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.

Objective: To investigate the relationship between night-time noise exposure and depressive symptoms among junior and senior high school students, so as to provide evidence to support strategies for promoting their physical and mental health. Methods: From September 2024 to December 2025, 2 900 junior and senior high school students were selected using stratified cluster random sampling in the three cities of Nanning, Lhasa, and Yanji. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive symptoms in junior and senior high school students, and a noise exposure survey was conducted. Chi-square test was used to compare the prevalence of depressive symptoms among junior and senior high school students with different types of night-time noise exposure, and Logistic regression models were employed to examine the association between night-time noise exposure and depressive symptoms among junior and senior high school students. Results: The prevalence of depressive symptoms among junior and senior high school students without night-time noise exposure was 33.0%, while that among junior and senior high school students with night-time noise exposure was 49.0%; the difference was statistically significant ( χ 2= 45.85 , P <0.01) . After adjusting for gender, age and region, Logistic regression analysis showed that exposure to night-time traffic noise, neighborhood noise, air conditioner noise, and other types of noise showed increased risk of detecting depressive symptoms in junior and senior high school students ( OR =2.22, 1.84, 2.41, 2.17, all P <0.05). Conclusion Night-time noise exposure is associated with an increased risk of depressive symptoms among junior and senior high school students.

Objective To investigate the clinical efficacy and safety of endoscopic ultrasonography-guided(EUS-guided)enterocolon anastomosis in treating patients with malignant bowel obstruction(MBO).Methods The clinical data of 12 patients with MBO,who underwent EUS-guided enterocolon anastomosis at the Nanjing Drum Tower Hospital of China from April 2023 to December 2023,were collected.The perioperative clinical efficacy and safety were retrospectively analyzed.Results Successful EUS-guided enterocolon anastomosis was accomplished in all the 12 patients,with a technical success rate of 100％(12/12).The clinical success rate was 83.3％(11/12),one patient developed obstruction of the stent.The clinical symptoms were relieved in 2-68 hours after treatment,and the time to resume defecation and exhaust was(18.02±15.75)hours.Within one week after the operation,4 patients took liquid diet and 8 patients took semi-fluid diet.Each dimension score of the Quality of Life Core-30 scale of The European Organization for Research and Treatment of Cancer(EORTC QLQ-C30)was remarkably improved,the patient's overall health score was increased from preoperative median 5 points to postoperative 8 points(P＜0.001).During the operation,stent displacement occurred in 2 patients,and the operation was successfully completed after promptly taking remedial measures.After operation,11 patients developed fever(37.5-39.4 ℃),and all the patients were discharged smoothly after symptomatic treatment.No complication such as bleeding,perforation,or stent displacement occurred.Conclusion EUS-guided enterocolon anastomosis is clinically safe and effective,it can effectively relieve the clinical symptoms and improve the quality of life of patients with MBO.

Objective To investigate the status of population dynamics and distribution changes of Aedes aegypti in Guangdong Province.Methods Continuous monitoring was conducted from May 2018 to July 2024 in Wushi Town and Qishui Town,Leizhou City,Zhanjiang City,Guangdong Province.Additionally,a survey of the distribution of Ae.aegypti along the Leizhou Peninsula coast was carried out.Results The density of Ae.aegypti in Zhanjiang showed a gradual decline from 2018 to 2024.The last detection of adult Ae.aegypti in Wushi Town was in September 2021,and the last larva was found in October 2023.No Ae.aegypti was detected in Qishui Town during surveys from 2021 to 2024.A survey of 18 coastal villages in the Leizhou Peninsula revealed no detections of Ae.aegypti.Conclusions This study provides a basis for understanding the distribution and population density fluctuations of Ae.aegypti,assessing its invasion risk,and scientifically conducting relevant prevention and control efforts.

Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards* ; Humans ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Surveys and Questionnaires

OBJECTIVE: To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021. METHODS: Using data from the Global Burden of Disease Study (GBD) 2021, the number of prevalent cases, prevalence rate, disability-adjusted life years (DALYs), and age-standardized DALY rates were analyzed by sex, age group, and province for headache disorders and their subtypes (migraine and tension-type headache [TTH]) between 1990 and 2021. Percentage changes during this period were also estimated. RESULTS: In 2021, approximately 426 million individuals in China were affected by headache disorders, with an age-standardized prevalence rate of 27,582.61/100,000. The age-standardized DALY rate for all headache disorders was 487.15/100,000. Between 1990 and 2021, the number of prevalent cases increased by 37.78%, while the prevalence of all headache disorders, migraine, and TTH increased by 6.92%, 7.57%, and 7.86%, respectively. The highest prevalence was observed in the 30-34 age group (39,520.60/100,000). Migraine accounted for a larger proportion of DALYs attributable to headache disorders, whereas TTH has a greater impact on its prevalence. In 2021, the highest age-standardized DALY rates for headache disorders were observed in Heilongjiang (617.85/100,000) and Shanghai (542.86/100,000). CONCLUSION The prevalence of headache disorders is increasing in China. Effective health education, improve diagnosis and treatment are essential, particularly for middle-aged working populations and women of childbearing age.
Humans ; China/epidemiology* ; Female ; Male ; Adult ; Middle Aged ; Prevalence ; Young Adult ; Adolescent ; Aged ; Child ; Headache Disorders/epidemiology* ; Disability-Adjusted Life Years ; Child, Preschool ; Cost of Illness ; Infant ; Aged, 80 and over

Objective To Observe the clinical characteristics and prognosis of patients with the acute macular neuroretinopathy(AMN)associated with novel coronavirus infection(COVID-19).Methods The data of 13 patients diagnosed with COVID-19-associated AMN attending the Department of Ophthalmology of the Affiliated Hospital of Yunnan University from December 2022 to February 2023,as well as 13 case reports in PubMed and Web of Science databases from 2020 to 2023 and a case series study totaling 41 patients were retrospectively selected and analyzed for their ophthalmic imaging and prognostic outcomes in clinic.Results A total of 13 cases with 25 eyes in the clinical case group were included in the study with a mean age of 30.23±6.02 years,of which 10 were females.The literature case group consisted of 41 cases and 72 eyes with a mean age of 30.12±13.24 years,including 31 female patients.(1)Duration between COVID-19 symptoms/diagnosis and ophthalmic symptoms:3(2.0,4.0)days in the clinical case group and 2(0.75,5.0)days in the literature case group.(2)Clinical characteristics:12(92.31％)of the clinical case group had the binocular onset and the literature case group,31(75.61％)had the binocular onset.The symptoms in both groups were mainly dark spots in vision,followed by decreased visual acuity.(3)Ancillary examinations:optical coherence tomography(OCT)showed the ellipsoid zone(EZ)and/or chimeric zone(IZ)breaks with strong reflections in the outer plexiform layer(OPL)and outer nuclear layer(ONL)in 13 patients in the clinical case group,and the near-infrared photography(NIR)showed the low-reflective wedge-shaped foci around the center of the macula,and some patients'optical coherence tomography angiography(OCTA)showed deep capillary lesions,and some patients'OCTA showed low reflectivity.Reduced blood flow in the deep capillary layer(DCP)and choroidal capillary layer(CC)was observed in all patients,7 patients with cotton-wool spots also had the reduced blood flow in the superficial capillary layer(SCP),and 33 patients in the case group in the literature had the visible EZ and/or IZ breaks on OCT.(4)Treatment and prognosis:11 out of 13 patients were treated with oral glucocorticoids,2 were under the observation.After year,the condition of 23 patients had been improved,1 case had visual field defects,1 case had retinal vein occlusion secondary to macular edema,and 1 case had a hyporeflective signal in the outer nuclear layer(ONL)and outer plexiform layer(OPL).Conclusion The age of onset of AMN related to COVID-19 is slightly older,with more cases involving both eyes.The main symptom is visual field scotoma,often accompanied by decreased vision.Near-infrared imaging shows low-reflective wedge-shaped lesions around the fovea,and OCT shows mainly disruption of the EZ and/or IZ.OCTA shows decreased blood flow density in the DCP and CC layers.The visual prognosis of AMN related to COVID-19 is good,but vigilance is needed for the occurrence of complications such as retinal vein occlusion.

