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 investigate the epidemiological characteristics of malaria and provide a basis for developing improved prevention and control measures. Methods Data were obtained from the Chinese Disease Prevention and Control Information System. Malaria surveillance data for Nanning City from January 1,2023, to December 31,2024, were exported from the Infectious Disease Reporting Information Management Subsystem. The characteristics of the two groups of malaria cases were compared. Results A total of 103 imported malaria cases were reported in Nanning City in 2024, representing a 38.32% decrease compared with the same period of the previous year. No statistically significant difference were observed between cases reported in 2023 and 2024 in terms of average age, gender ratio, proportion of parasite species, and monthly reporting distribution;however, statistically significant differences were found in the proportion of reporting areas and current residence areas(χ2= 13.572 and 10.355, respectively; P = 0.001 and 0.035, respectively). The proportion of cases reported in Shanglin County and the proportion of cases residing in Shanglin County were both lower than those during the same period of the previous year. Conclusions The high aggregation of imported malaria cases in Nanning City has decreased. Medical institutions in areas other than Shanglin County should strengthen their vigilance against malaria.

Objective To explore the effects of the disinfection port position and diameter and disinfectant concentration on the in-situ decontamination of the flow field-based biosafety high efficiency particulate air filter device with the computational fluid dynamics(CFD)method.Methods ANSYS DesignModeler was used to construct five models for the high efficiency particulate air filter device with the disinfection port at the side end in four ones and upper end in the remained one model,with the diameter being 70,100,150,260 and 260 mm respectively;secondly,a standard k-ε turbulence model was applied to simulating the velocity field and concentration field inside the high efficiency particulate air filter device,so as to analyze the influence of the vortex position inside the device and the structure of the device on the disinfection effect and to determine the optimal structure of the device;finally,H2O2 with the concentration of 0.45,0.35 or 0.30 mol/L was selected as the disinectant to investigate the effect of the disinfectant concentration on the disinfection under the optimal device structure.Results Simulation showed that there were vortexes existed the cavity between the filter compression structure and the filter of the high efficiency particulate air filter device.The disinfection effect in case of the disinfection port at the side end was higher than that in case of the disinfection port at the upper end;the diameter of the disinfection port had influences on the disinfection effect,and high-concentration disinfectant was found in the device when the diameter was 100 mm.The optimal structure with the disinfection port at the side end and the diameter of 100 mm was determined for the high efficiency particulate air filter device.An increase in H2O2 concentration was beneficial to improve disinfection without corroding and damaging the device when the in-situ decontamination of the flow field-based biosafety high efficiency particulate air filter device was carried out.Conclusion The characteristics of the internal flow field of the flow field-based biosafety high efficiency particulate air filter device and the influencing factors of the in-situ disinfection effect are revealed,and theoretical references are provided for the optimal design of the device.[Chinese Medical Equipment Journal,2025,46(9):22-27]

Objective To explore the effects of the disinfection port position and diameter and disinfectant concentration on the in-situ decontamination of the flow field-based biosafety high efficiency particulate air filter device with the computational fluid dynamics(CFD)method.Methods ANSYS DesignModeler was used to construct five models for the high efficiency particulate air filter device with the disinfection port at the side end in four ones and upper end in the remained one model,with the diameter being 70,100,150,260 and 260 mm respectively;secondly,a standard k-ε turbulence model was applied to simulating the velocity field and concentration field inside the high efficiency particulate air filter device,so as to analyze the influence of the vortex position inside the device and the structure of the device on the disinfection effect and to determine the optimal structure of the device;finally,H2O2 with the concentration of 0.45,0.35 or 0.30 mol/L was selected as the disinectant to investigate the effect of the disinfectant concentration on the disinfection under the optimal device structure.Results Simulation showed that there were vortexes existed the cavity between the filter compression structure and the filter of the high efficiency particulate air filter device.The disinfection effect in case of the disinfection port at the side end was higher than that in case of the disinfection port at the upper end;the diameter of the disinfection port had influences on the disinfection effect,and high-concentration disinfectant was found in the device when the diameter was 100 mm.The optimal structure with the disinfection port at the side end and the diameter of 100 mm was determined for the high efficiency particulate air filter device.An increase in H2O2 concentration was beneficial to improve disinfection without corroding and damaging the device when the in-situ decontamination of the flow field-based biosafety high efficiency particulate air filter device was carried out.Conclusion The characteristics of the internal flow field of the flow field-based biosafety high efficiency particulate air filter device and the influencing factors of the in-situ disinfection effect are revealed,and theoretical references are provided for the optimal design of the device.[Chinese Medical Equipment Journal,2025,46(9):22-27]

