Background: Patients with high myopia have an increased lifetime risk of complications. The prevalence patterns of high myopia in children and adolescents in southern China are unclear. Early identification of high-risk individuals is critical for reducing the occurrence and development of high myopia and avoiding the resulting complications. Objective: This study aimed to determine the prevalence of high myopia in children and adolescents in southern China via real-world screening data and to predict its onset by studying the risk factors for high myopia based on machine learning. Methods: This retrospective school-based study was conducted in 13 cities with different gross domestic products in southern China. Through data acquisition and filtering, we analyzed the prevalence of high myopia and its association with age, school stage, gross domestic product, and risk factors. A random forest algorithm was used to predict high myopia among schoolchildren and then assessed in an independent hold-out group. Results: There were 1,285,609 participants (mean age 11.80, SD 3.07, range 6-20 years), of whom 658,516 (51.2%) were male. The overall prevalence of high myopia was 4.48% (2019), 4.88% (2020), and 3.17% (2021), with an increasing trend from the age of 11 to 17 years. The rates of high myopia increased from elementary schools to high schools but decreased at all school stages from 2019 to 2021. The coastal and southern cities had a higher proportion of high myopia, with an overall prevalence between 2.60% and 5.83%. Age, uncorrected distance visual acuity, and spherical equivalents were predictive factors for high myopia onset in schoolchildren. The random forest algorithm achieved a high accuracy of 0.948. The area under the receiver operator characteristic curve (AUC) was 0.975. Both indicated sufficient model efficacy. The performance of the model was validated in an external test with high accuracy (0.971) and a high AUC (0.957). Conclusions: High myopia had a high incidence in Guangdong Province. Its onset in children and adolescents was well predicted with the random forest algorithm. Efficient use of real-world data can contribute to the prevention and early diagnosis of high myopia.

Introduction: Hypermature cataract is a form of late-stage cataract progression that can lead to a variety of complications. Spontaneous capsular rupture with lens nucleus displacement in hypermature cataracts has rarely been reported. We describe 2 cases of spontaneous dislocation of the lens nucleus in a hypermature cataract and perform a review of the literature on this complication. Patient Concerns: We report 2 rural men aged 50 and 76 years with deteriorating vision. Diagnosis: The final diagnosis was senile hypermature cataract with dislocation of the lens nucleus in both patients and secondary glaucoma for the second patient. Interventions and Outcomes: During admission, both patients complained of deteriorating vision. Slit-lamp examination showed lens nucleus dislocation into the anterior chamber. The 50-year-old patient exhibited a residual lens capsule and a turbid cortex, with a normal anterior chamber and intraocular pressure. The 76-year-old patient presented a shrunken and ruptured capsule and no cortex in the pupillary area, mild inflammation in the anterior chamber, and high intraocular pressure. Both patients underwent intracapsular cataract extraction combined with anterior vitrectomy and achieved good postoperative recovery. Conclusion: Lens nucleus dislocation in hypermature cataracts can be seen in clinical practice, particularly in underdeveloped areas. Early recognition and surgery can improve vision.

Major histocompatibility complex class I (MHC-I)-mediated antigen presentation plays a pivotal role in anti-tumor immunity by enabling CD8⁺ T cells to recognize and eliminate malignant cells. In melanoma, modulation of this pathway is critical for improving the efficacy of immunotherapies. Our study demonstrates that the natural compound Cepharanthine (CEP) exhibits notable antitumor activity by enhancing MHC-I-mediated antigen presentation. CEP treatment upregulated MHC-I expression (both membrane-bound and total levels) in melanoma cells in a concentration-dependent manner, thereby improving antigen-presenting capacity. Interestingly, when autophagy was pharmacologically blocked using Bafilomycin A1, co-treatment with CEP did not lead to further elevation of MHC-I expression, suggesting that CEP’s effect is mediated through disruption of the autophagic pathway. Mechanistically, CEP induced autophagosome accumulation, as evidenced by an increase in GFP-LC3 puncta. Fluorescence imaging further confirmed that CEP selectively impaired lysosomal acidification without affecting autophagosome–lysosome fusion, thereby inhibiting late-stage autophagic flux. Furthermore, CEP treatment promoted CD8⁺ T cell infiltration into tumor tissues and enhanced the antitumor efficacy of anti-PD-1 therapy, resulting in greater tumor suppression compared to either treatment alone. The study elucidates how CEP’s selective lysosomal inhibition creates a tumor microenvironment more susceptible to immune surveillance, primarily through preserved MHC-I surface expression and subsequent T cell recognition. This work highlights CEP as a promising immunomodulatory agent and provides a potential strategy for improving the outcomes of immune checkpoint blockade therapy.

