Volume 102 ·  Issue 02 ·  2022

The process of population aging is gradually deepening, and the problems of disability, cognitive impairment and frailty are widely prevalent among the elderly in China. The key to healthy aging is to optimize functional ability, which is not only related to healthy people; many older adults suffer from one or more diseases, which do not affect their functional ability. The health of the elderly is affected by multi-dimensional factors such as heredity, environment, lifestyle, social behavior and mental psychology. Previous studies, focusing on the outcomes of death, diseases, functional ability and intrinsic capacity decline, have revealed a series of distribution characteristics and influencing factors, and found that there are special epidemiological characteristics on health among the oldest-old and are different from that in the general elderly. Nevertheless, there are still insufficient research to identify the key factors and related mechanisms of elderly health. This issue focused on the functional ability, intrinsic capacity and disease outcomes of the elderly, carried out analysis and research by using the data of national representative cohort and key areas, and made a series of explorations on the important factors and possible mechanisms of the elderly health, so as to provide scientific evidence for coping with population aging and health in China.

Excessive emission of greenhouse gases is the most important reason for global warming. Severe climate change significantly threatens human health. World Health Organization estimated that 12.6 million deaths were attributable to modifiable environmental factors and climate change would lead to 0.25 million deaths annually during 2030-2050. All countries in the world try to reduce greenhouse gas emission to mitigate adverse impacts of climate change by following the Paris Agreement, through setting goals and measures of carbon peak, and carbon neutrality. China plays a very important role in the campaign of global Carbon Peak and Carbon Neutrality. Climate change is also a global health emergency, and Carbon Peak and Carbon Neutrality will be a strategic opportunity for China′s health system. The goals of Carbon Peak and Carbon Neutrality are harmonized with those of China′s health system, both aiming to provide high-quality health security for all Chinese people. China′s health system should try to not only reduce its own carbon footprints, but also make significant contributions to the global Carbon Peak and Carbon Neutrality campaign.

To investigate the association between urinary arsenic levels and anemia among older adults in nine longevity areas of China.

A total of 1 896 subjects aged 65 years and above who participated in the Healthy Aging and Biomarkers Cohort Study (HABCS) in 2017-2018 were included. A self-made questionnaire was used to collect demographic characteristics, lifestyle and other information from the subjects. Through physical examination, data including height, weight and blood pressure were determined and body mass index (BMI) was calculated. Blood and urine samples were collected for the detection of hemoglobin (Hb), blood glucose, blood lipids, plasma vitamin B₁₂ and urinary arsenic concentrations. The urinary arsenic levels were divided into four groups according to the quartiles of urinary arsenic concentrations (μg/g creatinine): Q₁ (<18.7), Q₂ (18.7-34.5), Q₃ (34.6-69.5) and Q₄(≥69.6). Multivariate logistic regression model and restricted cubic spline fitting logistic regression model were used to analyze the association between urinary arsenic levels and anemia.

The age of the 1 896 subjects (M (Q₁, Q₃)) was 83 (74, 92) years, including 952 females (50.21%), and the concentration of Hb (M (Q₁, Q₃)) was 135 (124, 147)g/L. The prevalence of anemia was 24.89% (472 cases). The geometric mean and M (Q₁, Q₃) of urinary arsenic concentrations were 37.5 and 34.6 (18.7, 69.6)μg/g creatinine, respectively. Multivariate logistic regression model analysis showed that after adjusting for age, gender, BMI, education level, smoking and drinking status, residence, economic level, ethnicity, the status of vitamin B₁₂ deficiency, consumption frequency of aquatic products and meat, the prevalence of hypertension, diabetes and dyslipidemia, urinary arsenic levels were positively associated with anemia (Taking group Q₁ as a reference, OR (95%CI) values in Q₂, Q₃ and Q₄ groups were 1.73 (1.20-2.50), 2.08 (1.43-3.02) and 1.52 (1.02-2.28), respectively). The results of restricted cubic spline fitting logistic regression analysis showed a non-linear association between urinary arsenic concentrations and anemia (P<0.001). Subgroup analysis showed there was a negative multiplicative interaction between the prevalence of chronic diseases and urinary arsenic levels with OR (95%CI) was 0.55 (0.30-0.99), while no multiplicative interaction was found between age, gender, residence, smoking status, drinking status and urinary arsenic levels (P>0.05). There was a positive association between urinary arsenic levels and anemia in participants who were absence of chronic diseases,male, living in rural, smoking and drinking with OR (95%CI) values of 3.62 (1.30-10.06),2.46 (1.34-4.52), 1.70 (1.03-2.80), 2.21 (1.01-4.82) and 2.79 (1.23-6.33), respectively.

