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.

Abstract Myopia is a complex disease influenced by multiple factors, and its prevention and control require a thorough identification and monitoring of its risk factors. The paper examines the defocus characteristics of the visual environment and their association with myopia among children and adolescents, and further describes their role in the prevention and control of myopia, as well as analyses the limitations of the current study and proposes directions for further research. Finally, the paper calls attention to the etiological significance of the defocus characteristics in the visual environment during the development of myopia among children and adolescents, which could provide a scientific basis for optimizing the learning environment and designing other measures to promote myopia prevention and control among children and adolescents.

Objective: To explore the association between sleep quality and dry eye symptoms in adolescents,so as to provide the evidence for reducing the prevalence of dry eye symptoms. Methods: The study population was adolescents aged 12-24 years from the Psychology and Behavior Investigation of Chinese Residents (PBICR) survey, which was conducted from 20 June to 31 August 2022. A stratified random sampling and quota sampling method was used to select 6 456 adolescents within mainland China. The Ocular Surface Disease Index (OSDI) and Brief version of the Pittsburgh Sleep Quality Index (B-PSQI) were used to assess dry eye symptoms and sleep quality. Multiple Logistic regression model was used to explore the relationship between sleep quality and dry eye symptoms in adolescents. The influence of gender on the association was explored by using interaction terms. Results: A total of 2 815 adolescents reported having dry eye symptoms, with a prevalence of 43.6%. Logistic regression analysis results showed an increased risk of exacerbation of dry eye symptoms in adolescents with poor sleep quality. The OR (95% CI ) for mild, moderate, and severe dry eye symptoms groups were 1.39(1.16-1.67), 1.52(1.28-1.81), and 2.35(2.02-2.72), respectively, compared with the ocularly normal group ( P <0.05). There was a significant interaction between sleep quality and gender on dry eye symptoms in adolescents ( P <0.01). Conclusions Sleep quality is associated with dry eye symptoms in adolescents, and those with poor sleep quality have a higher risk of dry eye symptoms. The effect of sleep quality on dry eye symptoms is greater in boys.

Objective To investigate the efficacy and safety of conventional open Latarjet surgery,arthroscopic Latarjet surgery,arthroscopic Bankart repair combined with Remplissage surgery in the treatment of recurrent anterior shoulder dislocation(RASD)with scapula glenoid bone defect>15%and meshing Hill-Sachs lesion.Methods The clinical data of 65 patients with RASD with 15%～25%scapula glenoid bone defect and meshing Hill-Sachs lesion admitted to our hospital from January 2022 to December 2024 were retrospectively analyzed.They were divided into group A,group B,and group C according to different surgical methods.Among them,group A underwent conventional open Latarjet surgery(n=18),group B underwent arthroscopic Latarjet surgery(n=21),and group C underwent arthroscopic Bankart repair combined with Remplissage surgery(n=26).The surgical conditions,preoperative and postoperative scores of related scales[visual analogue scale(VAS),Constant-Murley shoulder score,the University of California Los Angeles(UCLA)shoulder score],shoulder range of motion,postoperative complications and recurrence were compared among the three groups.Results Operation time:group B was longer than group A and group C(P<0.05),and group A was longer than group C(P<0.05).Intraoperative blood loss and hospital stay:group A was more or longer than group B and group C(P<0.05),group B was more or longer than group C(P<0.05).The VAS scores of the three groups at 1,6 and 12 months after operation were lower than those before operation(P<0.05).Pain VAS score at 1 and 6 months after operation:group A was higher than group B and group C(P<0.05).Pain VAS score at 1 month after operation:group B was higher than group C.Pain VAS score at 12 months after operation:there was no significant difference among the three groups(P>0.05).The UCLA shoulder scores of group A at 6 and 12 months after operation and group B and group C at 1,6 and 12 months after operation were higher than those before operation(P<0.05).UCLA score at 1 month after operation:group A0.05).The Constant-Murley scores of group A at 6 and 12 months after operation and group B and group C at 1,6 and 12 months after operation were higher than those before operation(P<0.05).Constant-Murley score at 1 month after operation:group A was lower than group B and group C(P<0.05).Constant-Murley score at 6 and 12 months after operation:three groups were equivalent(P>0.05).Forward flexion and lifting range of motion in the three groups:at 12 months after operation>before operation(P<0.05).Forward flexion and lifting range of motion was evaluated at 12 months after operation:there was no significant difference among the three groups(P>0.05).The range of motion of external rotation at body side and external rotation at 90° abduction before operation and at 12 months after operation:there was no significant difference between group A and group B(P>0.05).External rotation at body side and external rotation at 90° abduction of group C:at 12 months after operation of it was less than that before operation(P<0.05).The range of motion of external rotation at body side and external rotation at 90° abduction was obtained at 12 months after operation:group A and group B were greater than group C(P<0.05).Postoperative complication rate and recurrence rate:three groups were equivalent(P>0.05).Conclusion Conventional open Latarjet surgery,arthroscopic Latarjet surgery,arthroscopic Bankart repair combined with Remplissage surgery can effectively improve shoulder joint function and relieve pain in the treatment of RASD with 15%～25%scapula glenoid bone defect and meshing Hill-Sachs lesion.However,the two shoulder arthroscopic procedures are less traumatic and have faster postoperative recovery.

