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.

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 describe the temporal trend of disease burden of idiopathic epilepsy in China from 1990 to 2021 and predict the incidence of idiopathic epilepsy in China from 2022 to 2035 to provide references for the formulation of relevant health policies and measures.Methods:Based on data from the Global Burden of Disease Study 2021 (GBD 2021) database regarding idiopathic epilepsy in China, changes in disease burden from 1990 to 2021 were acquired. Disease burden was quantified using age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), age-standardized disability-adjusted life years (DALYs) rate (ASDR) and their 95% uncertain interval (UI). Temporal trend analysis was performed using a linear regression model to estimate the estimated annual percent change (EAPC) and annual percentage change (APC) in incidence of idiopathic epilepsy and their 95% CI. Additionally, incidence and number of patients with idiopathic epilepsy in China from 2022 to 2035 were predicted using Bayesian age-period-cohort model. Results:The ASIR of idiopathic epilepsy increased from 22.35 per 100,000 population in 1990 (95% UI: 15.04-30.92 per 100,000 population) to 28.19 per 100,000 population in 2021 (95% UI: 19.03-37.89 per 100,000 population), with an EAPC of 0.12% (95% CI: -0.10%-0.34%); ASPR of idiopathic epilepsy increased from 189.27 per 100,000 population in 1990 (95% UI: 132.48-252.95 per 100,000 population) to 214.71 per 100,000 population in 2021 (95% UI: 150.10-278.56 per 100,000 population), with an EAPC of -0.32% (95% CI: -0.57%-0.06%); ASMR of idiopathic epilepsy decreased from 1.86 per 100,000 population in 1990 (95% UI: 1.59-2.24 per 100,000 population) to 0.80 per 100,000 population in 2021 (95% UI: 0.67-1.00 per 100,000 population), with an EAPC of -2.96% (95% CI: -3.09%-2.82%); ASDR of idiopathic epilepsy decreased from 178.60 per 100,000 population in 1990 (95% UI: 143.44-220.63 per 100,000 population) to 101.39 per 100,000 population in 2021 (95% UI: 72.51-139.40 per 100,000 population), with an EAPC of -2.38% (95% CI: -2.54%-2.22%). The prediction model showed that by 2035, the prevalence of idiopathic epilepsy in China will be 28.27 per 100,000 (95% CI: 23.19-38.66), with an estimated 394,928 incident cases (95% CI: 324,037-540,128). Conclusions:From 1990 to 2021, the ASIR and ASPR of idiopathic epilepsy in China show an upward trend, while the ASMR and ASDR hace a decline trend. Incidence of idiopathic epilepsy in China is expected to remain stable over the next decade.

Objective To make a comparative analysis on mechancial properties of the modified cortical bone trajectory(MCBT)nailing technique using a novel variable-diameter screw and the traditional pedicle nailing technique using the cement-augmented pedicle screw(CAPS)in the L4 vertebral body.Merthods CAPS and MCBT instrumentation in the L4 vertebral body model were established by obtaining CT scan data from osteoporotic patients.The finite element method was used to compare the stability,screw axial pull-out force and lumbar spine motion under four working conditions(upper,lower,left and right loads)by using different nailing techniques.Results The axial pull-out force of the screws in MCBT group was 25.3％higher than that of the CAPS group(P＜0.05);the load-displacement ratios of the screws in MCBT group were 14.9％(P＞0.05),23.2％(P＞0.05),and 19.1％(P＜0.05)higher than those of CAPS group under the lower,left,and right working conditions,respectively;the load-displacement ratios of the screws in MCBT group were slightly lower than those of CAPS group under the upper working condition,but the differences were not statistically significant(P＞0.05);under the anterior and posterior flexion conditions,the lumbar spine motion of MCBT group was reduced by 13.3％and 2.5％,respectively,compared with CAPS group;under the left lateral bending,right lateral bending,and axial rotational conditions,the lumbar spine motion of MCBT group was improved by 69.1％,74.6％,and 118.1％,respectively,compared with CAPS group,but these differences were not statistically significant(P＞0.05).Conclusions MCBT screw was slightly better than CAPS in axial resistance to extraction force,and stability of vertebral anterior flexion under lower,left and right working conditions,and slightly weaker than CAPS in stability under upper,left lateral bending,right lateral bending,and axial rotational conditions.This study demonstrates that MCBT screw has certain advantages over CAPS,providing a pre-basic foundation for the clinical application of MCBT nailing technique for treating osteoporosis.

Acute large vessel occlusion stroke(ALVOS)of anterior circulation is associated with severe clinical manifestations and high rates of disability and mortality.Mechanical thrombectomy has emerged as the primary therapeutic intervention.However,post-procedural outcomes remain highly variable,and patients continue to face elevated risks of poor prognosis.Machine learning,a transformative tool in medical research,enables comprehensive analysis of multimodal data to identify specific biomarkers and improve the accuracy of predictions for clinical outcomes and adverse events.This review summarized the latest developments in machine learning applications aim at predicting post-thrombectomy prognosis and risk of adverse event,including futile recanalization,hemorrhagic transformation,and malignant cerebral edema in patients with anterior circulation ALVOS in order to provide a basis for developing personalized treatment plan and improve their clinical prognosis.

