Table of Content

15 April 2026, Volume 11 Issue 4

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Expert Recommendations on Emphasizing the Pre-Clinic Myopia in Children and Adolescents

Expert Working Group on Pre-Clinic Myopia Recommendations

2026, 11(4):  1-7.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 001

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Objective：To propose the concepts of pre-clinic myopia (PCM) and pre-myopia (PM) during the critical window phase for
myopia prevention and control in children and adolescents, and to explore their value in early myopia intervention. Methods: Relevant
domestic and international studies on myopia were systematically reviewed. Combined with multidisciplinary clinical experience, mul⁃
tiple rounds of expert discussions were conducted to formulate these recommendations. Results: PCM and PM represent important
stages before the onset of myopia. PCM is commonly identified through non-cycloplegic refraction in school screening programs,
whereas PM is confirmed by cycloplegic refraction in clinical settings. Both stages are mainly defined by a spherical equivalent (SE)
range of −0.50 D < SE ≤ +0.75 D. Early identification and intervention during these stages may help delay myopia onset and slow myo⁃
pia progression. Conclusion: Strengthening screening and intervention during the PCM and PM stages, together with establishing a co⁃
ordinated prevention and control system involving governments, schools, families, and medical institutions, may provide important sup⁃
port for early myopia prevention and control in children and adolescents.

Expert Recommendations on the Prevention and Control of Pre-Clinic Myopia in Children and#br# Adolescents

Expert Working Group on Pre-Clinic Myopia Recommendations

2026, 11(4):  8-13.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 002

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Objective：To clarify the concepts, screening methods, and intervention strategies for pre-clinic myopia (PCM) and pre⁃
myopia (PM) in children and adolescents, and to serve as a reference for early myopia prevention and control. Methods: Based on cur⁃
rent research progress in myopia prevention and control and expert clinical experience, the definitions, examination methods, and inter⁃
vention measures for PCM and PM were systematically reviewed and summarized. Results: PCM and PM are both critical stages before
the onset of myopia, with PCM typically detected earlier than PM during non-cycloplegic screening. Monitoring refractive status, hyper⁃
opic reserve, axial length, and related biological indicators can facilitate early identification of children at high risk of myopia. Compre⁃
hensive preventive strategies for PCM include behavioral, pharmacological, and optical interventions, such as increasing outdoor activity
time, improving visual habits, using low-concentration atropine eye drops, and wearing multifocal defocus spectacles, thereby de⁃
laying myopia onset and axial elongation. Conclusion: Early identification of PCM and implementation of comprehensive interventions
are of great significance for delaying myopia onset, slowing myopia progression, and reducing the risk of high-myopia-related complica⁃
tions in children and adolescents.

Expert Recommendations on Strengthening the Development of Intelligent Systems for Myopia Prevention#br# and Control

Expert Working Group on Pre-Clinic Myopia Recommendations

2026, 11(4):  14-20.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 003

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Objective：To clarify the concepts of pre-clinic myopia (PCM) and pre-myopia (PM) in children and adolescents and their
significance in myopia prevention and control, and to explore the application of information technology in early warning and interven⁃
tion for myopia. Methods: Based on current research progress in myopia prevention and control and expert clinical experience, the defi⁃
nitions of PCM and PM, the construction of information-based early warning systems, behavioral intervention measures, and evaluation
methods for prevention and control activities were systematically reviewed and summarized. Results: PCM and PM are important stages
before the development of myopia in children, with PCM generally identified earlier than PM through non-cycloplegic screening. By es⁃
tablishing behavior-based warning systems, examination-based warning systems, and myopia progression prediction systems, dynamic
monitoring and early warning of myopia risk can be achieved. Combined with scientific education, behavioral intervention, and medical
intervention, as well as screening evaluation, vision health record management, and feedback mechanisms through information plat⁃
forms, the precision and effectiveness of myopia prevention and control can be further improved. Conclusion: Establishing an informa⁃
tion technology-based system for early warning and intervention of myopia can facilitate early identification and precise intervention of
myopia risk in children and adolescents, thereby helping reduce myopia incidence and delay disease progression.

