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.

Objective To develop a single-person breast surgery teaching system to improve the teaching efficiency of breast surgery.Methods The single-person breast surgery teaching system consisted of a magnetic suspension and retraction device and a breast model.The magnetic suspension and retraction device was composed of a magnetic suspension component and a magnetic retraction component,of which,the magnetic suspension component included a bracket,an outer magnet and an inner magnet and the magnetic retraction component comprised a magnetic base and an elastic grasping forceps.The breast model was established with porcine abdominal tissue obtained from slaughterhouses.Twelve surgical trainees were randomized into an experimental group(n=6)and a control group(n=6),and the 2 groups performed flap release operations on the breast model with skin-preserving mastectomy as the target procedure.The operation was carried out with the developed system in the experimental group and with the traditional procedure in the control group.Results The two groups had the flap-free operation on the breast model finished successufully,which had no significant differences in the length of incision(P>0.05);the experimental group gained advantages over the control group in the number of assistants required,operation time,times of skin flap injuries,times of glandular injuries and effect of exposure,with the differences being statistically significant(all P<0.05).Conclusion The single-person breast surgery teaching system enhances the effect of exposure efficiently,meets the reequirements for single-person training and improves the teaching efficiency.[Chinese Medical Equipment Journal,2025,46(7):34-38]

Abdominal war trauma is a common and high-risk type of injury in the modern battlefield,with rapid changes in condition and a high mortality rate.There is an urgent need for emerging medical technologies to improve the efficiency and success rate of first aid for military casualties.With the development of artificial intelligence(AI),5G,and other emerging technologies,the concept of intelligent medical treatment is gradually forming and can assist in the diagnosis and treatment of abdominal trauma.This paper reviews the characteristics of abdominal war trauma in modern wars,discusses the application of intelligent medical treatment for abdominal war trauma and its drawbacks to be solved,aiming to provide reference for research related to abdominal war trauma.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Objective To develop a single-person breast surgery teaching system to improve the teaching efficiency of breast surgery.Methods The single-person breast surgery teaching system consisted of a magnetic suspension and retraction device and a breast model.The magnetic suspension and retraction device was composed of a magnetic suspension component and a magnetic retraction component,of which,the magnetic suspension component included a bracket,an outer magnet and an inner magnet and the magnetic retraction component comprised a magnetic base and an elastic grasping forceps.The breast model was established with porcine abdominal tissue obtained from slaughterhouses.Twelve surgical trainees were randomized into an experimental group(n=6)and a control group(n=6),and the 2 groups performed flap release operations on the breast model with skin-preserving mastectomy as the target procedure.The operation was carried out with the developed system in the experimental group and with the traditional procedure in the control group.Results The two groups had the flap-free operation on the breast model finished successufully,which had no significant differences in the length of incision(P>0.05);the experimental group gained advantages over the control group in the number of assistants required,operation time,times of skin flap injuries,times of glandular injuries and effect of exposure,with the differences being statistically significant(all P<0.05).Conclusion The single-person breast surgery teaching system enhances the effect of exposure efficiently,meets the reequirements for single-person training and improves the teaching efficiency.[Chinese Medical Equipment Journal,2025,46(7):34-38]

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Objective To investigate the causes and intervention measures of healthcare-associated infection(HAI)cluster events after cataract phacoemulsification combined intraocular lens(Phaco+Iol)implantation in an eye hospital,and provide reference for the prevention and control of HAI.Methods Epidemiological investigation was carried out on 4 cases of endophthalmitis after Phaco+Iol implantation within 34 days from July 25 to August 27,2020.Environmental hygiene monitoring on surgical environment was carried out,and comprehensive interven-tion measures were taken(from October to November)to avoid the spread of HAI.Results Within 34 days,a to-tal of 1 219 patients underwent Phaco+Iol implantation,and 4 patients developed endophthalmitis,with an infec-tion rate of 0.32％.The 4 infected patients,with an average age of 74 years,were implanted with three different brands and models of intraocular lenses respectively.They were diagnosed with endophthalmitis at different periods from the 2nd to the 9th day after surgery,which was initially suspected to be a cluster event of HAI.A total of 13 environmental hygiene monitoring specimens from operating room were unqualified.After taking infection preven-tion and control measures,the qualified rate of environmental hygiene monitoring before and after intervention was compared,difference was statistically significant(P=0.006).Three different bacterial species(Staphylococcus chromo genes,Staphylococcus epidermidis,and Enterococcus faecalis)were identified from vitreous and aqueous humor specimens of 4 patients.Bacteria culture results of vitreous specimens from 1 patient was negative.After the implementation of the infection prevention and control strategy,no similar infection occurred.Conclusion Impro-ving the awareness on HAI prevention and control,strengthening the comprehensive monitoring and management of the operating room and related departments in the hospital,as well as taking timely and targeted preventive and con-trol measures can effectively control the occurrence of HAI cluster events.

