ObjectiveIn traditional Chinese medicine (TCM), the foundational doctrine that the eyes reflect the essence of the internal viscera establishes ocular observation as a cornerstone of diagnostic practice. Specifically, the morphological characteristics and coloration variations of the scleral microvasculature serve as critical clinical indicators for assessing the dynamic balance of Qi and Blood, as well as the pathological status of internal organs. Historically, however, TCM eye diagnosis has relied predominantly on the subjective clinical experience and visual acuity of individual practitioners, leading to inherent challenges in standardization and reproducibility. While automated computer-aided diagnostic systems offer a promising solution, existing vessel segmentation algorithms encounter significant domain-specific bottlenecks when applied to scleral imagery. These challenges primarily stem from the highly reflective and moist nature of the ocular surface, which generates severe reflective interference. Furthermore, the inherent low contrast of fine capillary networks against complex background textures, compounded by non-uniform illumination, frequently results in high false-positive rates, misdetections, and severe vessel fragmentation. To address these critical limitations and advance the objective quantification of TCM diagnostics, this paper proposes a novel, highly robust sclera vessel segmentation framework that innovatively integrates Frangi-Sato dual-filter adaptive enhancement with pixel-level reflection detection. MethodsThe proposed methodology systematically addresses the segmentation pipeline through three synergistic stages. First, to overcome the structural limitations of single-filter approaches, a multi-scale weighted fusion strategy is meticulously designed to harness the complementary extraction capabilities of both Frangi and Sato filters. This adaptive enhancement optimally balances the preservation of main vessel trunk continuity with the heightened sensitivity required for delineating delicate, low-contrast peripheral capillaries. Second, to tackle the persistent issue of reflective highlights, a sophisticated multi-feature synergistic reflection detection module is introduced. By jointly analyzing local information entropy, gradient field variations, and intensity statistical distributions, this module achieves precise, pixel-level identification and elimination of reflective artifacts without compromising the underlying vascular structures. Finally, a dual-level adaptive thresholding strategy, featuring an innovative “core protection” mechanism, is implemented. This critical step effectively suppresses complex background noise while rigorously preserving the structural and topological integrity of the intricate vessel network, preventing the structural breaks often seen in conventional binarization methods. ResultsThe efficacy of the proposed framework was rigorously evaluated using both self-constructed clinical datasets specifically acquired for TCM research and standardized public datasets. Extensive experimental results demonstrate that the proposed method consistently outperforms state-of-the-art traditional approaches and contemporary deep learning models. Specifically, the proposed method achieves a Dice similarity coefficient of approximately 0.71 on the private clinical dataset, and secures the best performance across the majority of quantitative metrics on both datasets. Notably, the framework exhibits exceptional robustness and generalization capabilities in highly challenging scenarios characterized by intense reflective interference, low signal-to-noise ratios, and cross-domain image variations. ConclusionThis study successfully realizes the high-integrity, automated segmentation of scleral vessel networks under complex clinical imaging conditions. By overcoming the fundamental algorithmic challenges of reflection interference and micro-vessel loss, the proposed methodology provides potential support for the digitization, objective standardization, and intelligent advancement of modern TCM eye diagnosis systems.

