AIM:To investigate the current status and influencing factors of knowledge-attitude-practice in myopia prevention and control among children and adolescents in Ningbo City, thereby providing a scientific basis for formulating targeted prevention strategies.METHODS: Children and adolescents aged 6-12 years old were selected from the medical-school collaborative myopia prevention network in Ningbo City between August 2024 and May 2025 using stratified cluster sampling. Information on myopia prevention knowledge(15 items)and practice(9 items)was collected through questionnaire surveys. Logistic regression models were used to analyze factors influencing myopia occurrence in children and adolescents.RESULTS: A total of 664 children and adolescents aged 6-12 years were enrolled in this study. Participants were divided by age into three groups: 6-7 years old(n=221), 8-9 years old(n=221), and 10-12 years old(n=222). Of the 664 questionnaires distributed, 637 valid questionnaires were returned(201 from the 6-7 age group, 235 from the 8-9 age group, and 201 from the 10-12 age group), yielding an effective response rate of 95.9%. Based on myopia screening results, the non-myopic group comprised 203 participants(31.9%), including 100 males and 103 females, with a mean age of 8.82±1.98 years old. The myopic group comprised 434 participants(68.1%), including 213 males and 221 females, with a mean age of 9.10±1.95 years old. The myopia prevalence rates in the 6-7, 8-9, and 10-12 age groups were 37.8%(76/201), 71.9%(169/235), and 94.0%(189/201), respectively(P<0.001). Regarding the knowledge and practice of myopia prevention, the overall awareness rate in the non-myopic group(59.7%±9.7%)was significantly higher than that in the myopic group(48.7%±8.5%; P<0.001). Additionally, the non-myopic group scored higher on the key practice of “regular eye examinations”(4.27±0.96)compared to the myopic group(4.10±1.05; P<0.05). Logistic regression analysis indicated that age was the primary risk factor for myopia occurrence.CONCLUSION: Age is the dominant factor in the onset of myopia, and there is a phenomenon of “knowledge-practice gap”; the traditional health education model has limitations, and a precise prevention and control system based on developmental patterns should be established.

Background: Murraya, a genus of shrubs and trees in the Rutaceae family, consists of approximately 9 species in China with significant medicinal and horticultural value. However, the phylogeny and taxonomy of Murraya species remain controversial, particularly with respect to Murraya exotica and M. paniculata. Objective: This study aimed to provide insights into the taxonomy, phylogeny, and identification of Murraya. Methods: In this study, the chloroplast (CP) genomes of 7 Murraya species were sequenced, assembled, and subjected to comparative and phylogenetic analyses. Results: The CP genomes of Murraya ranged from 158,573 to 160,817 bp in length and encoded 112 unique genes, including 78 protein-coding genes, 30 tRNA genes, and 4 rRNA genes. Similar to other angiosperms, the inverted repeat regions of the CP genomes exhibited lower sequence divergence than the single-copy regions, and coding regions were more conserved than noncoding regions. Comparative analysis identified several highly variable regions (eg, matK, ycf1, ndhI-ndhA, trnH-GUG-psbA, rpl32-trnL) that could serve as molecular markers for species identification in Murraya. Among these, the ycf1 gene was validated as a useful marker for distinguishing M. exotica from M. paniculata. Positive selection was detected in 10 genes, including rbcL, psaJ, ndhD, ndhF, rpl2, rpl20, ycf1, accD, ccsA, and rpl32. Phylogenetic analysis based on CP genomes supported the recognition of M. exotica and M. paniculata as independent species. Moreover, the phylogenetic trees indicated that Murraya is not monophyletic, with sect. Bergera showing a closer relationship to Clausena. Molecular dating results suggested that the diversification of M. paniculata, M. alata, and M. exotica occurred approximately 9.11 Mya (95% highest posterior density: 4.90-13.87 Mya). Conclusion: These findings provide valuable CP genome data for clarifying the phylogenetic relationships between M. exotica and M. paniculata, and for advancing the study of DNA markers and the evolutionary history of Murraya.