Objective To investigate the causes and intervention measures of healthcare-associated infection(HAI)cluster events after cataract phacoemulsification combined intraocular lens(Phaco+Iol)implantation in an eye hospital,and provide reference for the prevention and control of HAI.Methods Epidemiological investigation was carried out on 4 cases of endophthalmitis after Phaco+Iol implantation within 34 days from July 25 to August 27,2020.Environmental hygiene monitoring on surgical environment was carried out,and comprehensive interven-tion measures were taken(from October to November)to avoid the spread of HAI.Results Within 34 days,a to-tal of 1 219 patients underwent Phaco+Iol implantation,and 4 patients developed endophthalmitis,with an infec-tion rate of 0.32％.The 4 infected patients,with an average age of 74 years,were implanted with three different brands and models of intraocular lenses respectively.They were diagnosed with endophthalmitis at different periods from the 2nd to the 9th day after surgery,which was initially suspected to be a cluster event of HAI.A total of 13 environmental hygiene monitoring specimens from operating room were unqualified.After taking infection preven-tion and control measures,the qualified rate of environmental hygiene monitoring before and after intervention was compared,difference was statistically significant(P=0.006).Three different bacterial species(Staphylococcus chromo genes,Staphylococcus epidermidis,and Enterococcus faecalis)were identified from vitreous and aqueous humor specimens of 4 patients.Bacteria culture results of vitreous specimens from 1 patient was negative.After the implementation of the infection prevention and control strategy,no similar infection occurred.Conclusion Impro-ving the awareness on HAI prevention and control,strengthening the comprehensive monitoring and management of the operating room and related departments in the hospital,as well as taking timely and targeted preventive and con-trol measures can effectively control the occurrence of HAI cluster events.

Osteoporosis(OP)is a bone-related disease characterized by an imbalance between bone resorption and bone formation.Recent studies have shown that endoplasmic reticulum stress(ERS)plays an important role in the pathogenesis of OP.On the one hand,moderate ERS can regulate the differentiation of mesenchymal stem cells,osteoblasts and osteoclasts through multiple signaling pathways to promote bone homeostasis.On the other hand,excessive ERS can induce apoptosis of bone-related cells through various ways to disrupt bone homeostasis.Traditional Chinese medicine monomer and compound have significant therapeutic effect on OP.Recent studies have found that regulating ERS is one of the important mechanisms of effective treatment of OP by traditional Chinese medicine.From the perspective of ER stress,many studies have explored the mechanism of action in the treatment of OP by Chinese medicine.In this paper,through analyzing and summarizing the literature at home and abroad in recent years,the relevant studies on the involvement of ERS process in osteoporosis and the studies on the treatment of OP by Chinese medicine ERS process were reviewed.To further reveal the involvement of ERS process in the pathogenesis of osteoporosis and the regulatory role of traditional Chinese medicine.

Objective:To compare thulium laser enucleation of the prostate(ThuLEP)with plasma kinetic resection of the prostate(PKRP)in the treatment of BPH.Methods:We retrospectively analyzed the medical records of 160 cases of BPH treated by ThuLEP(the observation group,n=80)or PKRP(the control group,n=80)in our hospital from January 2021 to December 2023.We recorded the operation time,bladder irrigation time,catheter retention time,hospitalization time,postoperative complica-tions,and pre-and postoperative maximum urinary flow rate(Qmax),residual urine volume(PVR),prostate-specific antigen(PSA)and prostate volume,followed by comparison of the data obtained between the two groups of patients.Results:Compared with the controls,the patients of the observation group showed significantly shorter operation time([67.25±7.24]vs[60.10±5.15]min,P<0.05),bladder irrigation time([46.90±10.77]vs[43.24±6.65]h,P<0.05),catheterization time([5.60±1.31]vs[5.03±1.24]d,P<0.05)and hospitalization time([7.31±2.00]vs[6.55±1.67]d,P<0.05),higher Qmax([18.50±1.24]vs[20.68±1.45]ml/s,P<0.05),lower PVR([12.10±3.53]vs[10.82±3.10]ml,P<0.05),PSA([4.60±0.78]vs[3.38±0.40]μg/L,P<0.05)and prostate volume([25.35±6.46]vs[20.12±5.13]ml,P<0.05)at 3 months after surgery,but no statistically significant difference in the total incidence of postoperative complications(7.50%[6/80]vs 5.00%[4/80],P>0.05).Conclusion:ThuLEP,with its advantages of notable effect,short operation and hospitaliza-tion time,significant improvement of urinary flow dynamics and prostate function,deserves clinical promotion for the treatment of BPH.