Purpose To compare the clinical and cardiovascular magnetic resonance(CMR)characteristics of hypertrophic cardiomyopathy(HCM)with and without diabetes mellitus,and to investigate the effect of diabetes mellitus on left ventricular remodeling in HCM patients.Materials and Methods A total of 96 HCM patients diagnosed with CMR in Chengdu Fifth People's Hospital from January 2021 to March 2023,retrospectively.They were divided into HCM with diabetes mellitus group(n=22)and HCM without diabetes mellitus group(n=74)according to whether they had diabetes mellitus.The clinical baseline and CMR data of HCM patients were analyzed,and left ventricular function and strain were compared between the two groups.Results The HCM group with diabetes mellitus was observed to have a significantly higher left ventricular mass index compared to HCM without diabetes mellitus group[(1.33±0.50)g/ml vs.(1.10±0.23)g/ml;t=3.002,P=0.003],along with a significantly lower left ventricular global circumferential strain[-19.69(-21.82,-17.06)%vs.-16.33(-20.84,-13.86)%;Z=543.000,P<0.05]and global longitudinal strain[(-8.69±3.94)%vs.(-10.74±3.62)%;t=2.227,P<0.05)].Furthermore,diabetes mellitus was identified as an independent factor associated with an increased left ventricular mass index(β=0.330,P<0.05)by multivariate linear regression analysis.Conclusion In patients with HCM,diabetes mellitus is independently associated with left ventricular remodeling.The global circumferential strain and longitudinal strain of HCM patients with diabetes mellitus decreases significantly,suggesting that diabetes mellitus has a significant impact on left ventricular strain in HCM patients.

Purpose To compare the clinical and cardiovascular magnetic resonance(CMR)characteristics of hypertrophic cardiomyopathy(HCM)with and without diabetes mellitus,and to investigate the effect of diabetes mellitus on left ventricular remodeling in HCM patients.Materials and Methods A total of 96 HCM patients diagnosed with CMR in Chengdu Fifth People's Hospital from January 2021 to March 2023,retrospectively.They were divided into HCM with diabetes mellitus group(n=22)and HCM without diabetes mellitus group(n=74)according to whether they had diabetes mellitus.The clinical baseline and CMR data of HCM patients were analyzed,and left ventricular function and strain were compared between the two groups.Results The HCM group with diabetes mellitus was observed to have a significantly higher left ventricular mass index compared to HCM without diabetes mellitus group[(1.33±0.50)g/ml vs.(1.10±0.23)g/ml;t=3.002,P=0.003],along with a significantly lower left ventricular global circumferential strain[-19.69(-21.82,-17.06)%vs.-16.33(-20.84,-13.86)%;Z=543.000,P<0.05]and global longitudinal strain[(-8.69±3.94)%vs.(-10.74±3.62)%;t=2.227,P<0.05)].Furthermore,diabetes mellitus was identified as an independent factor associated with an increased left ventricular mass index(β=0.330,P<0.05)by multivariate linear regression analysis.Conclusion In patients with HCM,diabetes mellitus is independently associated with left ventricular remodeling.The global circumferential strain and longitudinal strain of HCM patients with diabetes mellitus decreases significantly,suggesting that diabetes mellitus has a significant impact on left ventricular strain in HCM patients.

