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.

Cholangiocarcinoma (CCA) is a malignancy characterized by tumor cells originating in the liver or bile ducts, exhibiting features of cholangiocyte differentiation. It poses a significant clinical challenge due to the limited diagnostic and therapeutic options available. Robust animal models are essential for advancing our understanding of CCA pathogenesis and developing effective treatments. This review provides a comprehensive overview of CCA mouse models, highlighting various approaches, including chemical induction, genetically engineered models, and tumor xenografts. Each model is discussed in terms of its establishment techniques, pathological characteristics, and research significance, with a focus on intrahepatic CCA. Chemical induction models, such as diethylnitrosamine- and azoxymethane-induced models, offer insights into tumorigenesis processes, whereas genetically modified models involving alterations in key genes such as Kirsten rat sarcoma viral oncogene homolog, tumor protein 53, and isocitrate dehydrogenase serve as important tools for studying the molecular mechanisms underlying CCA. Xenograft models, including patient-derived xenografts, bridge the gap between experimental research and clinical applications, allowing for precise therapeutic evaluations. By comparing these models, this review underscores their respective advantages and limitations, paving the way for future studies aiming to optimize and innovate CCA modeling strategies.

Objective: To compare the effects of 12 week Tai Chi combined with inspiratory muscle resistance training on cardiopulmonary function among male college students in health care classes, so as to provide a reference for improving the cardiopulmonary function of the students. Methods: From March to May 2025, 72 male students from the physical education health care classes at North University of China were selected and randomly divided into the control group ( n =25), the Tai Chi group ( n = 24), and the Tai Chi combined with inspiratory muscle resistance training group (combined group, n =23) by random number table method. The control group maintained normal living habits, the Tai Chi group underwent 12 weeks of Tai Chi exercise (three sessions per week, 90 minutes per session), and the combined group received 12 weeks of Tai Chi training (three sessions per week, 60 minutes per session) combined with 30 minutes of inspiratory muscle resistance training. Cardiovascular function[heart rate(HR), stroke volume(SV), cardiac output(CO), mean systolic pressure(MSP), mean diastolic pressure(MDP), vascular elastic dilatation coefficient (VDC), total peripheral resistance (TPR), viscosity (V)], pulmonary function [vital capacity (VC), forced vital capacity (FVC), maximum minute ventilation volume (MVV), forced expiratory volume in one second (FEV1), FEV1/FVC] and heart rate variability (HRV) [HR, standard deviation of the normal to normal intervals (SDNN), root mean square successive difference (RMSSD), low frequency (LF), high frequency (HF), LF/HF] of the three groups of subjects were tested before and after the experiment, the data were analyzed using analysis of covariance. Results: There were no statistically significant differences in any indicators among the three groups before the intervention ( F =0.00-2.49, all P >0.05). After the intervention, except FEV1/FVC, MDP and V, there were statistically significant differences of pulmonary function, cardiovascular function and HRV indicators among the three groups ( F =4.38-62.93, all P <0.05). Compared with the control group [(VC ( 3.28± 0.30)L, FVC (3.20±0.29)L, MVV (107.01±9.55)L, SV (65.68±2.34)mL, CO (5.36±0.18)L/min, VDC (0.40±0.03), step index (50.64±3.11), MSP (133.17±6.47)mmHg, TPR (1 281.34±100.78)dyn ·s ·cm -5 ], the VC [(3.43±0.24, 3.69±0.21)L], FVC [(3.34±0.16, 3.46±0.20)L], MVV [(112.54±8.95, 117.11±6.37)L], SV [(71.75±4.20, 75.39±3.71)L/time], CO[( 5.53± 0.14, 5.58±0.15)L/min], VDC (0.43±0.03, 0.44±0.02) and step index (53.38±5.77, 56.17±4.91) in the Tai Chi group and the combined group significantly increased, while the MSP [(120.17±6.42, 118.04±12.99)mmHg] and TPR [( 1 227.01 ±107.25, 1 217.69±64.93)dyn ·s ·cm -5 ] significantly decreased (all P <0.05). The HRV showed improvement. Moreover, compared with the Tai Chi group, VC, FVC, MVV, FEV1[(2.99±0.14，3.05±0.15)L], SV, step index, RMSSD[( 45.41± 9.59，52.82±7.67)ms] and HF [(2.74±0.13，2.87±0.16)ms 2] increased, while HR [(77.17±6.01, 73.83± 3.71)beats/min ] decreased in the combined group (all P < 0.05 ). Conclusion Twelve weeks of Tai Chi exercise and Tai Chi combined with inspiratory muscle resistance training can improve the cardiopulmonary function of male college students in health care classes, and the effect of the combined training is superior to that of Tai Chi training alone.

