Abstract The prevention and control of myopia in Chinese children and adolescents has become a major public health issue. While maintaining increased outdoor activity as a cornerstone intervention, there is an urgent need to explore new complementary approaches that can be effectively implemented in both indoor and outdoor settings. In recent years, environmental spatial frequency has gained increasing attention as one of the key environmental factors influencing the development and progression of myopia. Both animal studies and human research have confirmed that indoor environments lacking mid to high spatial frequency components, often characterized as "visually impoverished", can promote axial elongation and myopia through mechanisms such as disruption of retinal neural signaling, impaired accommodative function, and altered expression of related molecules. Based on the scientific consensus, it is recommended that "enriching of environmental spatial frequency" should be integrated into the myopia prevention and control framework. Following the principles of schoolled organization, family cooperation, community involvement, and student participation, specific measures are put forward in three areas：optimizing school visual settings, improving home spatial environments, and promoting healthy visual behavior. The aim is to create "visually friendly" indoor environments as an important supplement to outdoor activity, thereby providing a novel perspective and strategy for comprehensively advancing myopia prevention and control among children and adolescents.

Objective To explore the molecular mechanism of Jianfu mixture in the treatment of erectile dysfunction （ED） by network pharmacology and molecular docking techniques, and validate its core targets and mechanisms through in vitro experiments. Methods The active components and corresponding molecular targets of Jianfu mixture were searched by searching TCMSP and Batman-TCM databases, and the disease targets of ED were searched by using GeneCards database. Find the intersection of drug ingredient target and disease target. The interaction between intersected targets was described and analyzed by String database, and the analysis results were visualized by Cytoscape software to determine the core target and the corresponding active components. GO functional enrichment analysis and KEGG pathway enrichment analysis were performed for intersection targets; the core target within the intersection were found through MCODE plug-in on Cytoscape software and molecular docking was performed with the corresponding active ingredients. An endothelial dysfunction model was established by transfecting HUVECs with si-eNOS. Intervene with different concentrations of the Jianfu mixture for the model cells for 24 h. QPCR was used to detect mRNA expression of core targets （MAPK1, MAPK3, JUN, ESR1, MAPK8）; Western blot was used to analyze protein expression （eNOS, JUN, p-JUN, MAPK, p-MAPK） and phosphorylation levels. Results 144 effective active components and 168 active components target-disease targe intersection of Jianfu mixture were obtained. GO analysis revealed 200 5 biological processes, 151 molecular functions, and 63 cellular components. KEGG analysis yielded 181 pathways. 5 core targets including MAPK1, MAPK3, JUN, ESR1 and MAPK8 were screened out. The active components such as β-sitosterol, kaempferol, astapterocarpan had good binding affinity with the core target. In vitro experiments confirmed successful construction of the endothelial dysfunction model （eNOS expression significantly decreased after si-eNOS transfection）. Jianfu mixture dose-dependently inhibited mRNA expression of MAPK1, MAPK3, JUN, ESR1, and MAPK8. Additionally, it reduced phosphorylation levels of JUN and MAPK, indicating inhibition of the JNK/c-Jun and ERK/MAPK signaling pathways to improve endothelial function. Conclusion Jianfu mixture treats ED by suppressing abnormal activation of multi-target signaling pathways （MAPK/JUN/ESR1）, reducing endothelial apoptosis, and promoting NO synthesis. This mechanism aligns with the traditional Chinese medicine principle of “activating blood circulation, resolving stasis, tonifying Qi, and strengthening cardiovascular function.” The study provided molecular-level evidence for the therapeutic efficacy of Jianfu mixture in ED management.

