In audiovisual emotion recognition, representational learning is a research direction receiving considerable attention, and the key lies in constructing effective affective representations with both consistency and variability. However, there are still many challenges to accurately realize affective representations. For this reason, in this paper we proposed a cross-modal audiovisual recognition model based on a multi-head cross-attention mechanism. The model achieved fused feature and modality alignment through a multi-head cross-attention architecture, and adopted a segmented training strategy to cope with the modality missing problem. In addition, a unimodal auxiliary loss task was designed and shared parameters were used in order to preserve the independent information of each modality. Ultimately, the model achieved macro and micro F1 scores of 84.5% and 88.2%, respectively, on the crowdsourced annotated multimodal emotion dataset of actor performances (CREMA-D). The model in this paper can effectively capture intra- and inter-modal feature representations of audio and video modalities, and successfully solves the unity problem of the unimodal and multimodal emotion recognition frameworks, which provides a brand-new solution to the audiovisual emotion recognition.
Emotions ; Humans ; Attention ; Algorithms

Automatic classification of medical questions is of great significance in improving the quality and efficiency of online medical services, and belongs to the task of intent recognition. Joint entity recognition and intent recognition perform better than single task models. Currently, most publicly available medical text intent recognition datasets lack entity annotation, and manual annotation of these entities requires a lot of time and manpower. To solve this problem, this paper proposes a medical text classification model, bidirectional encoder representation based on transformer-recurrent convolutional neural network-entity-label-semantics (BRELS), which integrates medical entity label semantics. This model firstly utilizes an adaptive fusion mechanism to absorb prior knowledge of medical entity labels, achieving local feature enhancement. Then in global feature extraction, a lightweight recurrent convolutional neural network (LRCNN) is used to suppress parameter growth while preserving the original semantics of the text. The ablation and comparison experiments are conducted on three public medical text intent recognition datasets to validate the performance of the model. The results show that F1 score reaches 87.34%, 81.71%, and 77.74% on each dataset, respectively. The results show that the BRELS model can effectively identify and understand medical terminology, thereby effectively identifying users' intentions, which can improve the quality and efficiency of online medical services.
Semantics ; Neural Networks, Computer ; Humans ; Natural Language Processing

Objective:To explore the molecular epidemiological characteristics of human metapneumovirus (HMPV) in children with acute respiratory infection (ARI) in Beijing from 2023 to 2024.Methods:In the longitudinal study, 9 834 children with ARI were enrolled from August 2023 to December 2024, including the influenza-like illness (ILI) group from emergency and outpatient department receiving influenza virus (Flu) and HMPV test and the ARI inpatient group for 13 common respiratory pathogen screening test including HMPV, Flu, respiratory syncytial virus, and so on. All respiratory samples positive with HMPV were genotyped by amplifying and sequencing of G gene and further phylogenetic analysis. The χ2 test and Wilcoxon rank-sum test were used to compare the positive rate and basic clinical data of the 2 groups. Results:Among 9 834 enrolled patient, there were 5 276 male and 4 558 female children, with age 5.4 (1.9, 8.2) years. In ILI group of 1 460 patients, there were 83 cases (5.7%) positive for HMPV, with the age 4.9 (3.6, 6.6) years and children under 6.0 years old 59 cases (71.1%). Among 8 374 ARI inpatients, there were 256 cases (3.1%) positive for HMPV, with age 3.5 (1.3, 6.4) years and children under 6.0 years old 188 cases (73.4%). The HMPV positive rate and the age of children positive for HMPV in ARI inpatient group were significantly lower than that in ILI group (both P<0.001). In December, 2024, the HMPV positive rates of ILI and ARI inpatient group (21.3% (17/80), 15.0% (47/314)) were significantly higher than the total positive rates of each group (both P<0.001). Among 279 subtyped specimens, there were 155 cases (55.6%) belonging to genotype A and 124 cases (44.4%) belonging to genotype B. Sub-lineage A2.2.2 containing 111nt-insertions was predominate one in 2023 with positive ratio 89.2% (91/102), and B2 was predominate in 2024 with positive ratio 64.4% (114/177). Conclusions:From 2023 to 2024, the positive rate of HMPV in the ILI group was higher than that in the ARI inpatient group, suggesting a common epidemic of HMPV infection. Children positive for HMPV in the ARI inpatient group were younger than that in the ILI group. A severe epidemic of HMPV was observed in the winter of 2024, which requires attention. Sub-lineage A2.2.2 with 111nt-duplicate insertions and B2 were the predominant epidemic strains in 2023 and 2024, respectively.