Chemoenzymatic Synthesis of Hyoscyamine

Wang Xueqian¹, Tian Hongchang, Duan Baozhong, Zhang Lei,

2026, 11(4):  21-27.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 004

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Objective：To establish an efficient synthetic method for hyoscyamine based on a chemoenzymatic strategy. Methods:
Acetyl-protected 2-phenyl-1,3-propanediol was used as the starting material. A chiral monoalcohol intermediate was constructed
through porcine pancreatic lipase (PPL)-catalyzed desymmetrization, followed by oxidation in a Fe(NO₃)₃/KCl catalytic system to generate
the tropic acid fragment. The key ester bond was then formed through acyl chlorination and esterification with tropine, followed by
deacetylation to afford the target product, L-hyoscyamine. Results: The PPL-catalyzed desymmetrization exhibited good regioselectivity
and stereoselectivity. The target product was successfully obtained through subsequent oxidation and esterification reactions. The
synthetic route consisted of five steps with an overall yield of 53.6%. Conclusion: The established chemoenzymatic strategy effectively
integrates the high selectivity of biocatalysis with the efficiency of chemical transformation, providing a new approach for the green syn⁃
thesis of tropane alkaloids.

Relationship of Psychological Stress with Empowerment and Coping Styles in Patients after Gastric#br# Cancer Surgery

Zhu Wenjuan¹, Gui Lingling¹, Ming Jing²

2026, 11(4):  28-34.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 005

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Objective：To investigate the level of psychological stress in patients after gastric cancer surgery and its relationship with
empowerment and coping styles, so as to provide evidence for improving psychological health and long-term prognosis. Methods: A
retrospective analysis was conducted on the clinical data of 138 patients who underwent radical gastrectomy at Anhui No. 2 Provincial
People's Hospital from March 2022 to February 2024. General information was collected, and the Chinese versions of the Patient Per⁃
ception of Empowerment Scale (PPES), Medical Coping Modes Questionnaire (MCMQ), and Psychosocial Stress Scale for Groups
(PSSG) were used to assess empowerment, coping styles, and psychological stress. Pearson correlation analysis and multiple linear re⁃
gression analysis were performed. Results: The mean PSSG score was (80.28±12.99), indicating that patients experienced psychologi⁃
cal stress to varying degrees. Psychological stress was positively correlated with age, monthly family income, medical payment method,
avoidance coping, and resignation coping, but negatively correlated with all dimensions of empowerment and confrontation coping (P<
0.05). Multiple linear regression analysis showed that decision-making, self-management, and information dimensions of empowerment
were protective factors, whereas resignation coping was a risk factor for psychological stress (P<0.05). Conclusion: Patients after gas⁃
tric cancer surgery generally experience a relatively high level of psychological stress. Empowerment and coping styles are closely asso⁃
ciated with psychological stress. Enhancing patient empowerment, providing information support, and promoting positive coping strate⁃
gies may help reduce psychological stress, thereby improving patients' psychological health and rehabilitation outcomes.

Distribution and Drug Resistance Analysis of Pathogens Causing Bloodstream Infections in 378 Adult#br# Patients in the Daye Area

