Abstract To clarify the service targets, service contents, and safeguard mechanisms of the basic public service program for student vision health management, the study grounded in the current status of child and adolescent myopia prevention and control in China and integrated with the practical experience and innovative practices of Wuhan National Demonstration Area for Student Vision Health Management, takes education as the main thread and schools as the base, consolidating resources from multiple stakeholders including education administrative departments, schools, families, and professional technical service institutions. Centering on four core components—vision health education, monitoring and record keeping, risk prevention and control, and dynamic management, the study constructs a multi tiered basic public service system for vision health management of primary and secondary school students. It further proposes the use of an intelligent management platform and a "three tier color coded early warning" mechanism (red, yellow, blue) to prevent and control student myopia at the source, providing schools with replicable and operable implementation pathways to enhance the level of student vision health management.

OBJECTIVES: This study aimed to construct a risk prediction model for the occurrence of the demora-lization syndrome in patients with oral cancer and provide a scientific basis for the prevention of this syndrome in patients with oral cancer and the development of personalized care programs. METHODS: A total of 486 patients with oral cancer in West China Hospital of Stomatology of Sichuan University and Sun Yat-sen Memorial Hospital of Sun Yat-sen University from 2024 March to July were selected by convenience sampling. We integrated clinical data and evidence from previous studies to identify the key variables affecting the demoralization syndrome in patients with oral cancer. The 486 patients were divided into a training set and a validation set in an 8∶2 ratio. A clinical risk prediction model was established based on the individual data of 365 patients in the development cohort. Through least absolute shrinkage and selection operator (LASSO) regression, a moderate to severe risk prediction model of demoralization syndrome in oral cancer was constructed, and a clinical machine-learning nomogram was constructed. Bootstrap resampling was used for internal validation. The data of 121 patients in the validation cohort were externally validated. RESULTS: The incidence of the demoralization syndrome in patients with oral cancer was 405 cases (83.3%), of which 279 cases (57.4%) were mild, 176 cases (36.2%) were moderate, and 31 cases (6.4%) were severe. The core model, including patient education level, disease understanding, and MDASI-HN score, was used to predict the risk of outcome. Internal validation of the model yielded C statistic of 0.783 6 (95% CI: 0.78-0.87), beta of 0.843 4, and calibration intercept of -0.040 6. Through external validation, the validation set C statistic was 0.80 (95%CI: 0.71-0.87), beta was 0.80, and calibration intercept was -0.08. CONCLUSIONS Our risk prediction mo-del of the demoralization syndrome in patients with oral cancer performed robustly in validation cohorts of different nur-sing environments. The model has good correction and good discrimination and can be used as an evaluation and prediction item at admission.
Humans ; Mouth Neoplasms/complications* ; Male ; Female ; Nomograms ; Middle Aged ; Syndrome ; Aged ; Adult ; Risk Factors ; Risk Assessment ; Machine Learning

Objective: To investigate the effects of cranial electrotherapy stimulation(CES) with varying parameter configurations on sleep quality in patients diagnosed with chronic insomnia disorder. Methods: Seventy-two participants meeting diagnostic criteria for chronic insomnia disorder were randomly allocated to a four-arm parallel study design.The intervention protocol comprised:Group 1(G1) received CES at 0.5 Hz,300 μA;Group 2(G2) underwent CES treatment at 1.5 Hz,300 μA;Group 3(G3) administered 100 Hz,300 μA stimulation;and Group4(G4) received sham stimulation with identical device placement but no current delivery.Primary outcomes were quantified through polysomnography(PSG) recordings conducted at baseline and post-intervention,whereas secondary outcomes were assessed via standardized sleep questionnaires including the Pittsburgh sleep quality index(PSQI) and Insomnia Severity Index(ISI). Results: Following a 10-day intervention protocol,significant clinical improvements were observed across all active treatment groups(G1-G3) as evidenced by reductions in PSQI.Insomnia severity index(ISI) scores quantitative polysomnographic analysis revealed that both G2(1.5 Hz) and G3(100 Hz) cohorts demonstrated statistically significant enhancements in Flinders Fatigue Scale(FFS) scores,total sleep time(TST),and sleep efficiency(SE),accompanied by reduced sleep onset latency(SOL) compared to baseline measurements.However,no statistically significant differences were detected between the G2 and G3 intervention arms across all measured parameters.CES exerted no significant effect on sleep architecture. Conclusion CES can effectively improve the sleep of patients with chronic insomnia.Within a certain range,a higher frequency of CES leads to better sleep improvement effects.