ObjectiveIn traditional Chinese medicine (TCM), the foundational doctrine that the eyes reflect the essence of the internal viscera establishes ocular observation as a cornerstone of diagnostic practice. Specifically, the morphological characteristics and coloration variations of the scleral microvasculature serve as critical clinical indicators for assessing the dynamic balance of Qi and Blood, as well as the pathological status of internal organs. Historically, however, TCM eye diagnosis has relied predominantly on the subjective clinical experience and visual acuity of individual practitioners, leading to inherent challenges in standardization and reproducibility. While automated computer-aided diagnostic systems offer a promising solution, existing vessel segmentation algorithms encounter significant domain-specific bottlenecks when applied to scleral imagery. These challenges primarily stem from the highly reflective and moist nature of the ocular surface, which generates severe reflective interference. Furthermore, the inherent low contrast of fine capillary networks against complex background textures, compounded by non-uniform illumination, frequently results in high false-positive rates, misdetections, and severe vessel fragmentation. To address these critical limitations and advance the objective quantification of TCM diagnostics, this paper proposes a novel, highly robust sclera vessel segmentation framework that innovatively integrates Frangi-Sato dual-filter adaptive enhancement with pixel-level reflection detection. MethodsThe proposed methodology systematically addresses the segmentation pipeline through three synergistic stages. First, to overcome the structural limitations of single-filter approaches, a multi-scale weighted fusion strategy is meticulously designed to harness the complementary extraction capabilities of both Frangi and Sato filters. This adaptive enhancement optimally balances the preservation of main vessel trunk continuity with the heightened sensitivity required for delineating delicate, low-contrast peripheral capillaries. Second, to tackle the persistent issue of reflective highlights, a sophisticated multi-feature synergistic reflection detection module is introduced. By jointly analyzing local information entropy, gradient field variations, and intensity statistical distributions, this module achieves precise, pixel-level identification and elimination of reflective artifacts without compromising the underlying vascular structures. Finally, a dual-level adaptive thresholding strategy, featuring an innovative “core protection” mechanism, is implemented. This critical step effectively suppresses complex background noise while rigorously preserving the structural and topological integrity of the intricate vessel network, preventing the structural breaks often seen in conventional binarization methods. ResultsThe efficacy of the proposed framework was rigorously evaluated using both self-constructed clinical datasets specifically acquired for TCM research and standardized public datasets. Extensive experimental results demonstrate that the proposed method consistently outperforms state-of-the-art traditional approaches and contemporary deep learning models. Specifically, the proposed method achieves a Dice similarity coefficient of approximately 0.71 on the private clinical dataset, and secures the best performance across the majority of quantitative metrics on both datasets. Notably, the framework exhibits exceptional robustness and generalization capabilities in highly challenging scenarios characterized by intense reflective interference, low signal-to-noise ratios, and cross-domain image variations. ConclusionThis study successfully realizes the high-integrity, automated segmentation of scleral vessel networks under complex clinical imaging conditions. By overcoming the fundamental algorithmic challenges of reflection interference and micro-vessel loss, the proposed methodology provides potential support for the digitization, objective standardization, and intelligent advancement of modern TCM eye diagnosis systems.

ObjectiveTo investigate the incidence， glucolipid metabolism characteristics， and associated factors of postoperative overweight/obesity in children and adolescent with craniopharyngioma. MethodsA retrospective study was conducted using follow-up data from 44 patients （aged 0-18 years） diagnosed with craniopharyngioma who underwent surgical treatment and received follow-up care at Sun Yat-sen Memorial Hospital， Sun Yat-sen University， between January 2006 and February 2024. The incidence and glucolipid metabolism characteristics of overweight/obesity were summarized， and potential influencing factors were analyzed. ResultsA total of 44 patients were enrolled. The mean age at surgery was （8.57 ± 4.25） years， and the mean age at last follow-up was （16.02 ± 5.36 ）years. The mean follow-up duration was （7.45 ± 4.64） years （range， 8 months to 17.5 years）. The preoperative incidence of overweight/obesity was 40.91% （predominantly overweight， 27.27%）， which increased to 68.18% postoperatively （predominantly obesity， 50.00%）. Postoperatively， all patients （44/44， 100%） underwent fasting plasma glucose （FPG） testing， among whom 2 （4.55%） had impaired fasting glucose （IFG）. Fasting insulin （FINS） was measured in 20 patients， and insulin resistance was identified in 11 （55.00%）. Oral glucose tolerance testing （OGTT） with insulin release assessment was performed in 12 patients， and all （100%） exhibited abnormal insulin secretion， including 5 （41.67%） with hyperinsulinemia and 3 （25.00%） diagnosed with diabetes mellitus （DM）. All patients （44/44， 100%） underwent lipid profile assessment. The incidence of dyslipidemia was 81.82% （36/44）， including elevated non-high-density lipoprotein cholesterol （29/44， 65.91%）， hypertriglyceridemia （29/44， 65.91%）， low high-density lipoprotein cholesterol （22/44， 50.00%）， and mixed hyperlipidemia （13/44， 29.55%）. Logistic regression analysis indicated that preoperative overweight/obesity and postoperative abnormal glucose metabolism were significant factors associated with postoperative overweight/obesity. Compared with normal-weight patients， those with postoperative overweight/obesity had higher FINS levels （14.22 mU/L vs. 3.57 mU/L）， higher insulin resistance index（HOMA-IR） （2.88 vs. 0.52）， and a higher incidence of abnormal glucose metabolism （77.78% vs. 23.08%）. However， no significant difference was observed in the incidence of dyslipidemia （94.44% vs. 73.08%）. ConclusionsChildren and adolescent with craniopharyngioma exhibit a higher incidence of overweight/obesity than healthy peers preoperatively， which becomes more pronounced after surgery. This is accompanied by a high incidence of glucolipid metabolic disorders， placing these patients at increased risk of metabolic syndrome， which warrants clinical attention and regular metabolic assessment. In patients who develop postoperative obesity， particular attention should be given to the risk of glucose metabolism abnormalities， and further monitoring of glucose homeostasis is recommended.