Objective:To explore the mediating role of activity of daily living between social support and cognitive function of rural elderly.Methods:A face-to-face questionnaire survey was conducted from July to August 2019 among 1 626 rural elderly people selected by multi-stage cluster random method in Guiyang City and Qiannan Prefecture, Guizhou Province.The contents include general situation, social support rate scale (SSRS), activity of daily living scale (ADL) and mini-mental state examination (MMSE). Partial correlation analysis and multiple linear regression analysis were used to analyze the relationship among social support, activity of daily living and cognitive function in the elderly by SPSS 23.0 software. AMOS 28.0 software was used to construct structural equation models, and Bootstrap method was used to test the mediating role of activity of daily living.Results:The scores of cognitive function, social support and activity of daily living of the rural elderly were (20.83±5.47), (34.96±6.42) and (16.51±3.29), respectively.There were statistically significant differences in the cognitive function scores among rural elderly with different levels of social support and activity of daily living( F=33.418, t=25.533, P<0.01). The partial correlation analysis showed that the social support score was positively correlated with the cognitive function score ( r=0.161, P<0.01), and the activity of daily living score was negatively correlated with scores of social support and cognitive function ( r=-0.083, -0.453, both P<0.01). Multiple linear stepwise regression analysis showed that social support, objective support dimensions, activity of daily living and instrumental activity of daily living were influencing factors of cognitive function of rural elderly( P<0.001).The results of structural equation model showed that the activity of daily living played a partial mediating role between social support and cognitive function in rural elderly, with the mediating effect of 0.046 (95% CI=0.025-0.075), accounting for 13.18% of total effect (effect value=0.349, 95% CI=0.277-0.415). Conclusion:The activity of daily living of rural elderly plays a partial mediating effect between social support and cognitive functioning.

AIM:This study aims to investigate the role of histone methyltransferase SET and MYND domain containing 2(SMYD2)in facilitating renal fibrosis through the macrophage-myofibroblast transition in diabetic kidney dis-ease(DKD).METHODS:(1)C57BL/6J mice were intraperitoneally administered 55 mg/kg of streptozotocin to induce diabetes mellitus(DM).The experimental groups were categorized as follows:normal control,DM(20 weeks),DM(28 weeks),and DM(36 weeks).Blood glucose(BG),serum creatinine(SCr)and blood urea nitrogen(BUN)levels were determined using a biochemical analyzer.Hematoxylin-eosin(HE)staining and Masson staining were performed to assess morphological and fibrotic changes in renal tissues.Western blot analysis was used to measure the protein levels of SMYD2,histone H3 lysine 4 trimethylation(H3K4me3),arginase-1,matrix metalloproteinase 9(MMP9),collagen type Ⅰ(Col Ⅰ)and α-smooth muscle actin(α-SMA).Immunofluorescence staining was conducted to examine the localization and expression of F4/80,α-SMA,SMYD2,CD86,CD206 and CD163.(2)Mouse monocyte/macrophage RAW264.7 cells were cultured in vitro and assigned to groups as follows:normal glucose(NG)+negative control siRNA(siNC),high glucose(HG)+siNC,NG+SMYD2 siRNA(siSMYD2),and HG+siSMYD2.Western blot analysis was used to assess the expression of relevant proteins.RESULTS:(1)Compared with normal control group,the levels of BG,SCr and BUN were significantly elevated in DM(28 weeks)and DM(36 weeks)groups(P＜0.05).Renal tissue exhibited tubular atro-phy,dilation,and collagen fiber deposition.The levels of H3K4me3,arginase-1,MMP9,Col Ⅰ and α-SMA proteins were up-regulated(P＜0.05).The CD86,CD206,CD163 and F4/80 were primarily localized in the interstitial macrophages of the renal tubules,α-SMA was predominantly detected in the renal interstitium,and SMYD2 was mainly expressed in renal tubular epithelial cells and the renal interstitium.(2)Compared with NG+siNC group,the protein levels of SMYD2,H3K4me3,arginase-1,CD163,Col Ⅰ,α-SMA,transforming growth factor-β1(TGF-β1)and p-Smad3 in the cells of HG+siNC group were significantly increased(P＜0.05).Knockdown of SMYD2 resulted in a reduction of these indicators(P＜0.05).CONCLUSION:The SMYD2 protein appears to facilitate renal fibrosis in DKD by promoting the macrophage-myofibroblast transition,potentially through the modulation of TGF-β1/Smad3 signaling pathway.

