ObjectiveTo propose an X-Gait motor rehabilitation assessment system based on a perception-cognition decoupling architecture to jointly achieve high-accuracy gait recognition and clinical interpretability for low clinical credibility and opaque decision-making workflows in existing intelligent gait assessment models. MethodsIn the perception layer, YOLOv11-Pose and PoseFormerV2 were integrated for 2D-to-3D human pose reconstruction. A long short-term memory network was adopted for temporal classification of normal, abnormal and pathological gaits. The layer-wise relevance propagation algorithm was used to identify discriminative joints and automatically quantify biomechanical indices including trunk forward inclination angle, stance phase percentage and stride symmetry. In the cognition layer, rehabilitation-oriented prompt engineering and prior knowledge graphs were combined to drive large language models, converting quantitative biomechanical measurements into clinically reasonable structured reports. Eight subjects were enrolled for bedside clinical validation to evaluate classification performance and clinical consistency. ResultsThe overall gait classification accuracy of X-Gait reached 94.1%. The 2D pose detection achieved 100% valid detection rate with an average confidence of 0.819. The mean per-joint position error of 3D pose reconstruction was 105.97 mm. In clinical validation of eight cases, outputs generated by explainable artificial intelligence combined with large language models showed high consistency with manual assessments from experienced rehabilitation physicians. ConclusionThe proposed X-Gait system based on perception-cognition decoupling realizes high-precision gait identification and clinically interpretable outputs.

Objective : To prepare silk protein(SF) guided bone regeneration(GBR) membranes reinforced by aragonite sheets(AP) and to investigate their potential as novel barrier membranes for bone tissue regeneration by testing their tensile properties,biocompatibility,and their effect on osteogenic differentiation. Methods : AP was extracted from natural abalone shell(AS) by oxidation method,and AP-SF composite and pure SF membranes with different component ratios were prepared by solution casting and evaporative self-assembly techniques,and their tensile properties were tested using a universal mechanical machine under wet state conditions.The tensile properties were tested using a universal mechanical machine under wet conditions.The microstructure of the AP-SF membrane with the highest tensile strength was observed using scanning electron microscopy(SEM) and characterized using Fourier transform infrared spectroscopy(FTIR) and X-ray diffraction(XRD).Observation of the adhesion of rat bone marrow mesenchymal stem cells(rBMSCs) on the surface by scanning electron microscopy,and exploration of the biocompatibility of AP-SF membrane by CCK-8 and live cell staining.Alkaline phosphatase staining(ALP) and alizarin red staining(ARS) were used to detect the osteogenic differentiation of rBMSCs in each group. Results: AP was successfully extracted from AS,and the membrane prepared from a mixed solution of SF and AP with a solid content of 10:9 had the strongest wet tensile performance,reaching 8.46 MPa.The CCK-8 and live dead cell staining test results of the AP-SF membrane showed no significant difference compared to the blank group and SF group,indicating that both membranes had good biocompatibility.The ALP test and ARS results indicated that AP-SF membrane had a more significant ability to promote osteogenic differentiation of rBMSCs compared to SF membrane. Conclusion The prepared AP-SF membrane has both good mechanical and biological properties,and has certain clinical application potential.

Objective To analyze the current situation of quality control and regulation of centralized decoction of Chinese materia medica in Hangzhou through a mixed study combining quantitative research and qualitative research;To provide references for its standardization.Methods A self-designed questionnaire was distributed from July 20,2023 to August 10,2023 in institutions providing centralized decoction services of Chinese materia medica in different regions of Hangzhou.Using the stratified sampling method,the institutional personnel who completed the questionnaire survey were selected as the interviewees,and the semi-structured interview was used to refine the theme according to the Colaizzi seven step method.Results Totally 98 questionnaires were distributed and 96 valid questionnaires were recovered,with a valid recovery rate of 97.96%.There were significant differences in soaking time,concentration degree,and special decoction method such as decocted earlier or later of decoction pieces of Chinese materia medica among different types of institutions(P<0.05).The centralized decoction of Chinese materia medica in Hangzhou mainly involves two themes and seven sub themes:the supervision and management of the whole process of centralized decoction of Chinese materia medica(optimizing distribution of medical resources,strengthening of supervision,demanding guidance of standards),the operation of centralized decoction of Chinese materia medica(soaking time of decoction pieces of Chinese materia medica,the pretreatment operation of"decocted earlier and decocted later",the concentration treatment of Chinese materia medica decoction,and the quality control of Chinese materia medica decoction).Conclusion At present,centralized decoction of Chinese materia medica in Hangzhou still needs to be further standardized.It is recommended to strengthen the construction of shared Chinese materia medica pharmacy in the region,establish and improve the standard system of centralized decoction of Chinese materia medica decoction,and strengthen the construction of digital full chain traceability to improve the service quality and management level of centralized decoction of Chinese materia medica in Hangzhou.

