This paper proposes a two-stage method integrating visual foundation models （VFM） and diffusion models. The segment anything model （SAM） as VFM is combined with the SegRefiner diffusion model to construct the SAM-SegRefiner framework for automated segmentation of edema， inflammation， and thrombus regions in histopathological images of hemorrhoidal tissue， providing a reproducible technical tool for the objective quantification of pathological morphology and its application in traditional Chinese medicine （TCM） syndrome research. Trained and validated on multi-center retrospective data， the SAM-SegRefiner model achieved an average pixel accuracy of 95.32% and a mean intersection over union （mIoU） of 66.81% on an independent test set， significantly outperfor-ming comparative models such as U-Net， MixU-Net， and SAM-Med2D， and also demonstrating robust cross-center generalization capability. Furthermore， by correlating the quantitatively segmented results from the model with the patients' TCM syndrome types， the potential associations between pathomorphological features and TCM syndrome differentiation have been explored. The analysis revealed no statistically significant differences in the degree of inflammatory infiltration and thrombus formation among different syndrome types， suggesting a complex relationship between local pathological changes and systemic syndrome manifestations.

This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

This paper introduces a real-world cohort research model for community-acquired pneumonia （CAP） based on the Jiangsu Traditional Chinese Medicine （TCM） Dominant Diseases Diagnosis and Treatment Data Platform. Firstly， data cleaning is performed by standardizing diagnosis， symptoms， treatment and imaging， intelligently extracting unstructured information， and cleaning and constructing a standardized database. Secondly， for cohort establishment， CAP patients across the province are screened in accordance with CAP diagnostic criteria to build a high-quality disease-specific cohort. Lastly， in terms of protocol design， the characteristics of TCM research and the CAP disease profile are considered to determine appropriate inclusion and exclusion criteria， estimate sample size， define interventions， outcomes and economic evaluations， providing a reference for real-world TCM research on CAP.

Objective By exploring changes of six degrees of freedom(6DOF)kinematics of the knee joint during extra weight bearing of the body trunk,the influence of extra weight on knee joint movement patterns was studied.Methods A total of 24 healthy subjects were recruited to walk/run on a treadmill at four speeds under two states:self-weight and wearing a 16 kg vest,and gait analysis was conducted.A three-dimensional(3D)portable knee kinematics analysis system based on infrared stereophotography was used to capture 6DOF movement trajectory data of the tibia relative to the femur.Results Compared to the self-weight state,when additional trunk weight was added,the knee external rotation angle was reduced at 3.6 km/h speed(1.4°-2.1°)and 5.4 km/h speed(2.2°-2.7°);the knee internal rotation angle was reduced at 10.8 km/h speed(2.1°-4.2°);the knee flexion angles was increased significantly at the speed of 3.6 km/h(1.5°-1.8°),9 km/h(1.6°-3.3°)和 10.8 km/h(1.9°-3.1°);the knee adduction angle increased at 5.4 km/h speed(0.5°-0.6°),and decreased at 10.8 km/h speed(0.9°-1.3°).At 10.8 km/h speed,the distal knee displacement(0.2-0.4 mm)was increased,and the lateral knee displacement(0.1-0.2 mm),and anterior knee displacement(0.2-0.3 mm)were significantly reduced.Conclusions The 6DOF kinematics of human knee is significantly affected by the extra trunk weight.Performance is also different at lower and higher speeds.It is suggested that there may exist a hidden injury in military training,and this study provides a kinematic basis for the occurrence of sports injury.

Objective To investigate the efficacy and mechanism of the combination of cryoablation and Yangfei establish the Lewis lung cancer mouse model,and randomly divided into model group,cryoablation group,cryoablation+cisplatin group,cryoablation+Yangfei Prescription low-,medium-and high-dosage groups,with 5 mice in each group.Sham-operation was performed in the model group,cryoablation+cisplatin group were given intraperitoneal injection of cisplatin 3 mg/kg after cryoablation,cryoablation+Yangfei Prescription low-,medium-and high-dosage groups were given 1.64,3.28,6.56 g/kg Yangfei Prescription by gavage after cryoablation respectively,and the model group was given equal volume of normal saline by gavage for 14 consecutive days.Tumor volume and tumor mass were measured,the morphology of tumor tissue was observed by HE staining,the expression of Ki-67 protein in tumor tissue was detected by immunohistochemistry.The differentially expressed genes in tumor tissues after cryoablation combined with Yangfei Prescription intervention were analyzed by whole transcriptome sequencing,GO and KEGG pathway enrichment analysis was performed on differentially expressed genes,and the lncRNA/circNA-mediated ceRNA network was constructed.Differentially expressed genes were verified using RT-qPCR.Results The main active components of Yangfei Prescription were terpenoids,flavonoids and aldehydes.Compared with the model group,tumor volume and tumor mass decreased(P<0.05)in cryoablation+Yangfei Prescription low-,medium-and high-dosage groups and cryoablation+cisplatin group;cryoablation combined with Yangfei Prescription could destroy the structure of tumor tissue and inhibit cell proliferation(P<0.05).A total of 1 585 differentially expressed genes(1 160 mRNA,225 lncRNA,155 miRNA and 45 circRNA)of the model group and cryoablation+Yangfei Prescription high-doseage group were obtained.GO enrichment analysis mainly involved biological processes such as immune system response and cell proliferation,cellular components such as protein complex and cell junction,molecular functions such as transcription regulator activity and molecular function regulator;KEGG pathway enrichment mainly occurred in cancer-related pathways such as PI3K-Akt signaling pathway,Th17 cell differentiation,mTOR signaling pathway,FOXO signaling pathway,etc.The lncRNA-mediated ceRNA network was composed of 97 lncRNA,73 miRNA and 417 mRNA,and the circRNA-mediated ceRNA network was composed of 26 circRNA,68 miRNA and 157 mRNA.RT-qPCR validated the expressions of 15 differentially expressed genes,which was consistent with the sequencing results.Conclusion Cryoablation combined with Yangfei Prescription can inhibit the tumor growth of Lewis lung cancer bearing mice,destroy the structure of tumor tissue,inhibit cell proliferation,the mechanism may be related to the regulation of Gm38393/miRNA-136-5p/Zfp704 axis.

