One of the significant hurdles in telemedicine, particularly in ophthalmology, is the absence of direct physical examination. This specialty depends extensively on specialized instruments that typically require proficient operators. Visual function tests are crucial for both outpatient and inpatient ophthalmic services, playing a vital role in screening, diagnosing, monitoring treatment effectiveness, and managing follow-ups for various eye conditions. The progress in mobile technology has paved the way for expanding these tests beyond traditional clinic settings, promoting the creation of patient-focused, straightforward, cost-effective, and efficient measurement tools. In light of the swift advancement of digital technologies, this article reviews the characteristics, and reliability of self-administered visual function tests tools, including visual acuity, refractive error assessment, visual field, contrast sensitivity, and color vision, along with other pertinent diagnostic tools that have been developed and validated for accuracy and repeatability through research, with a view to providing ophthalmologists and patients with scientific and practical references when selecting and using these tools, further promoting efficiency and efficacy of teleophthalmology.

Objective To verify the safety and effectiveness of a new percutaneous controllable curved plasma radiofrequency instrument for nucleus pulposus ablation. Methods A new percutaneous controllable curved plasma radiofrequency instrument were designed (controllable curved group), and its ablation effect was compared with the currently used straight head non-bendable plasma ablation instrument (non-bendable group) on gross specimens. The ablation instrument was placed through the right intervertebral foramen, and continuous ablation on the same intervertebral disc was conducted for three times. The ablation range and trajectory were recorded, and the temperature changes in the front, back, left, and right of the ablation center during and 15 seconds after ablation were monitored by the inserted temperature probe. Results There were no difference in temperature changes in the front, back, right regions of the ablation center during and 15 seconds after ablation between the two groups. The temperature changes in the left region of the ablation center both during and 15 seconds after 3rd ablation were larger than those in the non-bendable group (P＜0.01). Compared with the non-bendable group, the controllable curved group achieved angle control and larger single ablation area (2.282 5 mm² vs 1.135 8 mm², P＜0.000 1). Conclusions This new percutaneous controllable curved plasma ablation instrument can achieve angle control and ablation on the side opposite to the puncture site, increase ablation volume, and is safe.

OBJECTIVES: To propose a single repetition time (TR) quantitative magnetic susceptibility imaging method for the lumbar spine using bipolar readout gradient, and compare the quantitative magnetic susceptibility measurement using single TR and dual TR methods for the lumbar spine with different bone densities. METHODS: A translation correction method was proposed to correct spatial misalignment along the frequency encoding direction between positive and negative gradient readout images, and the phase difference between the images was eliminated using a phase correction method. The data of lumbar vertebrae L1-L5 were collected using single TR and dual TR methods from 6 normal individuals, 2 patients with osteopenia, and 2 patients with osteoporosis. The magnetic susceptibility map was reconstructed, the quantitative results of single TR before and after correction were compared with those of the dual TR method. RESULTS: The linear regression result of the lumbar spine magnetic susceptibility values obtained by the single TR method before calibration and the dual TR method is Y=0.64*X-11.61. The linear regression result of the lumbar spine magnetic susceptibility values corrected by the single TR method and the dual TR method is Y=1.03*X+0.25. The results of the corrected single TR method were highly consistent with those of the dual TR method, and the calibrated single TR method could effectively distinguish osteopenia and osteoporosis patients from normal individuals. CONCLUSIONS The calibrated single TR bipolar readout gradient method can generate artifact-free lumbar spine quantitative magnetic susceptibility distribution maps and reduce data acquisition time by 50%.
Humans ; Lumbar Vertebrae/pathology* ; Magnetic Resonance Imaging/methods* ; Female ; Middle Aged ; Male ; Osteoporosis/diagnosis* ; Adult ; Bone Density ; Aged ; Bone Diseases, Metabolic/diagnosis*