Objective:To explore the mediating role of activity of daily living between social support and cognitive function of rural elderly.Methods:A face-to-face questionnaire survey was conducted from July to August 2019 among 1 626 rural elderly people selected by multi-stage cluster random method in Guiyang City and Qiannan Prefecture, Guizhou Province.The contents include general situation, social support rate scale (SSRS), activity of daily living scale (ADL) and mini-mental state examination (MMSE). Partial correlation analysis and multiple linear regression analysis were used to analyze the relationship among social support, activity of daily living and cognitive function in the elderly by SPSS 23.0 software. AMOS 28.0 software was used to construct structural equation models, and Bootstrap method was used to test the mediating role of activity of daily living.Results:The scores of cognitive function, social support and activity of daily living of the rural elderly were (20.83±5.47), (34.96±6.42) and (16.51±3.29), respectively.There were statistically significant differences in the cognitive function scores among rural elderly with different levels of social support and activity of daily living( F=33.418, t=25.533, P<0.01). The partial correlation analysis showed that the social support score was positively correlated with the cognitive function score ( r=0.161, P<0.01), and the activity of daily living score was negatively correlated with scores of social support and cognitive function ( r=-0.083, -0.453, both P<0.01). Multiple linear stepwise regression analysis showed that social support, objective support dimensions, activity of daily living and instrumental activity of daily living were influencing factors of cognitive function of rural elderly( P<0.001).The results of structural equation model showed that the activity of daily living played a partial mediating role between social support and cognitive function in rural elderly, with the mediating effect of 0.046 (95% CI=0.025-0.075), accounting for 13.18% of total effect (effect value=0.349, 95% CI=0.277-0.415). Conclusion:The activity of daily living of rural elderly plays a partial mediating effect between social support and cognitive functioning.

Objective To study the expression characteristics of osteoprotegerin(OPG)/receptor activator of nuclear factor-κB ligand(RANKL)/receptor activator of nuclear factor-κB(RANK)system and the relationship with fibrosis in myocardial tissues of rats with chronic heart failure.Methods SD rats were randomly divided into sham-operation group(12 rats)and model group.In sham-operation group,surgical thread was passed through the abdominal aorta without constricting it after laparotomy;in model group,establish the heart failure model by abdominal aorta coarctation.The successful model rats were randomly divided into model 1 week(12 rats),model 2 weeks(11 rats),model 4 weeks(11 rats),model 8 weeks(11 rats)and model 12 weeks groups(11 rats).The end point of the study is at week 12.The contents of hydroxyproline(HYP),total myocardial collagen and collagen volume fraction(CVF)were compaired in all proups.The expression levels of OPG,RANKL and RANK proteins in cardiomyocytes were determined by Western blot.Results The contents of HYP in sham-operation,model 1 week,model 2 weeks,model 4 weeks,model 8 weeks and model 12 weeks group were(0.25±0.04),(0.37±0.05),(0.45±0.04),(0.60±0.05),(0.82±0.10)and(1.03±0.07)μg·mg-1;the total myocardial collagen contents were(1.87±0.31),(2.73±0.38),(3.36±0.31),(4.47±0.37),(6.08±0.74)and(7.67±0.49)μg·mg-1;the CVF were(1.95±0.23)％,(2.40±0.25)％,(3.65±0.25)％,(5.43±0.29)％,(6.97±0.36)％and(9.38±0.49)％;the relative expression levels of OPG protein were 0.64±0.07,0.80±0.07,1.02±0.07,1.32±0.11,2.13±0.12 and 2.84±0.16;the relative expression levels of RANKL protein were 0.71±0.08,1.06±0.07,1.53±0.07,2.62±0.12,4.46±0.14 and 6.11±0.16;the relative expression levels of RANK protein were 0.30±0.05,0.45±0.05,0.63±0.06,0.98±0.07,1.43±0.10 and 1.63±0.10.With the extention of time,the above indexs of all model groups were significantly higher than those in the sham-operation group(all P＜0.05).There were positive linear correlation between the relative expression levels of OPG,RANKL,RANK protein and the levels of CVF and total contents in cardiomyocytes of rats with chronic heart failure(allP＜0.01).Conclusions In the process of chronic heart failure,the expression of OPG/RANKL/RANK axis is obviously enhanced,in which the up-regulation of RANKL level is most obvious.The expression level of OPG/RANKL/RANK is positively correlated with CVF and total myocardial collagen content.