ObjectiveThe widespread adoption of portable fundus cameras for primary care and community screening is hindered by limitations in current autofocus(AF) technologies. Image-based methods relying on sharpness evaluation require iterative searches, resulting in slow convergence, while projection-based techniques are susceptible to optical artifacts and calibration errors. To address these challenges, this study introduces a novel AF system based on direct wavefront sensing, designed to deliver simultaneous high speed, high precision, and operational robustness within the compact form factor essential for portable ophthalmic devices. MethodsOur approach fundamentally reimagines the AF process by directly measuring the ocular wavefront aberration. We developed a custom portable fundus camera integrating a miniaturized Shack-Hartmann wavefront sensor (SHWS) into the optical path. An 850 nm laser diode projects a point source onto the retina via oblique illumination to minimize corneal reflections. Light scattered from this spot carries the eye’s refractive error through the imaging optics and is directed to the SHWS, positioned at a plane optically conjugate to the primary color CMOS imaging sensor. A microlens array within the SHWS samples the incident wavefront, generating a pattern of focal spots on a CCD. Real-time centroid analysis of these spots provides a map of local wavefront slopes. These measurements are processed through a singular value decomposition (SVD) algorithm to fit a Zernike polynomial basis set, enabling real-time reconstruction of the wavefront phase. The defocus component (S) is extracted from the second-order Zernike coefficients, providing a direct, quantitative measure of the refractive error in diopters. This value serves as a precise error signal in a closed-loop control system, which commands a voice-coil actuated focusing lens to its null position in a single, deterministic step, eliminating the need for iterative search algorithms. ResultsComprehensive evaluation demonstrated the system’s high performance. Testing on a calibrated model eye (OEMI-7) established a highly linear relationship between the computed defocus S and the focusing lens position across a ±20 Diopter (D) compensation range, achievable within a 5 mm mechanical travel. The system achieved a focusing precision of 0.08 D, corresponding to an 18-fold improvement over a conventional projection spot-size method tested under identical conditions. The total focus acquisition time, encompassing wavefront measurement, computation, and lens actuation, averaged under 0.5 s. Clinical validation with 25 human volunteers (50 eyes, refractive range -15 D to +10 D) confirmed practical efficacy. The wavefront-sensing AF succeeded in 92% of attempts with a mean time of 0.5 s, substantially outperforming a projection-based benchmark which achieved only a 32% success rate with an average time of 4.25 s. The system provided instantaneous directional guidance and maintained stability during minor ocular movements. Objective assessment of image quality, via amplitude contrast of retinal vasculature, showed consistent and significant enhancement following AF correction across the entire tested diopter range. ConclusionThis work successfully implements and validates a direct wavefront-sensing autofocus paradigm for portable fundus cameras. By directly quantifying and compensating for the optical defocus aberration, this method bypasses the fundamental limitations of image-processing and projection-based techniques, enabling rapid, precise, and deterministic diopter compensation. The developed system delivers an exceptional combination of a wide operational range (±20 D), high accuracy (0.08 D), fast convergence (0.5 s), and a compact physical footprint. This technology provides a practical and high-performance focusing solution capable of enhancing the reliability, throughput, and diagnostic utility of portable retinal imaging in large-scale screening applications. Future efforts will be directed towards system cost optimization and performance adaptation for diverse ocular conditions.

ObjectiveThe controllability changes of structural brain network were explored based on the control and brain network theory in young smokers, this may reveal that the controllability indicators can serve as a powerful factor to predict the sleep status in young smokers. MethodsFifty young smokers and 51 healthy controls from Inner Mongolia University of Science and Technology were enrolled. Diffusion tensor imaging (DTI) was used to construct structural brain network based on fractional anisotropy (FA) weight matrix. According to the control and brain network theory, the average controllability and the modal controllability were calculated. Two-sample t-test was used to compare the differences between the groups and Pearson correlation analysis to examine the correlation between significant average controllability and modal controllability with Fagerström Test of Nicotine Dependence (FTND) in young smokers. The nodes with the controllability score in the top 10% were selected as the super-controllers. Finally, we used BP neural network to predict the Pittsburgh Sleep Quality Index (PSQI) in young smokers. ResultsThe average controllability of dorsolateral superior frontal gyrus, supplementary motor area, lenticular nucleus putamen, and lenticular nucleus pallidum, and the modal controllability of orbital inferior frontal gyrus, supplementary motor area, gyrus rectus, and posterior cingulate gyrus in the young smokers’ group, were all significantly different from those of the healthy controls group (P<0.05). The average controllability of the right supplementary motor area (SMA.R) in the young smokers group was positively correlated with FTND (r=0.393 0, P=0.004 8), while modal controllability was negatively correlated with FTND (r=-0.330 1, P=0.019 2). ConclusionThe controllability of structural brain network in young smokers is abnormal. which may serve as an indicator to predict sleep condition. It may provide the imaging evidence for evaluating the cognitive function impairment in young smokers.

