSDs of precision,stability,and repeatability tests are less than 5%.The properties,mass difference,melting time,microbial limit,and stability assessment of the preparationwere all in accordance with the Pharmacopoeia of the People's Republic of China.Conclusion Compound Bupleurum suppository preparation technology is reasonable and feasible,which meets the quality standard.

Objectives:To describe, analyze, and compare the temporal trends of age and sex-specific burden of Otitis media(OM) in China and globally from 1992 to 2021.Methods:Data from the Global Burden of Disease(GBD) database from 1992 to 2021 were used to analyze the characteristics of OM burden in China and globally, including changes in incidence, prevalence, mortality, and disability-adjusted life years(DALYs). Epidemiological characteristics of OM were analyzed using methods such as Joinpoint analysis, age-period-cohort models, and decomposition analysis. Autoregressive Integrated Moving Average(ARIMA) models were used to forecast the incidence and prevalence rates over the next 15 years.Results:From 1992 to 2021, the age-standardized incidence rate (ASIR) of OM in China decreased from 4 183.54/100, 000 to 4 179.92/100, 000, while, the global ASIR increased from 5 345.09/100, 000 to 5 529.1/100, 000. The age-standardized prevalence rate (ASPR) in China decreased from 1 835.2/100, 000 to 1 332.11/100, 000, while, the global ASPR decreased from 1 786.56/100, 000 to 1 593.74/100, 000. The age-standardized mortality rate (ASMR) in China decreased from 0.01/100, 000 to 0, while, the global ASMR decreased from 0.03/100, 000 to 0.01/100, 000. The age-standardized DALY rate (ASDR) in China decreased from 37.39/100, 000 to 26.53/100, 000, while, the global ASDR decreased from 37.68/100, 000 to 32.54/100, 000. The average annual percent change (AAPC) for ASIR, ASPR, ASMR, and ASDR in China were -0.003%, -1.101%, -9.803%, and -1.178%, respectively, while, globally the AAPC were 0.116%, -0.395%, -4.396%, and -0.506%, respectively. The impact of age and sex on the burden of OM varied. The incidence rate was highest in children, especially in the group under 5 years old, followed by the elderly. The incidence and mortality of OM were higher in females than in males. Decomposition analysis indicated that the main factor contributing to the decline in DALYs in China was epidemiological changes, while, the main factor contributing to the increase in global DALYs was population growth. Over the next 15 years, it might be predicted that the prevalence of OM will decrease in both China and globally, with a decrease in incidence in China and an increase in the global incidence.Conclusion:From 1992 to 2021, the incidence, prevalence, mortality, and DALYs of OM in China have generally shown a declining trend, indicating a gradual reduction in the disease burden of OM in China. The disease burden of OM is age-related, with the highest incidence and prevalence observed in children and a higher mortality rate in the elderly population. OM remains a significant public health challenge in China.

Objectives:To evaluate the outcomes of cochlear implantation in prelingually deafened late-implanted patients with regular cochlear implant use and to analyze the influencing factors of rehabilitation effects.Methods:This before-after self-controlled study design included 60 subjects, comprising 36 males and 24 females, who had received cochlear implantation at Chinese PLA General Hospital. Post-implantation, all patients demonstrated continuous and regular use of cochlear implants (≥8 hours daily). Rehabilitation outcomes were evaluated by using the Categories of Auditory Performance scale (CAP), Meaningful Auditory Integration Scale (MAIS), Speech Intelligibility of Rating scale (SIR), Meaningful Use of Speech Scale (MUSS) and speech recognition score (SRS) in 2018 and 2023. 9 potential risk factors were analyzed by univariate analysis with SPSS 25.0. The influencing factors associated with outcomes were evaluated through multivariate logistic regression.Results:Longitudinal data of 60 participants followed-up in 2018 and 2023 were analyzed. The average duration of cochlear implant use for all patients was (11.3±3.0) years. The mean score of CAP, SIR and MUSS improved significantly over time. The mean CAP score before surgery was (1.0±0.9). From 2018 to 2023, the mean CAP score improved from (5.1±1.4) to (5.9±1.6), with a statistical significance ( P<0.01); the mean SIR score before surgery was (1.3±0.5), and the mean SIR score improved from (2.7±1.1) to (3.2±1.3), with a statistical significance ( P<0.01); the mean MUSS score increased from (16.8±9.7) to (21.1±10.9) between the two follow-ups, with a statistical significance ( P<0.01); the MAIS was only initiated in the 2023 follow-up, with a mean score of (31.0±10.2). The speech recognition score for monosyllabic words increased from (23.9±16.0)% to (25.2±13.0)%, with no statistically significant difference ( P=0.66). Preoperative residual hearing significantly predicted rehabilitation outcomes at univariate analysis ( P<0.05), but the statistical significance was lost at multivariate analysis ( P>0.05). Age at implantation was identified as an independent predictive factor by both univariate and multivariate analysis (Hazard Ratio, 0.88; 95% Confidence Interval 0.79-0.97; P=0.014). The cut-off point for predicting further rehabilitation effects was 19.2 years old. In the correlation analysis of different scales, the CAP score was positively correlated with the total score of MAIS. So were the SIR score and the total score of MUSS. Conclusions:For prelingually deafened late-implanted patients with regular CI use, there was still potential for further improvement of auditory and speech abilities even after 10 years post-implantation. Age at implantation was an independent predictive factor and the cut-off point was 19.2 years old.