Spinal cord injury represents a severe central nervous system trauma characterized by prolonged treatment duration, limited neural regeneration, and delayed functional recovery, greatly affecting patients′ quality of life. The impaired neural tissue struggles to recover effectively due to both the hostile microenvironment and its own compromised state. Current clinical interventions, including early reduction, laminectomy decompression, and intravenous or intrathecal methylprednisolone administration, fail to simultaneously modulate the microenvironment and improve the neural status. Zinc, a trace element abundant in the central nervous system, plays a critical role in gene expression regulation, synaptic plasticity, and neuronal activity. Clinical evidences have indicated that lower serum zinc concentration in patients with spinal cord injury correlates with poorer outcomes and animal experiments have also demonstrated the neuroprotective effects of zinc. In fact, zinc supplementation therapy has not yet been developed into a mature clinical protocol. Besides, related animal studies still lack comprehensive understanding. To this end, the authors reviewed the biological characteristics of zinc, its administration routes, neuroprotective effects and mechanisms in the management of spinal cord injury, aiming to provide references for future basic research and clinical practice.

Objective:To analyze the clinical and endoscopic features of elderly patients with early gastric neuroendocrine neoplasms(g-NEN)to provide insights for clinical diagnosis and treatment.Methods:Seven cases of early-stage g-NEN in elderly patients admitted to Beijing Hospital from May 2020 to October 2024 were reported.Information including patient demographics, medical history, laboratory findings, endoscopic features, and pathological results was summarized an analyzed.Meanwhile, a literature review was conducted on g-NEN cases reported domestically and internationally from the establishment of databases to April 2025, with a comparative analysis of baseline characteristics, background mucosal conditions, and pathological diagnoses.Results:A total of 7 elderly patients with early g-NEN were included, including 3 males and 4 females, with an average age of 67 years at diagnosis.Endoscopic and pathological features: endoscopic lesions were mainly located on the greater curvature of the stomach, mostly slightly elevated, with 4/7(57.1%)being single lesions and the others accompanied by multiple polyps.The size of gastric neuroendocrine tumor(g-NET) lesions ranged from 1 mm to 19 mm, with a median Kyoto gastritis score of 3.In terms of pathological grading, there were 6 cases of G1 and 1 case of gastric neuroendocrine carcinoma(g-NEC). All 7 patients underwent endoscopic submucosal dissection(ESD). The follow-up period after surgery ranged from 3 months to 4 years, and no tumor was found at the vertical and horizontal margins of all lesions on pathology.A literature review of 32 reported cases showed that 40.6%(13/32)of cases exhibited background mucosal atrophy or intestinal metaplasia, with positive rates of chromogranin A(CgA) and synapsin(Syn)reaching 95.8%(23/24) and 100.0%(25/25), respectively.Notably, elderly patients with g-NEC demonstrated aggressive invasiveness, with a metastasis rate of 62.5%(5/8).Conclusions:Elderly patients with g-NEN exhibit high heterogeneity and significant differences in invasiveness, necessitating heightened clinical vigilance.Precise management should integrate background mucosal status, Kyoto gastritis score, pathological biomarkers, and imaging techniques.Blue laser imaging with magnifying endoscopy(BLI-ME)and endoscopic ultrasonography(EUS)can further analyze the characteristics of these tumors, and endoscopic submucosal dissection(ESD)remains the primary treatment modality for early-stage g-NEN.

