Modern cataract surgery has completely moved beyond the traditional vision-restoring model and has fully entered a new era of refractive cataract surgery(RCS)centered on precise refractive correction. Its core objective is to provide patients with personalized visual experiences characterized by full-range, clear, and comfortable vision. Currently, although diagnostic and therapeutic technologies for RCS are rapidly evolving, there remain many bottlenecks in the precise management of the entire perioperative process that urgently need to be addressed. Preoperatively, the measurement consistency among ocular biometry devices based on different detection principles remains poor, and systematic measurement errors cannot be completely eliminated. Moreover, the individualized selection of intraocular lenses(IOLs)relies heavily on surgeons' clinical experience, lacking a standardized quantitative decision-making framework, which makes it difficult to achieve precise personalized matching. Intraoperatively, the quality of continuous curvilinear capsulorhexis is affected by multiple factors such as ocular anatomical characteristics and surgical proficiency, and its stability cannot be reliably ensured. Various intelligent surgical navigation systems are compromised by intraoperative ocular conditions, and their clinical performance fails to meet theoretical expectations. At the postoperative stage, existing IOL optical designs and materials have inherent limitations. The longterm prevention and control of posterior capsule opacification(PCO)remains a core factor restricting patients' long-term high-quality visual outcomes. This article systematically reviews the precise diagnostic and therapeutic challenges and core bottlenecks across the preoperative, intraoperative, and postoperative stages of RCS. It further explores frontier technological directions—including cross-device error compensation models, artificial intelligence-assisted decision-making, preoperative VR-based visual simulation, and the construction of intelligent surgical ecosystem platforms—to delineate targeted solutions and optimization pathways. This review aims to provide references and insights for the standardized clinical implementation, technological innovation, and future research endeavors in precision diagnosis and treatment of RCS.

Phacoemulsification represents the mainstream, efficient, and safe surgical modality for cataract treatment, and continuous technological advances have further improved the safety profile of this procedure in ordinary patients. However, patients with high myopia feature inherent anatomical abnormalities of the eyeball, leading to a fundamental incompatibility with conventional phacoemulsification protocols. Such patients face a markedly elevated risk of both anterior and posterior segment perioperative complications, posing a persistent clinical challenge in cataract surgery. Focusing on the unique ocular anatomical characteristics associated with high myopia, this review systematically summarizes the distinct traumatic effects and pathological impacts of phacoemulsification on the anterior and posterior ocular segments of affected patients. Moving beyond generalized discussions of routine cataract management, it consolidates clinical evidence specific to this special-population patients, aiming to provide refined references for perioperative risk prevention and control in cataract patients complicated with high myopia.

Objective To analyze the epidemiological and etiological characteristics of hand,foot and mouth disease(HFMD)in Nanning City,Liangqing District from 2012 to 2023.Methods Descriptive epidemiological methods were used to describe the three distribution characteristics of HFMD,and to predict the incidence trend of HFMD.Results From 2012 to 2023,Liangqing District of Nanning City reported a total of 19 715 cases of HFMD.The incidence rates varied significantly across different years,with statistically significant differences(P＜0.01).The urban area reported the highest number of cases.The disease primarily occurred from April to October,with the highest incidence among children aged 6 months to 5 years,mainly among children in daycare and preschools.From 2012 to 2023,a total of 588 cases were diagnosed through laboratory tests,with the highest detection rate of other enteroviruses,and a relatively lower detection rate of EV71.Predictions indicate that the incidence of HFMD in Liangqing District of Nanning City will decrease in 2025 compared to 2023.Conclusion Incidence of HFMD in Liangqing District,Nanning is high,especially among children aged 6 months to 5 years.It is suggested to strengthen the epidemic surveillance,continue to carry out pathogen surveillance.

Objective To analyze the epidemiological and etiological characteristics of hand,foot and mouth disease(HFMD)in Nanning City,Liangqing District from 2012 to 2023.Methods Descriptive epidemiological methods were used to describe the three distribution characteristics of HFMD,and to predict the incidence trend of HFMD.Results From 2012 to 2023,Liangqing District of Nanning City reported a total of 19 715 cases of HFMD.The incidence rates varied significantly across different years,with statistically significant differences(P＜0.01).The urban area reported the highest number of cases.The disease primarily occurred from April to October,with the highest incidence among children aged 6 months to 5 years,mainly among children in daycare and preschools.From 2012 to 2023,a total of 588 cases were diagnosed through laboratory tests,with the highest detection rate of other enteroviruses,and a relatively lower detection rate of EV71.Predictions indicate that the incidence of HFMD in Liangqing District of Nanning City will decrease in 2025 compared to 2023.Conclusion Incidence of HFMD in Liangqing District,Nanning is high,especially among children aged 6 months to 5 years.It is suggested to strengthen the epidemic surveillance,continue to carry out pathogen surveillance.