There is a positive association between urinary arsenic levels and anemia among older adults in nine longevity areas of China.

To investigate the association between sleep duration and activity of daily living (ADL) in the elderly aged 65 years and older in China.

A total of 11 247 subjects aged 65 and above were included in the Chinese Elderly Health Factors Tracking Survey from March 29, 2005 to April 8, 2019. Self-made questionnaire was used to collect the data of population sociological characteristics, health status and disease status. ADL status was assessed by basic activities of daily living. The association between sleep duration and ADL impairment was assessed by Cox proportional risk regression model. The dose-response relationship between sleep duration and ADL impairment was analyzed using restricted cubic spline function.

The age of the subjects was (79±10) years, including 5 793(51.5%) females. The incidence of ADL impairment was 33.3% (3 747/11 247). Subjects were divided into short, medium, and long sleep groups according to sleep duration of fewer than seven hours, seven to eight hours, or more than eight hours. The number of short, medium and long sleepers was 2 974 (26.4%), 4 922 (43.8%) and 3 351(29.8%), respectively. The intermediate sleep group had the lowest incidence of impaired ADL (4.98/100 person-years). Cox proportional risk regression model analysis showed that: taking the intermediate sleep group as reference, after adjustment of gender, age, marital status, educational level, place of residence, living with family, smoking, drinking, exercise, frequency of fruit consumption, vegetable intake frequency, sleep quality, factors such as hypertension, diabetes, heart disease and cerebrovascular disease, the long sleep time increased the risk of impaired ADL [HR (95%CI): 1.148 (1.062-1.241)]. Subgroup analysis showed a weak positive multiplicative interaction between sleep duration and age [HR (95%CI): 1.004 (1.000-1.009)], but no multiplicative interaction between sleep duration and sex [HR(95%CI): 0.948 (0.870-1.034)]. Longer sleep duration increased the risk of ADL impairment in women [HR (95%CI): 1.195 (1.074-1.329)], but not in men [HR (95%CI): 1.084 (0.966-1.217)]. Longer sleep duration increased the risk of ADL impairment in people aged 80 years and older [HR (95%CI): 1.185 (1.076-1.305)], but not in people younger than 80 years [HR (95%CI): 1.020 (0.890-1.169)]. There was a non-linear dose-response relationship between sleep duration and ADL damage (P=0.007), and the risk of ADL damage was lowest when sleep duration was 7.5 h.

Sleep duration was positively correlated with the risk of ADL impairment in the elderly in a nonlinear dose-response relationship.

To explore the relationship between nutritional status and depression of centenarians in Hainan Province.

A total of 1 002 elderly people in Hainan Province who were 100 years of age or older on June 1, 2014 were included in the study. The basic condition questionnaire, Mini Nutritional Assessment Short-Form (MNA-SF), Instrumental Activities of Daily Living-Lawton scale (Lawton-IADL) and Geriatric Depression Scale (GDS-15) were used to collect the subjects′ demographic characteristics, disease history, nutritional status, functional status of daily activities, and depression, respectively. The restricted cubic spline fitting logistic regression model was used to analyze the relationship between the scores of MNA-SF and depression. The multivariable logistic regression model was used to analyze the relationship between nutritional status and depression in the total population and different subgroups of daily activity function.

The M (Q₁, Q₃) of subjects′ age was 102 (101, 104) years old, among which 82.0% (822) were women. The prevalence of malnutrition, impaired daily activities, and depression was 20.8% (208 cases), 64.7% (648 cases) and 28.5%(286 cases), respectively. Restricted cubic spline fitting logistic regression model showed a linear association between the scores of the MNA-SF and depression (P=0.251). The higher the MNA-SF score was, the lower the risk of depression was in centenarians. Multivariable logistic regression model analysis showed that after adjusting for sex, education level, diabetes, hypertension, coronary heart disease, visual function, hearing function, and functional status of daily activities, malnutrition was positively associated with the development of depression in the total population and the subgroup with impaired daily activities [OR (95%CI) was 1.50 (1.07-2.11) and 1.56 (1.09-2.24), respectively], but not in the subgroup with good daily activities [OR (95%CI): 0.77 (0.21-2.80)].

