ObjectiveTo analyze the infection status of main respiratory pathogens in influenza-like illness (ILI) cases in Anji County, Huzhou City, Zhejiang Province, and to provide a reference for the prevention, diagnosis, and treatment of respiratory infections. MethodsThroat swab samples were collected from 520 ILI cases in an influenza sentinel surveillance hospital in Anji County of Zhejiang Province from December 2023 to November 2024. Multiplex real-time fluorescence quantitative polymerase chain reaction (mRT-PCR) was used to detect 18 pathogens and their subtypes, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A virus (Flu A), influenza A (H1N1) virus, influenza A (H3N2) virus, influenza B virus (Flu B), influenza B virus Victoria lineage (BV), influenza B virus Yamagata lineage (BY), coronavirus (CoV), human parainfluenza virus (HPIV), respiratory syncytial virus (RSV), human metapneumovirus (HMPV), adenovirus (ADV), human bocavirus (HBoV), enterovirus (EV), rhinovirus (RV), Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CP), and Streptococcus pneumoniae (SP). ResultsThe overall positivity rate of pathogens in 520 samples was 33.65%, among which the detection rates of Flu (9.14%), ADV (7.50%), SARS-CoV-2 (6.15%), and EV (3.65%) were relatively high. There were statistically significant differences in the overall positivity rate of pathogens by age and season (all P<0.05). The highest overall positivity rate was observed in the 5‒14 years old group (42.77%), and the overall positivity rate in winter (53.08%) was significantly higher than that in other seasons. ConclusionFrom 2023 to 2024, the main respiratory pathogens detected in ILI cases in Anji County were Flu, ADV, SARS-CoV-2, and EV. The epidemic characteristics showed age and seasonal specificity, so it is necessary to strengthen prevention and control for high-risk populations and epidemic seasons in a targeted manner.

Objective To analyze the influenza-like illness (ILI) data in Ordos City from 2017 to 2023 and conduct nucleic acid detection of the virus to understand the local influenza epidemic situation, and to provide a reliable basis for influenza prevention and control in the city. Methods Real-time quantitative polymerase chain reaction (qPCR) was used to identify virus subtypes in ILI throat swab samples. Comparisons of positive rates were conducted using the chi-square test, with a significance level of α=0.05. Results From 2017 to 2023, a total of 3,283,434 outpatient and emergency visits were recorded at the Ordos City Central Hospital, including 74,159 ILI cases, with an ILI proportion of 2.26%. The majority of ILI cases (74.43%) occurred in children aged 0~14 years old. The overall positive rate of influenza virus nucleic acid detection was 10.87%, with the highest proportion being subtype A (seasonal H3) at 43.03%. The highest detection rate was observed in the 5~14 years age group, with statistically significant differences in positive rates across age groups (χ²=155.638, P<0.001). Influenza peaks occurred mainly from November to March of the following year. From January to April, three types of influenza were prevalent alternately or mixed, while from October to December, subtype A (seasonal H3) predominated. Positive rates varied significantly across months (χ²=250.923, P<0.001). The temporal trends of ILI proportions and PCR-positive rates were consistent. Conclusion Influenza in Ordos City exhibits distinct seasonal and age distribution characteristics, with alternating or mixed circulation of three virus types. Continued efforts are needed to strengthen influenza surveillance, especially the prevention and control of influenza in infants and adolescents.

Implementation science (IS) aims to systematically analyze and address the real-world gaps from evidence to practice and the influencing factors of the context. It is necessary to carry out qualitative research to gather relevant implementation outcomes. Nevertheless, traditional qualitative analysis has issues such as consuming a great deal of time and energy, and it is unable to promptly provide the crucial data required for implementation science research. The Rapid Qualitative Analysis (RQA) method, through semi-structured interviews and the adoption of techniques such as immediate data condensation and matrix analysis, can effectively shorten the cycle of qualitative data collection and data processing. RQA can promptly identify social determinants of health such as structural barriers, facilitators, and the behavioral characteristics of target groups. It provides a real-time basis for public health decision-making, the interpretation of complex social phenomena, and the process and effectiveness evaluation of research projects. Although RQA is difficult to conduct in-depth theoretical analysis based on grounded theory, its efficiency and flexibility make it the preferred tool for large-scale and time-sensitive research. Thus, it has been widely applied in implementation science research. This paper sorts out the core concepts and commonly used technical methods of RQA, as well as the differences between RQA and traditional qualitative analysis. It also explores the applications of RQA in intervention optimization, process evaluation, and implementation outcome evaluation. By integrating specific cases, this paper clarifies its application value in the field of implementation science. In the future, it is advisable to explore the integration of RQA with technologies such as artificial intelligence and big data, in order to bridge the gap between the transformation of scientific research achievements into practice. Under circumstances of limited resources or tight time constraints, RQA can be used to efficiently conduct implementation science research, providing convenient and scientific methodological and technical support for accelerating evidence-based practice.

