The rapid development of intelligent ophthalmology research in recent years still faces some challenges in its clinical application or clinical translation process. Two important issues that urgently need to be addressed in the development of intelligent ophthalmology are: promoting clinical application and maintaining medical equity. In response to the aforementioned issues, this article analyzes the reasons and current situation of the insufficient promotion of clinical application and the potential challenges of medical equity, and proposes that promoting clinical application and maintaining medical equity are key issues in the development of intelligent ophthalmology. At the same time, it systematically proposes corresponding specific measures to promote the development of intelligent ophthalmology.

Glaucoma is an eye disease characterized by pathologically elevated intraocular pressure, optic nerve atrophy, and visual field defects, which can lead to irreversible vision loss. In recent years, the rapid development of artificial intelligence(AI)technology has provided new approaches for the early diagnosis and management of glaucoma. By classifying and annotating glaucoma-related images, AI models can learn and recognize the specific pathological features of glaucoma, thereby achieving automated image analysis and classification. Research on glaucoma imaging classification and annotation mainly involves color fundus photography(CFP), optical coherence tomography(OCT), anterior segment optical coherence tomography(AS-OCT), and ultrasound biomicroscopy(UBM)images. Color fundus photography is primarily used for the annotation of the optic cup and disc, OCT is used for measuring and annotating of the thickness of the retinal nerve fiber layer, and AS-OCT and UBM focus on the annotation of the anterior chamber angle structure and the measurement of anterior segment structural parameters. To standardize the classification and annotation of glaucoma images, enhance the quality and consistency of annotated data, and promote the clinical application of intelligent ophthalmology, this guideline has been developed. This guideline systematically elaborates on the principles, methods, processes, and quality control requirements for the classification and annotation of glaucoma images, providing standardized guidance for the classification andannotation of glaucoma images.

ObjectiveTo analyze the detected results of CD4⁺T lymphocytes and viral load in newly identified human immunodeficiency virus (HIV) infected patients in Huangpu District of Shanghai in 2023, to explore the correlation between them, so as to provide a scientific basis for the development of targeted prevention and control measures and antiviral treatment programs. MethodsThe data of CD4 cell count, viral load and demographic characteristics of the newly infected patients living with HIV in Huangpu District, Shanghai in 2023 were collected and analyzed by using descriptive epidemiological method. ResultsThe mean CD4 cell count of the 67 newly identified HIV infected patients in Huangpu District was (301.22±235.19) cells·µL^-1, with a mean viral load of (5.15±1.28) ×10⁵ copies·mL^-1.There were statistically significant differences in CD4 cell count and viral load among different age groups (P<0.05), but there were no statistically significant differences by gender and marital status (both P>0.05). The CD4 cell count and CD4/CD8 ratio both were negatively correlated with the lg value of viral load (r=-0.290, -0.378; P=0.027, 0.002). ConclusionThe CD4 cell counts of the newly identified HIV infected patients in Huangpu District in 2023 were generally low, the proportion of patients with high viral load was high, but the risk for elderly infected with HIV was high. The elderly have gradually become the key population for AIDS prevention and control in Huangpu District. It is recommended to expand HIV screening in the elderly to reduce the risk of HIV transmission and increase the rate of early detection and treatment.

This paper provides a comprehensive analysis of the current state of intelligent ophthalmology in China, including technological advancements, academic exchange platforms, policy support, future challenges, and potential solutions. Technologically, remarkable progress have been made in various areas of intelligent ophthalmology in China, including diabetic retinopathy, fundus image analysis, and crucial aspects such as quality assessment of medical artificial intelligence products, clinical research methods, technological evaluation, and industrial standards. Researchers are constantly improving the safety and standardization of intelligent ophthalmology technology by formulating clinical application guidelines and standards. Academic exchange platforms have been established to provide extensive collaboration opportunities for professionals across diverse fields, and various academic journals serve as publication platforms for intelligent ophthalmology research. Regarding public policy, the Chinese government has not only established a supportive policy environment for the advancement of intelligent ophthalmology through various documents and regulations, but provided a legal basis and management framework. However, there are still challenges to overcome, such as technological innovation, data privacy and security, outdated regulations, and talent shortages. To tackle these issues, there is a requirement for increased technological research and development, the establishment of regulatory frameworks, talent cultivation, and greater awareness and acceptance of new technologies among patients. By comprehensively addressing these challenges, intelligent ophthalmology in China is expected to continue leading the industry's global development, bringing more innovation and convenience to the field of ophthalmic healthcare.