Objective:To establish a rapid and precise dose measurement method with EBT4 film and ensure its measurement accuracy to be within the required range through strict operational procedures for the purpose of addressing the two essential issues of poor measurement accuracy and timeliness of EBT film under FLASH conditions.Methods:After storing under different humidity conditions for a certain period of time, the film was exposed to radiation for analyzing the influence of air humidity on the intrinsic performance of EBT film. By means of repeated scanning operations and the film angle rotation, the influences of repeated scanning and film placement angle were analuzed. Parabolic correction method was used to reduce the spatial position influence during the scanning process. By analying the relationship between net optical density (netOD) and absorbed dose through the comparison of three fitting method, the optimal fitting curve was selected. After irradiation of the same batch of films for 5 min and 24 h, the film doses were calibrated and then compared with ionization chamber-measured result. The rapid and precise film dosimetry method was used to measure both the percentage depth dose from X-rays at ultra-high dose rate and the dose distribution at a depth of 2 cm in water.Results:Air humidity had the greatest influence on the intrinsic performance of EBT film (approximately 20%). The average deviation of repeated scans is within 0.5%. The angle at which the film is placed significantly affected the readouts of the film with the maximum influence approximately 70%. The net optical density combined with polynomial fitting can control the fitting residuals of 1-16 Gy within 3%. The change rate of light channels at 5 min already mostly met the requirements of the rapid mode (< 0.5%). Compared with the measurement result obtained using the reference ionization chamber, the deviations of the 5 min or 24 h dose calibration curves were all within 2%.Conclusions:The EBT4 film can be employed as a precise dosimeter to quickly measure the FLASH radiation dose. Rapid and precise FLASH dose measurements can meet the stringent requirements of both preclinical and clinical FLASH research.

This case report summarizes the nursing experience in ensuring medication safety during intranasal esketamine spray treatment for a patient with treatment-resistant depression.Key nursing interventions included:pre-treatment assessment of concomitant medication risks,preparation of staff,environment,and medications;during treatment,strict adherence to administration protocols with simultaneous respiratory function monitoring and nasal tolerability assessment to minimize respiratory depression risk;post-treatment blood pressure surveillance combined with longitudinal symptom tracking and dynamic suicide risk evaluation for self-harm prevention;reinforcement of adverse reaction prevention and management.After completing the full 4-week treatment course(8 sessions),the patient exhibited the improved depressive symptoms and the reduced suicidal ideation,and the patient was successfully discharged.

Objective:To investigate the clinical value of anorectal ultrasound in diagnosing the internal opening of anal fistulas.Methods:A total of 1 353 patients with anal fistulas who were admitted to the Department of Anorectal Surgery at Ningbo No.2 Hospital and underwent anorectal ultrasound examinationResults:The accuracy of anorectal ultrasound in diagnosing the internal opening of anal fistulas was 89.32%. The accuracy for simple anal fistulas was 95.96% compared to 77.86% for complex anal fistulas，with a statistically significant difference（ χ2=178.328， P<0.001）. Further analysis revealed significantly higher rates of misdiagnosis and missed diagnosis in complex anal fistulas（ R=3.776，9.009），with statistically significant differences（| R|>1.960）. Conclusions:Anorectal ultrasound demonstrates high accuracy in diagnosing the internal opening of anal fistula，providing valuable guidance for clinical treatment decisions.