Objective:To investigate the value of biparametric-MRI (bpMRI) based peritumoral radiomics for preoperative prediction of extraprostatic extension (EPE) in prostate cancer (PCa).Methods:In this cross-sectional study, consecutive bpMRI of patients undergoing prostatectomy for PCa were retrospectively collected from the First Medical Center (center 1) and the Third Medical Center (center 2) of Chinese PLA General Hospital. A total of 274 patients were finally enrolled. Patients at center 1 from January 2020 to December 2022 were randomly divided into a training set (149 cases) and an internal validation set (63 cases) by stratified random sampling. Patients at center 2 from January 2023 to March 2024 were assigned to the external test set (62 cases). Patients were categorized into EPE-positive group and EPE-negative group according to pathological assessment postoperatively. In the training set, there were 49 cases in EPE-positive group and 100 cases in EPE-negative group. In the internal validation set, there were 26 cases in EPE-positive group and 37 cases in EPE-negative group. In the external test set, there were 22 cases in EPE-positive group and 40 cases in EPE-negative group. Axial T 2WI and apparent diffusion coefficient (ADC) images were manually annotated to obtain index lesion regions of interest (ROIs), with the peritumoral ROIs subsequently delineated by semi-automatic segmentation technique. Radiomics features were extracted from intra-tumoral, peri-tumoral, and intra-tumoral plus peri-tumoral ROIs. The training set data was employed to select and optimize features to build the radiomics models. The logistic regression analysis was used to develop radiomics, clinical, and integrated models. The predictive performance was assessed by the area under the receiver operating characteristic curve (AUC) in the external test set, and compared by the DeLong test. The sensitivity and specificity were compared by the exact McNemar test. Results:In the external test set, the peri-tumoral radiomics model based on bpMRI showed the highest performance in evaluating EPE, with an AUC of 0.739 (95% CI 0.611-0.842), which was identified as the optimal radiomics model. EPE grade ( OR=6.151, 95% CI 3.371-11.226, P<0.001) was incorporated into the clinical model, with an AUC of 0.780 (95% CI 0.657-0.875) in the external test set. The integrated model had an AUC of 0.817 (95% CI 0.698-0.904) in the external test set. There was no statistically significant difference in comparisons of AUCs among the three models (all P>0.05). The sensitivity of the integrated model (68.2%) showed no significant difference from those of the clinical model and the optimal radiomics model (77.3% and 86.4%, respectively; P=0.500 and P=0.289). However, the specificity of the integrated model (85.0%) was significantly higher than those of the clinical model (67.5%, P=0.016) and the optimal radiomics model (50.0%, P<0.001). Conclusion:A bpMRI-based peritumoral radiomics integrating clinical model demonstrates high performance for preoperative prediction of EPE in PCa.

