AIM:To automatically identify and quantitatively assess myopia-related fundus structural changes by combining non-mydriatic color fundus photography with an artificial intelligence(AI)-powered quantitative fundus analysis system and to further analyze the correlations between these fundus parameters and spherical equivalent(SE), axial length(AL), and age, providing the objective basis for monitoring myopia progression and supporting the formulation of personalized myopia prevention and control strategies. METHODS:A cross-sectional study was conducted enrolling myopic patients aged 18-50 y who underwent myopia screening from March 2023 to December 2023. Patients were stratified into three groups based on SE: the -3.00 D

Background Antibiotics are frequently detected in aquatic environments, posing potential threats to ecological systems and public health. Objective To characterize antibiotic contamination in source water in Wuhan, evaluate the removal efficiency of conventional drinking water treatment processes, identify potential pollution sources, and assess ecological risks, thereby providing evidence to support water safety management. Methods A total of 34 source water samples and paired finished water samples were collected. Twenty-seven target antibiotics were analyzed via solid-phase extraction coupled with high-performance liquid chromatography-tandem mass spectrometry. Total antibiotic concentrations and the relative contributions of individual antibiotics were calculated for each sampling site. Differences in removal performance across seasons and waterworks scales were further assessed. Antibiotic pairs with co-occurrence frequencies of ≥ 10 were included in Spearman’s rank correlation analysis to explore co-occurrence patterns. Potential sources were inferred according to their approved clinic and veterinary uses. For ecological risk assessment, predicted no-effect concentrations were derived from chronic toxicity values for fish, Daphnia, green algae, and mysid obtained from the ECOSAR database. Risk quotients (RQ) were calculated using both the median and the 95th percentile concentrations to characterize typical and high-end ecological toxicity. Results Seventeen antibiotics were detected in the source water. Lincosamides, macrolides, and sulfonamides were frequently detected, with detection frequencies exceeding 50%. Although quinolones were detected less frequently (2.94%-38.24%), they exhibited episodic high concentrations; the 95th percentile concentration of cinoxacin (CNX) reached 365.73 ng·L⁻¹. The mean total antibiotic concentration was 1.79 times higher in the wet season (105.97 ng·L⁻¹) than in the dry season (59.21 ng·L⁻¹). The contribution of quinolones increased markedly from 0.87% in the dry season to 43.10% in the wet season. Except for flumequine (FQ), ofloxacin (OFX), enoxacin (ENX), and clarithromycin (CLR), the median removal rates of the remaining antibiotics by conventional treatment processes all exceeded 80%. Ten antibiotics achieved complete removal (100%) in the wet season, compared with 4 antibiotics in the dry season. The median removal rate of CLR declined with decreasing waterworks scale, from 67.92% in large-scale plants to –1.96% in medium-scale plants and –71.25% in small-scale plants. Apparent negative removal was observed for sulfadiazine (SDZ), FQ, OFX, and CLR, with OFX exhibiting the highest frequency of negative removal events (n=14). Correlation analysis revealed significant positive correlations between sulfonamides and macrolides (ρ=0.52-0.83), indicating mixed influences from livestock farming and domestic wastewater. Lincomycin (LIN) was positively correlated with sulfamethoxazole (SMX), but negatively correlated with the aforementioned antibiotic network, suggesting a predominantly human medical source. Based on median concentrations, the ecological risk of individual antibiotics was negligible. However, the cumulative risk to Daphnia reached a low level (RQ > 0.01), with sulfonamides contributing more than 70% of this risk. Based on the 95th percentile concentrations, bost individual and cumulative risks of quinolones to fish and Daphnia increased to low levels, with quinolones contributing more than 55% of the total risk. Conclusion Antibiotics are commonly detected in source water in Wuhan, and conventional drinking water treatment dose not completely eliminate all target compounds. Quinolones, despite their relatively low detection frequencies, occur at episodically high concentrations and pose low risks to fish and Daphnia under high-end exposure scenarios, warranting priority control. The coexistence of human-use and veterinary-use antibiotics reflects diverse pollution sources and highlights the need for coordinated multi-source pollution control.

