BACKGROUND: Clinical research encompasses a wide variety of disciplines. Traditional Chinese medicine (TCM) and natural product research have made great contributions to preventing and treating illness. The number and content of original research reports evaluating TCM and natural products have not previously been described. Information in this area will identify areas of relative strength and weakness in terms of knowledge gaps with respect to clinical conditions and natural product remedies. METHODS: Original research reports (i.e. original articles, brief reports, and research letters) published in the Chinese Medical Journal (CMJ) from January 2000 to December 2009 evaluating TCM and other natural products were reviewed. The United Kingdom Clinical Research Collaboration (UK-CRC) Health Research Classification System was used to analyze the type of health research conducted. Further analysis on the major illnesses addressed and the major herbal components utilized was conducted. RESULTS: One hundred and seventeen original research reports involving TCM or other natural products were identified, comprising 3.82% of the CMJ output in the period covered by this study. Of the different materia medica described in these reports, 74.4% were derived exclusively from plant material, 10.3% from animals, 3.4% from fungi, 1.7% from minerals, and 10.3% were of mixed (plant/animal/fungal/mineral) composition. Twelve herbs were investigated exclusively or were constituents of 66/87 (75.9%) of the plant-based materia medica investigated. Panax ginseng was the most commonly investigated herb or constituent (14/87, 16.1%), followed by Astragalus membranaceus (9/87, 10.3%), Coptis chinensis/Berberis spp. (7/87, 8.0%) and Rheum spp. (7/87, 8.0%). Four UK-CRC health categories accounted for the majority of TCM and other natural product research (cancer, 20.9%; cardiovascular, 19.2%; oral/gastrointestinal, 9.8%; and inflammatory/immune, 9.0%). The most common research activity was "development of treatments and therapeutic interventions", which was undertaken by 103/117 (88.0%) of the research investigations reported. Human clinical trials involving natural products accounted for only 5.31% of the reported studies. CONCLUSIONS: This is a relatively early systematic description of published research from a single journal related to TCM and other natural products. The majority of the research reports described preliminary findings and very few controlled clinical trials in human subjects were reported. Further applied studies will be required to demonstrate the clinical effectiveness, utility and cost-effectiveness of TCM and natural products in clinical practice. The UK-CRC health research classification system is a useful tool for evaluating published research output and could be applied to describe the output from other journals, national and provincial funding bodies, charities, and non-governmental organizations involved in supporting health-related research.
To construct a Treatment Decision-making Needs Assessment Scale for cancer patients in China. Referring to the Ottawa Decision Support Framework (ODSF), along with the literature review of domestic and international papers and the existing related scales, we constructed an item pool of the scale. The initial version of the scale was developed as expert correspondence. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed in separate samples. The reliability and validity of the scale were tested by examining 407 cancer patients. The Treatment Decision-making Needs Assessment Scale for cancer patients comprised three dimensions: Decision-making cognition, Disease knowledge, and Support and resource acquisition, and 15 items. The Cronbach's α coefficient of the total scale was 0.833, while the test-retest reliability was 0.856. The total content validity index was 0.906. Three factors were extracted using EFA, with a cumulative variance contribution rate of 66.82%. CFA indicated adequate model fit. The Treatment Decision-making Needs Assessment Scale for Chinese cancer patients demonstrates acceptable reliability and validity, and may be useful for measuring treatment-related decisional needs among Chinese cancer patients in clinical practice and future research.
The associations of two-point change patterns of low-density lipoprotein cholesterol (LDL-C) and high-sensitivity C-reactive protein (hs-CRP) with major adverse cardiovascular events (MACE) remain underexplored, particularly in Chinese populations. This study aimed to identify LDL-C and hs-CRP change patterns and examine their associations with incident MACE in middle-aged and older Chinese adults. This prospective cohort study included 9597 participants aged 45 years or older and free of cardiovascular disease at baseline from the China Health and Retirement Longitudinal Study. Among them, 6405 participants with biomarker measurements available in both 2011 and 2015 were included in the two-point change pattern analysis. Group-based trajectory modeling was used to identify two-point change pattern groups for LDL-C and log-transformed hs-CRP. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), with adjustment for potential confounders including lipid-lowering medication use. Over a median follow-up of 9.00 years, 2248 participants (23.4%) developed MACE. Higher baseline hs-CRP levels were associated with increased MACE risk, with a significant association observed for the fourth quintile versus the first quintile (HR = 1.19, 95% CI: 1.04-1.36). In the two-point change pattern analysis, the High baseline, decreasing log-hsCRP group showed a lower HR estimate for MACE than the Low baseline, increasing group, although this association did not reach conventional statistical significance (HR = 0.82, 95% CI: 0.67-1.01, p = 0.06). Neither baseline LDL-C levels nor LDL-C two-point change pattern groups were significantly associated with MACE after full multivariable adjustment. Having one elevated biomarker (LDL-C Q5 or hs-CRP Q5) was associated with increased MACE risk (HR = 1.11, 95% CI: 1.02-1.21) compared with having neither elevated. Baseline hs-CRP showed a stronger association with MACE than LDL-C after comprehensive adjustment. A decrease in hs-CRP from a high baseline level was associated with a lower HR estimate for MACE, although this finding was not statistically significant. These results support the relevance of inflammatory status in cardiovascular risk assessment, while LDL-C monitoring remains a cornerstone of cardiovascular prevention.