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.

ObjectiveBiochemistry and Molecular Biology, a discipline that elucidates life phenomena at the molecular level, serves as a core foundational course in medical education. It provides the theoretical basis for studying other basic and clinical medical subjects, as well as for understanding pathogenesis, disease diagnosis, and treatment. However, its complex content and highly abstract concepts have posed a dual challenge to traditional teaching models: “inefficient instruction” and “inadequate learning outcomes”. Within limited classroom hours, how to engage students and stimulate their intrinsic motivation, and how to help them recognize, understand, and develop a passion for biochemistry from the perspective of the discipline’s essence, have long been key focuses of curriculum research. MethodsUsing the lipid metabolism chapter as an example, this study employs “Rain Classroom”, a generative artificial intelligence (AI)-assisted platform, to support education in four dimensions: teaching, learning, evaluation, and research. In teaching, it assists instructors through virtual experiments, lesson preparation support, knowledge mapping, and assignment design. For learning, it serves as an intelligent study assistant for students, providing automated assignment review, enabling educational resource sharing, and facilitating personalized learning pathways. In evaluation, the platform automates assignment grading, analyzes student performance data, and offers diagnostic feedback and teaching recommendations. In research, it aids educators in collecting and analyzing teaching data, as well as searching for and summarizing relevant literature. ResultsThe results indicate that an educational model integrating teacher-led instruction, student-centered learning, and generative AI assistance significantly enhances teaching quality, students’ self-directed learning abilities, and knowledge mastery. Furthermore, with the support of generative AI, curriculum-based ideological education—focusing on cutting-edge disciplinary advances and topical medical issues—helps cultivate students’ medical spirit of “honoring life and healing the wounded”, thereby fostering the establishment of appropriate professional values. Finally, while generative AI presents both opportunities and challenges for higher education, this study also analyzes potential risks in its teaching applications, emphasizing the need for both instructors and students to avoid over-reliance and to ensure that technological tools consistently serve the fundamental goals of education. ConclusionThis study demonstrates that integrating generative AI, specifically via the “Rain Classroom” platform, can effectively enhance biochemistry education. By supporting teaching, learning, evaluation, and research, this approach improves both educational effectiveness and student outcomes. It also facilitates the incorporation of cutting-edge knowledge and professional ethics, nurturing a patient-centered mindset. Additionally, the study addresses potential implementation risks to ensure that such technological tools remain aligned with the core purpose of education.