Objective To explore the molecular mechanism of Jianfu mixture in the treatment of erectile dysfunction （ED） by network pharmacology and molecular docking techniques, and validate its core targets and mechanisms through in vitro experiments. Methods The active components and corresponding molecular targets of Jianfu mixture were searched by searching TCMSP and Batman-TCM databases, and the disease targets of ED were searched by using GeneCards database. Find the intersection of drug ingredient target and disease target. The interaction between intersected targets was described and analyzed by String database, and the analysis results were visualized by Cytoscape software to determine the core target and the corresponding active components. GO functional enrichment analysis and KEGG pathway enrichment analysis were performed for intersection targets; the core target within the intersection were found through MCODE plug-in on Cytoscape software and molecular docking was performed with the corresponding active ingredients. An endothelial dysfunction model was established by transfecting HUVECs with si-eNOS. Intervene with different concentrations of the Jianfu mixture for the model cells for 24 h. QPCR was used to detect mRNA expression of core targets （MAPK1, MAPK3, JUN, ESR1, MAPK8）; Western blot was used to analyze protein expression （eNOS, JUN, p-JUN, MAPK, p-MAPK） and phosphorylation levels. Results 144 effective active components and 168 active components target-disease targe intersection of Jianfu mixture were obtained. GO analysis revealed 200 5 biological processes, 151 molecular functions, and 63 cellular components. KEGG analysis yielded 181 pathways. 5 core targets including MAPK1, MAPK3, JUN, ESR1 and MAPK8 were screened out. The active components such as β-sitosterol, kaempferol, astapterocarpan had good binding affinity with the core target. In vitro experiments confirmed successful construction of the endothelial dysfunction model （eNOS expression significantly decreased after si-eNOS transfection）. Jianfu mixture dose-dependently inhibited mRNA expression of MAPK1, MAPK3, JUN, ESR1, and MAPK8. Additionally, it reduced phosphorylation levels of JUN and MAPK, indicating inhibition of the JNK/c-Jun and ERK/MAPK signaling pathways to improve endothelial function. Conclusion Jianfu mixture treats ED by suppressing abnormal activation of multi-target signaling pathways （MAPK/JUN/ESR1）, reducing endothelial apoptosis, and promoting NO synthesis. This mechanism aligns with the traditional Chinese medicine principle of “activating blood circulation, resolving stasis, tonifying Qi, and strengthening cardiovascular function.” The study provided molecular-level evidence for the therapeutic efficacy of Jianfu mixture in ED management.

Objective To systematically evaluate robot-assisted gait training(RAGT)on motor function,ambulation and activities of daily living of patients after stroke and spinal cord injury(SCI),and to investigate the clinical value of differ-ent robotic technologies and control strategies.Methods In accordance with PRISMA guidelines,relevant randomized controlled trials(RCTs)published between 2020 and 2024 were identified from databases including Scopus,Web of Science,PubMed,Cochrane Library and CNKI.The PEDro scale was used to assess methodological quality,and a comprehensive analysis was performed on the therapeutic effects of RAGT on walking ability,balance,lower limb muscle strength and functional inde-pendence.Results Eight RCTs involving 702 participants were included,originating from countries such as China,Italy,India,Tur-key and Poland.The population consisted of adult patients with various subtypes of stroke or SCI.These studies were published in journals across geriatric neuroscience,biosciences,medicine and sports science.Interventions involved three categories of lower limb exoskeleton including treadmill-based systems(end-effector and exoskel-eton models),overground exoskeletons and specialized joint/platform-based robots.The training frequency was 20 to 45 minutes a time,once to twice a day,one to seven days a week,for a total of two to ten weeks.RAGT might significant improve gait parameters and lower limb muscle strength,though its impact on functional inde-pendence was heterogeneous.Adaptive control strategies(e.g.,assist-as-needed)proved superior to fixed-parame-ter modes.Treadmill-based systems(e.g.,Lokomat)were well-suited for early-stage rehabilitation,while over-ground exoskeletons(e.g.,EKSO-GT)better facilitated adaptation to real-world environments.Conclusion RAGT is an effective modality for improving gait and lower limb function of patients with stroke and SCI.The therapeutic outcome is contingent upon personalized setup of the exoskeleton and the implementation of adaptive control strategies.Different adaptive control modes have been developed for the three main types of lower limb exoskeleton.Rehabilitation training should consider the specific lower limb tasks with the robot's cor-responding adaptive movement and control modes.

Objective:To analyze the survival outcomes and prognostic factors of patients with ovarian carcino-sarcoma(OCS)based on SEER database.Methods:The data of 1285 OCS patients from 2000 to 2018 in SEER database were retrospectively analyzed.Univariate and multivariate Cox proportional hazards models were used to evaluate the prognostic factors associated with overall survival(OS)and cancer specific survival(CSS).Kap-lan-Meier survival curve was drawn to evaluate the survival analysis of patients' prognosis after clinical treatment.Results:①The study cohort included a total of 1285 OCS patients,The mean age of these patients was 66.21±11.71 years.Most patients had already experienced regional(22.80％)or distant(72.22％)metastasis at the time of diagnosis.②Multivariate Cox regression revealed,SEER stage of regional or distant metastasis,no surger-y,no chemotherapy,and no lymphadenectomy were independent risk factors for both patient OS and CSS(HR＞1,P＜0.05).Age ≥67 years was an independent risk factor for OS(HR＞1,P＜0.05).Age ≥ 83 years was an in-dependent risk factors for CSS(HR＞1,P＜0.05).③Kaplan-Meier survival analysis showed that among surgical patients with adjacent tissue invasion or distant metastasis had significantly better overall survival rate after lymph node dissection than those without(P＜0.001);We didn't see the significantly different effects of lymphadenecto-my on patients with localized disease(P=0.266).Among all patients who underwent surgery,the overall survival rate of all patients who received adjuvant chemotherapy after surgery was significantly better than that of those who did not(P＜0.001).Conclusions:Prognosis of OCS patients is associated with age,SEER comprehensive stage,surgery status,chemotherapy status,lymphadenectomy status.Patients with OCS who underwent cytore-ductive surgery and adjuvant chemotherapy had a better prognosis.However,it is questionable whether lymph-adenectomy is necessary in OCS patients with very early stage.