Malnutrition is positively associated with depression, especially in the centenarians with impaired daily activities.

To construct an epigenetic clock model for assessing and calibrating human biological age.

Convenience sampling was used to select 186 subjects from the longevity cohort of Guangxi Zhuang Antonornous Region from July 1 to November 30, 2019, and 124 subjects from the physical examination population of the Seventh Medical Center of the PLA General Hospital from October 1 to December 31, 2020. Self-designed questionnaire was applied to collect demographic characteristics and family history of disease. Physical examination was applied to determine heart rate and blood pressure. Fasting peripheral venous blood was drawn for determination of fasting plasma glucose, plasma total cholesterol, triglyceride, plasma high-density lipoprotein cholesterol, plasma low-density lipoprotein cholesterol and telomere length. Methylation levels of EDARADD cg09809672, IPO8 cg19722847, NHLRC1 cg22736354, P2RX6 cg05442902 and SCGN cg06493994 were detected by targeted methylation site sequencing. A total of 54 subjects with unqualified quality control of DNA methylation and telomere length were excluded, and 256 subjects′ data were finally analyzed. Trend test was used for the change of methylation level among different ages groups, multiple linear regression method was used to build prediction models of biological age. Kendal rank correlation analysis was used to evaluate the correlation of age gap (Gregorian calendar age minus biological age) with telomere length. Independent sample t-test was used to compare the health-related indicators between subjects with different age gap within different age groups.

The M(Q₁, Q₃)of age of subjects were 67 (51, 91) years old, including 166 females (64.84%). With increase of age, the methylation levels of gene loci were decreased (EDARADD cg09809672, IPO8 cg19722847 and P2RX6 cg05442902) and increased (NHLRC1 cg22736354 and SCGN cg06493994) (all P values<0.05). The established biological age prediction model was as follows: Y=-53.121×EDARADD cg09809672-137.564×IPO8 cg19722847+141.040×NHLRC1 cg22736354-67.893×P2RX6 cg05442902+149.547×SCGNcg06493994+4.592×sex+64.185 (R²=0.86, P<0.001), where Y was the biological age, and the items in the equation were methylation level, sex (male =1, female =2) and intercept in sequence. The Kendall rank correlation coefficient between age gap and telomere length was 0.731 (P<0.001). Compared with the subjects whose age gaP<0, the subjects with age gaP≥0 had higher systolic blood pressure in adolescence [(88.50±8.89) and (109.83±9.48) mmHg, respectively, 1 mmHg=0.133 kPa]; lower TC [(5.48±0.23) and (3.98±0.54) mmol/L, respectively, ] and TG [(3.51±0.32) and (3.41±0.20) mmol/L] in young adults; lower fasting blood glucose in middle age [(6.17±0.67) and (5.37±0.79) mmol/L, respectively, ] and higher diastolic blood pressure in nonagenarian age [(76.99±6.78) and (83.97±9.36) mmHg, respectively, ] (all P values<0.05).

The constructed epigenetic clock model can be used to evaluate and calibrate human biological age.

To investigate the feasibility of assessing cognitive function of the elderly by serum metabolites of brain-gut axis.

Convenience sampling was used to select 100 and 60 participants from the healthy population cohort and microecological balance cohort of the longevity population in Guangxi, to constitute subset of healthy population and longevity population, respectively. A questionnaire was used to investigate the demographic characteristics of the subjects, 2-5 ml of fasting venous blood was collected from the subjects, and the serum untargeted metabolomics was determined by liquid chromatography tandem mass spectrometry. The biomarkers related to the brain-gut axis were collected through literature retrieval, and the results were intersected with the untargeted metabolites and annotated. Spearman correlation analysis was used to screen serum metabolites of brain-gut axis associated with aging, and multiple linear regression method was used to construct biological age model. The mini mental status examination was used to evaluate the cognitive function of longevity population subsets. The differences of biological age and chronological age of longevity population subsets with different cognitive function were compared.