Objective By exploring changes of six degrees of freedom(6DOF)kinematics of the knee joint during extra weight bearing of the body trunk,the influence of extra weight on knee joint movement patterns was studied.Methods A total of 24 healthy subjects were recruited to walk/run on a treadmill at four speeds under two states:self-weight and wearing a 16 kg vest,and gait analysis was conducted.A three-dimensional(3D)portable knee kinematics analysis system based on infrared stereophotography was used to capture 6DOF movement trajectory data of the tibia relative to the femur.Results Compared to the self-weight state,when additional trunk weight was added,the knee external rotation angle was reduced at 3.6 km/h speed(1.4°-2.1°)and 5.4 km/h speed(2.2°-2.7°);the knee internal rotation angle was reduced at 10.8 km/h speed(2.1°-4.2°);the knee flexion angles was increased significantly at the speed of 3.6 km/h(1.5°-1.8°),9 km/h(1.6°-3.3°)和 10.8 km/h(1.9°-3.1°);the knee adduction angle increased at 5.4 km/h speed(0.5°-0.6°),and decreased at 10.8 km/h speed(0.9°-1.3°).At 10.8 km/h speed,the distal knee displacement(0.2-0.4 mm)was increased,and the lateral knee displacement(0.1-0.2 mm),and anterior knee displacement(0.2-0.3 mm)were significantly reduced.Conclusions The 6DOF kinematics of human knee is significantly affected by the extra trunk weight.Performance is also different at lower and higher speeds.It is suggested that there may exist a hidden injury in military training,and this study provides a kinematic basis for the occurrence of sports injury.

Objective:To examine the roles played by peer attachment and cognitive fusion in the association between negative life events and depression,as well as the differences in these relationships of variables among pri-mary and secondary school students.Methods:A total of 2 767 students(1 950 elementary school students and 817 middle school students)were selected.The Adolescent Life Events Scale,the Experiences in Close Relationships-Relationship Structures Questionnaire,the Cognitive Fusion Questionnaire,and the Patient Health Questionnaire were used to measure negative life events,peer attachment,cognitive fusion,and depression,respectively.Results:Negative life events,peer attachment,cognitive fusion and depression were positively correlated with each other(r=0.36-0.75,Ps＜0.001);the mediation effects of peer attachment and cognitive fusion and their chain mediation effects were 0.04,0.30,and 0.04,respectively,accounting for 6.7％,50％,and 6.7％of the total effect.There were significant differences in the chain mediation model between primary and secondary school students(△x2=47.12,△df=6,P＜0.001),and significant gender differences in the chain mediation effect among primary school students(△x2=43.72,△df=6,P＜0.001).Conclusion:Negative life events influence depression in primary and secondary school students both directly and indirectly through peer attachment and cognitive fusion.Negative life e-vents have greater impact on primary school students'(particularly girls)peer attachment.Peer attachment has grea-ter impact on secondary school students' cognitive fusion.Cognitive fusion has greater impact on primary school students' depression.Peer attachment has greater impact on primary school boys' depression.