Objective To observe the value of PET/CT radiomics for predicting Ki-67 expression level of non-small cell lung carcinoma(NSCLC).Methods 18F-FDG PET/CT data of 139 NSCLC patients were retrospectively analyzed.The patients were divided into high-expression group(≥40%,n=75)and low-expression group(＜40%,n=64)according to Ki-67 expression level of NSCLC.CT,PET and PET/CT data were divided into training set and test set at a ratio of 7∶3 and make the distribution of Ki-67 expression levels balanced between sets,respectively.CT,PET and PET/CT radiomics features of NSCLC were extracted,and the optimal radiomics features were screened,then random forest(RF),categorical boosting(CatBoost)and extreme gradient boosting(XGBoost)algorithms were used to construct models,respectively.Receiver operating characteristic curve was plotted,and the area under the curve(AUC)was calculated to screen the radiomics model with the highest efficacy for predicting Ki-67 expression level of NSCLC.Results RF models had the highest performance among radiomics models constructed based on CT,PET and PET/CT.The efficacy of RFCT,RFPET and RFPET/CT models for predicting Ki-67 expression level of NSCLC in test set increased sequentially,with AUC of 0.830,0.870 and 0.940,respectively(all P＜0.05),and RFPET/CT was the best radiomics model.Conclusion PET/CT radiomics could be used to effectively predict Ki-67 expression level of NSCLC,and RFPET/CT model had the best performance.

This paper aims to discuss the application value and progress of artificial intelligence (AI) in the diagnosis and treatment of gastrointestinal tumors and teaching practice of gastrointestinal oncology. Through a comprehensive analysis of the current clinical research status and literature, this paper summarizes the application practice and exploratory thinking of AI and deep learning technologies in gastrointestinal oncology. In diagnosis, AI technologies have improved the early detection and diagnosis efficiency for gastrointestinal tumors by optimizing medical image analysis, especially in the recognition of liver metastases. Applications of AI in pathological diagnosis include automatic recognition of tumor cells and tissue structure, as well as improving diagnostic sensitivity and specificity through feature extraction and pattern recognition. In treatment, the application scenarios of AI include rapid diagnosis, accurate staging, personalized treatment plan formulation, drug development, and surgical assistance. In surgical assistance, AI technology improves the safety and effectiveness of surgery through preoperative evaluation, surgical navigation, and postoperative evaluation. In teaching, AI technology facilitates knowledge acquisition and clinical skill enhancement of medical students by providing a multidisciplinary learning platform, simulating clinical environment and case details, and establishing a remote learning platform. The application of AI technology in teaching also includes deep learning and assessment feedback, providing personalized teaching and real-time assessment for students. This paper discusses the application prospects for AI technology in the teaching practice of gastrointestinal oncology. Although AI technology shows great potential in the diagnosis and treatment of gastrointestinal tumors and teaching gastrointestinal oncology, it also has limitations and needs to be combined with traditional teaching methods to achieve the best teaching results.

Tissue-resident memory T cells(TRM)are a key immune memory cell type responsible for the recurrence of many skin diseases.TRM cells remain in the skin tissue following infection or injury and maintain immune memory by forming a memory reservoir.When the same or similar external stimuli are encountered again,TRM cells can be rapidly activated,releasing inflammatory cytokines and cytotoxic substances,leading to local tissue damage and/or disease recurrence.The formation and function of TRM cells are regulated by various factors,such as T cell receptor signals,cytokines,co-stimulatory molecules,etc.Furthermore,TRM cells may exhibit different phenotypes and functions in different types of skin diseases.Therefore,understanding the characteristics and regulatory mechanisms of TRM cells is of great significance for studying the mechanisms of skin disease recurrence as well as for developing therapeutic strategies targeting TRM cells.