Objective To investigate the associations between physical health status,refraction and ocular biometrics in school-age children,and further clarify the relation of eyes'refractive status to physical growth and development,so as to provide scientific evidences for myopia prevention and con-trol.Methods A total of 1718 children(977 boys and 741 girls)aged 8-12 years were enrolled in this study.They were collected uncorrected visual acuity,refraction and ocular biometrics,including spherical equivalent,cylindrical equivalent,axial length(AL),corneal refraction(K1,K2)and anteri-or chamber depth(ACD),as well as the AL/CR ratio and spherical equivalent refraction(SER).Moreover,their height,weight and physical fitness level were measured,including speed,strength,flexibility,agility and aerobic endurance.Then all data were analyzed using the Pearson correlation,One-way ANOVA and multiple linear regression model.Results The overall prevalence of myopia was 43.83%,which was higher in girls than in boys(46.96%vs.41.45%).Moreover,the height and weight of school-age children were negatively correlated with SER(P<0.01),but positively correlated with AL,ACD and AL/CR(P<0.01).After controlling the age and gender variables in the multiple linear regression model,it was found that for 10-cm increase in height,SER decreased by 0.013 D(P<0.01),AL extended by 0.022 mm(P<0.01),and ACD increased by 0.002 mm(P<0.05).In addi-tion,for 10-kg increase in the body weight,the AL would be 0.009 mm longer(P<0.05)and ACD 0.002 mm deeper(P<0.05).Moreover,the speed,strength and agility were negatively correlated with SER(P<0.01,P<0.05),but positively correlated with AL,ACD and AL/CR(P<0.01,P<0.05).The maximal oxygen uptake level was positively correlated with SER(P<0.01),and negatively correlated with AL,ACD and AL/CR(P<0.01,P<0.05).After controlling the age and gender variables in the multiple linear regression model,it was found that the children with worse speed quality had shorter AL(-0.043 D,P<0.05).Meanwhile,the better agility was accompanied by the lower SER(-0.003 D,P<0.01),longer AL(+0.002 mm,P<0.05),lighter ACD(+4.812e-4 mm,P<0.05),and higher AL/CR(+2.446e-4,P<0.05).Conclusion With variables of age and gender controlled,the height,weight,and the speed and agility quality are highly associated with eyes'refractive status among chil-dren aged 8-12 years old.It is suggested that the human body may have a coordination mechanism to regulate the development of the body stature,physical fitness and ocular biometrics in the early child-hood,which should be considered in their myopia prevention and control.

Objective To analyze the current situation of quality control and regulation of centralized decoction of Chinese materia medica in Hangzhou through a mixed study combining quantitative research and qualitative research;To provide references for its standardization.Methods A self-designed questionnaire was distributed from July 20,2023 to August 10,2023 in institutions providing centralized decoction services of Chinese materia medica in different regions of Hangzhou.Using the stratified sampling method,the institutional personnel who completed the questionnaire survey were selected as the interviewees,and the semi-structured interview was used to refine the theme according to the Colaizzi seven step method.Results Totally 98 questionnaires were distributed and 96 valid questionnaires were recovered,with a valid recovery rate of 97.96%.There were significant differences in soaking time,concentration degree,and special decoction method such as decocted earlier or later of decoction pieces of Chinese materia medica among different types of institutions(P<0.05).The centralized decoction of Chinese materia medica in Hangzhou mainly involves two themes and seven sub themes:the supervision and management of the whole process of centralized decoction of Chinese materia medica(optimizing distribution of medical resources,strengthening of supervision,demanding guidance of standards),the operation of centralized decoction of Chinese materia medica(soaking time of decoction pieces of Chinese materia medica,the pretreatment operation of"decocted earlier and decocted later",the concentration treatment of Chinese materia medica decoction,and the quality control of Chinese materia medica decoction).Conclusion At present,centralized decoction of Chinese materia medica in Hangzhou still needs to be further standardized.It is recommended to strengthen the construction of shared Chinese materia medica pharmacy in the region,establish and improve the standard system of centralized decoction of Chinese materia medica decoction,and strengthen the construction of digital full chain traceability to improve the service quality and management level of centralized decoction of Chinese materia medica in Hangzhou.