Objective:To explore the feasibility of using a simplified multiple sleep latency test (MSLT) for the diagnosis of narcolepsy type 1.Methods:Data from 158 patients with narcolepsy type 1 and 58 patients with non-type 1 narcolepsy who underwent overnight video-polysomnography (V-PSG) and MSLT in the Sleep Center, Department of Neurology, Xijing Hospital, Air Force Military Medical University from March 2019 to April 2024 were retrospectively collected. By reducing the number of naps in the MSLT, the diagnostic consistency between the simplified MSLT and the standard 5-nap MSLT was evaluated using the receiver operating characteristic (ROC) curve. The DeLong test was used to compare whether there was a statistically significant difference between the simplified MSLT and the standard 5-nap MSLT. Cohen′s Kappa statistical analysis was performed to compare the diagnostic consistency between the simplified MSLT and the standard 5-nap MSLT.Results:The age of the 216 patients who were ultimately enrolled was 17 (13, 30) years, including 152 male patients (70.4%). The Cohen′s Kappa between the simplified 3-nap MSLT and the standard 5-nap MSLT was 0.875, which was 0.903 between the simplified 4-nap MSLT and the standard 5-nap MSLT (Bonferroni-corrected, both P0.001), indicating high and statistically significant agreement for both simplified protocols with the standard test. However, the DeLong test revealed that the area under the curve of the standard 5-nap MSLT (0.900, 95% CI 0.863-0.938) differed significantly from that of the simplified 3-nap MSLT (0.860, 95% CI 0.817-0.904; P0.05), whereas no significant difference was observed between the standard 5-nap MSLT and the simplified 4-nap MSLT (0.876, 95% CI 0.834-0.918; P0.05). Consequently, performing only the first 4 naps was sufficient for diagnosing narcolepsy type 1. Conclusion:The simplified 4-nap MSLT, specifically the first to fourth naps, may be used for the diagnosis of narcolepsy type 1.

Hepatocellular carcinoma is the most common type of primary liver cancer. Many patients who have been diagnosed with hepatocellular carcinoma are already at an advanced stage, leading to very limited treatment options and poor prognosis. Therefore, the key to improving prognosis is early-stage diagnosis. In recent years, with deeper analysis of the underlying biological mechanisms of HCC, new diagnostic methods have emerged, including emerging serum markers, liquid biopsy, molecular diagnostics, and imaging techniques. This article reviews and analyzes the research progress on early-stage screening and explores their value and application prospects in the early predictive diagnosis of HCC..

Objective:To explore the feasibility of using a simplified multiple sleep latency test (MSLT) for the diagnosis of narcolepsy type 1.Methods:Data from 158 patients with narcolepsy type 1 and 58 patients with non-type 1 narcolepsy who underwent overnight video-polysomnography (V-PSG) and MSLT in the Sleep Center, Department of Neurology, Xijing Hospital, Air Force Military Medical University from March 2019 to April 2024 were retrospectively collected. By reducing the number of naps in the MSLT, the diagnostic consistency between the simplified MSLT and the standard 5-nap MSLT was evaluated using the receiver operating characteristic (ROC) curve. The DeLong test was used to compare whether there was a statistically significant difference between the simplified MSLT and the standard 5-nap MSLT. Cohen′s Kappa statistical analysis was performed to compare the diagnostic consistency between the simplified MSLT and the standard 5-nap MSLT.Results:The age of the 216 patients who were ultimately enrolled was 17 (13, 30) years, including 152 male patients (70.4%). The Cohen′s Kappa between the simplified 3-nap MSLT and the standard 5-nap MSLT was 0.875, which was 0.903 between the simplified 4-nap MSLT and the standard 5-nap MSLT (Bonferroni-corrected, both P0.001), indicating high and statistically significant agreement for both simplified protocols with the standard test. However, the DeLong test revealed that the area under the curve of the standard 5-nap MSLT (0.900, 95% CI 0.863-0.938) differed significantly from that of the simplified 3-nap MSLT (0.860, 95% CI 0.817-0.904; P0.05), whereas no significant difference was observed between the standard 5-nap MSLT and the simplified 4-nap MSLT (0.876, 95% CI 0.834-0.918; P0.05). Consequently, performing only the first 4 naps was sufficient for diagnosing narcolepsy type 1. Conclusion:The simplified 4-nap MSLT, specifically the first to fourth naps, may be used for the diagnosis of narcolepsy type 1.