Objective To analyze the clinical characteristics and explore the potential mechanisms under-lying acute wheezing associated with respiratory syncytial virus(RSV)and human rhinovirus(HRV)infections in infants.Methods A retrospective analysis was conducted on 560 infants who consecutively presented to the emer-gency department of Qingdao University Affiliated Women and Children's Hospital between January 2022 and December 2024 with acute exacerbation of wheezing caused by RSV and/or HRV infection;these infants constituted the infection group.A control group of 120 healthy infants who underwent routine physical examinations at the same hospital during the same period was also included.Multiplex PCR amplification sequencing technology was employed to detect respiratory pathogens via nucleic acid analysis.The infection group was further classified into the RSV-only group(n=248),the HRV-only group(n=186),and the co-infection group(HRV+RSV,n=126).One-way analysis of variance(ANOVA)was used to compare body mass index(BMI),peripheral blood white blood cell(WBC)count,neutrophil count,lymphocyte count,C-reactive protein(CRP)levels,and concentrations of interleukin(IL)-1β,IL-6,Toll-like receptor 4(TLR4),NOD-like receptor protein 3(NLRP3)inflamma-some,and matrix metalloproteinase-9(MMP-9)across the groups.Additionally,comparisons were made regarding gender distribution,severity of wheezing,history of wheezing,history of eczema,parental allergic history,oxygen supplementation requirements,and presence of concurrent pulmonary infection among the infected infants.Based on wheezing severity,the infection group was further divided into a severe wheezing group and a mild wheezing group.Clinical characteristics and biological indicators were analyzed and compared between these two groups to identify potential independent risk factors.Pearson correlation analysis was performed to evaluate the association between peripheral blood levels of IL-6,NLRP3,and MMP-9 and the severity of acute wheezing exacerbation in children.Results A one-way ANOVA indicated statistically significant differences in WBC count,neutrophil count,CRP,IL-1β,IL-6,TLR4,NLRP3,and MMP-9 levels across the study groups(all P<0.001).Both the RSV and co-infection groups demonstrated significantly higher rates of severe wheezing,oxygen requirement,and prolonged wheezing duration compared to the HRV group(all P<0.05).Among these,the co-infection group exhibited the highest oxygen requirement rate,although the duration of wheezing was shorter than that observed in the RSV group(P<0.05).The incidence of concurrent pulmonary infection was significantly greater in the RSV group compared to the HRV group(P<0.05).Additionally,the proportion of infants with a prior history of wheez-ing was significantly higher in the RSV group than in both the HRV and co-infection groups(P<0.05).Both the RSV and co-infection groups showed a significantly higher prevalence of eczema history among infants compared to the HRV group(P<0.05).Moreover,the co-infection group had a significantly higher proportion of parental allergic history compared with both the RSV and HRV groups(P<0.05).Clinical data analysis stratified by wheezing severity revealed that RSV was the most commonly detected virus among the enrolled infants,particularly in those presenting with severe wheezing(χ2=3.940,P=0.002).The severe wheezing group exhibited significantly higher rates of prior wheezing,history of eczema,parental allergy,need for oxygen supplementation,and concurrent pulmonary infections compared to the mild wheezing group(P<0.001).Furthermore,the duration of wheezing was significantly prolonged in the severe group relative to the mild group(t=2.058,P=0.040).Levels of IL-6,NLRP3,and MMP-9 were also significantly elevated in the severe wheezing group(P<0.05).Multivariate logistic regression analysis revealed that RSV infection,along with elevated levels of IL-6,NLRP3,and MMP-9,were independent risk factors associated with severe wheezing(OR=3.217,1.023,1.022,and 1.056,respectively;all P<0.05).In children with RSV/HRV infection,the severity of acute wheezing demonstrated a positive correlation with NLRP3 and MMP-9 levels(P<0.05).The Pearson correlation coefficient between NLRP3 and MMP-9 was r=0.238(P<0.001),indicating a weak yet statistically significant positive relationship.Conclusions RSV may provoke more severe respiratory inflammatory responses and clinical manifestations compared to HRV.Individuals with a genetic predisposition to allergies or a pre-existing history of respiratory conditions may experience height-ened severity of wheezing following viral infection.The NLRP3 inflammasome may further intensify airway inflam-mation and remodeling through the promotion of MMP-9 release.These mechanisms may collectively contribute to the pathogenesis of acute wheezing episodes and subsequently influence the progression of respiratory diseases.

Objective:To assess the safety and efficacy of fenestrated endovascular aortic repair for the treatment of diseases involving in the aortic arch.Methods:The clinical data of 52 patients with aortic arch diseases treated with fenestrated endovascular aortic repair technique at Beijing Anzhen Hospital, Capital Medical University from Nov 2021 to Jan 2024 was retrospectively analyzed.Results:Fenestration technique was used to reconstruct the branches of the arch for all 52 patients, with a success rate of 100%. A total of 56 stent grafts in the thoracic aorta and 56 bridging stents in the branch artery were implanted. The follow-up time ranged from 3 to 24 months, with an average of 11.3 months. One patient with type B aortic dissection underwent secondary intervention treatment after six months due to the distal reentry tear, and none of the patients experienced branch vessel ischemia, spinal cord ischemia, renal dysfunction, or aortic disease-related deaths during the following-up period.Conclusion:Fenestrated technique in endovascular aortic repair is safe and effective for treating aortic arch diseases.