Objective To investigate the associations between physical health status,refraction and ocular biometrics in school-age children,and further clarify the relation of eyes'refractive status to physical growth and development,so as to provide scientific evidences for myopia prevention and con-trol.Methods A total of 1718 children(977 boys and 741 girls)aged 8-12 years were enrolled in this study.They were collected uncorrected visual acuity,refraction and ocular biometrics,including spherical equivalent,cylindrical equivalent,axial length(AL),corneal refraction(K1,K2)and anteri-or chamber depth(ACD),as well as the AL/CR ratio and spherical equivalent refraction(SER).Moreover,their height,weight and physical fitness level were measured,including speed,strength,flexibility,agility and aerobic endurance.Then all data were analyzed using the Pearson correlation,One-way ANOVA and multiple linear regression model.Results The overall prevalence of myopia was 43.83%,which was higher in girls than in boys(46.96%vs.41.45%).Moreover,the height and weight of school-age children were negatively correlated with SER(P<0.01),but positively correlated with AL,ACD and AL/CR(P<0.01).After controlling the age and gender variables in the multiple linear regression model,it was found that for 10-cm increase in height,SER decreased by 0.013 D(P<0.01),AL extended by 0.022 mm(P<0.01),and ACD increased by 0.002 mm(P<0.05).In addi-tion,for 10-kg increase in the body weight,the AL would be 0.009 mm longer(P<0.05)and ACD 0.002 mm deeper(P<0.05).Moreover,the speed,strength and agility were negatively correlated with SER(P<0.01,P<0.05),but positively correlated with AL,ACD and AL/CR(P<0.01,P<0.05).The maximal oxygen uptake level was positively correlated with SER(P<0.01),and negatively correlated with AL,ACD and AL/CR(P<0.01,P<0.05).After controlling the age and gender variables in the multiple linear regression model,it was found that the children with worse speed quality had shorter AL(-0.043 D,P<0.05).Meanwhile,the better agility was accompanied by the lower SER(-0.003 D,P<0.01),longer AL(+0.002 mm,P<0.05),lighter ACD(+4.812e-4 mm,P<0.05),and higher AL/CR(+2.446e-4,P<0.05).Conclusion With variables of age and gender controlled,the height,weight,and the speed and agility quality are highly associated with eyes'refractive status among chil-dren aged 8-12 years old.It is suggested that the human body may have a coordination mechanism to regulate the development of the body stature,physical fitness and ocular biometrics in the early child-hood,which should be considered in their myopia prevention and control.