ObjectiveTo investigate the effects of Ditantang on metabolic dysfunction-associated fatty liver disease （MAFLD） in rats by focusing on the regulation of glycogen synthesis mediated by the uridine diphosphate glucose （UDPG）-site-1-protease （S1P）-sterol regulatory element-binding protein （SREBP） axis. MethodsMAFLD was modeled in SD rats by feeding a high-fat diet for 12 weeks. Rats were randomized into a control group， a model group， low-， medium-， and high-dose （2.68， 5.36， and 10.72 g·kg^-1·d^-1， respectively） Ditantang groups， and a positive control （Yishanfu， 0.18 g·kg^-1·d^-1） group. Starting from week 9 of modeling， each treatment group received corresponding drug interventions via gavage. After the experiment， the serum levels of total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） were measured. The levels of TG， non-esterified fatty acids （NEFA）， glycogen， glucose-6-phosphate （G6P）， glucose-1-phosphate （G1P）， and UDPG in the liver tissue samples were measured by biochemical assay kits. Liver pathological morphology and lipid/glycogen deposition were observed via hematoxylin-eosin （HE） staining， oil red O staining， and Periodic acid-Schiff （PAS） staining. Immunofluorescence assay was conducted to detect the expression and localization of phosphoglucomutase-1 （Pgm1） and UDP-glucose pyrophosphorylase 2 （Ugp2） in the rat liver. Real-time PCR and Western blot were employed to quantify mRNA and protein levels， respectively， of key glycogen synthesis enzymes （Pgm1 and Ugp2）， key lipogenesis-related transcription factor SREBP and its target genes ［acetyl-CoA carboxylase （ACC）， fatty acid synthetase （FASN）， and stearoyl-CoA desaturase （SCD1）］， as well as S1P. ResultsCompared with the control group， the model group exhibited elevated levels of TC， TG， LDL-C in the serum and TG and NEFA in the liver， decreased serum HDL-C level （P<0.01）， reduced hepatic levels of G1P， G6P， UDPG， and glycogen （P<0.01）， appearance of fat vacuoles of varying sizes and abundant red lipid droplets， with prominent lipid deposition and reduced areas of deep glycogen staining in the liver tissue， upregulated mRNA and protein levels of SREBP1， S1P， ACC， FASN， and SCD1 （P<0.01）， and downregulated mRNA and protein levels of Pgm1 and Ugp2 （P<0.01）. Compared with the model group， all doses of Ditantang reduced the levels of TC and TG in the serum and TG and NEFA in the liver， while elevating the serum HDL-C level. Additionally， medium- and high-dose Ditantang reducted the LDL-C level （P<0.05）. Ditantang at all doses increased the hepatic levels of G1P， G6P， UDPG， and glycogen， alleviated hepatic steatosis and lipid deposition， enhanced glycogen storage， downregulated the mRNA and protein levels of SREBP1， S1P， ACC， FASN， and SCD1 （P<0.05）， while upregulating the expression of Pgm1 and Ugp2 （P<0.01）. Immunofluorescence analysis revealed decreased fluorescence intensity of S1P and enhanced fluorescence intensity of Ugp2 （P<0.01）. ConclusionDitantang can regulate glycogen synthesis through the UDPG-S1P-SREBP axis to prevent and treat MAFLD.