The clinical phenotype heterogeneity of epilepsy patients with ADGRV1 gene mutation is significant, ranging from self limiting febrile seizures to developmental epileptic encephalopathy, even causing sudden epileptic death. A case of infantile epileptic spasms syndrome with a novel heterozygous variant of the ADGRV1 gene c.4100C>A (p.Thr1367Lys) was reported in this article. The site of this variant had not been reported yet, and the clinical manifestations of the child mainly included epileptic spasms (first onset at 4 months old), mild growth and development delay, highly irregular video electroencephalogram, and effective treatment with adrenocorticotropic hormone.

Objective:To evaluate the application effect of a wearable visual field meter based on extended reality (XR) glasses for patients with macular disease.Methods:A self-controlled study was conducted.A total of 41 consecutive patients (41 eyes) with macular disease were recruited at Renmin Hospital of Wuhan University from October 2022 to October 2024.All patients underwent 10-2 center visual field test using a self-developed wearable visual field meter (XRVF), and the results were compared with those obtained using a traditional Humphrey field analyzer (HFA).The comparison parameters included mean retinal sensitivity (MS), false positive rate (FPR), false negative rate (FNR), and testing duration.A subject satisfaction questionnaire was administered.This study followed the Declaration of Helsinki.The study protocol was approved by the Medical Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY2024-K263), and all subjects signed the informed consent form.Results:The retinal sensitivity of patients measured by HFA was (23.24±3.71)dB, which was higher than (22.01±3.45)dB by XRVF, showing a statistically significant difference ( t=4.924, P=0.036).The FPR measured by HFA and XRVF were (2.39±2.51)% and (2.59±3.29)%, respectively, and the FNR were (3.49±6.05)% and (3.74±5.38)%, respectively, showing no statistically significant difference ( t=-3.624, P=0.948; t=-1.241, P=0.519).The median test duration for HFA and XRVF was 6.15 (5.78, 6.65) and 5.98 (5.71, 6.69)minutes, respectively, without statistically significant difference ( Z=-1.987, P=0.953).92.6% of the subjects thought the device was comfortable, simple and practical. Conclusions:The XRVF has good consistency with the HFA, can effectively and reliably evaluate the visual field function of patients with macular disease, and is easily accepted by patients.

Objective:To evaluate the application effect of a wearable visual field meter based on extended reality (XR) glasses for patients with macular disease.Methods:A self-controlled study was conducted.A total of 41 consecutive patients (41 eyes) with macular disease were recruited at Renmin Hospital of Wuhan University from October 2022 to October 2024.All patients underwent 10-2 center visual field test using a self-developed wearable visual field meter (XRVF), and the results were compared with those obtained using a traditional Humphrey field analyzer (HFA).The comparison parameters included mean retinal sensitivity (MS), false positive rate (FPR), false negative rate (FNR), and testing duration.A subject satisfaction questionnaire was administered.This study followed the Declaration of Helsinki.The study protocol was approved by the Medical Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY2024-K263), and all subjects signed the informed consent form.Results:The retinal sensitivity of patients measured by HFA was (23.24±3.71)dB, which was higher than (22.01±3.45)dB by XRVF, showing a statistically significant difference ( t=4.924, P=0.036).The FPR measured by HFA and XRVF were (2.39±2.51)% and (2.59±3.29)%, respectively, and the FNR were (3.49±6.05)% and (3.74±5.38)%, respectively, showing no statistically significant difference ( t=-3.624, P=0.948; t=-1.241, P=0.519).The median test duration for HFA and XRVF was 6.15 (5.78, 6.65) and 5.98 (5.71, 6.69)minutes, respectively, without statistically significant difference ( Z=-1.987, P=0.953).92.6% of the subjects thought the device was comfortable, simple and practical. Conclusions:The XRVF has good consistency with the HFA, can effectively and reliably evaluate the visual field function of patients with macular disease, and is easily accepted by patients.

The clinical phenotype heterogeneity of epilepsy patients with ADGRV1 gene mutation is significant, ranging from self limiting febrile seizures to developmental epileptic encephalopathy, even causing sudden epileptic death. A case of infantile epileptic spasms syndrome with a novel heterozygous variant of the ADGRV1 gene c.4100C>A (p.Thr1367Lys) was reported in this article. The site of this variant had not been reported yet, and the clinical manifestations of the child mainly included epileptic spasms (first onset at 4 months old), mild growth and development delay, highly irregular video electroencephalogram, and effective treatment with adrenocorticotropic hormone.