ObjectiveThis paper aims to observe the protective effect of Huamoyan granules on knee osteoarthritis （KOA） and explore whether its protective effect is oriented toward an anti-inflammatory direction by regulation of macrophage polarization， which can effectively inhibit the progression of pathological inflammatory response， reduce the release of inflammatory pain mediators， and downregulate the protein expression level of transient receptor potential vanilloid 1 （TRPV1）， so as to provide experimental evidence for its clinical application and investigate its action mechanism. MethodsAfter adaptive feeding， Sprague-Dawley （SD） rats were randomly divided into six groups： sham group， model group， celecoxib group， and high， medium， and low-dose synovitis granule groups （9.6， 4.8， 2.4 g·kg^-1）. The administration dose of celecoxib capsules was 20 mg·kg^-1. There were 10 rats in the sham group and 12 rats in the model group and each administration group. A KOA animal model was established by means of intra-articular injection of sodium iodoacetate into the knee joint. From the 10^th day of the experiment， each administration group was given intragastric administration at a dose of 10 mL·kg^-1 for 4 weeks. General conditions of rats in each group were assessed daily. The pressure pain threshold （PPT） to mechanical stimulation and joint diameter were recorded. X-ray examination was performed on the right knee joints of rats for imaging analysis. Enzyme linked immunosorbent assay （ELISA） was performed to detect the tumor necrosis factor-α （TNF-α）， serum interleukin-1β （IL-1β）， and other pro-inflammatory cytokines in rat serum samples， as well as the expression levels of neurogenic inflammatory mediators such as nerve growth factor （NGF） and calcitonin gene-related peptide （CGRP）. Histopathological changes in the knee joint synovial tissues were examined by hematoxylineosin （HE） staining. Safranin O-fast green staining was performed to observe and evaluate the degree of knee cartilage lesions. Western blot was employed to quantitatively analyze TRPV1， p38 mitogen-activated protein kinase （p38 MAPK）， and phosphorylated （p）-p38 MAPK in rat knee synovial tissues. Immunofluorescence （IF） was used to measure and assess M1/M2 macrophage polarization. ResultsCompared with those in the sham group， the circumference and joint diameter of the right knee were markedly enlarged in the model group （P<0.01）， while PPTs of rats showed a significant reduction （P<0.01）. The contents of IL-1β， TNF-α， CGRP， and NGF in rats' serum were significantly elevated （P<0.01）， and the synovial Krenn score was increased （P<0.01）. The Mankin score of cartilage tissue was increased （P<0.01）， and the protein expressions of TRPV1 and p-p38 MAPK/p38 MAPK were significantly upregulated （P<0.01）. The experimental intervention significantly reduced the proportion of pro-inflammatory M1 macrophages in the total macrophage population （P<0.01）， and the percentage of M2 macrophages was decreased （P<0.01）. The M1/M2 macrophage ratio was significantly elevated （P<0.01）. Knee joint diameters of all dose groups of Huamoyan granules and the celecoxib group were reduced （P<0.01） compared with those of the model group， and the PPT recovery speeds in the high and medium-dose groups of Huamoyan granules were more obvious （P<0.05）. The contents of IL-1β， CGRP， and NGF in the rats' serum in all administration groups were significantly reduced （P<0.05， P<0.01）， and the content of TNF-α in rats' serum was significantly reduced （P<0.01）. All dose groups of Huamoyan granules demonstrated significant reductions in both synovial Krenn score （P<0.05， P<0.01） and protein expression of TRPV1 and p-p38 MAPK/p38 MAPK in rats' synovial tissues （P<0.01）. The percentage of M1 macrophages in the synovial tissues of the celecoxib group and all dose groups of Huamoyan granules was decreased （P<0.01）. The percentage of M2 macrophages was increased （P<0.05）， and the M1/M2 ratio was decreased （P<0.01）. ConclusionHuamoyan granules can alleviate the inflammatory response of KOA， reduce the release of inflammatory pain mediators， and downregulate TRPV1 protein expression by regulating macrophage polarization. Its mechanism may be related to the TRPV1/p38 MAPK signaling pathway， thereby achieving the effect of improving peripheral pain hypersensitivity in KOA.

Objective: To analyze the demographic characteristics, return donation patterns, and risk of adverse reactions among donors temporarily deferred due to blood pressure abnormalities, so as to provide an evidence-based foundation for optimizing pre-donation blood pressure screening strategies, enhancing donor retention, and ensuring blood supply safety. Methods: Data from 2.939 million donor instances were collected through the Information Management System at the Beijing Red Cross Blood Center between January 2015 and August 2025. The analysis specifically focused on the 11 600 instances of donors temporarily deferred due to abnormal blood pressure, examining demographic characteristics (age, and gender) and donation-related features (number of donations, donation site, and type of donation). Further analysis was conducted on the return donation patterns, including the return rate, time interval to return, and the incidence, type, and severity of adverse reactions among returned donors. Results: Distribution of abnormal blood pressure: Among the 11 600 instances of abnormal blood pressure, the prevalence was significantly higher in males (0.48%, 10 111/2 086 909) than in females (0.17%, 1 465/852 090). The 46-55 age group had the highest prevalence (0.88%, 2 925/329 235), and the differences across age groups were statistically significant. The prevalence was, higher among repeat donors (0.41%, 5 242/1 276 452) than first-time donors (0.38%, 6 334/1 662 547). The prevalence at mobile donation sites outside the blood center (0.06%, 350/596 104) was higher than fixed donor centers (0.50%, 10 225/2 052 290) and group donation drives (0.34%, 1 001/290 608). Return donations: A total of 19.49% (2 256 out of 11 576) deferred donors returner and successfully donated. Among these donors, 36.17% (816 out of 2 256) returned within 7 days, while the highest proportion of returns was observed within 31-182 days (25.44%, 574/2 256). A higher return rate was observed among male donors (20.17%, 2 039/1 0111) compared to female donors (14.81%, 217/1 465). The return rate for repeat donors (43.02%, 2 255/5 242) was significantly higher than that of first-time donors (0.02%, 1/6 334). Individual donors showed a higher return rate (20.95%, 1 986/9 479) than group donors (12.88%, 270/2 097), with all differences being statistically significant (P<0.05). The differences in return rates across age groups were not statistically significant (P>0.05). Adverse reactions: The incidence of adverse reactions after return was 0.09% (2/2 256), significantly lower than the overall adverse reaction incidence during the same period (0.20%, 5 981/2 938 999). Both adverse reactions were local reaction (category A1, pain or bruising at the puncture site), with no reported cases of systemic vasovagal reactions (VR) or severe adverse events. Conclusion: The current blood pressure screening criteria may lead to the unnecessary deferral of eligible donors. The risk of adverse reactions is extremely low among returned donors who were deferred for abnormal blood pressure. A relaxation of the blood pressure screening criteria is therefore suggested, coupled with the optimization of donation site environment and blood pressure measurement procedure with reference to expert consensus to enhance donor retention and blood supply safety.