Objective:To compare the efficacy and safety of Rotarex mechanical thrombectomy (Rotarex) combined with drug-coated balloon (DCB) versus percutaneous transluminal angioplasty (PTA) combined with DCB in the treatment of femoropopliteal artery in-stent restenosis (ISR).Methods:A multicenter, prospective, randomized controlled trial was conducted. 46 patients with femoropopliteal artery ISR admitted to five hospitals (Beijing Friendship Hospital, Capital Medical University; Beijing Chaoyang Hospital, Capital Medical University; Beijing Jishuitan Hospital, Capital Medical University; Xuanwu Hospital, Capital Medical University; Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University) from July 2020 to June 2024 were enrolled. Patients were randomly divided into the Rotarex+ DCB group ( n=24) and the PTA+ DCB group ( n=22) using a random number table. The clinical data of the two groups were collected, including clinical characteristics, Fontaine classification, stent placement location, stent duration, and lesion length. The primary endpoint was the target blood vessel patency rate at 6 and 12 months postoperatively; the secondary endpoints included improvement in clinical symptoms (Fontaine classification), rate of reintervention, and safety indicators. Measurement data were expressed as mean±standard deviation ( ± s), and the t-test was used for comparison between groups; count data were expressed as the number of cases and percentages, and intergroup comparisons were performed using the Chi-test or Fisher exact probability method. Results:At 12 months postoperatively, the target blood vessel patency rate in the Rotarex+ DCB group was significantly higher than that in the PTA+ DCB group (81.8% vs 45.5%, P=0.012), and the proportion of patients in Fontaine classification stage I was also higher (86.4% vs 45.5%, P=0.004). The results at the 6-month follow-up were consistent (target blood vessel patency rate: 87.0% vs 59.1%, P=0.035). In terms of safety, no severe complications such as arterial rupture, amputation, or procedure-related death occurred during the perioperative period in either group. During the postoperative follow-up, no amputation or procedure-related deaths occurred in either group. Conclusion:For the treatment of femoropopliteal artery ISR, Rotarex mechanical thrombectomy combined with DCB is significantly superior to PTA+ DCB in terms of 12-month target blood vessel patency rate and improvement of clinical symptoms, with comparable safety.

Traditional mass measurement methods are not applicable in microgravity environments,and the main challenge for in-orbit body mass measurement technology based on inertial principles is to address the random errors brought about by the weightless environment.These include additional torques due to shifts in the center of mass,nonlinear accelerations due to non-rigid human bodies,mechanical energy consumption due to organ vibrations,and random vibrations of the measurement device itself.To address the above difficulties,the project proposes a technical scheme based on the principle of linear acceleration,designs and constructs a ground-specific air-floating experimental and simulation platform,studies key data such as motion trajectory,acceleration change,and vibration frequency amplitude during the mass measurement process,and simulates the changes in the center of mass and random vibrations of the human body in a weightless environment.The project has designed an adjustable posture bracket to adapt to changes in the center of mass,enhance body restraint,and greatly reduce shaking;it has also developed an integrated four-bar linkage motion guidance mechanism,high-precision integrated photoelectric distance measurement,and modular motion constant force measurement device to ensure the accurate measurement of acceleration and constant force data.The product has undergone simulation calculations,ground human applicability tests,and in-orbit applicability verification in the space station.Ground test results show that the device achieves a body mass measurement accuracy better than 0.5%,and the dispersion is better than 0.38%;after flight mission verification and evaluation,the in-orbit body mass measurement dispersion is less than 0.4%,which is superior to the SLAMMD,a mass measurement device of the same principle on the International Space Station,and is at the forefront internationally,achieving accurate body mass measurement.

Abdominal war trauma is a common and high-risk type of injury in the modern battlefield,with rapid changes in condition and a high mortality rate.There is an urgent need for emerging medical technologies to improve the efficiency and success rate of first aid for military casualties.With the development of artificial intelligence(AI),5G,and other emerging technologies,the concept of intelligent medical treatment is gradually forming and can assist in the diagnosis and treatment of abdominal trauma.This paper reviews the characteristics of abdominal war trauma in modern wars,discusses the application of intelligent medical treatment for abdominal war trauma and its drawbacks to be solved,aiming to provide reference for research related to abdominal war trauma.

Objective To develop an erythrocyte-based delivery system for butyrylcholinesterase(BChE)that is capable of prophylaxis against organophosphorus nerve agents.Methods Recombinant BChE was produced and analyzed for oligomerization via polyacrylamide gel electrophoresis(PAGE)and Western blotting.A modified hypotonic preswelling method was employed to prepare BChE-loaded erythrocytes.The drug loading capacity and encapsulation efficiency were quantified using enzyme-linked immunosorbent assay(ELISA).Catalytic activity was assessed in vitro with an activity detection kit.The system was characterized via scanning electron microscopy(SEM),flow cytometry and a hematology analyzer.Results Recombinant BChE predominantly existed as dimers(85％dimer,15％monomer).The optimized volume ratio of erythrocytes to hypotonic solution was determined as 1:7.Compared with native and empty erythrocytes,BChE-loaded erythrocytes exhibited significantly higher catalytic activity(P＜0.001).The mean corpuscular volume of BChE-loaded erythrocytes increased(P＜0.001),while the mean content of corpuscular hemoglobin and hemoglobin in erythrocytes per 100 mL decreased(P＜0.001).SEM revealed no morphological differences(biconcave disc shape).Hypotonic preswelling moderately increased erythrocyte apoptosis(P＜0.001),but no statistical difference was observed between BChE-loaded and hypotonic-treated erythrocytes(P＞0.05).CD47 expression remained unchanged compared to native erythrocytes(P＞0.05).Conclusion The modified hypotonic preswelling method can generate BChE-loaded erythrocytes that retain the characteristics of native erythrocytes while conferring catalytic activity,offering a novel strategy for clinical intervention against organophosphorus poisoning.

