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.

Osteopontin(OPN)is a multifunctional protein,widely distributed in a variety of cells,tissues,organs and body fluids.This protein has a classical RGD domain and can bind to a variety of integrins and CD44 receptors,thereby participating in various pathological processes in the body,such as infection,allergic reaction,autoimmune and tissue damage.Recently,many studies have revealed that OPN is highly expressed in the central nervous system(CNS)and plays different regulatory roles in CNS diseases,that is,OPN can play a pro-inflammatory role in some conditions to stimulate neurotoxicity,while it can play a neuroprotective role in other conditions.While there has been growing interest in the biological role of OPN in the CNS,a comprehensive review is currently lacking.The purpose of this paper is to provide an overview of the expression and function of OPN in the CNS,with a focus on microglia,astrocytes,and neurons.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Osteopontin(OPN)is a multifunctional protein,widely distributed in a variety of cells,tissues,organs and body fluids.This protein has a classical RGD domain and can bind to a variety of integrins and CD44 receptors,thereby participating in various pathological processes in the body,such as infection,allergic reaction,autoimmune and tissue damage.Recently,many studies have revealed that OPN is highly expressed in the central nervous system(CNS)and plays different regulatory roles in CNS diseases,that is,OPN can play a pro-inflammatory role in some conditions to stimulate neurotoxicity,while it can play a neuroprotective role in other conditions.While there has been growing interest in the biological role of OPN in the CNS,a comprehensive review is currently lacking.The purpose of this paper is to provide an overview of the expression and function of OPN in the CNS,with a focus on microglia,astrocytes,and neurons.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

Objective To analyze the characteristics of healthcare-associated infection(HAI)in patients in liver transplantation intensive care unit(ICU),and provide basis for the effective prevention and control of liver post-transplantation infection.Methods Targeted surveillance data of HAI in liver transplantation ICU from 2018 to 2022 were analyzed retrospectively.Incidence,incidence trend,infection site,pathogens and drug resistance were analyzed.Results A total of 3 762 liver transplantation patients were surveilled,106 patients developed 133 cases of HAI,with an incidence of 2.82％and a case incidence of 3.54％.There was no significant difference among the years(P=0.473).Infection mainly occurred within 2 weeks after admission to ICU,accounting for 85.85％.The main infection sites included blood system(26.32％),respiratory system(22.56％),and surgical site(19.55％).The average utilization rates of central veinous catheterization,urethral catheterization,and ventilator were 85.77％,70.58％,and 40.83％,respectively.The incidences of central line-associated bloodstream infection(CLABSI),catheter-associated urinary tract infection(CAUTI),and ventilator-associated pneumonia(VAP)were 0.54‰,0.33‰,and 1.84‰,respectively.A total of 131 strains of pathogens were detected,of which Gram-negative bac-teria accounted for 38.17％and Gram-positive bacteria accounted for 29.77％.The top three pathogens were Kleb-siella pneumoniae(15.27％),Enterococcus faecium(11.45％),and Acinetobacter baumannii(9.16％).Conclusion Effective prevention and control measures should be taken based on the characteristics of HAI in the liver transplan-tation ICU,so as to curb bacterial resistance and reduce liver post-transplantation HAI.

Objective To observe the therapeutic effect of thymopeptide enteric-coated capsules combined with human interferon α2b vaginal effervescent tablets in the treatment of patients with high-risk human papillomavirus(HPV)infection-related cervical lesions and the impact on T lymphocyte subsets.Methods The patients with high-risk HPV infection-related cervical lesions were divided into the treatment group and the control group according to the cohort method.The control group was given human interferon α2b vaginal effervescent tablets 5 × 105 U,once daily,for 2 months.On this basis,the treatment group was treated with thymopeptide enteric-coated capsules at a dose of 30 mg·time-1,three times a day,for 2 months.Therapeutic effects,cervical vaginal microecology indicators[pH values of vaginal secretions,Nugent scores and white blood cell count],T lymphocyte subsets,cytokines[interleukin-4(IL-4),IL-6,IL-10,tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ)]were compared between the two groups,and the safety were evaluated.Results Seventy cases in the treatment group and 72 cases in the control group.After treatment,the total effective rate of the treatment group was 94.29％(66 cases/70 cases),which was higher than the control group's 80.56％(58 cases/72 cases),the differences were statistically significant(P＜0.05).After treatment,pH values of vaginal secretions in treatment group and control group were 4.26±0.19 and 4.38±0.17;Nugent scores were(2.53±0.36)and(2.79±0.40)scores;Blood cell count were 5.12±1.14 and 6.03±1.21;CD3+were(69.32±8.10)％and(66.54±7.03)％;CD4+were(37.25±5.03)％and(34.67±4.82)％;CD4+/CD8+were 1.50±0.35 and 1.42±0.33;serum IL-4 levels were(7.49±1.64)and(9.20±2.18)pg·mL-1;serum IL-6 levels were(20.95±5.03)and(26.64±6.22)pg·mL-1;serum IL-10 levels were(11.72±2.46)and(13.43±2.97)pg·mL-1;serum TNF-α levels were(16.48±3.75)and(13.25±2.03)pg·mL-1;serum IFN-γ levels were(13.35±2.11)and(10.93±2.86)pg·mL-1;the differences were statistically significant(all P＜0.05).Adverse drug reactions in the treatment group included nausea,fever,vaginal itching and pain;which in the control group included vaginal itching and pain.The total incidence rates of adverse reactions in the treatment group and the control group were 8.57％(6 cases/70 cases)and 5.56％(4 cases/72 cases),without statistically significant difference(P＞0.05).Conclusion Thymopeptide enteric-coated capsules combined with human interferon α2b vaginal effervescent tablets can improve immune function,reduce inflammatory reactions,and improve cervical and vaginal micro-ecological environment in patients with high-risk HPV infection-related cervical lesions.

Clostridium perfringens is an important foodborne pathogen that causes intestinal infections and tissue necrosis in both human and animals.A variety of exotoxins it produces are lethal.The increasing demand for ratio-nal use of antimicrobial agents and healthy farming make the implementation of vaccination critically important.H owever,traditional Clostridium perfringens exotoxin vaccines may have problems such as inconsistent efficacy,residual toxins and formaldehyde,raising concerns about the safety of these vaccines.This article systematically in-troduces the latest research progress in traditional toxoid vaccine,genetically engineered recombinant vaccines,and epitope peptide vaccines designed based on reverse vaccinology and immunoinformatics for Clostridium perfringens,providing new ideas for the development and preparation of effective and safe novel Clostridium perfringens toxin vaccines.

Humans ; Vascular Stiffness ; Coal Mining ; Occupational Diseases/epidemiology* ; Risk Factors ; Coal ; Miners