Abstract The prevention and control of myopia in children and adolescents has become a national health strategy in China, and its prevention and management are transitioning from experience driven approaches to precise and intelligent strategies. Understanding the role of artificial intelligence (AI) in myopia prevention and control can provide a foundation for a comprehensive myopia prevention and control system. AI, with its powerful capabilities in data analysis and pattern recognition, shows significant potential in myopia risk prediction, screening and diagnosis, intervention support and behavior monitoring in children and adolescents. The article systematically summarizes the scientific evidence and consensus on the application of AI for myopia prevention and control in children and adolescents. From the perspective of public health practice, it proposes hierarchical expert recommendations for multiple scenarios including schools, families, communities and medical institutions, as well as policy and research with development. Furthermore, it discusses current challenges and future directions, aiming to provide a reference for building an intelligent, precise and fully covered comprehensive myopia prevention and control system in children and adolescents.

his cross-sectional study employed convenience sampling to enroll 1 994 community-dwelling older adults (aged ≥65 years) undergoing health examinations at a Guangzhou community hospital between January and December 2024, aiming to investigate associations between blood lipid profiles and cognitive impairment. Cognitive function was assessed using the AD8 scale, with demographic characteristics (age, sex, education, occupation), health status (hypertension, diabetes mellitus), and lifestyle factors (smoking/alcohol use) collected via questionnaires. Fasting blood samples quantified triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Propensity score matching (PSM) balanced baseline characteristics between lipid-level groups. Pre-PSM analyses revealed significant intergroup differences: TG groups differed in sex, BMI, alcohol use, hypertension, and self-rated health ( P<0.05); TC groups in sex, age, occupation, diabetes, and hypertension; LDL-C groups in sex, age, occupation, diabetes, hypertension, and daily living ability; HDL-C groups in sex, age, education, occupation, BMI, smoking, diabetes, and hypertension. Post-PSM adjustment eliminated baseline differences ( P>0.05). Multivariable logistic regression adjusted for demographic, clinical, and lifestyle factors demonstrated that elevated TG levels conferred a 48% reduced risk of cognitive dysfunction [ OR (95% CI): 0.52 (0.29-0.94)], whereas TC, LDL-C, and HDL-C showed no significant associations (all P>0.05). These findings suggest an inverse association between higher triglyceride levels and cognitive dysfunction risk in older adults, highlighting TG′s potential protective role in cognitive health.

Objective To establish an efficient and stable model of pelvic inflammatory disease in rats via a non-surgical method,and to evaluate its application in pharmacodynamic testing.Methods Female Sprague-Dawley rats were divided randomly into the following groups:control group;model group with phenol for 7 d;model group with phenol for 10 d;treatment group modeled with phenol;model group with low concentration of bacteria;model group with high concentration of bacteria;and treatment group modeled with bacteria.Rats in the model and treatment groups were injected with 25%phenol gel and 2×107 or 2×108 Escherichia coli and Staphylococcus aureus mixture via a non-surgical method,to construct a rat model of pelvic inflammatory disease.Rats in the treatment groups received the Chinese patent medicine Jingangteng capsules by gavage,and rats in the control group received the same volume of solvent solution.The health status,weight changes,and uterine appearance were monitored and the uterine coefficient was calculated.Pathological changes in the uterus and fallopian tubes,endometrial thickness,and number of glands were detected by hematoxylin and eosin staining.Serum levels of interleukin(IL)-1β,IL-6,and tumor necrosis factor(TNF)-α were detected by enzyme-linked immunosorbent assay.Protein expression of the macrophage marker CD68 was detected by immunofluorescence.Expression of Toll-like receptor 4(TLR4)/nuclear factor(NF)-κB pathway-related proteins in the uterus was detected by Western blot.Results The mortality rate in the model group was only 5%.Compared with the control group,model rats showed decreased body weight,increased uterine coefficient,pathological changes in the uterus and Fallopian tubes,thinner endometrium,fewer glands,significantly higher serum levels of IL-1β,IL-6,and TNF-α and more macrophages in the uterine tissue,and activation of the TLR4/NF-κB signaling pathway.The 7 d phenol and low-concentration bacterial solution models were judged to be mild pelvic inflammatory disease models,and the 10 d phenol and high-concentration bacterial solution models were considered severe pelvic inflammatory disease models.Treatment with Jingangteng capsules relieved the pathological symptoms in the uterus and fallopian tubes,in line with the efficacy evaluation of clinical pelvic inflammatory disease.Conclusions We established rat models of pelvic inflammatory disease using phenol and a mixed bacterial solution via a non-surgical method,to simulate the different pathological states of pelvic inflammatory disease caused by different factors.These models will be suitable for evaluating drug efficacy and elucidating the pathological mechanism of pelvic inflammatory disease.