ObjectiveTo investigate the value of intestinal fatty acid-binding protein （I-FABP） in predicting 6-week mortality in patients with liver cirrhosis after successful endoscopic hemostasis for esophagogastric variceal bleeding （EVB）. MethodsA retrospective analysis was performed for the clinical data of 207 patients with liver cirrhosis who underwent successful endoscopic treatment for EVB （including ligation and sclerotherapy） in The Affiliated Hospital of Yanbian University from September 2020 to June 2025， with the endpoint of 6-week bleeding-related mortality. ELISA was used to measure the serum level of I-FABP on admission， and a stratified analysis was performed based on the quartiles of I-FABP measurements. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier survival analysis， Cox regression analysis， and restricted cubic spline （RCS） curve were used to investigate the association between I-FABP and mortality. Machine learning models were used to further quantify the impact of I-FABP on mortality. The integrated Brier score and an integrated cumulative/dynamic area under the curve were used to assess the importance of time-dependent variables， and the receiver operating characteristic （ROC） curve was used to assess the performance of the predictive model. ResultsDuring the study， 29 patients （14.0%） died within 6 weeks after successful endoscopic hemostasis， with a median time to death of 16 （8—26） days. The mortality group had a significantly higher serum level of I-FABP than the survival group （Z=-3.731， P<0.001）. The Kaplan-Meier survival analysis showed that there was a significant difference in 6-week mortality between the groups of patients based on I-FABP quartiles （χ²=12.78， P=0.005）. The multivariable Cox regression analysis showed that an increase in I-FABP （hazard ratio=1.87， P=0.003） was an independent influencing factor for 6-week mortality. The RCS analysis showed a linear relationship between I-FABP and 6-week mortality （P_non-linear=0.280， P_overall=0.029）. Machine learning models showed that there was a dynamic change in the importance of I-FABP over time， and Brier score loss and the loss of cumulative/dynamic area under the curve after permutation showed that I-FABP was an important variable affecting 6-week mortality rate. ConclusionI-FABP level is independently associated with the risk of 6-week mortality endoscopic hemostasis for EVB in patients with liver cirrhosis， and therefore， it can be used as a potential biomarker for poor short-term prognosis.

Tacit knowledge of tongue inspection is content that affects diagnostic results but is difficult to be explicit. Its cognitive characteristics are rooted in xiang thinking and embodiment. It constructs multidimensional associations between tongue manifestations and disease mechanisms through imagery mapping， and it relies on the practitioner's bodily perception， clinical context， and long-term practice for continuous internalization. In response to the neglect of tacit transmission and individual cognitive processes in current traditional Chinese medicine （TCM） tacit knowledge research， an empirical research framework integrating cognitive neuroscience is proposed. Specifically， event-related potential （ERP） and eye tracking （ET） technologies can be used to capture the brain electrical activity and eye movement trajectories of experts and novices in different tongue diagnosis cognitive tasks. By integrating multimodal cognitive data such as behaviorism， ERP components， and ET indicators， the implicit cognitive advantages of experts in the perception， mapping， and decision-making stages of tongue diagnosis are presented， and the possibility of achieving tacit knowledge transformation through visual cognitive transfer training is explored. Exploring empirical pathways to uncover the cognitive mechanisms of tongue diagnosis tacit knowledge is of great significance for the inheritance of traditional Chinese medicine.