Objective:To investigate the value of biparametric-MRI (bpMRI) based peritumoral radiomics for preoperative prediction of extraprostatic extension (EPE) in prostate cancer (PCa).Methods:In this cross-sectional study, consecutive bpMRI of patients undergoing prostatectomy for PCa were retrospectively collected from the First Medical Center (center 1) and the Third Medical Center (center 2) of Chinese PLA General Hospital. A total of 274 patients were finally enrolled. Patients at center 1 from January 2020 to December 2022 were randomly divided into a training set (149 cases) and an internal validation set (63 cases) by stratified random sampling. Patients at center 2 from January 2023 to March 2024 were assigned to the external test set (62 cases). Patients were categorized into EPE-positive group and EPE-negative group according to pathological assessment postoperatively. In the training set, there were 49 cases in EPE-positive group and 100 cases in EPE-negative group. In the internal validation set, there were 26 cases in EPE-positive group and 37 cases in EPE-negative group. In the external test set, there were 22 cases in EPE-positive group and 40 cases in EPE-negative group. Axial T 2WI and apparent diffusion coefficient (ADC) images were manually annotated to obtain index lesion regions of interest (ROIs), with the peritumoral ROIs subsequently delineated by semi-automatic segmentation technique. Radiomics features were extracted from intra-tumoral, peri-tumoral, and intra-tumoral plus peri-tumoral ROIs. The training set data was employed to select and optimize features to build the radiomics models. The logistic regression analysis was used to develop radiomics, clinical, and integrated models. The predictive performance was assessed by the area under the receiver operating characteristic curve (AUC) in the external test set, and compared by the DeLong test. The sensitivity and specificity were compared by the exact McNemar test. Results:In the external test set, the peri-tumoral radiomics model based on bpMRI showed the highest performance in evaluating EPE, with an AUC of 0.739 (95% CI 0.611-0.842), which was identified as the optimal radiomics model. EPE grade ( OR=6.151, 95% CI 3.371-11.226, P<0.001) was incorporated into the clinical model, with an AUC of 0.780 (95% CI 0.657-0.875) in the external test set. The integrated model had an AUC of 0.817 (95% CI 0.698-0.904) in the external test set. There was no statistically significant difference in comparisons of AUCs among the three models (all P>0.05). The sensitivity of the integrated model (68.2%) showed no significant difference from those of the clinical model and the optimal radiomics model (77.3% and 86.4%, respectively; P=0.500 and P=0.289). However, the specificity of the integrated model (85.0%) was significantly higher than those of the clinical model (67.5%, P=0.016) and the optimal radiomics model (50.0%, P<0.001). Conclusion:A bpMRI-based peritumoral radiomics integrating clinical model demonstrates high performance for preoperative prediction of EPE in PCa.

Depression is primarily characterized by persistent low mood,emotional disorders,and loss of interest.Somatization disorder is a type of neurotic disorder,primarily featuring recurrent,varied,and non-organic physical discomfort symptoms.In traditional Chinese medicine,depression with somatization disorder can be classified under the category of"depression"and"hysteria"according to its clinical symptoms.This article focuses on the dynamic evolution of the functions of the kidney,spleen,and liver,and explains the core pathogenesis of depression with somatization disorder based on the theory of"cold water,damp earth,and stagnant wood"proposed by HUANG Yuanyu.It explores the causes and related manifestations.Symptoms mainly characterized by cramps and convulsions can be attributed to the liver;symptoms primarily characterized by heaviness,distension,and dull pain accompanied by weakness can be attributed to the spleen;symptoms primarily characterized by stiffness,reluctance to move or inability to move,and reluctance to extend outward can be attributed to the kidney.Liver depression and spleen dampness,as well as wood depression and earth congestion,are treated by strengthening the spleen and soothing the liver,drying dampness and calming wind,and the modified Xiaoyao Powder combined with Yueju Pill is recommended.Spleen dampness and kidney coldness,earth failure and water overflow,are treated by tonifying the spleen and kidney,warming water and transforming dampness,and the modified Jingui Shenqi Pill combined with Linggui Zhugan Decoction is recommended.Kidney coldness and liver hyperactivity,water not nourishing wood,are treated by warming the kidney and enriching essence,replenishing water and nourishing wood,and the modified Dihuang Yinzi is recommended.This article explores the corresponding etiology,pathogenesis,treatment methods,and prescriptions for depression with somatization disorder,with the aim of providing new insights for clinical diagnosis and treatment.