Shang Fangjian, Zhou Liping, Zhang Guihua, Xiao Fang, Zhang Maohai, Zhu Zhonghua

2026, 11(4):  35-41.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 006

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Objective：To analyze the distribution characteristics and drug resistance of pathogens causing bloodstream infections in
the Daye area, and to provide a reference basis for clinical diagnosis, treatment, and empirical antimicrobial therapy. Methods: A retro⁃
spective analysis was conducted on the clinical data of adult patients with bloodstream infections in Daye People's Hospital from Sep⁃
tember 2022 to September 2024. The distribution and drug resistance of pathogens were statistically analyzed. Results: The top five
pathogens with the highest detection rates were Escherichia coli (accounting for 32.54%), Staphylococcus hominis (accounting for
12.70%), Klebsiella pneumoniae (accounting for 9.26%), Staphylococcus aureus (accounting for 6.08%), and Staphylococcus epidermidis
(accounting for 5.03%) in sequence. Pathogen distribution was significantly associated with sex, type of underlying disease, and some
clinical departments (P < 0.05). The detection rates of methicillin-resistant coagulase-negative staphylococci and methicillin-resistant
Staphylococcus aureus were 65.77% and 30.43%, respectively. Both strains were completely susceptible to vancomycin and linezolid.
Escherichia coli isolates were completely susceptible to carbapenems and tigecycline, with a high resistance rate of 71.43% to
sulfamethoxazole-trimethoprim. The detection rate of extended-spectrum β-lactamase-producing E. coli was 44.72%. Klebsiella pneu⁃
moniae isolates showed complete susceptiblility to minocycline. Conclusion: Staphylococcus species and E. coli are the primary patho⁃
gens causing bloodstream infections in the Daye area. Clinically, the pathogen detection strategy and empirical anti-infection regimens
should be optimized in combination with the distribution and drug resistance characteristics of pathogens in the local area to reduce the
incidence of infection and the risk of multi-drug resistant bacteria.

Bibliometric and Visual Analysis of Research on Depression in Older Adults and Gut Microbiota Based#br# on CiteSpace

Chen Zizhen¹, Yuan Zhiqiong¹, Zhang Xiao², Ji Siyu¹, Guo Shouxia¹, Guo Qinghua¹, Li Lijuan¹

2026, 11(4):  42-54.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 007

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Objective：To analyze the development trends, cooperative network structure, knowledge base and evolution of research
hotspots in studies concerning depression in older adults and gut microbiota through bibliometric and visualization methods, and to pro⁃
vide references for future research. Methods: Relevant publications indexed in the Web of Science Core Collection from January 2005
to December 2025 were retrieved. A total of 486 original research articles and review articles were included. CiteSpace 6.4.R1 software
was used to construct collaboration networks of countries, institutions, and authors, co-citation networks, and keyword co-occurrence
networks, and to identify research frontiers via burst detection. Results: Publication output showed a phased increase, peaking in 2024
with 87 papers (17.9% of total). A total of 61 countries and 286 institutions contributed to this field. The United States ranked first in
both publication volume and centrality(126 papers, centrality 0.40), whereas China ranked second (119 papers) but had a low centrality
(0.02). A total of 328 authors participated, with highly productive authors all showing a centrality of 0.00, indicating fragmented collabo⁃
ration. Co-citation analysis formed 13 knowledge clusters (Silhouette values all > 0.85), covering topics such as dysbiosis and metabo⁃
lism, affective disorders, neurodevelopment, and inflammatory aging. Burst detection showed an evolution of research foci from descrip⁃
tive phenomena ("intestinal microbiota", strength 3.61) to mechanistic exploration ("gut brain axis", strength 2.76) and methodological
validation ("validity", strength 2.94). Conclusion: From 2005 to 2025, research on older adults depression and gut microbiota has
evolved from phenomenological description to mechanistic exploration and then to clinical translation. The research network exhibits a
"strong core-weak periphery" structure, and international collaboration needs to be strengthened. Cognitive impairment, gender differ⁃
ences, and expansion of disease spectrum may emerge as important future research directions, providing new insights for personalized
diagnosis and treatment of geriatric depression based on microbiome characteristics.

Prevalence and Influencing Factors of Abnormal Renal Function among Individuals Aged 65 Years and#br# Above in Yuxi City