Objective To investigate the efficacy and safety of conventional open Latarjet surgery,arthroscopic Latarjet surgery,arthroscopic Bankart repair combined with Remplissage surgery in the treatment of recurrent anterior shoulder dislocation(RASD)with scapula glenoid bone defect>15%and meshing Hill-Sachs lesion.Methods The clinical data of 65 patients with RASD with 15%～25%scapula glenoid bone defect and meshing Hill-Sachs lesion admitted to our hospital from January 2022 to December 2024 were retrospectively analyzed.They were divided into group A,group B,and group C according to different surgical methods.Among them,group A underwent conventional open Latarjet surgery(n=18),group B underwent arthroscopic Latarjet surgery(n=21),and group C underwent arthroscopic Bankart repair combined with Remplissage surgery(n=26).The surgical conditions,preoperative and postoperative scores of related scales[visual analogue scale(VAS),Constant-Murley shoulder score,the University of California Los Angeles(UCLA)shoulder score],shoulder range of motion,postoperative complications and recurrence were compared among the three groups.Results Operation time:group B was longer than group A and group C(P<0.05),and group A was longer than group C(P<0.05).Intraoperative blood loss and hospital stay:group A was more or longer than group B and group C(P<0.05),group B was more or longer than group C(P<0.05).The VAS scores of the three groups at 1,6 and 12 months after operation were lower than those before operation(P<0.05).Pain VAS score at 1 and 6 months after operation:group A was higher than group B and group C(P<0.05).Pain VAS score at 1 month after operation:group B was higher than group C.Pain VAS score at 12 months after operation:there was no significant difference among the three groups(P>0.05).The UCLA shoulder scores of group A at 6 and 12 months after operation and group B and group C at 1,6 and 12 months after operation were higher than those before operation(P<0.05).UCLA score at 1 month after operation:group A0.05).The Constant-Murley scores of group A at 6 and 12 months after operation and group B and group C at 1,6 and 12 months after operation were higher than those before operation(P<0.05).Constant-Murley score at 1 month after operation:group A was lower than group B and group C(P<0.05).Constant-Murley score at 6 and 12 months after operation:three groups were equivalent(P>0.05).Forward flexion and lifting range of motion in the three groups:at 12 months after operation>before operation(P<0.05).Forward flexion and lifting range of motion was evaluated at 12 months after operation:there was no significant difference among the three groups(P>0.05).The range of motion of external rotation at body side and external rotation at 90° abduction before operation and at 12 months after operation:there was no significant difference between group A and group B(P>0.05).External rotation at body side and external rotation at 90° abduction of group C:at 12 months after operation of it was less than that before operation(P<0.05).The range of motion of external rotation at body side and external rotation at 90° abduction was obtained at 12 months after operation:group A and group B were greater than group C(P<0.05).Postoperative complication rate and recurrence rate:three groups were equivalent(P>0.05).Conclusion Conventional open Latarjet surgery,arthroscopic Latarjet surgery,arthroscopic Bankart repair combined with Remplissage surgery can effectively improve shoulder joint function and relieve pain in the treatment of RASD with 15%～25%scapula glenoid bone defect and meshing Hill-Sachs lesion.However,the two shoulder arthroscopic procedures are less traumatic and have faster postoperative recovery.

Hepatocellular carcinoma is the most common type of primary liver cancer. Many patients who have been diagnosed with hepatocellular carcinoma are already at an advanced stage, leading to very limited treatment options and poor prognosis. Therefore, the key to improving prognosis is early-stage diagnosis. In recent years, with deeper analysis of the underlying biological mechanisms of HCC, new diagnostic methods have emerged, including emerging serum markers, liquid biopsy, molecular diagnostics, and imaging techniques. This article reviews and analyzes the research progress on early-stage screening and explores their value and application prospects in the early predictive diagnosis of HCC..

To summarize the nursing experience of 5 patients with severe ARDS complicated with hypercapnia who underwent extracorporeal carbon dioxide removal(ECCO2R).Key points of nursing care included:establishing a rapid emergency response nursing team for ECCO2R;PETCO2 real-time monitoring to grasp the timing of the machine;ensuring continuity of treatment and improving the removal efficiency;respiratory-related monitoring;prevention of complications of blood coagulation and hypothermia;and weaning from extracorporeal carbon dioxide removal.After careful treatment and care,all the 5 patients were successfully removed from ECCO2R treatment.