Depression is primarily characterized by persistent low mood,emotional disorders,and loss of interest.Somatization disorder is a type of neurotic disorder,primarily featuring recurrent,varied,and non-organic physical discomfort symptoms.In traditional Chinese medicine,depression with somatization disorder can be classified under the category of"depression"and"hysteria"according to its clinical symptoms.This article focuses on the dynamic evolution of the functions of the kidney,spleen,and liver,and explains the core pathogenesis of depression with somatization disorder based on the theory of"cold water,damp earth,and stagnant wood"proposed by HUANG Yuanyu.It explores the causes and related manifestations.Symptoms mainly characterized by cramps and convulsions can be attributed to the liver;symptoms primarily characterized by heaviness,distension,and dull pain accompanied by weakness can be attributed to the spleen;symptoms primarily characterized by stiffness,reluctance to move or inability to move,and reluctance to extend outward can be attributed to the kidney.Liver depression and spleen dampness,as well as wood depression and earth congestion,are treated by strengthening the spleen and soothing the liver,drying dampness and calming wind,and the modified Xiaoyao Powder combined with Yueju Pill is recommended.Spleen dampness and kidney coldness,earth failure and water overflow,are treated by tonifying the spleen and kidney,warming water and transforming dampness,and the modified Jingui Shenqi Pill combined with Linggui Zhugan Decoction is recommended.Kidney coldness and liver hyperactivity,water not nourishing wood,are treated by warming the kidney and enriching essence,replenishing water and nourishing wood,and the modified Dihuang Yinzi is recommended.This article explores the corresponding etiology,pathogenesis,treatment methods,and prescriptions for depression with somatization disorder,with the aim of providing new insights for clinical diagnosis and treatment.

Objective To investigate the status and developmental trends of clinical trials for weight control drugs in China,and to provide data support for sponsors,researchers,and regulatory authorities.Methods The drug clinical trial registration and information platform of the National Medical Products Administration was utilized to search for registered clinical trials of weight control drugs from November 2012 to June 2024.The search employed"overweight","obesity",and"weight loss"as keywords.The information collected included project registration time,drug name,dosage form,drug classification,indications,trial staging,study progress,design type,lead unit,and sponsor.Microsoft Office Excel software was employed for data entry,organization,and extraction.Results A total of 95 registered clinical trials of weight control drugs were identified,comprising 40 domestic multicenter trials,47 domestic single-center trials,and 8 international multicenter trials.Regarding trial phasing,46(48.4％)were phase Ⅰ clinical trials,17(17.9％)were phase Ⅱ clinical trials,19(20.0％)were phase Ⅲ clinical trials,and 13(13.7％)were bioequivalence trials.The drug categorization encompassed 22 chemical drugs,20 biological products,and 1 traditional Chinese medicine/natural drug.Concerning drug dosage forms,there were 32 items of injectable dosage forms,8 items of tablets,2 items of capsules,and 1 item of chewable tablets.Conclusions Registered clinical trials for weight-loss medications in China are predominantly concentrated in regions with developed medical resources.Injectable biologics constitute most test drugs,with most drugs in the early stages of research and development.The examination of the safety and efficacy of these drugs remains to be substantiated,and it is anticipated that a considerable period will elapse before their approval and market introduction.

Objective:To investigate the effect of family primary caregiver-centered enabling education on mental resilience and self-efficacy in patients with acute myocardial infarction(AMI)after percutaneous coronary inter-vention(PCI).Methods:This randomized controlled study enrolled 94 AMI patients undergoing PCI in First Affili-ated Hospital of Xinjiang Medical University between July 2022 and December 2022.They were divided into control group(n=47,traditional nursing)and intervention group(n=47,family primary caregiver-centered enabling ed-ucation).Both groups were intervened for 3 months.Cardiac function,mental resilience,self-efficacy,social support,sleep quality,quality of life and incidence of adverse events were compared between the two groups.Re-sults:After intervention,compared with patients in control group,those in intervention group had significant high-er left ventricular ejection fraction(L VEF)[(59.20±5.93)％vs.(52.57±4.67)％],scores of Connor-Davidson Resilience Scale(CD-RISC)[(91.96±1.61)points vs.(80.02±2.63)points],General Self-Efficacy Scale(GSES)[(32.53±3.21)points vs.(21.45±2.09)points],Social Support Rating Scale(SSRS)[(49.27±3.11)points vs.(39.45±2.72)points],and significant lower left ventricular end-diastolic diameter(LVEDd)[(50.54±3.57)mm vs.(59.03±3.62)mm],left ventricular end-systolic diameter(LVESd)[(39.60±2.31)mm vs.(45.52±2.68)mm],scores of Athens Insomnia Scale(AIS)[(9.63±1.68)points vs.(12.90±1.20)points],Myocardial Infarction Dimensional Assessment Scale(MIDAS)[(89.24±2.63)points vs.(117.63±4.89)points]and incidence of adverse events(4.26％vs.21.28％)(P＜0.05 or＜0.01).Conclusion:Family primary caregiver-centered enabling education could improve the cardiac function and mental resilience,enhance self-efficacy and social support,improve sleep quality and quality of life,and reduce the incidence of adverse events in AMI patients after PCI.