ObjectiveTo investigate the mechanism of anti-pulmonary fibrosis of cannabidiol by ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS）. MethodSD rats were randomly divided into blank group， model group， prednisone group（3.15 mg·kg^-1） and cannabidiol low， medium and high dose groups（12， 36， 108 mg·kg^-1）， with 8 rats in each group. The rat model of pulmonary fibrosis was established by intratracheal injection of bleomycin（5 mg·kg^-1）， which was administered continuously for 28 days after successful modeling. The pathological changes of rat lung tissue were observed， and enzyme-linked immunosorbent assay（ELISA） was used to detect the expression levels of matrix metalloproteinase-7（MMP-7）， type Ⅱ alveolar cell surface antigen（KL-6）， pulmonary surfactant-associated protein A（SP-A） and SP-D in serum. The expression levels of type Ⅰ collagen（Col-Ⅰ） and fibronectin（FN） in lung tissues were detected by immunohistochemistry， and the expression of mucin 5 subtype AC（MUC5AC） was detected by immunofluorescence. UPLC-Q-TOF-MS was used to search for potential biomarkers and related metabolic pathways of cannabidiol in treating pulmonary fibrosis. ResultCompared with the blank group， there were a large number of inflammatory cell infiltration and continuous fibrosis lesions in the lung tissue of rats in the model group. Compared with the model group， the inflammatory infiltration and blue collagen deposition in the lung tissue of rats in the prednisone and cannabidiol groups were reduced. Compared with the blank group， the expressions of MMP-7， KL-6， SP-A and SP-D in serum of the model group were significantly increased（P<0.01）， while the expressions of MMP-7， KL-6， SP-A and SP-D in the prednisone and cannabidiol high dose groups were significantly decreased by comparing with the model group（P<0.05， P<0.01）. Compared with the blank group， the expression levels of Col-Ⅰ and FN in the lung tissues of the model group were significantly increased， and the fluorescence intensity of MUC5AC was significantly increased（P<0.01）. Compared with the model group， the expression levels of Col-Ⅰ and FN in the lung tissues of the prednisone and cannabidiol high dose groups were significantly decreased（P<0.05， P<0.01）， and the expression of MUC5AC was significantly decreased（P<0.01）. Compared with the blank group， a total of 18 differential compounds were screened out in the model group， which could be used as potential biomarkers， and cannabidiol could call back 16 of them， mainly involving 4 metabolic pathways（linoleic acid metabolism， phenylalanine， tyrosine and tryptophan biosynthesis， arachidonic acid metabolism， and niacin and niacinamide metabolism）. Compared with the blank group， the relative contents of potential biomarkers arachidonic acid and linoleic acid were significantly increased in the model group（P<0.05， P<0.01）， while the relative contents of 5，6-EET， L-tyrosine and niacinamide were significantly decreased（P<0.01）. Compared with the model group， cannabidiol could significantly reduce the relative contents of arachidonic acid and linoleic acid， and significantly increase the relative contents of 5，6-EET， L-tyrosine and niacinamide（P<0.01）. ConclusionCannabidiol has an intervention and remission effect on pulmonary fibrosis， and its mechanism may be related to linoleic acid metabolism， phenylalanine， tyrosine and tryptophan biosynthesis， arachidonic acid metabolism， niacin and niacinamide metabolism.

Objective:In this study, we aimed to compare the short-term safety of two digestive tract reconstruction techniques, laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis, following radical resection of Siewert Type II adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, we analyzed relevant clinical data of 139 patients who had undergone radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. These included 89 patients treated at the First Affiliated Hospital of Air Force Medical University from November 2021 to July 2023, 36 patients treated at the First Affiliated Hospital of Xi'an Jiaotong University from December 2020 to June 2021, and 14 patients treated at the Yuncheng Central Hospital in Shanxi Province from September 2021 to November 2022. The group consisted of 107 men (77.0%) and 32 women (23.0%) of mean age 62.5±9.3 years. Forty-eight patients underwent laparoscopic total abdominal overlap anastomosis (overlap group), and 91 laparoscopic-assisted end-to-side anastomosis (end-to-side group). Clinical data, surgical information, pathological findings, postoperative recovery, and related complications were compared between the two groups.Results:There were no significant differences in general clinical data between the overlap and end-to-side anastomosis groups (all P>0.05), indicating comparability. There was no significant difference in operation time (267.2±60.1 minutes vs. 262.8±70.6 minutes, t=0.370, P=0.712). However, the intraoperative blood loss in the overlap group (100 [50, 100] mL) was significantly lower compared to the end-to-side group (100[50, 175] mL, Z=2.776, P=0.005). Compared to the end-to-side group, longer distances between the tumor and distal resection margin proximal(1.7±1.0 cm vs. 1.3±0.9 cm, t=2.487, P=0.014) and the tumor and distal resection margin (9.5±2.9 cm vs. 7.9±3.5 cm, t=2.667, P=0.009) were achieved in the overlap group. Compared with the end-to-side group, the overlap group achieved significantly earlier postoperative ambulation (1.0 [1.0, 2.0] days vs. 2.0 [1.0, 3.0] days, Z=3.117, P=0.002), earlier time to first drink (4.7±2.6 days vs. 6.2±3.0 days, t=2.851, P=0.005), and earlier time to first meal (6.0±2.7 days vs. 7.1±3.0 days, t=2.170, P=0.032). However, the hospitalization costs were higher in the overlap group (113, 105.5±37, 766.3) yuan vs. (97, 250.2±27, 746.9) yuan; this difference is significant ( t=2.818, P=0.006). There were no significant differences between the two groups in postoperative hospital stay, total number of lymph nodes cleared, or time to first postoperative flatus (all P>0.05). The incidence of surgery-related complications was 22.9%(11/48) in the overlap group and 19.8% (18/91) in the end-to-side group; this difference is not significant (χ2=0.187, P=0.831). Further comparison of complications using the Clavien-Dindo classification also showed no significant differences ( Z=0.406, P=0.685). Conclusions:Both laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis are feasible for radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. Laparoscopic total abdominal overlap anastomosis achieves longer proximal and distal resection margins and better postoperative recovery; however, end-to-side anastomosis is more cost-effective.