Diabetes mellitus has the characteristics of chronic inflammatory diseases,often accompanied by intestinal flora disorders.Based on the TCM theory of"stomach exuberance and spleen deficiency",combined with modern medical research,this article explained the occurrence and development of diabetes mellitus from intestinal flora and inflammatory reaction.Diabetes mellitus was divided into three categories:stomach heat and deficiency of spleen yin,stomach heat and deficiency of spleen qi,and stomach heat and deficiency of spleen yang,and summarized the three methods of"clearing and draining heat,nourishing yin and moistening intestine","clearing dampness and heat,strengthening spleen and qi"and"clearing dampness and heat,strengthening spleen and warming yang",which could treat diabetes mellitus by improving intestinal flora disorder and reducing inflammatory reaction.

Under the new situation of establishing the new standard system for pharmaceutical packaging materials in the 2025 edition of the Chinese Pharmacopoeia and promulgating the appendix on pharmaceutical packaging ma-terials in the Good Manufacturing Practice for Drugs,it is urgently necessary to introduce relevant standards for quality agreements on pharmaceutical packaging materials.This article focuses on analyzing the development of group standards for pharmaceutical packaging materials under the new situation,the role and significance of quality agreements for pharmaceutical packaging materials,as well as the interpretation of key parts of the"Guidelines for the Management of Quality Agreements for Pharmaceutical Packaging Materials",in order to help enterprises quick-ly shift from the original"standard-only"approach to strengthening the quality management of the entire product life cycle through quality agreements.

Diabetes mellitus has the characteristics of chronic inflammatory diseases,often accompanied by intestinal flora disorders.Based on the TCM theory of"stomach exuberance and spleen deficiency",combined with modern medical research,this article explained the occurrence and development of diabetes mellitus from intestinal flora and inflammatory reaction.Diabetes mellitus was divided into three categories:stomach heat and deficiency of spleen yin,stomach heat and deficiency of spleen qi,and stomach heat and deficiency of spleen yang,and summarized the three methods of"clearing and draining heat,nourishing yin and moistening intestine","clearing dampness and heat,strengthening spleen and qi"and"clearing dampness and heat,strengthening spleen and warming yang",which could treat diabetes mellitus by improving intestinal flora disorder and reducing inflammatory reaction.

Under the new situation of establishing the new standard system for pharmaceutical packaging materials in the 2025 edition of the Chinese Pharmacopoeia and promulgating the appendix on pharmaceutical packaging ma-terials in the Good Manufacturing Practice for Drugs,it is urgently necessary to introduce relevant standards for quality agreements on pharmaceutical packaging materials.This article focuses on analyzing the development of group standards for pharmaceutical packaging materials under the new situation,the role and significance of quality agreements for pharmaceutical packaging materials,as well as the interpretation of key parts of the"Guidelines for the Management of Quality Agreements for Pharmaceutical Packaging Materials",in order to help enterprises quick-ly shift from the original"standard-only"approach to strengthening the quality management of the entire product life cycle through quality agreements.

Objective To compare the difference in the efficacies of arthroscopic microfracture operation for talar osteochondral injuries with hyperuricemia and non-hyperuricemia,and to explore the correlation be-tween blood urate level and efficacy.Methods Fifty-three patients with talar osteochondral lesions meeting the inclusion and exclusion criteria from February 2015 to August 2021 were selected as the research subjects and divided into the hyperuricemia group (22 cases) and non-hyperuricemia group (31 cases) according to whether or not the preoperative blood uric acid level exceeding 420 μmol/L.The joint range of motion (ROM),visual analog scale (VAS) score,American Foot and Ankle Surgery Society (AOFAS) score,mag-netic resonance score of cartilage repair tissue (MOCART) score and postoperative satisfaction before and af-ter surgery were compared between the two groups.Results The preoperative blood uric acid level in the hy-peruricemia group was higher than that in non-hyperuricemia group,and the difference was statistically signif-icant[(504.35±86.40)μmol/L vs.(332.56±45.80)μmol/L,P<0.05].The ROM score,VAS score and AOFAS score in postoperative 1 year follow up and last follow up in the two groups were significantly im-proved compared with before operation (P<0.001).The AOFAS scores before operation,in postoperative 1 year and postoperative last follow up in the hyperuricemia group were lower than those in the non-hyperurice-mia group (P<0.05).The VAS scores before operation and postoperative last follow up in the hyperuricemia group were higher than those in the non-hyperuricemia group (P<0.05).The uric acid level was negatively correlated with the postoperative AOFAS score (r2=0.076,P=0.041).The MOCART score in postopera-tive last follow up in the hyperuricemia group was lower than that in the non-hyperuricemia group,and the difference was statistically significant (P<0.05).The cartilage defect repair and filling degree and the fusion of repaired tissue with adjacent cartilage had statistical differences between the hyperuricemia group and non-hyperuricemia group (P<0.05).Conclusion Arthroscopic microfracture operation in treating talar osteo-chondral injuries has good clinical effect,the postoperative clinical effect in the patients with complicating hy-peruricemia is lower than that in the patients with non-hyperuricemia and the blood uric acid level is negative-ly correlated with the AOFAS score after microfracture surgery.