Objective:To investigate the cffect of Orem's self-care theory on mental health and cognitive function in patients with chronic heart failure(CHF).Methods:We retrospectively collected clinical data of 97 CHF patients treated in the First Affiliated Hospital of Xinjiang Medical University between February 2019 and August 2022.According to intervention way,they were divided into control group(n=45,routine intervention)and intervention group(n=52,Orem's self-care theory model intervention).Both groups were intervened for 6 months.Scores of Hamil-ton Anxiety scale(HAMA),Hamilton Depression scale(HAMD),Mini-Mental State Examination(MMSE),left ven-tricular ejection fraction(LVEF),resting heart rate(HR),scores of the Medical Outcomes Study 36-Item Short-Form Health Survey(SF-36)and Barthel index were compared between two groups.Kaplan-Meier survival curve was used to compare incidence of unfavorable outcome between two groups.Results:After 6-month intervention,compared with pa-tients in control group,those in intervention group had significant lower scores of HAMA[(12.50±4.89)points vs.(19.09±5.80)points],HAMD[(12.31±4.28)points vs.(19.56±5.79)points]and HR[(87.33±7.42)beats/min vs.(100.11±7.89)beats/min],and significant higher LVEF[(50.25±5.24)％vs.(42.11±4.51)％],scores of MMSE[(21.90±3.37)points vs.(18.27±3.50)points],SF-36[(63.65±10.43)points vs.(51.71±6.83)points]and Barthel index[(60.67±8.43)points vs.(45.00±9.56)points](P＜0.001 all).Kaplan-Meier survival analysis indicated that incidence of unfavorable outcome in intervention group was significantly lower than that of control group(5.77％vs.24.44％,P=0.035).Conclusion:Orem's self-care theory intervention could significantly improve negative emotions and cognitive ability,restore patients'cardiac function,improve the quality of life and self-care capacity,and re-duce risk of unfavorable outcome in CHF patients.

Objective To investigate the status and developmental trends of clinical trials for weight control drugs in China,and to provide data support for sponsors,researchers,and regulatory authorities.Methods The drug clinical trial registration and information platform of the National Medical Products Administration was utilized to search for registered clinical trials of weight control drugs from November 2012 to June 2024.The search employed"overweight","obesity",and"weight loss"as keywords.The information collected included project registration time,drug name,dosage form,drug classification,indications,trial staging,study progress,design type,lead unit,and sponsor.Microsoft Office Excel software was employed for data entry,organization,and extraction.Results A total of 95 registered clinical trials of weight control drugs were identified,comprising 40 domestic multicenter trials,47 domestic single-center trials,and 8 international multicenter trials.Regarding trial phasing,46(48.4％)were phase Ⅰ clinical trials,17(17.9％)were phase Ⅱ clinical trials,19(20.0％)were phase Ⅲ clinical trials,and 13(13.7％)were bioequivalence trials.The drug categorization encompassed 22 chemical drugs,20 biological products,and 1 traditional Chinese medicine/natural drug.Concerning drug dosage forms,there were 32 items of injectable dosage forms,8 items of tablets,2 items of capsules,and 1 item of chewable tablets.Conclusions Registered clinical trials for weight-loss medications in China are predominantly concentrated in regions with developed medical resources.Injectable biologics constitute most test drugs,with most drugs in the early stages of research and development.The examination of the safety and efficacy of these drugs remains to be substantiated,and it is anticipated that a considerable period will elapse before their approval and market introduction.