ObjectiveTo delineate imaging findings using an imaging platform and investigate the correlation between MRI characteristics of spinal cord atrophy and clinical diagnosis in children with spinal cord injury (SCI). MethodsImaging data of 150 children with SCI admitted to Beijing Bo'ai Hospital, China Rehabilitation Research Center, from January, 2002 to March, 2024 were collected and imported into the imaging platform. The anteroposterior and transverse diameters of the middle part of the spinal cord at the cross-section with the most severe atrophy were measured, and the relevant indicators of the previous normal spinal cord segment were measured as controls; the radiomic features were extracted. Clinical data of the children including gender, age, cause of injury, sensory level, motor level, spinal cord injury level, injury severity and disease course were collected. ResultsSpinal cord atrophy was identified in 81 cases (54%), among which 78 cases (96%) were American Spinal Injury Association Impairment Scale (AIS) grade A and 3 cases (4%) were AIS grade C. The upper boundary of the spinal cord atrophy site strongly correlated with the injury level, motor level and sensory level (r > 0.8, P < 0.001). ConclusionMore than half of children with SCI may develop secondary spinal cord atrophy, the vast majority of whom suffer from complete spinal cord injury; the upper boundary of spinal cord atrophy is correlated with the injury level.

ObjectiveTo develop a full-process data platform of renal rehabilitation, diagnosis and quality control information. MethodsA hierarchical architectural design was proposed, adhering to clinical pathway models and standardized data protocols. The platform comprehensively covered assessment, intervention, follow-up and quality control for maintenance hemodialysis (MHD) patients. By integrating multidisciplinary resources and standardizing rehabilitation workflows, it delivered standardized and intelligent rehabilitation services. ResultsThe platform achieved standardized and intelligent management of rehabilitation services, effectively improved the physiological function, psychological state and quality of life convenience for MHD patients, while significantly reduced the economic and care burden on patients' families and society. ConclusionThe rehabilitation service model based on a full-process data platform may provide scientific and systematic support for MHD patients.

Under the combined effects of globalization, human activities, climate change, pathogen variation and other multiple factors, various infectious diseases have shown different trends in prevalence, posing a serious threat to human health. Neurological infections and autoimmune diseases have always been at the forefront of the field of neurology, involving complex pathogenesis, depicting with diverse clinical manifestations and posing numerous challenges in treatment. Infections of pathogens can damage the nervous system directly or induce autoimmune reactions. In recent years, with a deeper understanding of the pathogenesis of infection and autoimmunity, especially the expansion of the autoantibody spectrum and the progress in molecular immunotherapy, the prognosis of infectious and autoimmune diseases has been significantly improved. However, the risk of relapse is still high. Uncovering the pathogenesis is crucial to seek opportunities for early treatment.

Under the combined effects of globalization, human activities, climate change, pathogen variation and other multiple factors, various infectious diseases have shown different trends in prevalence, posing a serious threat to human health. Neurological infections and autoimmune diseases have always been at the forefront of the field of neurology, involving complex pathogenesis, depicting with diverse clinical manifestations and posing numerous challenges in treatment. Infections of pathogens can damage the nervous system directly or induce autoimmune reactions. In recent years, with a deeper understanding of the pathogenesis of infection and autoimmunity, especially the expansion of the autoantibody spectrum and the progress in molecular immunotherapy, the prognosis of infectious and autoimmune diseases has been significantly improved. However, the risk of relapse is still high. Uncovering the pathogenesis is crucial to seek opportunities for early treatment.

The outbreak of monkeypox has become a global matter of concern since last year. Monkeypox is a zoonotic disease caused by monkeypox virus（MPXV）infection，and in addition to the typical symptom of rash，MPXV infection can cause a series of neurological manifestations，with the potential mechanisms of immune-mediated neurological damage after infection and direct invasion of the virus into the nervous system. This article reviews the neurological manifestations of MPXV infection，so as to facilitate the early identification and diagnosis of the neurological complications of MPXV infection and adopt appropriate prevention and treatment measures in a timely manner.
Monkeypox virus

This paper provides a comprehensive analysis of the current state of intelligent ophthalmology in China, including technological advancements, academic exchange platforms, policy support, future challenges, and potential solutions. Technologically, remarkable progress have been made in various areas of intelligent ophthalmology in China, including diabetic retinopathy, fundus image analysis, and crucial aspects such as quality assessment of medical artificial intelligence products, clinical research methods, technological evaluation, and industrial standards. Researchers are constantly improving the safety and standardization of intelligent ophthalmology technology by formulating clinical application guidelines and standards. Academic exchange platforms have been established to provide extensive collaboration opportunities for professionals across diverse fields, and various academic journals serve as publication platforms for intelligent ophthalmology research. Regarding public policy, the Chinese government has not only established a supportive policy environment for the advancement of intelligent ophthalmology through various documents and regulations, but provided a legal basis and management framework. However, there are still challenges to overcome, such as technological innovation, data privacy and security, outdated regulations, and talent shortages. To tackle these issues, there is a requirement for increased technological research and development, the establishment of regulatory frameworks, talent cultivation, and greater awareness and acceptance of new technologies among patients. By comprehensively addressing these challenges, intelligent ophthalmology in China is expected to continue leading the industry's global development, bringing more innovation and convenience to the field of ophthalmic healthcare.

