AIM:To investigate the visual development of children under 6 years old in Wuhan, and provide evidence-based support for the formulation and optimization of regional policies for children's eye health care.METHODS:Suresight refractive screener was applied to rapid refractive status examination in 4 989 preschool children under 6 years old in Wuhan City, with results determined according to the manufacturer's age-specific referral criteria. All screened pre-school children completed vision screening and comprehensive ophthalmic examination.RESULTS: A total of 4 989 children under 6 years old were screened out, including 2 641 males and 2 348 females. They were divided into 6 groups according to age: 426 aged from 6-month to 1-year-old, 903 aged >1 to 2 years old, 1 078 aged >2 to 3 years old, 442 aged >3 to 4 years old, 808 aged >4 to 5 years old, and 1 332 aged >5 to 6 years old. The abnormal rate in the 6-month to 1-year-old group was 44.60%, in the >1 to 2 years old group was 26.02%, in the >2 to 3 years old group was 15.58%, in the >3 to 4 years old group was 10.86%, in the >4 to 5 years old group was 21.91%, in the >5 to 6 years old group was 23.27%, and the total refractive abnormal rate for children aged 6 mo to 6 years old was 22.61%. The refractive abnormal rate generally showed a decreasing trend with increasing age(P<0.001); the refractive abnormal rate in boys aged 6-month to 6 years old was 12.33%, and in girls was 10.28%, with no statistically significant difference in the abnormal rate between boys and girls(P>0.05); among children aged 6-month to 6 years old, the abnormal rate of single-eye myopia was 0.98%, of single-eye hyperopia was 5.41%, of single-eye astigmatism was 9.92%, of binocular myopia was 0.98%, of binocular hyperopia was 2.79%, and of binocular astigmatism was 8.14%; the prevalence of astigmatism in children aged 6-month to 1-year-old was 40.38%, in those aged >1 to 2 years old was 19.82%, in those aged >2 to 3 years old was 12.34%, in those aged >3 to 4 years old was 9.05%, in those aged >4 to 5 years old was 18.81%, and in those aged >5 to 6 years old was 16.89%; the prevalence of astigmatism in children aged 6-month to 6 years old was 18.06%. The abnormal rate of astigmatism in the four age groups ranging from 6-month to 4 years old decreased continuously with age(P<0.001). There was no statistically significant difference in the abnormal rate of astigmatism between the >4 to 5 years old group and the >5 to 6 years old group(P>0.05).CONCLUSION:Refractive error has become a common eye disease among preschool children. Through early vision screening, establishing a systematic refractive management file, and early intervention, the best treatment period can be seized to avoid missing it and causing adverse consequences.

Laser photocoagulation is one of the important methods for treating retinal diseases, and retinal laser technology continues to advance. For decades, researchers have been striving to find a laser treatment that can minimize tissue damage while achieving optimal results. With low toxicity, low scattering light, strong penetrating power, small compared with the traditional laser damage, light reaction and no pain, the 577 nm subthreshold micropulse laser(SML)turns this goal into reality and ushers in a new era of laser treatment for fundus diseases. This article reviews the concept, mechanism, related parameters and clinical application progress of 577 nm SML in a variety of retinal diseases, aiming to provide references for clinical treatments.

ObjectiveTo investigate the association between estimated glucose disposal rate （eGDR） and the severity of coronary heart disease. MethodsWe conducted a hospital-based cross-sectional study that included 1258 patients （mean age： 62（53-68） years） who underwent coronary angiography for suspected coronary artery disease （53.9% were male）. Insulin resistance level （IR） was calculated according to eGDR formula： eGDR = 21.158 - （0.09 × WC） - （3.407 × hypertension） - （0.551 × HbA1c） ［hypertension （yes = 1 / no = 0）， HbA1c = HbA1c （%）］. Subjects were grouped according to the eGDR quantile. CAD severity was determined by the number of narrowed vessels： no-obstructive CAD group （all coronary stenosis were<50%， n=704）， Single-vessel CAD group （only one involved major coronary artery stenosis≥50%， n=205）， Multi-vessel CAD group （two or more involved major coronary arteries stenosis≥50%， n=349）； Multivariate logistic regression model was used to analyze the association between eGDR and CAD severity. The linear relationship between eGDR and CAD in the whole range of eGDR was analyzed using restricted cubic spline. Subgroup analyses were used to assess the association between eGDR and CAD severity in different diabetic states. Receiver operating characteristic （ROC） curve analysis were used to evaluate the value of eGDR in improving CAD recognition. ResultsA decrease in the eGDR index was significantly associated with an increased risk of CAD severity （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. In multivariate logistic regression models， individuals with the lowest quantile of eGDR （T1） were 2.79 times more likely to develop multi-vessel CAD than those with the highest quantile of eGDR （T3） （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. Multivariate restricted cubic spline analysis showed that eGDR was negatively associated with CAD and multi-vessel CAD （P-nonlinear>0.05）. In non-diabetic patients， compared with the reference group （T3）， the T1 group had a significantly increased risk of CAD （OR： 1.42； 95% CI： 1.00~2.01； P<0.05） and multi-vessel CAD （OR： 1.86； 95%CI： 1.21~2.86； P<0.05）. No statistical association was found between eGDR and CAD in diabetic patients. In ROC curve analysis， when eGDR was added to traditional model for CAD， significant improvements were observed in the model's recognition of CAD and multi-vessel CAD. ConclusionOur study shows eGDR levels are inversely associated with CAD and CAD severity. eGDR， as a non-insulin measure to assess IR， could be a valuable indicator of CAD severity for population.