Objectives:To describe, analyze, and compare the temporal trends of age and sex-specific burden of Otitis media(OM) in China and globally from 1992 to 2021.Methods:Data from the Global Burden of Disease(GBD) database from 1992 to 2021 were used to analyze the characteristics of OM burden in China and globally, including changes in incidence, prevalence, mortality, and disability-adjusted life years(DALYs). Epidemiological characteristics of OM were analyzed using methods such as Joinpoint analysis, age-period-cohort models, and decomposition analysis. Autoregressive Integrated Moving Average(ARIMA) models were used to forecast the incidence and prevalence rates over the next 15 years.Results:From 1992 to 2021, the age-standardized incidence rate (ASIR) of OM in China decreased from 4 183.54/100, 000 to 4 179.92/100, 000, while, the global ASIR increased from 5 345.09/100, 000 to 5 529.1/100, 000. The age-standardized prevalence rate (ASPR) in China decreased from 1 835.2/100, 000 to 1 332.11/100, 000, while, the global ASPR decreased from 1 786.56/100, 000 to 1 593.74/100, 000. The age-standardized mortality rate (ASMR) in China decreased from 0.01/100, 000 to 0, while, the global ASMR decreased from 0.03/100, 000 to 0.01/100, 000. The age-standardized DALY rate (ASDR) in China decreased from 37.39/100, 000 to 26.53/100, 000, while, the global ASDR decreased from 37.68/100, 000 to 32.54/100, 000. The average annual percent change (AAPC) for ASIR, ASPR, ASMR, and ASDR in China were -0.003%, -1.101%, -9.803%, and -1.178%, respectively, while, globally the AAPC were 0.116%, -0.395%, -4.396%, and -0.506%, respectively. The impact of age and sex on the burden of OM varied. The incidence rate was highest in children, especially in the group under 5 years old, followed by the elderly. The incidence and mortality of OM were higher in females than in males. Decomposition analysis indicated that the main factor contributing to the decline in DALYs in China was epidemiological changes, while, the main factor contributing to the increase in global DALYs was population growth. Over the next 15 years, it might be predicted that the prevalence of OM will decrease in both China and globally, with a decrease in incidence in China and an increase in the global incidence.Conclusion:From 1992 to 2021, the incidence, prevalence, mortality, and DALYs of OM in China have generally shown a declining trend, indicating a gradual reduction in the disease burden of OM in China. The disease burden of OM is age-related, with the highest incidence and prevalence observed in children and a higher mortality rate in the elderly population. OM remains a significant public health challenge in China.