Malignant gastrointestinal tumors （GT） mainly include laryngeal cancer， esophageal cancer， gastric cancer， pancreatic cancer， hepatocellular carcinoma， bile duct cancer， and colorectal cancer. At present， the morbidity and mortality of GT are high. Tumor immune escape is one of the key reasons for cancer development and treatment failure， and it is also the main direction of current tumor immunotherapy research. Traditional Chinese medicine （TCM） plays a role in treating GT and alleviating systemic symptoms， especially showing potential advantages in regulating the immune escape mechanism. This article elaborates on the immune escape mechanism of GT and systematically reviews that TCM active components or compound prescriptions act on key immune checkpoints such as programmed cell death protein-1 （PD-1） and programmed cell death ligand-1 （PD-L1） to reduce the proportion of marrow-derived suppressor cells （MDSCs）， promote the polarization of M1 macrophages， activate effector immune cells， enhance CD8⁺ T cell recruitment and interferon （IFN）-γ secretion， enhance the killing activity of natural killers （NKs）， and reduce foxhead box protein P3（FoxP3⁺）-positive regulatory T （Treg） cell infiltration. TCM active components or compound prescriptions can remodel the tumor microenvironment （TME）， such as improving immunosuppressive factors， promoting vascular normalization， and regulating intestinal microbiota. Through the regulation of TME， enhancement of antigen presentation， inhibition of immune checkpoint molecules， regulation of cellular network factors and metabolites， etc.， TCM active components or compound prescriptions enhance the immune function， thereby inhibiting the immune escape of GT. This paper summarizes and reflects on the research results of TCM in regulating immune escape to treat GT in recent years， aiming to help transform TCM from empirical medication to precision treatment based on immune regulation， reduce drug resistance and enhance treatment effect.

To explore the clinical value of a multimodal predictive model based on multiparametric magnetic resonance imaging(MRI) radiomics combined with deep learning(DL) features for the preoperative noninvasive assessment of mismatch repair-deficient(MMRd) status in endometrial cancer(EC).

ObjectiveTo construct a new quality classification method for Ophiopogonis Radix by systematically quantifying and integrating its appearance traits and bioactive components as objective indicators according to the theory of excellent shape， high quality， and superior effect of authentic medicinal materials. MethodsWith Ophiopogonis Radix from Zhejiang （a traditionally recognized authentic variety） as the research model， extensive samples were collected. Through textual research on classical herbal literature and modern references， root tuber length and hardness were selected as representative indicators of traditional appearance traits. These indicators were accurately measured by a digital vernier caliper and a universal testing machine for objective quantification. According to prescription data and literature review results， total saponins， total polysaccharides， and total flavonoids were chosen as key component indicators， and their content was determined. Descriptive statistics， cluster analysis， and other methods were comprehensively employed to identify the core objective indicators and their threshold ranges defining the excellent shape and high quality. The constructed evaluation system was subsequently applied to Ophiopogonis Radix from Zhejiang and Sichuan to verify its applicability. ResultsThe core quantitative indicators for the excellent shape and high quality of Ophiopogonis Radix were determined as follows： Length≥2.09 cm， hardness≤7.0 N， and content of total saponins， total polysaccharides， and total flavonoids not lower than 0.12%， 1.69%， and 0.13%， respectively. Verification results showed that this evaluation system could effectively identify Ophiopogonis Radix samples from Zhejiang， with the results consistent with traditional high-quality recognition. Its successful application to the samples from Sichuan further confirmed its cross-region universality. ConclusionThis study established an objective indicator-based evaluation system for the excellent shape and high quality of Ophiopogonis Radix， which breaks through the reliance on production regions. This system provides theoretical and methodological bases for precise quality control， scientific grading， and quality-based pricing of Ophiopogonis Radix， offering an innovative paradigm for the objective evaluation of authentic medicinal materials.