Li Yajie, Bai Guangbao, Liu Rui, Yang Rui, Wang Weihua, Li Ji, Qi Kun

2026, 11(4):  55-62.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 008

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Objective：To investigate the prevalence and influencing factors of abnormal renal function among individuals aged 65
and above in Yuxi City. Methods: A systematic sampling method was adopted to select 10 280 elderly people aged 65 and above from
the Yunnan Provincial Basic Public Health Service Information Management System as the research subjects. The binary Logistic re⁃
gression model was used to analyze the related influencing factors of abnormal renal function in the elderly population. Results: The
prevalence of abnormal renal function among individuals aged 65 and above in Yuxi City was 13.79%. Binary Logistic regression analy⁃
sis showed that for the elderly ( the 75-84 years old group OR=3.031, 95%CI: 2.674-3.436, and the 85 years old and above group OR=
6.893, 95%CI: 5.531-8.590), obesity (OR=1.399, 95%CI: 1.062-1.841), former smoking (OR=1.337, 95%CI: 1.037-1.725), hyperten⁃
sion (OR=1.790, 95%CI: 1.575-2.035), diabetes (OR=1.286, 95%CI: 1.101-1.503), dyslipidemia (OR=1.364, 95%CI: 1.199-1.551),
anemia (OR=2.595, 95%CI: 2.140-3.145) were risk factors for abnormal renal function, while regular exercise (OR=0.674, 95%CI:
0.584-0.777) was a protective factor. Conclusion: Age, obesity, exercise habits and multiple chronic diseases are all associated with
abnormal renal function in the elderly population. Renal function monitoring should be strengthened for high-risk individuals. Adopt⁃
ing healthy lifestyle habits may help preserve glomerular filtration rate and reduce the risk of abnormal renal function.

Investigation and Analysis on Job Satisfaction of Vaccination Workers in Dali Bai Autonomous Prefecture

Zhao Lina, Tang Tingting, Zhao Hongmei, Liu Ying, Duan Jing

2026, 11(4):  63-67.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 009

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Objective：To investigate the job satisfaction of vaccination workers in Dali Bai Autonomous Prefecture and its influencing
factors. Methods: Stratified random sampling was adopted to select vaccination workers in Dali Bai Autonomous Prefecture. Data were
collected through face-to-face questionnaire surveys to analyze job satisfaction and influencing factors. Results: The job satisfaction
score of 216 vaccination workers in Dali Bai Autonomous Prefecture was (4.07±0.48) points, among which the satisfaction score of col⁃
league relationship was the highest, which was (4.35±0.54) points. The satisfaction score for salary and benefits was the lowest, which
was (3.32±0.90) points. Most vaccination workers had relatively low professional titles and had been engaged in vaccination work for a
short period of time. Conclusion: The overall job satisfaction of this group is relatively high, but satisfaction with salary, benefits, and
career promotion needs improvement. Therefore, the salary system and career development mechanisms should be enhanced to improve
job satisfaction among vaccination workers and ensure better vaccination services for the public.

Research Progress on the Mechanisms of Haze-Induced Respiratory System Injury and Prevention

Li Wu

2026, 11(4):  68-75.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 010

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In recent years, with the acceleration of global industrialization and urbanization, haze has become an increasingly serious
global environmental issue, posing a major threat to human health. Haze is composed of various harmful substances such as particulate
matter (PM2.5), nitrogen oxides (NOX), sulfur dioxide (SO2), and volatile organic compounds (VOCs). These harmful substances not only
cause environmental pollution, but also seriously endanger human health. The respiratory system, as the part of the human body that
comes into direct contact with air, is highly vulnerable to the damage caused by haze. Frequent respiratory tract inflammation, continu⁃
ous decline in lung function, and a significant increase in the risk of chronic respiratory diseases are all direct manifestations of the
harm of haze to the respiratory system. This study systematically analyzes the impacts and mechanisms of harmful substances in haze,
including PM2.5, NOX, SO2 and VOCs, on the respiratory system and proposes targeted protective measures, with the aim of providing a
scientific basis for public health protection.