Objective To investigate the brain activation at the Stroop task in a group of adolescents diagnosed as the internet gaming disorder (IGD).Methods 10 IGD adolescents and 10 adolescent recreational internet game users (RGU) completed a functional magnetic resonance imaging (fMRI) Stroop task.The response time and accuracy of the two groups and the whole brain activation were measured.The differences between the two groups in response time and accuracy were assessed by t test,and the fMRI data was analyzed by SPM8.Results (1) Compared with the RGU group,the response time in congruent (CC) stimulus was longer ((707.7± 56.1) ms vs.(632.1 ± 83.5) ms;t=2.38,P=0.031) and the accuracy to incongruent (IC) stimulus was less((60.2± 17.5)％ vs.(79.0± 19.5)％;t=-2.27,P=0.034) in IGD group;(2) During IC stimulus,compared to RGU group,the neural activation in IGD group significantly decreased in the bilateral cerebellum posterior lobe,left superior temporal gyrus,left prefrontal lobe,left thalamus,left precentral gyrus,left middle frontal gyrus and the right cingulate gyrus (Peak value=-4.11--5.13,P＜0.05,AlphaSim corrected).And the IGD group showed less activation during the CC stimulus in right cerebellum anterior lobe,right superior temporal gyrus,right prefrontal lobe and left insula (Peak value=-3.84--4.72,P＜0.05,AlphaSim corrected).During the Stroop effect (IC-CC),IGD group showed significantly less activation in left precentral gyrus,left precuneus lobe,and left paracentral lobule (Peak value=-3.94,-5.49,P＜0.05,AlphaSim corrected).Conclusion IGD adolescents have poor Stroop performance in response time and accurate rate,which might be correlated to the abnormal activation of their dysfunctional brain regions,such as the frontal lobe,cingulate cortex,temporal lobe,thalamus,precuneus,and the cerebellum.

Objective To investigate the brain activation at the Stroop task in a group of adolescents diagnosed as the internet gaming disorder (IGD).Methods 10 IGD adolescents and 10 adolescent recreational internet game users (RGU) completed a functional magnetic resonance imaging (fMRI) Stroop task.The response time and accuracy of the two groups and the whole brain activation were measured.The differences between the two groups in response time and accuracy were assessed by t test,and the fMRI data was analyzed by SPM8.Results (1) Compared with the RGU group,the response time in congruent (CC) stimulus was longer ((707.7± 56.1) ms vs.(632.1 ± 83.5) ms;t=2.38,P=0.031) and the accuracy to incongruent (IC) stimulus was less((60.2± 17.5)％ vs.(79.0± 19.5)％;t=-2.27,P=0.034) in IGD group;(2) During IC stimulus,compared to RGU group,the neural activation in IGD group significantly decreased in the bilateral cerebellum posterior lobe,left superior temporal gyrus,left prefrontal lobe,left thalamus,left precentral gyrus,left middle frontal gyrus and the right cingulate gyrus (Peak value=-4.11--5.13,P＜0.05,AlphaSim corrected).And the IGD group showed less activation during the CC stimulus in right cerebellum anterior lobe,right superior temporal gyrus,right prefrontal lobe and left insula (Peak value=-3.84--4.72,P＜0.05,AlphaSim corrected).During the Stroop effect (IC-CC),IGD group showed significantly less activation in left precentral gyrus,left precuneus lobe,and left paracentral lobule (Peak value=-3.94,-5.49,P＜0.05,AlphaSim corrected).Conclusion IGD adolescents have poor Stroop performance in response time and accurate rate,which might be correlated to the abnormal activation of their dysfunctional brain regions,such as the frontal lobe,cingulate cortex,temporal lobe,thalamus,precuneus,and the cerebellum.