ObjectiveThe quality of fresh Gastrodiae Rhizoma directly determines the efficacy of its terminal products. According to the theory of excellent shape， high quality， and superior effect of authentic medicinal materials， this study aimed to develop a novel quality evaluation system for fresh Gastrodiae Rhizoma by systematically quantifying and integrating appearance traits with bioactive components. MethodsFresh Gastrodiae Rhizoma samples were collected from four major producing regions. After herbal textural research and a literature review， tuber weight， width， length， and aspect ratio were selected as quantitative indicators of appearance， and they were measured by an electronic balance and a digital vernier caliper. Key active components， including gastrodin， p-hydroxybenzyl alcohol， parishins， and total polysaccharides， were quantified via ultra performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS） and the phenol-sulfuric acid method. Descriptive statistics and K-means clustering analysis were employed to establish the threshold ranges for the excellent shape and high quality indicators. ResultsTwo specific quantitative evaluation systems for characterizing the excellent shape and high quality of fresh Gastrodiae Rhizoma were established. System 1： tuber weight > 83.90 g， tuber width > 3.50 cm， total gastrodin and p-hydroxybenzyl alcohol content > 0.277%， and total parishin content > 0.561%. System 2： tuber length < 9.89 cm， aspect ratio < 3.41， and total polysaccharide content > 195.274 mg·g^-1. The verification results showed that the systems effectively identified fresh Gastrodiae Rhizoma samples with both excellent appearance features and stable bioactive components. ConclusionThis study establishes a multi-dimensional evaluation and grading system for fresh Gastrodiae Rhizoma based on the correlation between shape and quality. This framework provides a scientific basis for the quality control and resource grading of fresh Gastrodiae Rhizoma and lays a methodological foundation for the efficient utilization of both the medicinal and edible value of this herbal medicine.

ObjectiveTo establish an objective evaluation system based on the quality characteristics of Gardeniae Fructus without relying on the origin label according to the theory of excellent shape， high quality， and superior effect of authentic medicinal materials， thus providing a scientific basis for the standardization of Gardeniae Fructus. MethodsDifferent batches of Gardeniae Fructus samples were collected from different producing areas. Through herbal textual research and a review of modern literature， fruit length， maximum fruit diameter， and chroma were selected as quantitative indicators to characterize the traditional appearance traits of Gardeniae Fructus. The above indicators were measured by a vernier caliper and a spectrophotometer. Through classical famous prescription data and literature analysis， total iridoid glycosides， total crocus glycosides， and total flavonoids were selected as the core component indicators related to efficacy， and their content was determined. Finally， through cluster analysis， the threshold ranges of the quantitative indicators of excellent shape and high quality were determined， and the applicability of the established evaluation system was verified by the determination of the indicators for each batch of medicinal materials. ResultsThe excellent shape indicators of Gardeniae Fructus were the fruit length-to-maximum fruit diameter ratio ≤1.86， 0°≤h≤45°， and L^*≥ 37.32. The content of total iridoid glycosides， total crocus glycosides， and total flavonoids should be no less than 2.2%， 0.44%， and 0.028%， respectively. The measurement results of different batches of Gardeniae Fructus showed that the evaluation system could effectively distinguish the Gardeniae Fructus samples in line with the traditional cognition of excellent shape and high quality. ConclusionThis study preliminarily constructs an excellent shape and high quality-based quality evaluation system for Gardeniae Fructus， which links appearance traits with chemical indicators and provides a methodological basis for the quality control and scientific grading of this herbal medicine.

ObjectiveTo identify and quantify the excellent shape and high quality indicators of Sarcandrae Herba and establish an evaluation method for Sarcandrae Herba based on appearance traits and active components according to the theory of excellent shape， high quality， and superior effect of authentic medicinal materials. MethodsSarcandrae Herba samples from various producing areas were systematically collected. Through classical herbal textual research and modern literature analysis， colorimetric values of leaves and stems were selected as shape indicators. According to compound preparation data and literature reports， total flavonoids， total phenolic acids， and coumarins were selected as component indicators. Cluster analysis and correlation analysis were performed to identify core objective indicators and their threshold ranges for the excellent shape and high quality of Sarcandrae Herba. ResultsGreener Sarcandrae Herba exhibited higher levels of phenolic acids， total flavonoids， and coumarins. Core quantitative indicators characterizing the excellent shape and high quality of Sarcandrae Herba were Leaf a^* value<0.99， stem a^* value<4， phenolic acid content≥2.49%， total flavonoid content≥5.32%， and coumarin content≥1.98%. By calculating the compliance rate of each batch against this indicator system， the quality stability of different batches can be quantitatively evaluated. ConclusionThis study validates the traditional empirical principle that greener stems and leaves indicate high quality. It establishes a quality evaluation method for Sarcandrae Herba based on the correlation between color and bioactive components， providing a scientific basis for the quality control and grading of this herbal medicine.