Aerosol-assisted plasma amplification laser-induced breakdown spectroscopy(LIBS)was employed for phosphorus detection in water.To address the multivariate coupling effects in LIBS and nebulization sampling system,an orthogonal experiment was employed to systematically optimize the key experimental parameters.Using the orthogonal experimental design,the parametric effects of laser energy(output voltage),signal acquisition delay,liquid velocity,and gas velocity on the signal to background ratio(SBR)of P I 213.618 nm were evaluated,and the optimal conditions were achieved,including laser energy of 86 mJ,delay time of 3 μs,gas velocity of 1.05 mL/min,and liquid velocity of 60 μL/min,which were in agreement with the control-variable optimization results.Moreover,the SBR response trends at P I 213.618 nm with all experimental parameters was strong in consistency with control-variable optimization results,which demonstrated the validity of the orthogonal array experimental design.This study established an efficient and accurate parameter optimization methodology for complex LIBS systems,significantly advancing the application of LIBS in environmental monitoring.

Natural products (NPs) have long held a significant position in various fields such as medicine, food, agriculture, and materials. The chemical space covered by NPs is extensive but often underexplored. Therefore, high-throughput and efficient methodologies for the annotation and discovery of NPs are desired to address the complexity and diversity of NP-based systems. Mass spectrometry (MS) has emerged as a powerful platform for the annotation and discovery of NPs. MS databases provide vital support for the structural characterization of NPs by integrating extensive mass spectral data and sample information. Additionally, the released annotation methodologies, based on a variety of informatics tools, continuously improve the ability to annotate the structure and properties of compounds. This review examines the current mainstream databases and annotation methodologies, focusing on their advantages and limitations. Prospects for future technological advancements are then discussed in terms of novel applications and research objectives. Through a systematic overview, this review aims to provide valuable insights and a reference for MS-based NPs annotation, thereby promoting the discovery of novel natural entities.
Biological Products/chemistry* ; Mass Spectrometry/methods* ; Databases, Factual ; Drug Discovery/methods* ; Humans

Objective To explore the traditional Chinese medicine(TCM)syndrome characteristics of patients with Chikungunya hemorrhagic fever and to provide empirical data to support the application of TCM in diagnosing and treating Chikungunya hemorrhagic fever.Methods A cross-sectional survey was conducted to collect clinical data(sex,age,days since onset,and comorbidity underlying disease conditions)and TCM with four-examination information(symptoms,tongue manifestations,and pulse manifestations)from 255 patients with Chikungunya hemorrhagic fever who visited Lecong Hospital of Shunde,Foshan,the Third People's Hospital of Shunde District of Foshan,Shunde Hospital of Southern Medical University Affiliated Chencun Hospital between July 23 and July 29,2025.Factor and cluster analyses were used to summarize TCM syndrome characteristics and analyze core pathogenesis in conjunction with clinical features.Results Among the 255 patients with Chikungunya hemorrhagic fever,131 were male and 124 were female,with a age of(49.05±17.93)years and a disease duration of(3.26±1.78)days.Among the four types of examination information in TCM,35 items exhibited a frequency exceeding 10%.The most prevalent symptoms were arthralgia(180 patients,70.59%),exanthem(153 patients,60.00%),fatigue(99 patients,38.82%),anhidrosis(98 patients,38.43%),pruritus(96 patients,37.65%),and fever(92 patients,36.08%).Tongue and pulse manifestations were primarily white fur(155 patients,60.78%),pink tongue(111 patients,43.53%),slippery pulse(143 patients,56.08%),and greasy fur(134 patients,52.53%).Patients with disease onset≤3 d had a higher incidence of arthralgia,fatigue,fever,aversion to cold,generalized muscle pain,aversion to wind,insomnia,headache,sweating,low-grade fever,poor appetite,loose stool,hyperhidrosis,and red tongue than those with disease onset≥4 d(P<0.05).Patients with disease onset≥4 d had a higher incidence of pink tongue and thick fur than those with disease onset≤3 d(P<0.05).The syndrome elements in patients with Chikungunya hemorrhagic fever predominantly manifested on the defensive exterior,with involvement of the sinew-bone joints,skin-muscle,and spleen.Pathogenic factors were primarily characterized by external winds,dampness,and heat.Factor and cluster analysis result indicated three TCM pathogenesis progression patterns:imbalance of the defensive exterior with wind-dampness conflict and heat transformation;dampness-heat flowing into muscles and meridians causing joint obstruction and qi blood stasis;and dampness-heat congelation resulting in qi mechanism obstruction,consumption of body fluids,and infiltration of the skin.Conclusion Patients with Chikungunya hemorrhagic fever primarily present with fever,joint pain,and rashes.In TCM,this condition falls under the category of"dampness-warmth"syndrome.Its etiology is attributed to pathogens,with transmission occurring through mosquito bites.The core pathogenesis of TCM is the invasion of the defensive exterior and dampness-toxic heat accumulation.The therapeutic principles focus on clearing heat pathogens,resolving dampness pathogens,dispersing wind pathogens,and promoting the resolution of rashes.