The M (Q₁, Q₃) of subset of healthy population and longevity population were 64 (38, 72) and 97 (95, 99) years old, respectively, and there were 50 (50.0%) and 44 (73.3%) females, respectively. Nine serum metabolites of brain-gut axis were obtained by initial screening, which were propionic acid, glutamic acid, γ-aminobutyric acid (GABA), lactic acid, 5-hydroxytryptamine (5-HT), tryptophan, trimethylamine oxide, dopamine and canine urea. Spearman correlation analysis showed that glutamic acid and dopamine were positively correlated with aging (r values were 0.208 and 0.524, respectively, all P values<0.05), and tryptophan, 5-HT and GABA were negatively correlated with aging (r values were -0.308, -0.533 and -0.213, respectively, all P values<0.05). The biological age model was constructed as: y=49.81-1.18×10^-5× GABA-1.82×10^-4×5-HT+1.99×10^-3×dopamine+1.65×10^-6×glutamic acid -2.04×10^-6×tryptophan+2.36×gender, where y was the biological age (years), the items on the right were the intercept item, the relative concentration of each metabolite, and gender (male=1, female=2). The coefficient of determination of model was 0.50 (P<0.001). The M (Q₁, Q₃) of the chronological age of the subset of longevity population with poor, moderate and good cognitive function were 97 (94, 100), 97 (93, 101) and 96 (94, 101) years old, respectively, and there was no statistical significance in pairwise comparison (all P values>0.05). The M (Q₁, Q₃) of the biological age of the subjects with better cognitive function was 51 (38, 54) years old, which was lower than that of the subjects with poor cognitive function [57 (47, 61)] (P=0.040).

The biological age model can be constructed based on serum metabolites of brain-gut axis and used to evaluate the cognitive function of the elderly.

To construct an easy-to-use risk prediction tool for 6-year risk of activities of daily living(ADL) disability among Chinese elderly aged 65 and above.

A total of 34 349 elderly aged 65 and above were recruited from the Chinese Longitudinal Healthy Longevity Survey. Demographic characteristics, lifestyle and chronic diseases of the elderly were collected through face-to-face interviews. The functional status of the elderly was evaluated by the instrumental activities of daily living(IADL) scale. The mental health status of the elderly was evaluated by the Mini-Mental State Examination. The height, weight, blood pressure and other information of the subjects were obtained through physical examination and body mass index(BMI) was calculated. The ADL status was evaluated by Katz Scale at baseline and follow-up surveys. Taking ADL status as the dependent variable and the key predictors were selected from Lasso regression as the independent variables, a Cox proportional risk regression model was constructed and visualized by the nomogram tool. Area under the receiver operating characteristic curve(AUC) and calibration curve were used to evaluate the discrimination and calibration of the model. A total of 200 bootstrap resamples were used for internal validation of the model. Sensitivity analysis was used to evaluate the robustness of the model.

The M(Q₁, Q₃) of subjects′ age as 86(75, 94) years old, of which 9 774(46.0%) were males. A total of 112 606 person-years were followed up, 4 578 cases of ADL disability occurred and the incidence density was 40.7/1 000 person-years. Cox proportional risk regression model analysis showed that older age, higher BMI, female, hypertension and history of cerebrovascular disease were associated with higher risk of ADL disability [HR(95%CI) were 1.06(1.05-1.06), 1.05(1.04-1.06), 1.17(1.10-1.25),1.07(1.01-1.13) and 1.41(1.23-1.62), respectively.]; Ethnic minorities, walking 1 km continuously, taking public transportation alone and doing housework almost every day were associated with lower risk of ADL disability [HR(95%CI): 0.71(0.62-0.80), 0.72(0.65-0.80), 0.74(0.68-0.82) and 0.69(0.64-0.74), respectively]. The AUC value of the model was 0.853, and the calibration curve showed that the predicted probability was highly consistent with the observed probability. After excluding non-intervening factors(age, sex and ethnicity), the AUC value of the model for predicting the risk of ADL disability was 0.779. The AUC values of 65-74 years old and 75 years old and above were 0.634 and 0.765, respectively. The AUC values of the model based on walking 1 km continuous and taking public transport alone in IADL and the model based on comprehensive score of IADL were 0.853 and 0.851, respectively.

The risk prediction model of ADL disability established in this study has good performance and robustness.

To investigate the characteristics and effect factors of collateral blood supply of patients with early trimester cesarean scar pregnancy(CSP).