Allergic diseases exhibited the characteristics of latent concealment and dynamic transmutation， which highly align with the pathogenic features of "latency and transformative change" described in the theory of latent pathogens. Based on the "latent pathogens with transformative potential" theory， this paper systematically explored the mechanisms of occurrence， transmission， and outcome of allergic diseases. It proposed that the insufficiency of kidney essence is the root cause enabling pathogens to lurk internally， leading to disease onset due to deficient healthy qi and lurking pathogens； the dysfunction of sanjiao serves as the pathway for pathogen stagnation， driving multi-system transmission； the accumulation of phlegm， stasis， and toxins constitutes the predicament of a protracted course， ultimately resulting in intractable pathological entanglement. Accordingly， a tiered intervention strategy is formulated，i.e. during the latency period， treatment should tonify the kidney and replenish essence to consolidate the foundation and halt the tendency of pathogens to lurk internally； during the transmission period， treatment should regulate sanjiao to intercept disease transmission and curb multi-system proliferation； during the protracted period， treatment should purge phlegm and resolve stasis to eliminate stubborn lesions， and break the vicious cycle of chronic accumulation and damage.

Objective To investigate the prevalence, distribution characteristics, and influencing factors of mental health problems among the elderly, and to provide a scientific basis for policy-making.  Methods A convenience sampling method was used to investigate depression, anxiety, and cognitive function among permanent residents aged 65 and older at 59 mental health care sites for the elderly in Hubei Province. Multinomial logistic regression was employed to analyze influencing factors. Results The screening rates for depression, anxiety, and cognitive function at critical/high-risk levels among the elderly in Hubei Province were 9.7%, 5.4%, and 12.2%, respectively. Urban elderly had lower risks of depression and cognitive function at critical/high-risk levels compared to rural elderly (OR for critical depression = 0.640, P < 0.001; OR for high-risk depression = 0.595, P = 0.012; OR for critical cognitive function = 0.448, P < 0.001; OR for high-risk cognitive function = 0.188, P < 0.001). Six key population groups had higher risks of depression, anxiety, and cognitive function at critical/high-risk levels than others (OR for critical depression = 1.463, P < 0.001; OR for high-risk depression = 1.912, P < 0.001; OR for critical anxiety = 1.462, P < 0.001; OR for high-risk anxiety = 2.882, P < 0.001; OR for critical cognitive function = 1.381, P < 0.001; OR for high-risk cognitive function = 2.345, P < 0.001). A higher number of chronic diseases was associated with increased risks of critical and high-risk depression (OR for critical = 1.316, P < 0.001; OR for high-risk = 3.677, P < 0.001) and cognitive impairment (OR for critical depression = 1.316, P < 0.001; OR for high-risk depression = 3.677, P < 0.001; OR for critical anxiety = 1.512, P < 0.001; OR for high-risk anxiety = 1.801, P < 0.001). Conclusion It is recommended to expand mental health care sites in rural areas, improve the layout of mutual-support elderly care facilities, and explore sustainable models for rural elderly care. Efforts should also focus on enhancing social participation among the elderly through community-based activities, and strengthening cognitive screening and emotional regulation interventions, with particular attention to the mental health needs of older, isolated, and chronically ill individuals.

Subclinical hypothyroidism (SCH) is a subclinical state of mild hypothyroidism. In recent years, the impact of SCH on multiple systems of the body has gradually attracted attention. Although SCH patients usually do not have obvious clinical symptoms, studies have shown that SCH may be associated with a variety of chronic diseases, such as cardiovascular disease and metabolic syndrome. Due to the complex interrelationship between diabetes mellitus and thyroid disease, researchers have begun to pay attention to the potential impact of SCH on diabetic retinopathy (diabetic retinopathy, DR). This article aims to comprehensively review the current research progress on the impact of SCH on DR, and explore in depth the pathophysiological mechanisms, clinical manifestations, and treatment strategies, providing clinicians with more comprehensive diagnostic and treatment ideas.