Atherosclerosis (AS) is a vascular disease characterized by chronic inflammation and represents a major pathological basis for cardiovascular events such as myocardial infarction and ischemic stroke. During disease initiation and progression, endothelial dysfunction, lipid retention, sustained recruitment of immune cells, and aberrant activation of inflammatory signaling pathways interact to establish a self-perpetuating inflammatory microenvironment. This process is accompanied by dysregulation of inflammatory cytokine networks, persistent activation of key signaling pathways such as nuclear factor-κB (NF-κB) and mitogen-activated protein kinase (MAPK), increased oxidative stress, and enhanced thrombotic susceptibility, ultimately driving plaque formation, destabilization, and acute cardiovascular events. Given that these pathological mechanisms involve multiple cell types, interconnected signaling axes, and dynamic changes across different disease stages, single-target therapeutic strategies often show limited efficacy in long-term disease control. Traditional Chinese medicine (TCM), characterized by its multi-component, multi-target, and system-level regulatory properties, has attracted increasing attention for its potential to modulate inflammation-related pathological processes in atherosclerosis at multiple levels. Accumulating evidence indicates that TCM and its bioactive constituents can regulate inflammatory cytokine expression, inhibit NF-κB- and MAPK-mediated inflammatory signaling, alleviate oxidative stress, improve endothelial function, and reduce thrombotic susceptibility, thereby collectively attenuating chronic inflammatory burden and promoting plaque stability. This review focuses on inflammation-associated key pathological processes in atherosclerosis and systematically summarizes recent advances in the regulatory effects of TCM on inflammatory responses, signaling pathways, oxidative stress, and thrombosis. The aim is to provide mechanistic insights that may support integrated strategies for atherosclerosis prevention and treatment, as well as the modernization of TCM research.
The objectives of the present study were to identify the genetic variations in a Chinese patient with Usher syndrome and to determine the pathogenicity of the identified variations. Whole-exome sequencing was performed for the proband. Alphafold3 and PyMOL software were used to determine the impact of a variation on three-dimensional protein structure. A Minigene Splicing Assay was performed to investigate the impact of a variant on MYO7A splicing. Two compound heterozygous missense and splicing variations of MYO7A (NM_000260:c.487G > A:p.G163R, rs1472566324 and c.2187 + 2_2187 + 8del, rs1416744060) were identified in the proband. After glycine (G, WT) is replaced by arginine (R, rs1472566324), arginine forms additional hydrogen bonds with the surrounding amino acids. In the Minigene Splicing Assay, abnormal splicing bodies (associated with an Exon18 jump) were observed in the mutant plasmids (rs1416744060). This abnormal splicing event caused a deletion of 31 aa inside the protein, generating a truncated protein of 2,184 aa. Compound heterozygous missense and splicing variants of MYO7A (rs1472566324 and rs1416744060) were the likely pathogenic variants of a patient with Usher syndrome type 1B.
Prior research has identified a range of risk factors for and functions of non-suicidal self-injury (NSSI), of which two broad classes are most prominent: adverse early experiences and individual susceptibility. Much less is known, however, about how these two classes of factors operate together within an integrated mechanism. We therefore examined whether self-control mediates the relationship between impulsivity and NSSI in senior high school students, and whether an early left-behind experience moderates this mediated pathway. Questionnaires measuring impulsivity, self-control, and NSSI were administered to senior high school students in Guizhou Province, China. A total of 534 valid responses (Mage = 17.26 years, SD = 1.30; 57.62% girls) were analysed. Impulsivity was positively associated with NSSI, and self-control significantly mediated this association, accounting for a substantial proportion of the indirect effect. Left-behind experience further moderated the mediation pathway: among students with a left-behind experience, the indirect effect of impulsivity on NSSI via self-control was significant, whereas the direct effect was not; among students without a left-behind experience, the opposite pattern was observed. Because the proposed model explained only a modest proportion of the variance in NSSI, these results are best regarded as identifying one theoretically grounded pathway to NSSI rather than as a complete account of how NSSI develops. Impulsivity is an important correlate of NSSI in senior high school students, and its association with NSSI appears to operate largely through self-control. Moreover, the pathway to NSSI differs markedly between students with and without a left-behind experience. These findings provide an empirical basis for designing more targeted NSSI interventions.