Objective:Measure the global longitudinal strain (GLS) of the left ventricle in trauma patients by beside speckle tracking echocardiography to explore the role of STE -GLS in evaluating left ventricular systolic function in trauma patients, and then explore the clinical value of GLS in judging the prognosis of trauma patients.Methods:Trauma patients admitted to intensive care unit from September 1, 2020 to April 1, 2021 with an Injury Severity Score (ISS) of ≥ 16 points. were consecutively enrolled. Moreover, those patients who met the following criteria were selected as the research subjects: aged between 18 and 80 years old, had no serious underlying diseases in the past, the time from trauma onset to admission was within 24 hours, and were able to complete an echocardiogram examination within 24 hours after the onset of the disease. Exclude patients who are unable to complete the ultrasound examination within 24 hours after the onset of the disease, or those with poor image quality, or those complicated with severe heart diseases and systemic comorbidities. The left ventricular global longitudinal strain (GLS) was measured by bedside speckle tracking echocardiography. According to the GLS values they were divided into abnormal group (GLS> -15%) and normal group (GLS≤ -15%). Independent sample t-tests and chi-square tests were applied to conduct a comparative analysis of the clinical characteristics between the two groups of patients. Furthermore, multiple linear regression analysis was conducted to explore the correlation between STE-GLS and the duration of intensive care unit stay.Results:A total of 32 trauma patients were eligible for this study. One patient was found to have abnormal left ventricular systolic function (LVEF<50%) detected by conventional echocardiography, however speckle tracking echocardiography detected decreased left ventricular systolic function (GLS> -15%) in 13 Patients. Multiple linear regression analysis showed that the global longitudinal strain of left ventricle and serum high sensitivity troponin I were independent risk factors affecting the time of intensive care in trauma patients.Conclusions:Speckle tracking echocardiography (STE) is more sensitive than traditional echocardiography and can detect left ventricular systolic dysfunction early. STE-GLS is an independent risk factor affecting hospitalization time of trauma patients in intensive care unit. Clinically, STE-GLS and serum Hs-TnI can be combined to determine the prognosis of trauma patients.

Alzheimer's disease(AD)is the leading cause of dementia,and no effective treatment has been devel-oped for it thus far.Recently,the use of natural compounds in the treatment of neurodegenerative diseases has garnered significant attention owing to their minimal adverse reactions.Accordingly,the potential therapeutic effect of pterostilbene(PTS)on AD has been demonstrated in multiple in vivo and in vitro experiments.In this study,we systematically reviewed and summarized the results of these studies investigating the use of PTS for treating AD.Analysis of the literature revealed that PTS may play a role in AD treatment through various mechanisms,including anti-oxidative damage,anti-neuroinflammation,anti-apoptosis,cholinesterase activity inhibition,attenuation of β-amyloid deposi-tion,and tau protein hyperphosphorylation.Moreover,PTS interferes with the progression of AD by regulating the activities of peroxisome proliferator-activated receptor alpha(PPAR-α),monoamine oxi-dase B(MAO-B),silent information regulator sirtuin 1(SIRT1),and phosphodiesterase 4A(PDE4A).Furthermore,to further elucidate the potential therapeutic mechanisms of PTS in AD,we employed network pharmacology and molecular docking technology to perform molecular docking of related proteins,and the obtained binding energies ranged from-2.83 to-5.14 kj/mol,indicating that these proteins exhibit good binding ability with PTS.Network pharmacology analysis revealed multiple po-tential mechanisms of action for PTS in AD.In summary,by systematically collating and summarizing the relevant studies on the role of PTS in treatment of AD,it is anticipated that this will serve as a reference for the precise targeted prevention and treatment of AD,either using PTS or other developed drug interventions.