Seven novel acylphloroglucinol-sesquiterpenoid adducts, designated as dryatraols J-P (1-7), were isolated from the rhizomes of Dryopteris atrata (Wall. ex Kunze) Ching. The structures, including absolute configurations, were elucidated using comprehensive spectroscopic data, calculated ¹³C Nuclear Magnetic Resonance-Diastereotopic Probability Assignment Plus (¹³C NMR-DP4+) probability analysis, and ECD calculations. These structures represent a rare subclass of carbon skeleton of acylphloroglucinol-sesquiterpenoid adducts with a furan ring connecting the acylphloroglucinol and sesquiterpenoid moieties. Notably, compounds 1-6 are the first reported examples of acylphloroglucinol-sesquiterpenoid adducts with dimeric acylphloroglucinol incorporated into the aristolane- or rulepidanol-type sesquiterpene, while compound 7 features a hydroxylated monomeric acylphloroglucinol motif. A preliminary evaluation of their antiviral activities revealed that compounds 1-6 exhibited more potent activities against respiratory syncytial virus (RSV) with IC₅₀ values ranging from 0.75 to 3.12 μmol·L^-1 compared to the positive control (ribavirin).
Antiviral Agents/isolation & purification* ; Phloroglucinol/isolation & purification* ; Sesquiterpenes/isolation & purification* ; Molecular Structure ; Dryopteris/chemistry* ; Respiratory Syncytial Viruses/drug effects* ; Humans ; Rhizome/chemistry* ; Drugs, Chinese Herbal/pharmacology*

OBJECTIVE To investigate the changes in serum metabolites of mice with radiation-induced intestinal injury under the intervention of baicalein and the changing characteristics of endogenous biological small molecules during the process of baicalein's participation in the prevention and treatment of radiation-induced intestinal injury through the metabolomics method based on GC-MS technology,in order to explore the potential regulatory mechanism of baicalein.METHODS A mouse radioactive intestinal injury model was established and randomly divided into normal control group,model group,low-dose baicalein group and high-dose baica-lein group.Baicalein was administered by gavage.Gas chromatography-mass spectrometry(GC-MS)technology was used to analyze the serum samples of mice in each group,and differential metabolites were screened through partial least squares-discriminant analysis(PLS-DA).Potential metabolic pathways were analyzed with MetaboAnalyst.RESULTS The pathological sections of mouse intesti-nal tissue showed that the high-dose and low-dose baicalein groups had a certain protective effect on radiation-induced intestinal dam-age.Metabolomic analysis showed that there were significant differences in the metabolic profiles of the blank control group,model group,low-dose and high-dose baicalein administration groups.After intragastric administration of baicalein,the endogenous metabo-lites in mice with radiation intestinal injury tended to normalize.The study screened out a total of 11 potential metabolic markers and 5 related metabolic pathways,among which pathways related to glucose metabolism,glutathione pathway,and ammonia metabolism were particularly significant.CONCLUSION Baicalein has a certain preventive and therapeutic effect on radiation-induced intestinal in-jury;baicalein participates in glucose metabolism and glutathione metabolism,and improving the endogenous substance disorder caused by radiation is its potential mechanism of action.

Purpose To explore the ability of proton density fat fraction(PDFF)and decay constant T2* values in MRI to reflect skeletal muscle aging.Materials and Methods 3T MRI data of skeletal muscle in the middle thigh of 211 healthy adults from the Third Affiliated Hospital of Southern Medical University from August to December 2023 were prospectively collected.Gender,age,height,weight and body mass index(BMI)were recorded.PDFF value and T2* value of thigh skeletal muscle were measured at post-processing workstation,and statistical differences among different age,gender and BMI groups were analyzed.The correlation between PDFF value and T2* value of thigh skeletal muscle and age and BMI was analyzed.Results There were statistically significant differences in PDFF values of thigh skeletal muscle among different age groups(H=18.476-85.619,all P<0.01).There were significantly differences in T2*values of the left and right quadriceps muscles,hamstrings and adductors among different age groups(H=13.342-47.566,all P<0.05).There were statistically significant differences in the PDFF values of right quadriceps,left and right hamstring,adductor and sartor muscles between male and female groups(Z=-4.929--1.626,all P<0.05),while there were statistically significant differences in T2* values of left sartor muscle(Z=-2.971,P=0.003).There was no statistical significance in PDFF value of skeletal muscle of thigh in different BMI groups(P>0.05),but there were statistically significant differences in T2* value of left and right quadriceps muscle,hamstring muscle and adductor muscle(H=9.542-24.495,all P<0.05).There was a moderate positive correlation between age and PDFF value of thigh skeletal muscle(r=0.635,P<0.01),but a slight negative correlation with T2* value of left and right quadriceps,hamstring and sarcoleus(r=-0.451--0.189,all P<0.01).There was a slight positive correlation between BMI and T2* values of thigh skeletal muscle(r=0.317,P<0.01).There was a moderate negative correlation between the PDFF value and T2* value of all thigh skeletal muscles(r=-0.749--0.624,P<0.01).The PDFF and T2* values of the front and back thigh muscles(quadriceps,hamstring)were most significantly correlated with age and BMI.Conclusion PDFF based on MRI can reflect the age-related changes in the microenvironment of thigh skeletal muscle,and is a potential imaging biological marker for accurate and non-invasive quantitative evaluation of thigh skeletal muscle aging.