Objective:In this study, we aimed to compare the short-term safety of two digestive tract reconstruction techniques, laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis, following radical resection of Siewert Type II adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, we analyzed relevant clinical data of 139 patients who had undergone radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. These included 89 patients treated at the First Affiliated Hospital of Air Force Medical University from November 2021 to July 2023, 36 patients treated at the First Affiliated Hospital of Xi'an Jiaotong University from December 2020 to June 2021, and 14 patients treated at the Yuncheng Central Hospital in Shanxi Province from September 2021 to November 2022. The group consisted of 107 men (77.0%) and 32 women (23.0%) of mean age 62.5±9.3 years. Forty-eight patients underwent laparoscopic total abdominal overlap anastomosis (overlap group), and 91 laparoscopic-assisted end-to-side anastomosis (end-to-side group). Clinical data, surgical information, pathological findings, postoperative recovery, and related complications were compared between the two groups.Results:There were no significant differences in general clinical data between the overlap and end-to-side anastomosis groups (all P>0.05), indicating comparability. There was no significant difference in operation time (267.2±60.1 minutes vs. 262.8±70.6 minutes, t=0.370, P=0.712). However, the intraoperative blood loss in the overlap group (100 [50, 100] mL) was significantly lower compared to the end-to-side group (100[50, 175] mL, Z=2.776, P=0.005). Compared to the end-to-side group, longer distances between the tumor and distal resection margin proximal(1.7±1.0 cm vs. 1.3±0.9 cm, t=2.487, P=0.014) and the tumor and distal resection margin (9.5±2.9 cm vs. 7.9±3.5 cm, t=2.667, P=0.009) were achieved in the overlap group. Compared with the end-to-side group, the overlap group achieved significantly earlier postoperative ambulation (1.0 [1.0, 2.0] days vs. 2.0 [1.0, 3.0] days, Z=3.117, P=0.002), earlier time to first drink (4.7±2.6 days vs. 6.2±3.0 days, t=2.851, P=0.005), and earlier time to first meal (6.0±2.7 days vs. 7.1±3.0 days, t=2.170, P=0.032). However, the hospitalization costs were higher in the overlap group (113, 105.5±37, 766.3) yuan vs. (97, 250.2±27, 746.9) yuan; this difference is significant ( t=2.818, P=0.006). There were no significant differences between the two groups in postoperative hospital stay, total number of lymph nodes cleared, or time to first postoperative flatus (all P>0.05). The incidence of surgery-related complications was 22.9%(11/48) in the overlap group and 19.8% (18/91) in the end-to-side group; this difference is not significant (χ2=0.187, P=0.831). Further comparison of complications using the Clavien-Dindo classification also showed no significant differences ( Z=0.406, P=0.685). Conclusions:Both laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis are feasible for radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. Laparoscopic total abdominal overlap anastomosis achieves longer proximal and distal resection margins and better postoperative recovery; however, end-to-side anastomosis is more cost-effective.

As an important part of the enteric nervous system(ENS),enteric glial cells(EGCs)play an important role in regulating intestinal homeostasis and maintaining intestinal health in hu-mans and animals.This review focuses on the role of EGCs in maintaining intestinal barrier homeo-stasis,maintaining gastrointestinal transit and motor function,regulating the niche of intestinal cells,and the role in the occurrence and development of intestinal diseases,hoping to provide new ideas for further research on the function and mechanism of EGCs in the intestine and the occur-rence,development and treatment of related intestinal diseases.