This study was a multicenter case-control study, with 219 inpatients with CSP in First People′s Hospital of Zhengzhou, Zhengzhou Central Hospital, Third People′s Hospital of Zhengzhou and Henan No3 Provincial People′s Hospital from January 1, 2017 to June 30, 2020 who were selected to obtain their clinical data. Double-blind method was performed in digital subtraction angiography imaging analysis. The patients were divided into collateral blood supply group and non-collateral blood supply group, and the incidence of collateral blood supply of patients with early trimester CSP was calculated. Multivariate binary logistic regression analysis was performed to find the independent risk factors of collateral blood supply of patients with early trimester CSP. As well, clinical outcomes after uterine artery embolization (UAE) were compared between the two groups.

A total of 219 patients with early trimester CSP have average age of (32.4±5.0) years old and average pregnancy of (51.0±10.6) days. The incidence of collateral blood supply was 12.3% (27 cases), of which16 cases were on the left, 6 on the right and 5 in both sides. A total of 43 collateral vessels were found, with 1.59 vessels per patient on average. Bladder artery was the most common source of collateral blood supply, accounting for 74.4% (32/43), followed by internal pudendal artery for 18.6% (8/43). Multivariate binary logistic regression analysis showed that gestational weeks ≥8 weeks, maximum diameter of gestational sac ≥50 mm and rich blood supply of gestational sac are independent risk factors for collateral blood supply of patients with early trimester CSP, with OR (95%CI) 3.68 (1.06-12.76), 7.00 (1.52-32.19)、9.96 (3.59-27.58), respectively, all P<0.05. The success rates of UAE were 100% in both groups. The reduction in serum β-Human chorionic gonadotropin (β-HCG) level at 24 hours after UAE, vaginal bleeding during uterine curettage, hysterectomy and menstrual recovery time were not found to have significant difference between groups (all P>0.05).

Early trimester CSP leads to a certain occurrence of collateral blood supply, which may have adverse impact on the efficacy of UAE and patient safety. Gestational weeks, the maximum diameter of gestational sac and the degree of vascularization of gestation sac have certain value in suggesting the collateral blood supply of patients with early trimester CSP, which is helpful for the complete embolization of gestational sac in the process of UAE.

To analyze the efficacy and safety of toripalimab combined with axitinib in the treatment of advanced renal cell carcinoma.

Clinical data of 50 patients with advanced renal cell carcinoma who received axitinib combined with toripalimab were retrospectively collected from the database of Peking University Cancer Hospital. ORR, DCR, PFS, and OS were analyzed.

Among the 50 patients, 37 were males; median age was 56 (22-73) years; 38 were pathologically diagnosed as clear cell renal cell carcinoma and 12 were non-clear cell carcinoma. Common metastatic sites included lung, bone, lymph node, liver, and so on. 90% of the patients had received at least one-line of systemic therapy. With a median follow-up time of 11.9 months (0.8-24), 27 of the 50 patients are still on treatment, ORR was 34%, DCR was 86%, median PFS was 13.1 months (95%CI 5.8-20.4), and median OS has not yet reached. One-year OS rate was 84.6%. Common adverse reactions were proteinuria, diarrhea, hypertension, abnormal thyroid function, elevated transaminase, and hand-foot syndrome. Most adverse events were grade 1-2.

Toripalimab combined with axitinib was efficient in the treatment of advanced renal cell carcinoma, and had manageable adverse reactions.

To investigate the change of innate lymphoid cells (ILC) subsets in peripheral blood and ascites in liver cirrhotic patients complicated with spontaneous bacterial peritonitis (SBP).

The data of 62 patients with liver cirrhosis admited to the Zhumadian Central Hospital from November 2019 to November 2020 were analyzed. Among them, 41 cases were complicated with untainted ascites (untainted ascites group), while the other 21 cases were complicated with SBP (SBP group). Meanwhile, 20 cases of controls who received healthy examination in the same period were also enrolled (control group). Peripheral blood mononuclear cell (PBMC) was isolated from peripheral blood of all patients and controls. Mononuclear cell in ascites was isolated from patients with liver cirrhosis. The percentage of ILC1, ILC2, and ILC3 subsets in PBMC and mononuclear cell in ascites were measured by flow cytometry. CD3^-CD19^-CD20^-CD14^- cells (lin^-cells) were purified from ascites and were stimulated with lipopolysaccharide (LPS) for 24 h. The transcription factor T-bet, GATA3, and RORγt mRNA relative level in lin^-cells was semi-quantified by real-time PCR. Cytokine level in the supernatants was measured by enzyme linked immunosorbent assay. Differences of ILC subsets in peripheral blood and ascites were compared among groups.