Objective To explore the relationship of metabolic comorbidities and insulin resistance(IR)with chronic kidney disease(CKD)among elderly individuals undergoing health exam.Methods A cross-sectional observational study was conducted on 8358 older adults who took health exam in Chinese PLA General Hospital between December 2009 and May 2021.According to the guidelines for CKD diagnostic criteria,they were divided into CKD group(983 cases)and non-CKD(7375 cases).Clinical data was collected,and the eGDR was calculated.Quasi-Bayesian method was used for causal mediation analysis.Results The prevalence of metabolic comorbidi-ties including hypertension,CHD,DM,hyperlipidemia,and hyperuricemia was significantly higher in the CKD group than the non-CKD group(P＜0.01).The eGDR was obviously lower in the CKD group than the non-CKD group[6.88±2.09 mg/(kg·min)vs 8.41±2.12 mg/(kg·min),P＜0.01].Logistic regression analysis revealed that,without adjusting covariates,each 1-unit increase in eGDR was associated with a 29％reduction in the risk of developing CKD(OR=0.714,95％CI:0.691-0.738,P＜0.01),and after adjusting covariates,eGDR remained signifi-cantly negatively association with the risk of CKD(P＜0.01).Mediation analysis indicated that DM and brachial-ankle pulse wave velocity accounted for the highest proportions of the mediating effect in the relationship between eGDR and CKD(14.2％and 12.5％,respectively).Conclusion In the elderly population undergoing health exam,reduced insulin sensitivity is significantly asso-ciated with the development of CKD.Diabetes and arteriosclerosis exert mediating effect in this association.

Objective:To investigate the influence of prolonged post-cesarean skin-to-skin contact (SSC) on breastfeeding outcomes.Methods:A quasi-experimental study was conducted, employing convenience sampling to recruit mother-infant dyads (intervention group: 82 dyads; control group: 85 dyads) from term cesarean deliveries at Northwest Women's and Children's Hospital from December 2021 to May 2022. The control group received routine care, while in the intervention group, SSC was immediately initiated for 90 min upon returning to the ward after cesarean delivery, followed by daily SSC for≥2 h until 42 d postpartum. Propensity score matching was used for 1∶1 matching to control for confounders, resulting in 82 dyads per group. Two independent samples t-test, Mann-Whitney U test, Chi-square test and repeated-measures analysis of variance were used to compare the data between the two groups, including first breastfeeding scores and success rates, the initiation time of lactation, the incidence of delayed lactation, exclusive breastfeeding rates, breastfeeding self-efficacy, and breastfeeding duration. Results:Compared with the control group, the intervention group showed higher first breastfeeding score [11 (11-11) vs. 10 (8-11) scores, Z=30.43] and success rate [82.9% (68/82) vs. 69.5% (57/82), χ2=4.07], shorter initiation time of lactation [45 (35-48) vs. 48 (40-72) h, Z=12.60], and lower incidence of delayed lactation [17.1% (14/82) vs. 32.9% (27/82), χ2=4.68] (all P<0.05). The exclusive breastfeeding rates at 3 d, 42 d, and 3 months after birth were significantly higher in the intervention group than in the control group [76.8% (63/82) vs. 58.5% (48/82), 81.7% (67/82) vs. 67.1% (55/82), 80.5% (66/82) vs. 64.6% (53/82); χ2=5.46, 3.87, 4.41; all P<0.05]. The breastfeeding self-　efficacy scores at 3 d, 42 d, 3 months, and 6 months after birth were also higher in the intervention group [(54.7±6.0) vs. (51.3±9.0) scores, (57.9±5.7) vs. (53.3±8.4) scores, (58.5±7.0) vs. (54.3±7.9) scores, (56.5±8.0) vs. (52.4±11.6) scores; t=－2.81,－4.12,－3.63,－2.63; all P<0.05]. Repeated-measures analysis of variance revealed significant time, group, and interaction effects on self-efficacy ( F=24.29, 13.02, 3.28; all P<0.05). Conclusion:Prolonged SSC after cesarean section promotes the success of early breastfeeding during hospitalization, improves maternal breastfeeding self-efficacy, and increases the exclusive breastfeeding rate within the first 3 months after delivery.