AIM: To evaluate the binocular visual function in high myopia patients after the implantation of implantable collamer lens(ICL)V4c.METHODS: A total of 35 cases(70 eyes)that received binocular ICL implantation at our hospital from May 2019 to May 2021 were enrolled in this prospective study. Binocular full-range visual acuity, contrast sensitivity, stereopsis, mesopic vision and glare sensitivity, and monocular wavefront and the quality of vision questionnaire were assessed before the surgery and at 1 mo postoperatively.RESULTS: At 1 mo postoperatively, 35 cases(100%)had binocular uncorrected distance visual acuity(UDVA)≤0.00(LogMAR), 16 cases(46%)had binocular UDVA≥preoperative corrected distance visual acuity(CDVA). Binocular UDVA and uncorrected intermediate visual acuity(UIVA,80 cm)were improved compared to preoperative CDVA and distance-corrected intermediate visual acuity(DCIVA,80 cm)(all P<0.05).While there were no differences in the binocular postoperative UIVA(60 cm)and preoperative DCIVA(60 cm),and uncorrected near visual acuity(UNVA,40 cm)and preoperative distance-corrected near visual acuity(DCNVA,40 cm)(all P>0.05). The binocular contrast sensitivity was significantly improved postoperatively(P=0.001), and the postoperative binocular mesopic vision, glare sensitivity(no glare/glare)and binocular stereopsis(5 m/40 cm)had no differences(all P>0.05). The postoperative total higher-order aberration, trefoil aberration, coma and spherical aberration were increased, besides the median of total coma in the right eye with a pupil diameter of 3.0 mm was decreased after surgery. The mean total score of quality of vision questionnaire was significantly increased from 54.87 preoperatively to 80.92 after implantation(P<0.05), with high satisfaction and no obvious visual disturbance in patients.CONCLUSION: Although the monocular high-order aberrations increased in the early stage after ICL V4c binocular implantation in patients with high myopia, the binocular visual function was improved.

Purpose/Significance The paper analyzes the application of remote consultation in Henan province and the factors affect-ing service efficiency,optimizes service mode,and provides suggestions for the sound development of telemedicine.Method/Process The volume of remote consultation business,patient and doctor data,and consultation process data carried out through the regional tele-medicine integrated service platform in Henan province in 2022 are collected and sorted out.IBM SPSS 23.0 software is used to analyze the distribution of patients and business development of remote consultation,and factors affecting the efficiency of consultation are ana-lyzed through multiple logistic regression.Result/Conclusion The level of the hospital applying for remote consultation and the consulta-tion department affect the duration of the consultation process.The consultation department,expert titles,and referral suggestions are the main factors affecting the response time of consultation.It is suggested to optimize the service process of remote consultation,enhance the enthusiasm of doctors to participate in consultation,reduce the response time of consultation,and improve the efficiency of consultation.

【Objective】 To compare the bioactive ingredients in activated platelet-rich plasma (PRP) from cord blood and adult blood, explore its reasonable indicators reflecting the inflammatory regulation ability, in order to guide the preparation. 【Methods】 PRP was prepared and activated from 63 healthy adults (31 males, 32 females) and 61 neonates (30 males, 31 females), and 20 cytokines were measured using Luminex technology for assessing the age- and sex-based bioactive differences of PRP. High-sensitivity C-reactive protein(hs-CRP), procalcitonin and MMPs/TIMPs from each sample were measured for their correlations with the 10 inflammation-related cytokines. 【Results】 The activated cord blood PRP released 10 growth factors and chemokines more than the adult blood PRP, whereas IGF-1, HGF and 8 pro-inflammatory cytokines lower than the latter. Most cytokines of adult PRP were more in females than in males (P<0.05), except for IGF-1 and HGF, which showed no difference by gender. Compared with hs-CRP and PCT, MMPs/TIMPs ratio was more closely related with the inflammation-related cytokines, which can reflect the inflammatory regulation of PRP. 【Conclusion】 Due to the lower immunocompetence and no age or gender disturbance, cord blood PRP has the rational MMPs/TIMPs ratio and more cytokines which promote the inflammation and wound healing.