Objective:To clarify the medical security plan and its practical effects at the main venue of the 19th Hangzhou Asian Games.Methods:The plan described the medical security implementation plan of the main venue of the 19th Asian Games in Hangzhou (organizational management and operation mechanism, medical security operation system, standardized training and support processes, application of Asian Games intelligent first aid security system, and so on). And through high-facticity simulation verify the operation effect of the main venue's medical support (team mode and response time). Finally, the feasibility and effectiveness of the medical security program verified through the effect of medical services (quantity, disease types, transfers, etc.) during the Asian Games and Asian Paralympic Games.Results:The medical security team of the main venue of the 19th Hangzhou Asian Games included the management team and the operation team, of which consisted of 44 medical staffs (22 doctors and 22 nurses); and were deployed to 16 different security positions. It was also accompanied with 16 volunteers to assist medical staff to transport patients. In addition, a total of 300 medical observers were enrolled in audience area to assist rapid identification, intervention, and collaborative diagnosis and treatment with the medical team. Medical security teams were arranged to cover all the audience areas who can arrive at the patient's area within 2 minutes after receiving orders, transfer the patient to the ambulance’s site in 8 minutes, and transport the patient to a designated hospital within 10-20 minutes. During the Asian Games and Asian Paralympic Games, the medical-care team treated a total of 3 742 patients, including 9 patients transported from medical service sites of the audience area to the stadium infirmary, as well as 83 patients referred to the designated hospital.Conclusions:The medical security implementation plan for the main venues of the Asian Games provides good medical security for the Asian Games and Asian Paralympic Games. It also provides theoretical and practical experience for the development of the medical security system for international events in future.

With the continuous deepening of aging in our country,the demand and importance of medical care and health management of the elderly are becoming more and more prominent,and the construction of discipline system of medical care and health management of the elderly provides powerful talent support for promoting the development of aging cause and the development of medical care and health industry.However,there are still many shortcomings in the professional construction and talent cultivation in the field of medical care and health management of the elderly in our country.Universities are still exploring and practicing in this area,and there is an urgent need to strengthen the construction of disciplinary systems and promote the development of the medical care and health industry.This paper introduces the construction of discipline system of medical care and health management of the elderly,analyzes the existing problems,looks forward to its future development direction,and elaborates the specific measures and characteristics in the construction of discipline system of medical care and health management of the elderly.

In order to cope with the challenges of an aging society,the construction and implementation of a policy system about integrated elderly care and medical services is an important measure to protect the health rights and interests of the elderly.By integrating medical care with elderly care services,the policy aims to provide comprehensive and continuous support for elderly care and health,and meet the diversified needs of the elderly in terms of medical treatment,rehabilitation,nursing,and life care.The construction and implementation of this policy system will not only help to improve the quality of life of the elderly,but also help to improve the service efficiency of the medical and health system and promote sustainable social and economic development.This paper reviews the policy of integrated elderly care and medical services from multiple perspectives such as its development history,policy level,classification and characteristics.

Objective This study aims to investigate the impact of cultivation time on dendritic cells(DCs)and their derived exosomes′ expression of immune-related membrane proteins(CD80,MHC-Ⅰ,MHC-Ⅱ)and provides experimental evidence for future research.Methods Mouse bone marrow cells were induced to differentiate into DCs using GM-CSF and IL-4,followed by maturation stimulation withTNF-α.Exosomes were extracted using ultracentrifugation.Western blot and Amnis image flow cytometry were used to identify exosomes derived from mouse DCs.Amnis image flow cytometry was used to detect the expression of immune-related proteins CD80,CD11c,MHC-Ⅰ,and MHC-Ⅱ in mouse DCs and their exosomes.Results After 5 days of in vitro cultivation,more than 50%of dendritic cells expressed CD80,CD11c,MHC-Ⅰ,and MHC-Ⅱ,reaching the highest level on day 13.The positivity rates were as follows:CD80(97.29±0.63)%,CD11c(92.31±1.18)%,MHC-Ⅰ(97.91±0.49)%,and MHC-Ⅱ(97.91±0.49)%.The differences were statistically significant(P<0.001).The expression gradually decreased after day 13,but approximately 80%of DC cells still expressed MHC-Ⅰ and MHC-Ⅱ immune molecules on day 30.The expression levels of CD80,CD11c,and MHC-Ⅱ on the exosome membrane were highest on day 5 and then decreased overall with prolonged cultivation time,except for MHC-Ⅰ molecules.The differences were statistically significant(P<0.01).Conclusions In vitro-cultured mouse dendritic cells express high levels of immune-related membrane proteins and can be stably maintained for a long time under suitable culture conditions.The secreted exosomes also carry abundant immune-related membrane proteins,but no significant correlation was found between the immune-related proteins on the dendritic cell surface and the exosome membrane surface.