Pancreatogenic diabetes is a type of diabetes mellitus secondary to exocrine pancreatic disease,and it was officially proposed by the American Diabetes Association in 2014,with chronic pancreatitis as the most common etiology,followed by pancreatic cancer.At present,the misdiagnosis rate of this disease is extremely high,and patients with pancreatogenic diabetes have a higher risk of death and readmission than patients with type 2 diabetes.Therefore,it is of great significance to fully understand,correctly identify,and diagnose pancreatogenic diabetes in the early state,so as to reduce the disability rate and mortality rate of this disease.This article reviews the advances in the possible pathogenesis,diagnosis,treatment,and management of pancreatic diabetes secondary to pancreatitis and pancreatic cancer.

Stomach exuberance and spleen deficiency are common pathogenesis of many metabolic diseases. Through analyzing the pathogenesis of stomach exuberance and spleen deficiency， it is believed that its essence is stomach heat and spleen deficiency. Stomach heat includes gastrointestinal heat， spleen and stomach damp-heat， and spleen deficiency is divided into deficiency of spleen yin， deficiency of spleen qi ， and deficiency of spleen yang. It is suggested that the metabolic diseases of stomach-exuberance and spleen-deficiency syndrome can be divided into three categories，i.e. stomach-heat and spleen yin-deficiency， stomach-heat and spleen qi-deficiency， and stomach-heat and spleen yang-deficiency， and the main treatment methods are clearing and draining heat， nourishing yin and moistening intestine， clearing dampness and heat， strengthening spleen and qi， clearing dampness and heat， strengthening spleen and warming yang， respectively， with prescriptions as Maziren Pills （麻子仁丸）， Qinlian Pingwei Powder （芩连平胃散）， and Jiawei Lianli Decoction （加味连理汤） accordingly.

Objective:To confirm the efficacy and safety of cinepazide maleate injection in acute ischemic stroke patients with obvious motor function deficit.Methods:This study is a subgroup analysis of multi-center, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial. A total 812 patients of acute ischemic stroke with obvious limb motor deficit [motor function of limbs score in National Institutes of Health Stroke Scale (NIHSS) ≥4] were enrolled in this subgroup analysis. Patients received either cinepazide maleate injection or placebo. The treatment period was 14 days and follow-up was 90 days. The efficacy endpoints included the proportions of patients with a modified Rankin Scale (mRS) score ≤2, mRS score ≤1 and Barthel Index <95 on day 90. Safety was evaluated by recording all adverse events, monitoring vital signs, laboratory parameters and electrocardiogram.Results:A total of 732 patients were involved in the final efficacy analysis (361 in cinepazide maleate group and 371 in control group). The baseline limb motor function score of NIHSS was 5.23±1.43 in the cinepazide maleate group whereas 5.20±1.36 in the control group. Logistic regression analysis showed that following treatment for 90 days, the proportion of patients with a mRS score ≤2 was significantly higher in the cinepazide maleate group than in the control group [56.0% (202/361) vs 44.2% (164/371), OR=0.60, 95% CI 0.44-0.82, P=0.002]. The proportion of patients with a mRS score ≤1 was higher in the cinepazide maleate group than in the control group [43.3% (139/361) vs 35.2% (118/371), OR=0.69, 95% CI 0.50-0.97, P=0.031]. The proportion of patients with a Barthel Index <95 on day 90 was significantly lower in the cinepazide maleate group than in the control group [45.2% (145/361) vs 55.2% (185/371), OR=0.64, 95% CI 0.46-0.88, P=0.007]. During the treatment and follow-up period, the incidence of the most common adverse events in the cinepazide maleate group was 50.4% (199/395). Constipation and abnormal liver function were more common, but there were no statistically significant differences between the two groups. Conclusion:Cinepazide maleate injection is superior to placebo in improving neurological function and activities of daily living, reducing disability, and promoting functional recovery and safe in patients with acute ischemic stroke with obvious limb motor deficit.