Objective:To validate the accuracy of three-dimensional anatomical models reconstructed from cone beam CT (CBCT) using micro-CT as the gold standard, and to evaluate the feasibility of performing anatomical analyses on such models.Methods:A total of 13 isolated deciduous teeth with intact roots were collected, including 5 anterior teeth and 8 molars, with a total of 34 root canals. The teeth were extracted from children aged 3-9 years who visited Peking University Hospital of Stomatology from January 2019 to April 2022 due to trauma or periapical disease, and were then scanned by micro-CT (with a voxel size of 0.018 mm) and CBCT (with a voxel size of 0.125 mm), respectively. Using a threshold-based semi-automated region segmentation method, anatomical models of these isolated teeth were reconstructed from the two CTs. Subsequently, the two CT reconstructed models were registered based on the iterative closest point algorithm, followed by deviation analysis. The key anatomical parameters were measured on the micro-CT and CBCT models, respectively, and the differences were calculated.Results:The CBCT reconstruction models were relatively accurate in the hard tissue morphology, and 97.1% (33/34) of the root canals were identified accurately. When it comes to the deviation analysis, the average distance between the matched points on the CBCT reconstruction models and the micro-CT models was (0.01±0.03) mm for the hard tissue, and (0.00±0.03) mm for the pulp chambers and canals, which did not affect clinical observation. The hard tissue and root canal length of CBCT models were both smaller than those of micro-CT models ( P<0.05), with a 95% limits of agreement of (-0.70, 0.14) mm for the hard tissue, and a 95% limits of agreement of (-1.93, 1.00) mm for the pulp chambers and canals. The impact of these differences on clinical operations was all within the acceptable range. Conclusions:Using micro-CT as a validate standard, CBCT with a voxel size of 0.125 mm was proved to be an effective tool for the reconstruction of deciduous teeth. Therefore, the reconstructed models were appropriate for studying deciduous teeth anatomy.

ObjectiveTo investigate the whole genomic characteristics and phylogenetic relationships of clinical isolates of enteroaggregative Escherichia coli (EAEC) in diarrhea outpatients in Pudong New Area, Shanghai. MethodsBased on the diarrheal disease surveillance network in Pudong New Area, Shanghai, whole-genome sequencing was performed on a total of 55 EAEC strains isolated from fecal samples of the diarrhea outpatients from January 2015 to December 2019. The genome analyses based on raw sequencing data encompassed genome size, coding genes, dispersed repeat sequences, genomic islands, and protein coding regions, and pan-genome analyses were conducted simultaneously. Contigs sequences assays were performed to analyze molecular characteristics including serotypes, antibiotic resistance genes, and virulence factors. The phylogenetic clusters and multilocus sequence typing (MLST) were identified, and a phylogenetic tree was constructed. ResultsEAEC exhibited an open pan-genome. The predominant serotype of EAEC in diarrhea outpatients in Pudong New Area was O130:H27, and the carriage rate of β-lactam resistance genes was the highest (67.27%, 37/55). A total of 29 virulence factors and 106 virulence genes were identified, phylogenic group B1 was the predominant group, and clonal group CC31 was the dominant clonal group. The strain distribution was highly heterogeneous. ConclusionThe genomic characteristics of EAEC displayed significant strain polymorphism. It is necessary to develop effective strategies for differential diagnosis and improve detection capabilities for infection with EAEC of different serotypes and genotypes.