Objective To investigate the diagnostic value of superb microvascular imaging(SMI)grading,CT angiography(CTA),and serum small and dense low-density lipoprotein cholesterol(sdLDL-C)in elderly hypertension patients with acute cerebral infarction(ACI).Methods A ret-rospective study was conducted on 180 elderly hypertension patients admitted to our hospital from June 2021 to June 2023,and those admitted due to ACI were assigned into ACI group(95 cases)and those without into non-ACI group(85 cases).The SMI grade,CTA,and serum sdLDL-C level were compared between the two groups.ROC curve was plotted to analyze the diagnostic value of SMI grading and CTA combined with serum sdLDL-C for ACI in patients with hyperten-sion.Multivariate logistic regression analysis was employed to analyze the factors affecting the oc-currence of ACI in the patients.Results The ACI group had significantly larger proportion of hy-perlipidemia,and higher DBP,SBP,and HDL-C,and LDL-C than the non-ACI group(P＜0.05).The proportion of SMI grade 2 and grade 3 and serum sdLDL-C level were also greatly higher[35.79％vs 10.59％,43.16％vs 8.24％,(1.62±0.25)mmol/L vs(1.35±0.19)mmol/L,P＜0.01],and the proportion of SMI grade 0 and grade 1 was lower(11.58％vs 51.76％,9.47％vs 29.41％,P＜0.01)in the ACI group than the non-ACI group.ROC curve analysis showed that the AUC value of SMI grade and CTA combined with serum sdLDL-C in diagnosing ACI in patients with hypertension was 0.934(95％CI:0.897-0.972).Multivariate logistic regression analysis in-dicated that SMI grade,CTA,and sdLDL-C were risk factors for ACI in hypertensive patients(P＜0.01).Conclusion Combination of carotid artery plaque SMI grading,CTA,and serum sdLDL-C has high auxiliary diagnostic value for elderly hypertension patients with ACI.

Objective: To investigate the association of parental knowledge and skills in myopia prevention and control with healthy eye behavior in primary school children, so as to provide a basis for accurate family education. Methods: A total of 4 979 students in grades 1-5 from eight elementary schools in Pudong New Area were sampled between October and December in 2022 by using a stratified cluster sampling method. A self administered questionnaire was used to assess healthy eye behavior in primary school children and parental knowledge and skills in myopia prevention and control. The Chi squared test, independent samples t-test and Logistic regression were used to analyse the association between parental knowledge and skills in myopia prevention and control and healthy eye behaviour in primary school children. Results: Parents of primary school children with a high level of knowledge and skills in myopia prevention and control were 50.97% and 56.36%, respectively. The knowlegde entry scores for parents of lower and middle elementary school students were higher than those of parents of upper primary students with respect to their understanding, on the main causes of myopia in their children, the correct knowledge of myopia prevention and control, the role of family members in helping each other to manage and treat myopia in their children and the parents responsibility to teach their children to use their eyes correctly and scientifically (3.05±1.21, 2.97±1.20; 5.92±0.68, 5.83±0.86; 4.46±0.88, 4.40±0.93; 3.88±1.04, 3.72±1.07); all differences were statistically significant (t=2.04, 3.39, 2.00, 4.87, P<0.05). The differences in the scores of parents of primary school children in different grades for all items were statistically significant (t=2.93-7.31, P<0.05) in the skill entries. Parental knowledge levels were poor for items of full scores that assessed the following: knowing the main causes of their childrens myopia, awareness of the correct knowledge of myopia prevention and control measures, awareness of Comprehensive Prevention and Control Strategy for Children and Adolescents with Myopia, and concerning that their childrens future education and employment will be affected by myopia, understanding the responsibility of parents for guiding children to use their eyes scientifically and correctly, with 12.71%, 22.90%, 19.30%, 21.83% and 22.47% respectively. Parental skills were poor for items of full scores that assessed the following:reminding their children to rest their eyes when doing homework, reading or writing, deliberately avoiding mobile phone use when spending time with their children, the number of times which taking children to the hospital for refractive screening in the past year, and giving their children extra learning tasks, with 33.26%, 15.12%, 9.00% and 5.36% respectively. Compared to parental knowledge in myopia prevention and control, parental skills had a more pronounced effect on the four dimensions of healthy eye behavior (reading and writing, screen time, outdoor activities, and sleep duration) among students in different grades (OR=1.41-3.37, P<0.05). Conclusions Parental knowledge and skills in myopia prevention and control are still insafficient, associated with healthy eye behavior in primary school children. There is a need to strengthen accurate health education for parents on the prevention and control of myopia, to cultivate healthy eye behaviour among primary school students and reduce the incidence of myopia among them.