The section:

```Python
from .routers import items, users
```

means:

* Starting in the same package that this module (the file `app/main.py`) lives in (the directory `app/`)...
* look for the subpackage `routers` (the directory at `app/routers/`)...
* and from it, import the submodule `items` (the file at `app/routers/items.py`) and `users` (the file at `app/routers/users.py`)...