Objective To explore the prescription and preparation technology of compound Bupleurum suppository and draft its quality standard.Methods The volatile oil of Bupleurum was extracted by steam distillation,and the compound Bupleurum-based suppository was prepared by mixing the volatile oil with taurine using the melting method.The quality standard of the preparation was formulated according to the quality inspection items of the general rule 0107 of the Pharmacopoeia of the People's Republic of China(2020 Edition,Volume IV);The contents of n-hexanoic acid and n-heptanoic acid in the preparation were determined by gas chromatography-mass spectrometry(GC-MS).The content of taurine in the preparation was determined by high-performance liquid chromatography(HPLC).Results The optimized distillation time of the volatile oil was 1.5 h,The linear ranges of n-hexanoic acid,n-heptanoic acid and taurine are 23.175 0-115.875 0 μg·mL-1(R2=0.999 4),4.590 0-68.850 0 μg·mL-1(R2=0.998 9)and 15-125 μg·mL-1(R2=0.999 6),respectively.The average recoveries are 99.83%,101.96%,98.89%with RSDs of 2.84%,1.36%,2.88%,respectively.The RSDs of precision,stability,and repeatability tests are less than 5%.The properties,mass difference,melting time,microbial limit,and stability assessment of the preparationwere all in accordance with the Pharmacopoeia of the People's Republic of China.Conclusion Compound Bupleurum suppository preparation technology is reasonable and feasible,which meets the quality standard.

A local context fusion based segmentation model which uses a local context attention mechanism to filter out irrelevant feature information and enhance the attention to important regions is presented for accurate polyp segmentation. The features at different scales are captured by multi-kernel dilated convolution for improving the accuracy of polyp boundary segmentation. Pyramid context selection module utilizes shallow encoder features to compensate for the low-level information lost by the deeper encoder,enabling the model to adapt to polyps of various sizes. The proposed model achieves accuracies of 97.67％,97.19％ and 99.23％ on Kvasir-SEG,EndoScene and CVC-ClinicDB datasets,respectively,with mIoU of 91.20％,88.31％ and 94.75％,respectively,exhibiting higher accuracy and generalizability than the existing classical methods and validating its superior performance in polyp segmentation. The proposed model can improve polyp segmentation accuracy and provide a more accurate aid for polyp segmentation.

A local context fusion based segmentation model which uses a local context attention mechanism to filter out irrelevant feature information and enhance the attention to important regions is presented for accurate polyp segmentation. The features at different scales are captured by multi-kernel dilated convolution for improving the accuracy of polyp boundary segmentation. Pyramid context selection module utilizes shallow encoder features to compensate for the low-level information lost by the deeper encoder,enabling the model to adapt to polyps of various sizes. The proposed model achieves accuracies of 97.67％,97.19％ and 99.23％ on Kvasir-SEG,EndoScene and CVC-ClinicDB datasets,respectively,with mIoU of 91.20％,88.31％ and 94.75％,respectively,exhibiting higher accuracy and generalizability than the existing classical methods and validating its superior performance in polyp segmentation. The proposed model can improve polyp segmentation accuracy and provide a more accurate aid for polyp segmentation.

Objective To compare the clinical effects of arthroscopically-assisted reduction and internal fixation(ARIF)combined with enhanced recovery after surgery(ERAS)and open reduction and internal fixation surgery(ORIF)in the treatment of posterior lateral tibial plateau fractures.Methods Seventy patients with posterior lateral tibial plateau fractures in the Department of Orthopaedics,Xuzhou Central Hospital,from January 2020 to November 2022 were retrospectively selected and divided into ARIF group(with ERAS,n=32)and ORIF group(without ERAS,n=38)according to the treatment methods.All patients were evaluated for fracture type by imaging examination after admission.The operation time,length of hospital stay,early postoperative pain score(evaluated by visual analogue scale[VAS]),knee joint function(evaluated by hospital for special surgery[HSS]scale)at 3 months and thigh circumference difference at 6 months postoperatively were compared between the two groups.Results The operation time in the ARIF group was significantly shorter than that in the ORIF group([67.84±9.89]min vs[85.16±9.18]min,P＜0.001),and the length of hospital stay was significantly shorter in the ARIF group([7.13±1.41]d vs[8.74±1.84]d,P＜0.001).On the third day after operation,the VAS score in the ARIF group was significantly lower than that in the ORIF group([4.00±1.44]vs[5.39±1.24],P＜0.001).ARIF group had better joint function than ORIF group 3 months after operation,and the difference of 10 cm thigh circumference on patella in ARIF group was smaller than that in ORIF group 6 months after operation.Conclusions Compared to ORIF,patients with posterior lateral tibial plateau fractures treated with ARIF combined with ERAS showed faster postoperative recovery,shorter hospital stay,and more precise clinical efficacy.