The rapid development of intelligent ophthalmology research in recent years still faces some challenges in its clinical application or clinical translation process. Two important issues that urgently need to be addressed in the development of intelligent ophthalmology are: promoting clinical application and maintaining medical equity. In response to the aforementioned issues, this article analyzes the reasons and current situation of the insufficient promotion of clinical application and the potential challenges of medical equity, and proposes that promoting clinical application and maintaining medical equity are key issues in the development of intelligent ophthalmology. At the same time, it systematically proposes corresponding specific measures to promote the development of intelligent ophthalmology.

Glaucoma is an eye disease characterized by pathologically elevated intraocular pressure, optic nerve atrophy, and visual field defects, which can lead to irreversible vision loss. In recent years, the rapid development of artificial intelligence(AI)technology has provided new approaches for the early diagnosis and management of glaucoma. By classifying and annotating glaucoma-related images, AI models can learn and recognize the specific pathological features of glaucoma, thereby achieving automated image analysis and classification. Research on glaucoma imaging classification and annotation mainly involves color fundus photography(CFP), optical coherence tomography(OCT), anterior segment optical coherence tomography(AS-OCT), and ultrasound biomicroscopy(UBM)images. Color fundus photography is primarily used for the annotation of the optic cup and disc, OCT is used for measuring and annotating of the thickness of the retinal nerve fiber layer, and AS-OCT and UBM focus on the annotation of the anterior chamber angle structure and the measurement of anterior segment structural parameters. To standardize the classification and annotation of glaucoma images, enhance the quality and consistency of annotated data, and promote the clinical application of intelligent ophthalmology, this guideline has been developed. This guideline systematically elaborates on the principles, methods, processes, and quality control requirements for the classification and annotation of glaucoma images, providing standardized guidance for the classification andannotation of glaucoma images.

Cancer stands as a significant global public health challenge,and cancer screening serves as a pivotal strategy for reducing its mortality.Presently,only a limited number of cancer types have appropriate screening methods available.Traditional single-cancer screen-ing approaches are fraught with limitations,including invasiveness,low accuracy,and poor patient compliance.Multi-cancer early detection(MCED)leveraging liquid biopsy technology enables non-invasive and efficient early detection of multiple cancers by analyzing biomarkers such as cell-free DNA,cell-free RNA,proteins,and metabolites in blood and other bodily fluids.This innovative approach substantially broadens the spectrum of detectable cancers and enhances population coverage,showcasing immense potential for improving existing can-cer screening strategies.This expert consensus comprehensively reviews the progress of liquid biopsy-based MCED,biomarker selection and detection technologies,the criteria for cancer type selection,research design and clinical utility evaluation,as well as implementation path-ways.The overarching goal of this consensus is to offer scientific guidance for further research and the widespread adoption of MCED,thereby facilitating the continuous optimization of cancer screening strategies.

Objective:To summarize the long-term efficacy of nicotinamide in treating pediatric early-onset progressive encephalopathy with brain edema and (or) leukoencephalopathy-2 (PEBEL2) caused by NAXD gene variation .Methods:This was a case report conducted from February 2019 to January 2025. The long-term efficacy of nicotinamide was observed by following up a child with PEBEL2 who received the treatment in the Department of Neurology, Beijing Children′s Hospital Affiliated to Capital Medical University. The clinical data included changes in skin lesions, neurological symptoms. The modified Rankin scale (mRS) was used to evaluate the recovery of neurological function.Results:A boy was diagnosed with PEBEL2 caused by NAXD gene variation via genetic testing at Beijing Children′s Hospital Affiliated to Capital Medical University in February 2019, when he was 4 years and 6 months of age. Immediately after diagnosis, nicotinamide treatment was initiated at an initial dose of 100 mg/d, which was increased by 100 mg per week and gradually increased to 500 mg/d; meanwhile, other therapeutic drugs were gradually discontinued. After 1 year and 8 months of treatment, the child′s skin lesions had completely resolved; at the 2-year follow-up, dystonia in both upper limbs and swallowing dysfunction was alleviated significantly; by 2.5-year follow-up, his cognitive function also showed improvement. When the child was treated with 500 mg/d for 3 years, a rash appeared around the mouth. After the dose was reduced to 250 mg/d, the rash resolved, and the dose of 250 mg/d was maintained until the last follow-up. At the last follow-up in January 2025, the child was 10 years and 5 months of age. His mRS score decreased from 5 (before treatment) to 4. During the 6-year of continuous nicotinamide treatment, the child′s condition remained stable without progression. Drug-related skin rashes occurred, but no severe drug-related adverse reactions were observed.Conclusions:PEBEL2 is a treatable mitochondrial disease. Nicotinamide treatment can effectively improve skin lesions and neurological symptoms in PEBEL2 patients, and the long-term administration demonstrates a favorable safety profile.