Objective To explore a method of screening the core indicators in the emergency database that can be used to evaluate the in-hospital fatal gastrointestinal rebleeding by using the big data algorithm. Methods Based on the emergency database of the Chinese PLA General Hospital, through the big data retrieval technology, all the 647 patients diagnosed as gastrointestinal bleeding in the emergency database were enrolled, except those who were admitted to the hospital for the first time and whose hemoglobin (Hb) was less than 90 g/L or did not undergo Hb test. Among them, there were 313 in the rebleeding group (fatal rebleeding in the hospital) and 334 in the non-rebleeding group (no fatal rebleeding in the hospital). General data of patients were collected, including gender, age, physical signs, blood gas, test index collection data, and the identification of gastrointestinal rebleeding. The fusion algorithm of rough set algorithm, genetic algorithm, and cellular automaton algorithm were used to calculate the key indicators that affect gastrointestinal rebleeding. Results A total of 499 indicators were calculated by machine fusion algorithm, after screening 5 times repeatedly, 24 key indicators were screened out, 3 of which were vital signs, including systolic blood pressure (SBP), diastolic blood pressure (DBP), temperature (T); 7 key indicators of blood routine, including white blood cell count (WBC), eosinophil (EOS), monocyte (MONO), Hb, hematocrit (HCT), red cell distribution width (RDW), mean corpuscular hemoglobin (MCH); 3 key indicators of coagulation, including prothrombin time (PT), plasma fibrinogen (FIB), activated partial thromboplastin time (APTT); 5 key indicators of biochemical, including myoglobin (MYO), chloride, glucose (GLU), serum albumin (ALB), total bilirubin (TBil); and 6 key indicators of blood gas, including pH, lactate (Lac), oxygen saturation (SO2), base excess (BE), bicarbonate (HCO3-), partial pressure of carbon dioxide (PaCO2). Conclusions Using big data technology, 24 core indicators for evaluating the fatal gastrointestinal rebleeding in hospitals can be screened out from the emergency database, providing new ideas and methods for clinical diagnosis of the disease.

Objective To investigate the synergistic regulation of KDM3B and JMJD1C in leukemia. Methods The expression level of JMJD1C and KDM3B were analyzed in multiple acute myeloid leukemia (AML) cell lines. AML cell lines NB4 and HL-60 were treated with Daminozide, followed by determination of H3K9 mono-methylation and di-methylation. AML cell lines NB4 and HL-60 were treated with Daminozide, ATRA (retinoid acid All-trans), C Vitamin and the expression of KDM3B and JMJD1C were detected by real-time quantitative PCR. Results The expression level of KDM3B and JMJD1C in the AML cell lines was negatively correlated. In NB4 and HL-60 cells treated by daminozide, H3K9 mono-methylation and di- methylation level showed a rising trend in these two cell groups. After treatment of NB4 cells with the 3 reagents, the level of mRNA of KDM3B was down-regulated while the level of mRNA of JMJD1C was up-regulated. In HL-60 cells treated by daminozide, the mRNA level of KDM3B was up-regulated and the mRNA level of JMJD1C was down-regulated. Conclusion The expression of KDM3B and JMJD1C is negatively correlated in patients with AML.

Objective To study the change of levels of IL-6,IL-17,IL-23,IL-8,TNF-α and IFN-γ and their clinical significance on children with different types of Henoch-Schonlein purpura (HSP) Methods The blood specimens of 180 children with HSP as disease group and 30 health children as normal group were collected respectively.Disease group included 30 children at acute stage and 30 at convalescence stage of primary abdominal type,30 at acute stage and 30 at convalescence stage of primary non-abdominal type,30 at acute stage of secondary abdominal type,and 30 at acute stage of secondary non-abdominal type.The plasma levels of IL-6,IL-8,IL-17,IL-23,TNF-α and IFN-γ in the two groups were measured by ELISA method for comparison and analysis.Results The plasma levels of IL-6,IL-8,IL-17,IL-23 and TNF-α in disease group were higher than those in the normal group (P＜0.05).Those levels in the children at acute stage and of primary group were also found to be higher than those at convalescence stage (P＜0.05) and of secondary group (P＜0.05) respectively.Comparison of IL-6,IL-8,IL-17,IL-23 and TNF-α between abdominal type and the non-abdominal type had no significant difference (P＞0.05).The plasma level of IFN-γ in disease group was lower than those in normal group (P＜0.05).The levels of IFN-γ in the children at acute stage and of primary group were lower than those at convalescence stage (P ＜0.05) and of the secondary group (P ＜0.05) Comparison of IFN-γ between abdominal type and non-abdominal type had no significant difference (P＞0.05) Conclusions The plasma levels of IL-6,IL-8,IL-17,IL-23,TNF-o,IFN-γ show obvious changes in children with HSP,which suggests that the changes of cytokines are associated with the pathogenesis and prognosis of Henoch-Schonlein purpura.