Objective:To investigate the efficacy and adverse reactions of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) combined with chemotherapy in the treatment of superior mediastinal lymph node metastasis after esophageal cancer surgery.Methods:The clinical data of 72 patients with concurrent chemoradiotherapy for superior mediastinal lymph node metastasis after esophageal cancer surgery in Tai'an Cancer Prevention and Treatment Hospital from January 2019 to May 2021 were retrospectively analyzed, and they were divided into intensity-modulated radiotherapy (IMRT) group (36 cases) and SIB-IMRT group (36 cases) according to different radiotherapy methods. The short-term efficacy, long-term survival rate and adverse reactions of the two groups were compared.Results:The response rate in the IMRT group was 66.7% (24/36), the response rate in the SIB-IMRT group was 86.1% (31/36), and the difference between the two groups was statistically significant ( χ2 = 3.77, P = 0.047). The 1-, 2- and 3-year overall survival rates in the IMRT group were 75.0%, 44.4% and 27.8%, and the 1-, 2- and 3-year overall survival rates in the SIB-IMRT group were 83.3%, 52.8% and 33.3%; the difference in the overall survival between the two groups was not statistically significant ( χ2 = 0.70, P = 0.401). There were statistical differences in the incidence of leukopenia, radiation esophagitis and radiation pleural gastritis between the two groups (all P < 0.05). There were no statistical differences in the incidence of radiation pneumonia and gastrointestinal reactions between the two groups (both P > 0.05). Conclusions:SIB-IMRT combined with chemotherapy in patients with superior mediastinal lymph node metastasis after esophageal cancer surgery has good local control rate and mild adverse reactions.

Objective To study the distinct clinical phenotype of chronic airway diseases by hierarchical cluster analysis and two-step cluster analysis.Methods A population sample of adult patients in Donghuamen community,Dongcheng district and Qinghe community,Haidian district,Beijing from April 2012 to January 2015,who had wheeze within the last 12 months,underwent detailed investigation,including a clinical questionnaire,pulmonary function tests,total serum IgE levels,blood eosinophil level and a peak flow diary.Nine variables were chosen as evaluating parameters,including pre-salbutamol forced expired volume in one second(FEV1)/forced vital capacity (FVC) ratio,pre-salbutamol FEV1,percentage of post-salbutamol change in FEV1,residual capacity,diffusing capacity of the lung for carbon monoxide/alveolar volume adjusted for haemoglobin level,peak expiratory flow (PEF) variability,serum IgE level,cumulative tobacco cigarette consumption (pack-years) and respiratory symptoms (cough and expectoration).Subjects' different clinical phenotype by hierarchical cluster analysis and two-step cluster analysis was identified.Results (1) Four clusters were identified by hierarchical cluster analysis.Cluster 1 was chronic bronchitis in smokers with normal pulmonary function.Cluster 2 was chronic bronchitis or mild chronic obstructive pulmonary disease (COPD) patients with mild airflow limitation.Cluster 3 included COPD patients with heavy smoking,poor quality of life and severe airflow limitation.Cluster 4 recognized atopic patients with mild airflow limitation,elevated serum IgE and clinical features of asthma.Significant differences were revealed regarding pre-salbutamol FEV1/FVC％,pre-salbutamol FEV1％ pred,postsalbutamol change in FEV1 ％,maximal mid-expiratory flow curve (MMEF)％ pred,carbon monoxide diffusing capacity per liter of alveolar(DLCO)/(VA)％ pred,residual volume(RV)％ pred,total serum IgE level,smoking history (pack-years),St.George' s respiratory questionnaire (SGRQ) score,acute exacerbation in the past one year,PEF variability and allergic dermatitis (P ＜ 0.05).(2) Four clusters were also identified by two-step cluster analysis as followings,cluster 1,COPD patients with moderate to severe airflow limitation;cluster 2,asthma and COPD patients with heavy smoking,airflow limitation and increased airways reversibility;cluster 3,patients having less smoking and normal pulmonary function with wheezing but no chronic cough;cluster 4,chronic bronchitis patients with normal pulmonary function and chronic cough.Significant differences were revealed regarding gender distribution,respiratory symptoms,pre-salbutamol FEV1/FVC％,pre-salbutamol FEV1 ％ pred,post-salbutamol change in FEV1 ％,MMEF％ pred,DLCO/VA％ pred,RV％ pred,PEF variability,total serum IgE level,cumulative tobacco cigarette consumption (pack-years),and SGRQ score (P ＜ 0.05).Conclusion By different cluster analyses,distinct clinical phenotypes of chronic airway diseases are identified.Thus,individualized treatments may guide doctors to provide based on different phenotypes.