Objective:To develop and validate the Pain nursing Competency Evaluation Questionnaire for Nursing Students to provide an effective tool for measuring the pain management competency of nursing students in China.Methods:The questionnaire was constructed through literature review, semi-structured interviews, focus group discussions, Delphi expert consultation, and a pre-survey. From September 2023 to January 2024, a convenience sampling method was used to select 250 nursing students from Hangzhou Normal University and Lishui University in Zhejiang Province for the survey. Reliability and validity of the developed questionnaire were tested. A random sample of 30 nursing students was selected for retesting after two weeks.Results:A total of 10 female experts were consulted through correspondence. The Pain Care Competency Evaluation Questionnaire for nursing students consists of 36 items. Through exploratory factor analysis, five common factors were extracted: pain health education, comprehensive pain assessment, pain screening and assessment, analgesic interventions, and analgesic side effects nursing, which together explained 61.695% of the variance. The content validity of the questionnaire was 0.96, and the item-level content validity index ranged from 0.900 to 1.000. The overall Cronbach′s α coefficient was 0.924, and the Cronbach′s α coefficients for the five dimensions ranged from 0.856 to 0.915. The test-retest reliability was 0.831. Conclusions:The Pain Care Competency Evaluation Questionnaire for nursing students developed in this study has good reliability and validity. It can be used as a tool to assess nursing students′ competency in pain care and provides a reference for the design and optimization of pain care courses and clinical practice programs for nursing students in undergraduate institutions.

Objective:To investigate the possible mechanism of Zaogong Erteng decoction (ZGETD) in the treatment of endometritis.Methods:Femal mice were injected 2.5 mg/mL lipopolysaccharide into uterine horn to induce endometritis model. After modelling, low-dose ZGETD, high-dose ZGETD or amoxicillin was given once a day for 7 d. The appearance of the uterus and pathological changes of uterine tissue were observed 7 d later, and the uterine index was calculated. The expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 in mouse uterine tissue was detected by enzyme-linked immunosorbent assay. The activity of myeloperoxidase (MPO) in mouse uterine tissue was measured by redox reaction. The active ingredients of ZGETD and the target and signal pathway of treatment of endometritis were analyzed by network pharmacology. Western blotting and qRT-PCR were used to detect the expressions of Toll-like receptor 4 (TLR4), P65, p-P65, interferon regulatory factor 3 (IRF3) and p-IRF3 proteins and chemokines CXCL5 and CXCL8 in the mouse uterus, respectively. Terminal dUTP nick end labeling detected endometrial cell apoptosis and endometrial thickness was measured. After treatment, the female rats were mated with the male rats, and the mating rate, the pregnancy rate and the number of implantation sits in the injected uterine horn on day 8 of gestation were counted. Results:Both ZGETD and amoxicillin have atherapeutic effect on endometritis, but compared with low-dose ZGETD and amoxicillin, high-dose ZGETD can significantly alleviate the edema and congestion of uterine tissue and reduce the uterine index (all P=0.001). After treatment, the uterine cavity epithelium of mice was smooth and complete, the uterine gland structure was normal, and no bleeding area and inflammatory cell aggregation were observed. Compared with amoxicillin, high-dose ZGETD significantly decreased the expression of inflammatory factors (TNF-α, IL-1β and IL-6) and MPO activity (all P<0.001). The expression of chemokines ( CXCL5 and CXCL8) was significantly reduced (all P<0.05). The signaling pathways TLR4, nuclear factor kappa-B (NF-κB) and TNF related to the treatment of endometritis by ZGETD were screened by network pharmacology, and their action targets (TLR4, NF-κB and IRF3) were verified. Quercetin, fisetin and luteolin were found to be the most active ingredients acting on these targets. High-dose ZGETD significantly inhibited the activation of TLR4/NF-κB and TLR4/IRF3 pathways ( P<0.05), decreased endometrial cell apoptosis ( P<0.05), and increased endometrial thickness ( P<0.001), mating rate ( P<0.001), pregnancy rate ( P<0.001) and implantation site number of uterine horn on the injection side of LPS after treatment ( P=0.001). Conclusion:High-dose ZGETD has a significant therapeutic effect on endometritis, which may be closely related to the down-regulation of TLR4 signaling pathway.

Intrauterine adhesions are adhesions of the uterine wall caused by damage to the basal layer of the endometrium, which will affect women's menstruation and fertility. At present, the effect of surgery and drug treatment is not ideal, and it is easy to relapse. Platelet-rich plasma (PRP) is a kind of plasma with high concentration of platelets obtained by centrifuging autologous blood, containing a variety of bioactive factors (platelet-derived growth factor, transforming growth factor-β, vascular endothelial growth factor, insulin-like growth factor 1, etc.), which can significantly promote cell proliferation and differentiation, angiogenesis, relieve inflammation and prevent infection, reduce fibrosis and be used as biological scaffold in the treatment of uterine adhesion. It can significantly improve endometrial morphology, reduce fibrosis and improve fertility. In view of the advantages of PRP in the treatment of intrauterine adhesions, this paper will discuss the characteristics, mechanism and application of PRP in the treatment of intrauterine adhesions, so as to further understand the important role of PRP in the treatment of intrauterine adhesions and lay a foundation for its clinical application.