Objective:The clinicopathological features of pulmonary epithelioid hemangioendothelioma (PEHE) were analyzed to provide guidance for clinical practice.Methods:The clinical manifestations, imaging examination, pathological morphology and molecular characteristics, treatment and prognosis of patients with pulmonary epithelioid hemangioendothelioma were retrospectively collected. All cases were admitted to Fujian Medical University Union Hospital from January 2012 to May 2023.Results:Of 7 PEHE cases, 2 underwent tumor biopsy and 5 underwent tumor resection. There were 4 males and 3 females, with a median age of 58 years old. Six cases showed multiple bilateral nodules, and only one case showed a single lesion in the lower left lung lobe. Five patients presented with respiratory symptoms, like cough, sputum, hemoptysis, shortness of breath. There were round-like solid lesions with clear border and homogeneous density on lung CT. Histologically, it showed nodular growth with a distinctive myxohyaline stroma. Necrosis was seen in the center of some cases. Epithelioid tumor cells were arranged in cords, solid pattern or single cells, with abundant eosinophilic cytoplasm and occasional intracytoplasmic vacuoles. The plasmacytoid nucleus were round to oval in shape with obvious nucleoli, minimal pleomorphism and few mitoses. The tumor cells were positive for vascular endothelial markers: CD31 (7/7), CD34 (5/7), ERG (6/6), and Fli-1 (5/6); CKpan was focally positive in 3 cases (3/7), and TFE3 in 2 cases. Ki-67 index ranged from 5% to 10%. Additionally, the tumor cells partially express PD-L1 in two cases. Moreover, lung carcinoma-related gene detection was negative in one case. The TFE3 break-apart probe in two cases did not display a split signal. In terms of treatment, 4 cases were treated with surgery, 1 case was treated with chemotherapy and surgery, and 2 cases were follow-up observation. After the median 34.4 months follow-up time, one was lost to follow-up, six were survived. Their CT scans showed slight enlargement of pulmonary nodules without other organ metastases.Conclusions:PEHE is a rare vascular-derived tumor, which is usually characterized by multiple solid bilateral nodules with slow growth. It tends to lack specific clinical symptoms, and is prone to be misdiagnosed as a metastatic carcinoma. Diagnosis primarily rely on pathology, with the use of an immunohistochemical package being crucial for definitive and differential diagnosis.

Objective:To assess the efficacy and safety of azacitidine combined with lenalidomide in MDS patients and explore potential mechanisms of therapeutic response.Methods:Sixteen MDS patients with TP53 mutations received azacitidine plus lenalidomide at ZhongDa Hospital, Southeast University (January 2021–June 2025). Efficacy and safety were assessed, and TP53 mutation status was correlated with treatment response. Whole-transcriptome sequencing and bioinformatics were used to explore molecular biomarkers associated with therapeutic efficacy.Results:Sixteen patients (median age 69.5 years, range 52–82; 8 males, 8 females) were enrolled. According to the Molecular International Prognostic Scoring System (IPSS-M), 1, 2, and 13 patients were classified as median low, high, and very high risk, respectively. Among 16 TP53-mutated patients, 11 had biallelic mutations and 5 had monoallelic mutations. Overall response rate was 56.3% (9/16), composite complete remission rate (CRc) was 31.3% (5/16), and hematology improvement rate was 25% (4/16). Among TP53-mutated patients, the response rate was 56.3% (9/16), with variant allele frequency dropping from 65.6% to 16.5% in responders ( P=0.017). In patients with TP53 mutations and complex karyotype, response rate was 53.8% (7/13), with 57.1% (4/7) showing disappearance of CK post-treatment. The most common grade 3–4 nonhematologic adverse events were infections (9/16, 56.3% ), including pneumonia (4/16, 25.0% ), gastrointestinal infections (3/16, 18.8% ), perianal infections (1/16, 6.3% ) and sepsis (1/16, 6.3% ). High CBX8 expression may be linked to treatment response. Conclusion:Azacitidine plus lenalidomide is an effective and safe therapy for MDS, including patients with TP53 mutations and complex karyotypes. Treatment markedly reduces TP53 variant allele frequency in responders, and high CBX8 expression may predict therapeutic response.