Objective:To evaluate the short-term rehabilitation effect of wearable visual training devices based on extended reality (XR) glasses in patients after macular hole surgery.Methods:A self-controlled study was conducted.Eleven patients with monocular low vision after macular hole surgery were recruited at Renmin Hospital of Wuhan University from October 2022 to March 2024.All patients underwent biofeedback training for 3 months using the independently developed visual rehabilitation training glasses LOOKBON T10.The LogMAR best corrected visual acuity (BCVA), retinal sensitivity, effective fixation rate, fixation stability, reading speed, vertical metamorphopsia (MV), horizontal metamorphopsia (MH), and Chinese version of the visual-related quality of life assessment form (CVRQoL-25) were compared before and after training.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY2024-K263).Written informed consent was obtained from each subject.Results:After training, the patients' BCVA, retinal sensitivity, effective fixation rate, fixation stability, and reading speed were 0.69±0.19, (21.61±2.75)db, (92.43±4.06)%, (93.09±4.31)%, and (104.82±21.85) characters/minute, respectively, which were significantly improved compared to 0.85±0.28, (17.71±3.17)db, (31.83±19.05)%, (32.35±19.12)%, and (69.64±20.17) characters/minute before training ( t=5.253, -5.987, -11.561, -12.003, -11.682; all at P<0.001).After training, MV and MH were (0.29±0.20)° and (0.21±0.24)°, respectively, which were significantly reduced compared to pre-training (0.44±0.24)° and (0.43±0.41)° ( t=9.238, 4.068; both at P<0.01).After training, the CVRQoL-25 score was 1 193.18±229.43, which was significantly higher than pre-training 947.73±203.86 ( t=-11.687, P<0.001). Conclusions:The application of wearable visual training equipment based on XR glasses can effectively improve the visual function of patients with poor visual function recovery after macular hole surgery, and enhance their quality of life.

It is estimated that approximately seven million people worldwide are affected by inflammatory bowel disease(IBD),causing a huge burden on healthcare systems and society.In the occurrence,progression,and treatment of IBD,the intestinal microbiota and its key metabolic product,bile acids,play a crucial role.The intestinal microbiota not only participates in the biotransformation of bile acids,enriching the diversity of bile acids,but also regulates their synthesis and transport through the farnesoid X receptor(FXR).Meanwhile,bile acids contribute to regulating the structure and function of the intestinal microbiota by supporting microbial diversity,exerting direct toxicity,participating in indirect antimicrobial pathways,and influencing microbial metabolic capabilities.Furthermore,under normal physiological conditions,intestinal microbiota-derived bile acids facilitate the repair process of the intestinal epithelial barrier.They also promote the balance of the immune system by modulating the functions of various immune cells including helper T(Th)cells 17,regulatory T(Treg)cells,CD8+T cells and natural killer T(NKT)cells,thereby slowing down the development of IBD.This article focuses on exploring the role of intestinal microbiota and bile acids in the onset and progression of IBD,and investigating new effective treatment strategies by targeting intestinal microbiota and bile acids,such as bile acid receptor modulators,probiotics,prebiotics,fecal microbiota transplantation(FMT),and phage therapy.

Objective:To investigate the difference of lymphocyte subsets between elderly patients with rheumatoid arthritis and non-elderly patients and its clinical significance.Methods:A total of 124 patients with rheumatoid arthritis in Affiliated Hospital of Nantong University from January, 2017 to December, 2019 were enrolled.The patients were divided into elderly group(≥60 years old, 34 cases)and non-elderly group(<60 years old, 90 cases). Rheumatoid arthritis activity(DAS-28)scoring was performed for each patient.Peripheral blood mononuclear cells(PBMCs)were extracted by Ficoll density centrifugation.Lymphocytes were labeled and detected by 18-color flowcytometry with more than 30 fluorescent antibodies.Results:DAS-28 scoring showed that the disease activity score of the elderly group(4.56±1.89)was higher than that of the non-elderly group(3.37±1.49)( t=3.633, P<0.001). Flow cytometry showed that MAIL%T(mucus-associated lymphoid tissue T cell subset)( Z=-2.798, P=0.005), Tn%CD8 T cells(initial CD8 T cells)( Z=-2.179, P=0.029), VD2% T(Vδ2+ T, γδT cell subtype)( Z=-2.806, P=0.005), PD1-CD28-%Th( Z=-2.050, P=0.040)and IGM+ D-%B( Z=-2.376, P=0.017)were lower in the elderly group than in the non-elderly group.While, CD45+ CD27+ %CD8 T cells( Z=-3.069, P=0.002), abT%T cell(αβT cells)( Z=-2.103, P=0.035), CD27-CD28+ %T cells( Z=-2.341, P=0.019), ASC%PBMC( Z=-2.341, P=0.019)and ASC%CD19+ ( Z=-2.000, P=0.046)subgroup expression were higher in the elderly group than in the non-elderly group. Conclusions:The disease activity of elderly patients with rheumatoid arthritis is significantly higher than that of younger patients.The expressions of abT%T and CD4% abT in effector T cells of elderly patients with rheumatoid arthritis are higher than those of younger patients, while the expression of VD2% T is lower.The expression level of CD45RA+ CD27+ %CD8 T with cytotoxic effect is higher; However, the expression level of Tn%CD8 T in naive cells is lower.