The menopausal age is one of the important menopausal factors, and women of different menopausal ages have different risks of diabetes. This study reviewed the evidence from prospective studies on the association between the age at natural menopause and diabetes risk, both domestically and internationally, and presented its research design and main findings. Advanced menopause, especially premature and early menopause, will increase the risk of diabetes in postmenopausal women. The research on the influence of delayed menopause on the incidence of diabetes is still insufficient. Many factors may modify the association between menopausal age and the risk of diabetes.

Objective To explore the interaction between vitamin D(VD)and hemoglobin A1c(HbA1c)and its relationship with type 2 diabetes mellitus(T2DM)combined with osteoporosis(OP).Methods A total of 228 T2DM patients admitted to our hospital from February 2020 to April 2023 were selected and divided into OP group(n=65),osteopenia group(n=89)and T2DM group(n=74)according to the standard deviation of bone mineral density(BMD)decline.Logistic regression was used to analyze the relationship of 25-hydroxyvitamin D[25(OH)D]and HbA1c with OP.Restricted cubic spline model was used to analyze the dose-response relationship of 25(OH)D and HbA1c with OP in different genders.Results DM duration,fasting plasma glucose(FPG),C-telopeptide of type Ⅰ collagen,fasting insulin(FIns)and 2 hIns in the T2DM,osteopenia and OP groups were increased(P<0.05),while osteocalcin,25(OH)D,lumbar L1～L4,BMD of femoral neck and its proximal end,and total hip were decreased(P<0.05).The age and HbA1c in OP group were higher than those in T2DM and osteopenia groups(P<0.05),and the proportion of taking calcium preparations was lower than that in T2DM group(P<0.05).Logistic regression analysis showed that after adjusting for confounding factors,serum 25(OH)D(OR 0.145,95%CI 0.036～0.204)and HbA1c(OR 1.108,95%CI 1.013～1.140)were influencing factors of OP in T2DM patients.There was no nonlinear dose-response relationship between 25(OH)D,HbA1c and OP both in male and female T2DM patients.There were multiplication and additive interactions between serum 25(OH)D and HbA1c(P<0.05).Conclusions There is a multiplicative and additive interaction between serum 25(OH)D and HbA1c,both of which are risk factors for concurrent OP in T2DM patients.

For TCM to go global,while carrying forward its own characteristics,it should also build a set of measurement methods recognized by the international medical field.PRO scale is more and more widely used in the field of traditional Chinese medicine because there are many confluence points between PRO scale and TCM connotation.The patient-reported outcomes measurement information system(PROMIS)provides a reference for the development of PRO scales in the field of TCM.We can learn from the methods and models relied on by PROMIS and build a PRO evaluation system for TCM diseases based on TCM culture,so as to promote the standardization,standardization and modernization of TCM.

Objectives:To investigate association of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) with the stroke severity and short-term outcome in patients with acute ischemic stroke (AIS), and to evaluate the predictive value of NHHR for outcome.Methods:Patients with the first-ever AIS admitted to the Affiliated Hospital of Qingdao University from June 2018 to June 2024 whose etiological types were large artery atherosclerosis (LAA), small vessel occlusion (SVO) and cardiac embolism (CE) were included retrospectively. According to the National Institutes of Health Stroke Scale (NIHSS) score at admission, the patients were divided into mild stroke group (≤8) and moderate to severe stroke group (>8). According to the modified Rankin Scale score at discharge, they were divided into good outcome group (≤2) and poor outcome group (>2). Multivariate logistic regression analysis was use to determine the independent correlation between NHHR and stroke severity and short-term outcome in patients with AIS. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of NHHR for short-term poor outcome in overall patients with AIS and different etiological subtypes. Results:A total of 2 865 patients with AIS were enrolled, including 1 925 males (67.2%), aged (61.00 ± 10.17) years. 2 483 patients (86.67%) had mild stroke and 382 (13.33%) had moderate to severe stroke; 2 161 (75.43%) had good short-term outcome, while 704 (24.57%) had poor short-term outcome. Multivariate logistic regression analysis showed that NHHR was significantly and independently associated with moderate to severe stroke (odds ratio [ OR] 2.251, 95% confidence interval [ CI] 1.895-2.675; P<0.001) and poor short-term outcome ( OR 3.454, 95% CI 2.936-4.063; P<0.001). ROC curve analysis showed that NHHR had a high predictive value for short-term poor outcome in patients with AIS (the area under the curve [AUC] 0.764, 95% CI 0.745-0.784), and it also demonstrated high predictive value in patients with various etiological types such as LAA (AUC=0.755, 95% CI 0.730-0.781), SVO (AUC=0.801, 95% CI 0.777-0.824) and CE (AUC=0.797, 95% CI 0.774-0.820). Conclusion:NHHR is significantly correlated with the severity of stroke and poor short-term outcome in patients with AIS, and has a high predictive value for poor short-term outcome.