Objective To observe the therapeutic effects and mechanisms of acupuncture at"Yanglingquan"(GB34)and"Zusanli"(ST36)on knee osteoarthritis(KOA)rats,focusing on the regulation of PTEN-induced kinase 1/Parkin(PINK1/Parkin)-mediated mitophagy in chondrocytes.Methods Ten out of 40 male SD rats were randomly selected as the normal group,and the remaining 30 rats were used to construct a KOA model.A total of 27 rats were successfully modeled.The successfully modeled rats were randomly divided into a model group,an acupuncture group(acupuncture at Yanglingquan and Zusanli),and an acupuncture+autophagy inhibitor(3-MA)group(acupuncture at Yanglingquan and Zusanli combined with intraperitoneal injection of 3-MA),with 9 rats in each group.After intervention,the morphology of cartilage tissue in each group was observed,and the Mankin's score of cartilage was assessed.The apoptosis rate of chondrocytes was calculated.Enzyme-linked immunosorbent assay(ELISA)was used to detect inflammatory factors[cyclooxygenase 2(COX-2),interleukin 1β(IL-1β),and tumor necrosis factor α(TNF-α)],oxidative damage indicators[nitric oxide(NO),superoxide dismutase(SOD),malondialdehyde(MDA),and glutathione peroxidase(GSH-Px)],and the levels of matrix metalloproteinase 3(MMP-3)and tissue inhibitor of metalloproteinase 1(TIMP-1).The DHE probe was used to measure reactive oxygen species(ROS)level.Polymerase chain reaction(PCR)was used to detect the mRNA expression levels of PTEN-induced kinase 1(PINK1),Parkin,and microtubule-associated protein 1 light chain 3-Ⅱ(LC3-Ⅱ)in cartilage tissue.Western blot was used to measure the protein expression levels of PINK1,Parkin,and LC3-Ⅱ in cartilage tissue.Results Compared with the normal group,the model group showed increased Mankin's score,apoptosis rate,COX-2 level,IL-1β and TNF-α levels,NO and MDA levels,MMP-3 and TIMP-1 levels,and ROS content,as well as decreased SOD and GSH-Px levels,and reduced mRNA and protein expressions of PINK1,Parkin and LC3-Ⅱ,with statistically significant differences(P＜0.05).Compared with the model group,the acupuncture group showed decreased Mankin's score,apoptosis rate,COX-2 level,IL-1β and TNF-α levels,NO and MDA levels,MMP-3 and TIMP-1 levels,and ROS content,as well as increased SOD and GSH-Px levels,and elevated mRNA and protein expressions of PINK1,Parkin and LC3-Ⅱ,with statistically significant differences(P＜0.05).Compared with the acupuncture group,the acupuncture+3-MA group showed increased Mankin's score,apoptosis rate,COX-2 level,IL-1β and TNF-α levels,NO and MDA levels,MMP-3 and TIMP-1 levels,and ROS content,as well as decreased SOD and GSH-Px levels,and mRNA and protein expressions of PINK1,Parkin and LC3-Ⅱ,with statistically significant differences(P＜0.05).Conclusion Acupuncture at"Yanglingquan"and"Zusanli"can inhibit chondrocyte apoptosis by activating PINK1/Parkin-mediated mitophagy,thus improving the condition of KOA rats.

With the rapid development of population aging in various countries around the world,the health and elderly care industry has been paid high attention.The standardization of smart health and elderly care technology and services is particularly important.This paper firstly reviewed the policies related to healthy elderly care in China.By analyzing the industrial standards and provincial standards issued,this paper focused on the policies proposed by the Shanghai Municipal Government for the standardization of smart health and elderly care,as well as the researches on the standard system and the construction of standard families.Shanghai group standards in the field of smart health and elderly care were summarized,including the guidelines for the construction of standard systems,elderly care service platforms,community elderly cafeterias,portable health monitoring terminals,indoor sports services,and home-based elderly care safety monitoring.A series of case analyses of the standardized implementation of the above aspects were also provided.Through standardization research and practice in recent years,it has been fully demonstrated that the standard research plays an important leading role in the field of smart health and elderly care.