ObjectiveTo investigate the possible mechanism of Shenfuhuang Formula （参附黄配方） in prevention and treatment of epsis-associated encephalopathy from the perspective of brain genomics. MethodsC57BL/6 mice were randomly divided into sham surgery group， sepsis group， and Shenfuhuang group， with 20 mice in each group. The sepsis group and Shenfuhuang group were induced to develop sepsis by cecal ligation and puncture （CLP） procedure. At 4 hours after modelling， Shenfuhuang group were gavaged with 2.5 g/（kg·d） of Shenfuhuang Formula， 0.5 ml each time， at 12 hours intervals， for a total of 4 times after modelling. Sepsis group and sham surgery group were given 0.5 ml of purified water orally. At 48 hours after modeling， the transcriptome sequencing was used to explore the differential gene expression in the effects of Shenfuhuang Formula on the brain regions of septic mice， and real-time PCR and ELISA were later used to further validate the differential gene and proteins expression. ResultsA total of 4605 genes were differentially expressed in Shenfuhuang group compared with sepsis group， of which 2353 genes were up-regulated and 2252 genes were down-regulated. According to the results of previous publications， six key genes were screened， including serine/threonine-protein kinase （Nek1）， myelin-associated glycoprotein （Mag）， endothelial cell-specific tyrosine kinase receptor （Tek）， a disintegrin and metalloproteinase with thrombospondin motifs 20 （Adamts20）， lymphocyte antigen 86 （Ly86）， and E3 ubiquitin-protein ligase （Traip）. Further genetic and protein validation revealed that， compared to the sham surgery group， the mRNA levels and corresponding protein levels of Nek1， Mag， Tek， Adamts20， Ly86， and Traip in the brain tissue of septic mice significantly reduced （P＜0.05）. In comparison to the sepsis group， Shenfuhuang group showed significantly increased mRNA levels and corresponding protein levels of Nek1， Mag， Tek， Adamts20， Ly86， and Traip （P＜0.05）. ConclusionThe potential therapeutic targets of Shenfuhuang Formula for treating sepsis-associated encephalopathy may be related to the Nek1， Mag， Tek， Adamts20， Ly86， and Traip genes and their encoded proteins.

Low anterior resection syndrome (LARS) is a series of symptoms of intestinal dysfunction, and its research is mainly focused on patients with low rectal surgery. However, with the deepening understanding of postoperative LARS, surgeons found that LARS not only exists among patients who have undergone low anterior resection of rectum, but also plagues a considerable number of patients who have undergone non-rectal (mainly colon) surgeries. This article aims to elaborate on the incidence and treatment of LARS after colon surgery. Through a comprehensive analysis of relevant studies, it is found that the incidence of LARS after colon surgery is approximately 20%-30%, and the incidence is relatively higher in patients undergoing right hemicolectomy. Its pathogenesis is related to multiple factors, including surgical methods, resection range, changes in intestinal flora, patient age, gender, and underlying diseases. Treatment methods include conservative treatments such as dietary adjustment, drug therapy, transanal irrigation, and rehabilitation training. Single treatment methods have limited effect, while comprehensive treatment can effectively improve patients' symptoms and quality of life. The current LARS scoring system has not been effectively verified in the application after colon cancer surgery, and it is necessary to develop a more targeted scoring system.

With the rising incidence of breast cancer and the widespread use of chemotherapy,the efficacy and adverse effects of chemotherapeutic agents have become a focus of attention.There is a potential association between microorganisms and breast cancer development and therapeutic response,and the potential value of probiotics with the role of regulating intestinal flora and other effects in breast cancer chemotherapy has been increasingly valued.In this paper,we review the regulatory role of intestinal flora in the efficacy of breast cancer chemotherapy and post-chemotherapy adverse reactions,predict its impact on chemotherapeutic effects and adverse reactions to chemotherapy,and focus on the positive role of probiotics in improving post-chemotherapeutic adverse reactions to breast cancer chemotherapy,to provide the scientific basis for the improvement of the quality of life of breast cancer patients,optimization of the chemotherapy regimen for breast cancer,and enhancement of the comprehensive effect of chemotherapy for breast cancer.