Objective:To extract, evaluate, and summarize evidence related to family participation in delirium management of ICU patients and provid a reference for clinical practice.Methods:A systematic search was conducted in databases such as UpToDate, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, Medlive, Cochrane Library, PubMed, Embase, CINAHL, China National Knowledge Infrastructure, and China Biology Medicine disc. The search covered clinical decisions, guidelines, expert consensus, evidence summaries, systematic reviews, and randomized controlled trials related to family participation in ICU delirium management, with a timeframe up to March 20, 2024. Two researchers independently screened literature, assessed quality, extracted evidence, and graded it.Results:A total of 28 articles were included, comprising seven evidence summaries, five guidelines, three expert consensuses, six systematic reviews, and seven randomized controlled trials. The findings were synthesized into five themes: visitation, assessment, non-pharmacological management, psychological and physical care, and health education, with a total of 26 best evidence points.Conclusions:The best evidence summarized in this study provides an evidence-based foundation for ICU healthcare providers to guide and encourage family participation in delirium management, which aida in the prevention of delirium in ICU patients.

Objective:To perform a Meta-synthesis of qualitative studies on the positive psychological experiences of cardiac surgery patients post-operation, and to analyze and evaluate these experiences.Methods:A systematic search was conducted in PubMed, Web of Science, CINAHL, Embase, ProQuest, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc, with the search period from the establishment of the database to March 10, 2024. The quality of the included literature was assessed using the Australia Joanna Briggs Institute for Evidence-Based Healthcare Centre Database Quality Assessment Criteria for Qualitative Research (2016). Results were integrated using the Meta synthesis method.Results:A total of 13 studies were included, of which one study was rated as Grade A and 12 as Grade B. 46 research outcomes were identified, which were summarized into 10 new categories and integrated into three main results: awakening of self-awareness, changes in health behaviors, and perceived social support.Conclusions:Cardiac surgery patients post-operation exhibit positive psychology. Medical staff should be able to identify and understand the supporting factors for these psychological states, correctly guide and maintain the positive psychological state of patients, and help facilitate active recovery.

Objective:To summary the best evidence of integrated traditional Chinese and Western medicine exercise rehabilitation for phase I cardiac rehabilitation after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) and to provide an evidence-based basis for clinical practice.Methods:The literature on integrated Chinese and Western medicine exercise rehabilitation among AMI patients in phase I after PCI was systematically searched in UpToDate, National Guideline Clearinghouse, Guidelines International Network, Scottish Intercollegiate Guidelines Network, Canadian Medical Association Clinical Practice Guideline, Chinese Medical Association, China National Knowledge Infrastructure, Medlive, VIP, China Biology Medicine disc, Wanfang Data, Scops, Cochrane Library, PubMed, and Web of Science, etc. The search period was from database establishment to May 20, 2024. Literature quality assessment and data extraction were performed independently by two researchers.Results:A total of 19 papers were included, including four guidelines, eight expert consensus, six systematic reviews, and one randomized controlled trial. Thirty-two pieces of best evidence were summarized from eight areas containing pre-rehabilitation assessment, timing of exercise, type of exercise, exercise program, exercise monitoring, frequency of exercise, criteria for termination of exercise, and health education and follow-up.Conclusions:The summary of the best evidence of integrated Chinese and Western medicine exercise rehabilitation among AMI patients in phase I after PCI provides an evidence-based basis for standardizing the process and practice standards of exercise rehabilitation among AMI patients in phase I after PCI.

Objective:To explore the current status, research hotspots, and development trends of shared decision-making in the field of cardiovascular disease nursing, and to provide a reference for future research.Methods:Relevant literature on shared decision-making in cardiovascular disease nursing published up to October 31, 2024, was retrieved from the Web of Science Core Collection and China National Knowledge Infrastructure. CiteSpace 6.4.R1 software was used for visualized analysis.Results:A total of 2 748 publications were identified, including 2 446 in English and 302 in Chinese. The overall number of publications has shown an increasing trend. Research hotspots include quality of life, palliative care, machine learning, and artificial intelligence. The emerging trend involves integrating evidence-based approaches with artificial intelligence technologies to build scientific evidence frameworks that support patients in making optimal decisions.Conclusions:Research on shared decision-making in cardiovascular disease nursing has been increasing year by year but remains largely concentrated in developed countries. Future studies should draw on international research frontiers while considering China's national and cultural contexts, enhance academic exchange and collaboration, and explore effective strategies to promote shared decision-making between Medical staff and patients.