Objective To study the effects of Weibimei and its Chinese medicine portions(cortex frangulae, fennel powder, acorus tatarinowii, glycyrrhizae and asparagus) on cell cycle regulation in gastric cancer cells and growth inhibition in gastric cancer Xenografts.Methods Gastric cancer SGC-7901 cells were normally cultured and treated with Weibimei, extractum glycyrrhizae, cortex frangulae, fennel powder, acorus tatarinowii and asparagus.Then, the proliferation of SGC-7901 cells were detected by MTT assay, their effect on SGC-7901 cell cycle were measured by flow cytometry, and the expression of cell cycle related proteins were examined by Western blot.Animal models of SGC-7901 cells xenografts in nude mice were constructed to evaluate the growth inhibition effects of Weibimei and its Chinese medicine portions, and the expression of STAT3,p-STAT3, Cyclin D1, Bcl-2 and Survivin in gastric tumors were detected by immunohistochemical assays.Results Weibimei and its three kinds of Chinese medicine portions, cortex frangulae, fennel and acorus tatarinowii could obviously inhibit the proliferation of SGC-7901 cells, compared to control group, with a statistical significant difference (P<0.05).The cell cycle of SGC-7901 was arrested at G1 phase with cortex frangulae, fennel and acorus tatarinowii treatment, the expression of Cyclin A, B, D, E were decreased significantly (P<0.05).However, no significant effects was found in glycyrrhizae or asparagus group.Xenografts tumor sizes in Weibimei, cortex frangulae, fennel or acorus tatarinowi groups were much smaller than that in saline group or Triple Therapy group (three-kinds-drugs-combination for the treatment of gastric ulcer) (P<0.05).Xenografts experiments showed that the tumor growth in nude mice in Weibimei, cortex frangulae, fennel or acorus tatarinowi groups were significantly smaller than that in control group or in Triple Therapy Group (P<0.05), and phosphorylated STAT3, and STAT3 signaling targeted genes, including Bcl-2, Cyclin D1 and Survivin were all significantly down-regulated by immunostaining.Conclusion Weibimei and its Chinese medicine portions including cortex frangulae, fennel and acorus tatarinowii can could significantly inhibit the growth of SGC-7901 cells proliferation and arrested the cell cycle of G1 phase in vitro, and inhibit gastric cancer xenografts in nude mice in vivo.

Objective To explore the clinical phenotype of airways disease in elderly patients using hierarchical cluster analysis.Methods A total of 67 elderly patients with respiratory symptoms were enrolled in a prospective study.Demographic and clinical data,such as respiratory symptoms,cumulative tobacco cigarette consumption,acute exacerbation,atopic symptoms and peak flow diary were collected.Pulmonary function tests,blood tests (total serum IgE level and blood eosinophil level) were performed in each patient during the stable stage.Then patients with different clinical phenotype were identified by hierarchical cluster analysis.Results Four clusters were identified with the following characteristics by hierarchical cluster analysis:cluster 1,atopic patients with no smoking,normal lung function,but increased total serum IgE levels and asthma symptom;cluster 2,patients with no smoking and normal pulmonary function with wheezing but without chronic cough;cluster 3,patients with chronic obstructive pulmonary disease and smoking,severe airflow limitation and poor quality of life;cluster 4,patients with asthma-chronic obstructive pulmonary disease overlap syndrome and smoking,airflow limitation and increased total serum IgE levels.The forced expiratory volume in 1 second (FEV1) / forced vital capacity (FVC) ratio,FEV1/predicted value,rate of FEV1 change,maximal mid-expiratory flow (MMEF)/ predicted value,the diffusion lung capacity for carbon monoxide (DLCO)/alveolar volume (VA)/predicted value,residual volume (RV)/ predicted value,total serum Ig E levels,cumulative tobacco cigarette consumption,the St.George's Respiratory Questionnaire (SGRQ) score had significant differences in patients before versus after treatment (all P＜0.05 or P＜0.01).Conclusions Based on hierarchical cluster analysis,distinct clinical phenotypes of airways disease in elderly patients can be identified.Conclusions With patients having asthma or COPD alone,patients with Asthma-COPD overlap syndrome (ACOS) always experience a more rapid decline in lung function and frequent exacerbations,having poor health-related quality-of-life (HRQOL) outcomes,which deserve our high attention.