Purpose. The aim of the study is to assess the impact of a multifaceted education strategy for Uyghur patients with glaucoma on their anxiety, satisfaction, and comprehension of disease information in rural China. Methods. This study recruited 100 patients who were randomized into two groups: the control group that received a conventional consultation and the intervention group that received a multifaceted education approach. Information comprehension was evaluated using a 15-item questionnaire. A 6-item State-Trait Anxiety Inventory (STAI-6) score was used to assess patient anxiety levels. Satisfaction was evaluated on the day of discharge. Results. After education, patients in the intervention group scored significantly higher than those in the control group on their knowledge of glaucoma ( ). Education level, family history of glaucoma, and number of glaucoma clinic visits were independently associated with baseline scores (p = 0.038, 0.002, and 0.017, respectively). The age was negatively correlated with scores ( ) after education. The STAI-6 score of the intervention group was 28.50 ± 5.13, which was significantly lower than that of the control group (32.50 ± 6.47, p = 0.001). Income levels were negatively correlated and the duration of glaucoma was positively correlated with STAI-6 scores ( and , respectively). Overall satisfaction was significantly higher in the intervention group ( ). The knowledge score was positively correlated with overall satisfaction and follow-up probability (both ). The STAI-6 score was negatively correlated with overall satisfaction and follow-up probability ( and 0.006, respectively). Conclusions. This new multifaceted educational strategy can enhance patients’ knowledge of glaucoma, reduce their anxiety, and improve their satisfaction. ClinicalTrials.gov (No. 2100050926)

Healthcare workers (HCWs) in China are at a high risk of self-reported dry eye symptoms due to occupational exposures, yet population-based epidemiological data on this issue among Chinese HCWs remain scarce. This multicenter cross-sectional study aimed to quantify the prevalence of frequent dry eye symptoms, their diagnostic status, and independent occupational risk factors among Chinese HCWs. From September 2024 to December 2025, 269 active HCWs from 5 tertiary hospitals in Guangdong completed anonymous questionnaires covering demographics, occupational/lifestyle factors, and ocular symptoms. Multivariate logistic regression identified independent risk factors for frequent dry eye symptoms (≥3 times/wk). The prevalence of frequent dry eye symptoms among participants (mean age = 38.5 ± 8.2 years, 59.9% female, 74.4% were physicians) was 54.3%, but only 6.3% had a formal clinical diagnosis. Daily screen time of 7 hours or more emerged as the strongest modifiable risk factor (odds ratio [OR] = 2.31, P = .005). Other independent risk factors included perceived dry work environment (OR = 1.98), frequent night work (OR = 2.15), and myopia (OR = 1.89; all P < .01). A striking gap between knowledge, belief, and behavior was observed: 92.2% recognized screen-use risks, yet only 2.6% performed regular eye exercises. Chinese HCWs face a high burden of frequent dry eye symptoms, which remain severely underdiagnosed. The identified screen-time threshold (≥7 hours/d) is lower than conventional occupational health recommendations and should be considered a modifiable target for intervention. Importantly, current occupational health checkups for HCWs lack ocular surface screening, representing a systemic gap. Given that data were collected in the post-pandemic era (2024–2025), our findings likely reflect the new normal of digitally intensive healthcare work. Workplace-oriented interventions – such as incorporating symptom screening into annual exams, electronic medical record rest reminders, and eye care training – are urgently needed to bridge the awareness-behavior gap and protect HCWs’ ocular health. Our findings are based on self-reported symptoms rather than clinical diagnosis, highlighting the need for objective screening in routine occupational health checkups.