Background The decline of physical activity in the elderly due to aging may increase the risk of sarcopenia. Currently, there is a lack of evidence from large natural populations on the relationship between PA and sarcopenia. Objective To explore the relationship between PA and sarcopenia in the elderly aged 60 years and above in 10 provinces (autonomous regions) of China. Methods Data were retrieved from the 2022—2023 round of the China Development and Nutrition Health Impact Cohort. Personal basic information and PA data were collected by questionnaire survey. Skeletal muscle mass was measured by bio-electrical impedance analysis, muscle strength was measured using a grip dynamometer, and physical performance was reflected by 6-meter walk speed. The Asian Working Group for Sarcopenia (AWGS) 2019 criteria were used to diagnose sarcopenia. Light physical activity (LPA) duration, moderate-to-vigorous physical activity (MVPA) duration, and total physical activity volume were calculated. A total of 3326 residents aged ≥60 years with complete data were selected as the survey participants. Multiple logistic regression models and restricted cubic splines (RCS) were used to assess the association between PA duration/volume and sarcopenia. Results In 10 provinces (autonomous regions) of China, the prevalence of sarcopenia in the elderly aged 60 years and above was 5.5% (95%CI: 4.7%, 6.2%). The logistic regression analysis showed that compared with the elderly reporting 0-7.0 h·week⁻¹ in LPA duration, the risk of sarcopenia in the elderly with LPA duration of >14.0-21.0 h·week⁻¹ was reduced by 51% (OR=0.49, 95%CI: 0.26, 0.96). Compared with the elderly with total physical activity ≥15.0 metabolic equivalent of task (MET)-h·week⁻¹, those with <7.5 MET-h·week⁻¹ had a 2.24-fold increased risk of sarcopenia (OR=2.24, 95%CI: 1.17, 4.29). The RCS results found that LPA duration and total physical activity volume each showed a nonlinear dose-response relationship with the risk of sarcopenia (P_overall<0.05, P_non-linear<0.05). Compared with the elderly with an LPA duration of 0 h· week⁻¹, the risk of sarcopenia in the elderly with an LPA duration of 12.6 h· week⁻¹ was the lowest (OR=0.42, 95%CI: 0.21, 0.83). Compared with the elderly with a total physical activity volume of 15.0 MET-h· week⁻¹, the elderly with a total physical activity volume of 46.0 MET-h· week⁻¹ had the lowest risk of sarcopenia (OR=0.57, 95%CI: 0.38, 0.84). There was no statistically significant association between weekly MVPA duration and the risk of sarcopenia (P>0.05). Conclusion Increasing weekly LPA duration and total physical activity volume would help to reduce the risk of sarcopenia.

AIM: To assess the stability of the tear film and the characteristics of corneal nerves in patients with Parkinson's disease(PD).METHODS: This cross-sectional observational study included 72 PD patients and 50 healthy controls. Disease severity was determined using the Hoehn-Yahr(H-Y)scale, dividing patients into mild and moderate PD groups. Dry eye symptoms were evaluated via the ocular surface disease index(OSDI)questionnaire, while tear secretion was quantified using the Schirmer I test. Ocular surface damage was assessed through staining scores, and comprehensive ocular examinations were performed utilizing the LipiView ocular surface interferometer and an ocular surface analyzer. Corneal nerve parameters were examined using corneal confocal microscopy in conjunction with automated analysis software ACCMetrics, with correlations drawn between these parameters, PD course, and severity.RESULTS: PD patients exhibited significantly elevated OSDI scores, indicative of more pronounced dry eye symptoms compared to the control group(F=70.290, P<0.01). Tear film stability was markedly compromised, with significantly shorter tear film breakup time and increased corneal fluorescein staining, both showing statistically significant differences relative to controls(all P<0.01). Tear secretion indices, including Schirmer I test results and tear meniscus height, were significantly reduced in PD patients(all P<0.01), whereas lipid secretion indices, such as lipid layer thickness and meibomian gland dropout score, did not show significant variation. Corneal nerve analysis revealed significant reductions in corneal nerve fiber density, nerve branch density, fiber length, and total branch density in PD patients compared to controls(all P<0.01). Furthermore, blink frequency was markedly prolonged(F=62.353, P<0.01). Correlation analysis demonstrated a significant relationship between alterations in tear film stability and both disease duration and H-Y scores.CONCLUSION: PD patients have obvious dry eye manifestations in the early stage of the disease, including the reduction of tear film stability and corneal nerve fiber density, and gradually aggravate with the progress of the disease. Neurodegenerative disease-related dry eye needs to be diagnosed early and actively treated.

Objective:To examine the roles played by peer attachment and cognitive fusion in the association between negative life events and depression,as well as the differences in these relationships of variables among pri-mary and secondary school students.Methods:A total of 2 767 students(1 950 elementary school students and 817 middle school students)were selected.The Adolescent Life Events Scale,the Experiences in Close Relationships-Relationship Structures Questionnaire,the Cognitive Fusion Questionnaire,and the Patient Health Questionnaire were used to measure negative life events,peer attachment,cognitive fusion,and depression,respectively.Results:Negative life events,peer attachment,cognitive fusion and depression were positively correlated with each other(r=0.36-0.75,Ps＜0.001);the mediation effects of peer attachment and cognitive fusion and their chain mediation effects were 0.04,0.30,and 0.04,respectively,accounting for 6.7％,50％,and 6.7％of the total effect.There were significant differences in the chain mediation model between primary and secondary school students(△x2=47.12,△df=6,P＜0.001),and significant gender differences in the chain mediation effect among primary school students(△x2=43.72,△df=6,P＜0.001).Conclusion:Negative life events influence depression in primary and secondary school students both directly and indirectly through peer attachment and cognitive fusion.Negative life e-vents have greater impact on primary school students'(particularly girls)peer attachment.Peer attachment has grea-ter impact on secondary school students' cognitive fusion.Cognitive fusion has greater impact on primary school students' depression.Peer attachment has greater impact on primary school boys' depression.