Purpose: This study aims to evaluate the efficacy and safety of a new combination treatment of vinorelbine and pyrotinib in human epidermal growth factor receptor 2 (HER2)–positive metastatic breast cancer (MBC) and provide higher level evidence for clinical practice. Materials and Methods: This was a prospective, single-arm, phase 2 trial conducted at three institutions in China. Patients with HER2-positive MBC, who had previously been treated with trastuzumab plus a taxane or trastuzumab plus pertuzumab combined with a chemotherapeutic agent, were enrolled between March 2020 and December 2021. All patients received pyrotinib 400 mg orally once daily plus vinorelbine 25 mg/m2 intravenously or 60-80 mg/m2 orally on day 1 and day 8 of 21-day cycle. The primary endpoint was progression-free survival (PFS), and the secondary endpoints included the objective response rate (ORR), disease control rate (DCR), overall survival, and safety. Results: A total of 39 patients were enrolled. All patients had been pretreated with trastuzumab and 23.1% (n=9) of them had accepted trastuzumab plus pertuzumab. The median follow-up time was 16.3 months (95% confidence interval [CI], 5.3 to 27.2), and the median PFS was 6.4 months (95% CI, 4.0 to 8.8). The ORR was 43.6% (95% CI, 27.8% to 60.4%) and the DCR was 84.6% (95% CI, 69.5% to 94.1%). The median PFS of patients with versus without prior pertuzumab treatment was 4.6 and 8.3 months (p=0.017). The most common grade 3/4 adverse events were diarrhea (28.2%), neutrophil count decreased (15.4%), white blood cell count decreased (7.7%), vomiting (5.1%), and anemia (2.6%). Conclusion Pyrotinib plus vinorelbine showed promising efficacy and tolerable toxicity as second-line treatment in patients with HER2-positive MBC.

ObjectiveTo construct a traditional Chinese medicine （TCM） syndrome diagnosis and prescription model for coronary heart disease with the improved Transformer algorithm. MethodTaking the syndrome elements of coronary heart disease as key links， the model was constructed based on the clinical diagnosis and treatment principle of "symptoms-syndrome elements-syndrome-treatment method-prescription-medicine （dose）". The basic logic of improved Transformer algorithm was constructed with multi-head attention mechanism， compound term vector and dropout， in order to form the model with functions of TCM syndrome elements judgment， syndrome diagnosis， prescription recommendation. After the model was constructed， it was trained by 8 030 cases. And 100 cases with TCM prescriptions were randomly selected for testing， and the model output prescriptions were compared with those of clinicians for qualitative evaluation of the model. ResultThe improved Transformer with multi-head attention improved the accuracy of the model. The model was consistent with clinicians in the judgment of main syndromes and the selection of prescriptions. Whereas there was a certain room for improvement in the addition and subtraction of medicines. ConclusionThe improved Transformer model can improve the accuracy and stability of output， which is an embodiment of the intelligent development of TCM.

Humans ; Parkinson Disease/diagnosis* ; Machine Learning

Obesity is one of the most challenging global public health issues, and more than half of adults in Chia are overweight or obese. Obesity has been shown to be a risk factor for type 2 diabetes, cardiovascular disease, colon cancer and other specific cancers, and has become a serious threat and even a danger to the health and quality of life of the nation. With the mature development of bariatric surgery in the last 20 years, it is now widely recognized for its effectiveness and safety in the treatment of obesity and related metabolic diseases, as well as improving patients′ life expectancy and quality of life. However, previous data from the literatures suggest that some patients require revisional surgery after bariatric surgery, with the incidence of revisional bariatric surgery as 5% to 50%. The main reasons for revisional bariatric surgery are poor post-operative outcomes, including the lack of significant weight loss, weight regain and no significant improvement or even recurrence of associated metabolic disease, and other reasons include the development of anaemia, malnutrition and long-term chronic pain. Currently, there is only the East Asian expert consensus on revised bariatric surgery proposed by Chinese Society for Metabolic & Bariatric Surgery in 2018. However, there are still no uniform standards regarding the indications, contraindications and surgical modalities of revisional bariatric surgery in clinical practice. The authors summarize the latest researches of revisional bariatric surgery, in order to provide the guidance value for clinical practice.