Objective To evaluate the efficacy of narrow-band ultraviolet B(NB-UVB)phototherapy combined with enteric-coated thymopeptide in treatment of pityriasis rosea and its impacts on vascular cell adhesion molecule-1(VCAM-1)and intercellular adhesion molecule-1(ICAM-1).Methods Eighty patients with pityriasis rosea who were admitted to Haimen District People's Hospital from September 2022 to February 2024 were selected as research objects.They were divided into treatment group(n=41)and control group(n=39)according to random number table method.The control group was treated with NB-UVB phototherapy for one month,and the treatment group received NB-UVB phototherapy and enteric-coated thymopeptide for one month.The efficacy,rash-related time changes,symptom improvement,Pityriasis Rosea Severity Score(PRSS),VCAM-1 and ICAM-1 levels,and adverse events were compared between the two groups.Results The total effective rate of the treatment group was higher than that of the control group.The skin rash came to a halt and disappeared in a shorter time in the treatment group than in the control group,while the time to itch cessation in the treatment group was significantly longer than that in the control group(all P<0.05).The PRSS scores and levels of VCAM-1 and ICAM-1 in the treatment group were lower than those in the control group after treatment(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion NB-UVB phototherapy combined with enteric-coated thymopeptide can enhance the therapeutic effects on pityriasis rosea and reduce VCAM-1 and ICAM-1 levels.

Hypoxia-related diseases,such as altitude sickness,acute lung injury,and heart failure,have emerged as significant public health challenges worldwide and are strongly associated with increased mortality risks.These conditions tend to cause functional impairment and structural alterations in multiple organs,primarily due to inadequate oxygen supply or the inability of tissues to utilize oxygen effectively.To elucidate the pathophysiological mechanisms underlying hypoxia-associated diseases and to explore potential therapeutic strategies,researchers have employed animal models to conduct extensive mechanistic studies and drug development trials.In this review,we provide a comprehensive overview of the methods used to construct animal models for various hypoxia-related diseases.We made a thorough evaluation of the strengths,weaknesses,limitations,and applicability of each approach.In particular,we focus on modeling strategies for key pathologies such as altitude sickness,acute lung injury,pulmonary hypertension,and heart failure,discussing their respective advantages and restrains.Furthermore,we examined the potential application of gene editing technologies in optimizing animal models,especially its role in enhancing the accuracy and reproducibility of the models.The integration of these advanced technologies holds great promise for developing animal models with improved specificity and simulation of key features of diseases,which will serve as a solid foundation for basic research,drug screening,and preclinical trials concerning hypoxia-related diseases.Herein,we present a systematic summary and future outlook of animal models for hypoxia-related diseases,ultimately providing theoretical support for developing clinical treatment strategies and improving patient outcomes.

Objective To establish an animal model of hand,foot,and mouth disease(HFMD)in Syrian hamsters coinfected with coxsackievirus A6(CVA6)and coxsackievirus B1(CVB1).Methods 42 Syrian hamsters were divided into a CVA6 infection group,CVB1 infection group,CVA6 and CVB1 coinfection group and control group.A HFMD model was established by nasal instillation of virus solution and phosphate-buffered saline.Clinical and physiological indicators and detoxification status were monitored and recorded for 15 d,and animals were selected on day 7(D7)after infection for histopathology and viral antigen and nucleic acid testing.Results Hamsters in the single-infection and coinfection groups showed clinical symptoms similar to human HFMD.White blood cell,neutrophil,and lymphocyte result were characteristic of viral infection.Both viral nucleic acids were detected in throat swabs,feces,blood,and tissues and both viruses were isolated from fecal samples.Pathological damage and positive co-localization of CVA6 and CVB1 viral antigen proteins and nucleic acids were found in brain and other tissues.Conclusions Nasal instillation of a CVA6 and CVB1 mixture can successfully coinfect Syrian hamsters,replicate herpes infection similar to human HFMD,and cause pathological viral myocarditis and encephalitis damage.The result showed that the coinfection group was more seriously affected than the single-infection group,with worse clinical symptoms,increased viral replication,and obvious tissue pathological damage.This study provides a reference for further basic and clinical research into human enterovirus coinfection.

With the rapid development of artificial intelligence(AI),how to digitize the teaching of Medical Immunology is a new challenge posed by the times and education.This study is based on the advanced teaching model of Medical Immunology,which includes lectures-PAD class-flipped classrooms-expert lecture.By introducing knowledge mapping and AI teaching assistant into the entire learning process,the students not only deepen their understanding of the knowledge system of Medical Immunology,but also ex-ercise their ability to apply immunological knowledge to solve practical clinical problems,enhance their self-learning ability,expres-sion ability,communication ability,on-site performance ability,and cultivate a spirit of unity,cooperation,and exploration.The practice of empowering Medical Immunology teaching with digital intelligence achieves the integration of theory and application,the linkage between in class and out of class teaching,the connection between commonalities and individualities,and the union of abili-ties and qualities in Medical Immunology teaching.It also provides practical basis for exploring the implementation path of digital intel-ligence empowerment in Medical Immunology teaching.