There were twenty-nine males and twelve females in untainted ascites group, aged M(Q₁,Q₃) 49(33, 78) years. There were twelve males and nine females in SBP group, aged 50(37, 76) years. There were eleven males and nine females in control group, aged 48(32, 69) years. lin^-CD45⁺CD161⁺CD127⁺ ILC cells could be detected in both peripheral blood and ascites. There was no significant difference in total ILC percentage within PBMC among untainted ascites group, SBP group, and control group (P=0.235). There was also no significant difference of total ILC percentage within mononuclear cells in ascites between untainted ascites group and SBP group (P=0.232). The differences were not statistically significant of peripheral CD117^-CRTh2^-ILC1, CRTh2⁺ILC2, or CD117⁺CRTh2^-ILC3 within peripheral ILC among untainted ascites group, SBP group, and control group (all P>0.05). ILC1 percentage in ascites was up-regulated in SBP group compared with untainted ascites group (35.69%±3.39% vs 26.40%±3.85%, P<0.001), while ILC2 in ascites was down-regulated in SBP group (36.83%±7.70% vs 48.35%±9.45%, P<0.001). There was no statistical difference in ILC3 percentage in ascites between the two groups (P=0.230). T-bet mRNA relative level and IFN-γ production by lin^- cells from ascites were elevated in response to LPS stimulation in SBP group compared with untainted ascites group (both P<0.001). GATA3 mRNA relative level and IL-5/IL-13 secretion by lin^-cells from ascites were reduced in SBP group compared with untainted ascites group (both P<0.05). There was no significant difference of RORγt mRNA relative level or IL-17/IL-22 expression between the two groups (both P>0.05).

Peripheral ILC subsets do not change in liver cirrhosis patients with SBP. ILC1 percentage is up-regulated, and ILC2 percentage is down-regulated in ascites in liver cirrhosis patients with SBP.

A total of 16 detrusor hyperactivity with impaired contractility (DHIC) patients who received 12 weeks remote variable frequency stimulation (VFS) were enrolled at the First Affiliated Hospital of Zhengzhou University from September 2020 to February 2021. The voiding diary, symptom score scales and incidence of complications were completed and recorded at baseline, constant frequency stimulation (CFS) and VFS phases. Compared with the CFS phase, voiding times, urge incontinence times and daily catheterization volume were reduced; average voiding amount and functional bladder capacity increased; and the quality of life score and mental health questionnaire assessment were improved in the VFS phase(all P<0.05). In the end, among all 16 patients, there were 14 whose symptoms had improved, and there were no new complications such as pain or infection at the implantation site, electrode displacement, and electric shock sensation in the stimulation area. VFS-SNM can not only improve the DHIC patients′ lower urinary tract symptoms during storage and urination period, but also improve the patients′ quality of life and satisfaction of the therapy.

This article reports a rare male patient with positive antinuclear antibody with leukopenia and hypocomplementemia, who developed acute renal injury during hospitalization. The diagnosis of systemic lupus erythematosus (SLE) was once suspected, but it was confirmed by renal biopsy pathological examination to be renal invasive B-cell lymphoma. Because this case has many clinical manifestations that simulate SLE, but lacks the common manifestations of lymphoma, it is easy to cause misdiagnosis.

This study reports a typical case ofKMT2DKabuki syndrome (KS) caused by a new truncated pathogenic variant of the gene (the mutation locus is c.849delG, p.Asn284MetfsTer20), and the effect of growth hormone therapy was followed up in patients, which suggests that growth hormone therapy can improve the height problem of KS patients to some extent.

Improvements in virtual reality and augmented reality devices and technological advances are changing the way we perceive and interact with various digital information, so that many scenes can put users in an ideal visual sensory environment through head-mounted devices. In recent years, the research of virtual reality/augmented reality in the field of ophthalmology is mainly reflected in clinical application and teaching. This paper reviews the relevant research in the fields of vision training and amblyopia treatment, myopia prevention and control, eye adjustment and convergence function, strabismus diagnosis, ophthalmic surgery assistance and ophthalmology teaching, and expounds the relevant parameters in eye health.