Effectiveness Evaluation of Humanistic Practice Competency Training for Nursing Students Based on the#br# Kirkpatrick Model

Hu Xinyu, Zhang Wenyu, Fang Ruiping, Zhang Gejun, Xu Yue

2026, 11(4):  76-81.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 011

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Objective: This study investigates the effectiveness of humanistic practice competency training based on the Kirkpatrick
Model for nursing students. Methods: A randomized controlled trial was conducted, dividing 110 nursing trainees into a control group
and an experimental group, with 55 trainees in each group. The experimental group received 52 hours of systematic humanistic practice
competency training of "theory-simulation-practice", while the control group only participated in regular internships. The evaluation
framework was based on the four levels of the Kirkpatrick model (reaction, learning, behavior, and results), and the assessment was con⁃
ducted respectively at four time points: pre-training (T0), post-training (T1), 3-month post-training (T2), and 6-month post-training
(T3). Results: At T1, the satisfaction rate, theoretical test scores and communication scores of the Objective Structured Clinical Exami⁃
nation in the experimental group were significantly higher than those in the control group (P<0.001). At T2, the clinical humanistic be⁃
havior scores and patient satisfaction of the experimental group were significantly higher than those of the control group (P<0.001). At
T3, the self-assessment of professional identity and humanistic practice competency in the experimental group also significantly im⁃
proved (P<0.001), with an effect size d>1.4. Conclusion: The Kirkpatrick Model-based humanistic practice competency training can
effectively enhance the humanistic practice competency and professional identity of nursing students, demonstrating significant shortto
medium-term intervention effects. Therefore, it is recommended to incorporate it into the nursing education curriculum system.

The Impact of Mobile Phone Addiction Tendency on School Adjustment in College Freshmen: The Chain#br# Mediating Effect of Loneliness and Meaning in Life#br# #br# The Impact of Mobile Phone Addiction Tendency on School Adjustment in College Freshmen: The Chain#br# Mediating Effect of Loneliness and Meaning in Life

Peng Ting, Zhang Xiaozhou,

2026, 11(4):  82-89.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 012

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This study aimed to explore the effect of mobile phone addiction tendency on the school adjustment of college freshmen,
and to explore the chain mediating role of loneliness and meaning in life. A questionnaire survey was conducted among 945 college
freshmen using the Mobile Phone Addiction Tendency Scale, the Loneliness Scale, the Meaning in Life Scale, and the School Adjust⁃
ment Scale. The results showed that: (1) mobile phone addiction tendency was significantly positively correlated with loneliness, signifi⁃
cantly negatively correlated with meaning in life and school adjustment; loneliness was significantly negatively correlated with meaning
in life and school adjustment; meaning in life was significantly positively correlated with school adjustment. (2) Loneliness played a me⁃
diating role in the influence of mobile phone addiction tendency on school adjustment. (3) Meaning in life played a mediating role in the
influence of mobile phone addiction tendency on school adjustment. (4) Loneliness and meaning in life played a chain mediating role in
the influence of mobile phone addiction tendency on school adjustment. The study suggests that mobile phone addiction tendency indi⁃
rectly influences college freshmen's school adjustment through loneliness and meaning in life. This study enriches the research achieve⁃
ments in the field of college freshmen school adjustment, and has important theoretical and practical significance to improve the college
freshmen's school adjustment level.

Bidirectional Adaptation of "Resources-Functions": Theoretical Logic and Practical Pathways for#br# Human Resource Development of Youths with Intellectual Disabilities

Su Ai¹, Wang Chen², Huang Yanfei³, Li Hong⁴, Lu Jingying¹, Wei Jiajia¹

2026, 11(4):  90-100.  DOI: 10. 3969 / j. issn. 2096-2266. 2026. 04. 013

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A lack of independent thinking skills and behavioral control makes it more difficult for youths with intellectual disabilities
to gain employment compared with other disability groups. How to accomplish human resource development for this group and help
them achieve employment is key to improving their quality of life and realizing the goal of "common prosperity". This study constructs a
combinatorial framework for human resource development of youths with intellectual disabilities based on theories of social support, so⁃
cial networks, and human resource development. Taking the Chuhe Community School as a case study, it explores the structure, opera⁃
tional processes, and interactive synergy between the "resource support side" and the "human resource development side" within the
system, proposing a theoretical framework and effect mechanism of "resources-functions" bidirectional adaptation. Through the above
analyses, this study completes the theoretical logic construction and practical experience exploration of how youths with intellectual dis⁃
abilities can achieve successful employment through human resource development.