This study assessed pharmacokinetics and safety of subcutaneous (SC) belimumab in Chinese paediatric patients with systemic lupus erythematosus (cSLE) who previously received intravenous (IV) belimumab; only the IV form is approved for cSLE in China. This single-arm, open-label, 12-week bridging study (GSK Study 217091) characterised belimumab 200 mg SC exposure in Chinese paediatric patients (5-17 years) with cSLE who completed the 48-week IV belimumab Phase 4 trial (GSK Study 213560). Safety and tolerability of SC belimumab on-treatment and in a 16-week follow-up period were also assessed. Patients were categorised based on weight; data were summarised using descriptive statistics. Overall, 16 patients were enrolled (≥ 15- < 30 kg, n = 1; ≥ 30- < 50 kg, n = 5; ≥ 50 kg, n = 10) with a mean age of 12.9 years. The geometric mean approximate Cmax (3 days post-administration) after the first and last dose were 92.44, 63.41 and 68.87 μg/mL, and 28.01, 85.11 and 88.61 μg/mL for the three weight groups, respectively. The geometric mean Ctrough at steady state were, 20.44, 71.57 and 85.55 μg/mL for the ≥ 15- < 30 kg, ≥ 30- < 50 kg and ≥ 50 kg weight groups, respectively. Thirteen patients (81%) reported ≥ 1 AE. No SAEs, severe AEs, AESIs, AEs resulting in belimumab discontinuation, deaths, or local injection site reactions were reported. SC belimumab demonstrated expected steady-state exposure and tolerability in Chinese paediatric patients with SLE, supporting its use in this patient population. GSK Study 217091; NCT05917288. Belimumab is a treatment for lupus, a disease where the immune system attacks healthy parts of the body. Doctors can give belimumab either as an infusion into a vein or as an injection under the skin. Most patients are happy getting belimumab as an infusion, but self-injection at home with an easy-to-use injection device may be more convenient and provide greater freedom. It also means patients wouldn’t need to go to the hospital for infusion treatments, which can help them stick to their treatment plan better. In China, only the infusion form is approved for children. To understand the safety and effect of the injection version of belimumab in China, this study looked at how the body tolerates belimumab when given as an injection under the skin in Chinese children with lupus who had already been treated with belimumab through infusion. Overall, 16 children between 5 and 17 years of age took part, after finishing almost 1 year of treatment with infusions. Each child got injections for 12 weeks; their weight determined how often they received injections: every week, every 10 days or every 2 weeks. After 10–12 weeks of injections, the amount of medicine in their blood became steady. Most children had at least one mild side effect, but none had serious problems or bad reactions at the injection site. Overall, this study found that giving belimumab as an injection under the skin has few side effects and works as expected in Chinese children with lupus.
Passive smoking is associated with substantial morbidity and mortality, yet public awareness of its health risks remains limited. As social media increasingly serves as a source of health information, this study evaluated the quality and reliability of passive smoking-related short videos on two major Chinese platforms, Bilibili and Douyin (TikTok in China). In this cross-sectional study, the top 100 videos for each Chinese search term ('passive smoking' and 'secondhand smoking') were retrieved from Bilibili and Douyin on 10 June 2026. After excluding duplicates, irrelevant videos, promotional videos, and videos shorter than 30 seconds, eligible videos were analyzed for basic characteristics and engagement metrics. Two independent reviewers assessed video quality using the Global Quality Scale (GQS), modified DISCERN (mDISCERN), Journal of the American Medical Association (JAMA) benchmark criteria, and Video Information and Quality Index (VIQI). Comparisons were performed using non-parametric tests, and correlations were examined using Spearman analyses. A total of 157 videos were included (59 Bilibili, 98 Douyin). Bilibili videos were significantly longer than Douyin videos (median: 130.0 vs 73.0 s, Z= -3.93, p<0.001), whereas Douyin videos received more comments (median: 89.0 vs 27.0, Z= -2.48, p<0.05) and shares (median: 1829.5 vs 72.0, Z= -4.88, p<0.001). Overall, video quality and reliability were moderate. No significant differences were observed between platforms in GQS, mDISCERN, or JAMA. However, Douyin videos achieved significantly higher VIQI scores than Bilibili videos (median: 12.0 vs 11.0, Z= -3.37, p<0.001). Videos produced by science communicators and doctors consistently demonstrated higher quality than those uploaded by lay users. Engagement metrics were not associated with video quality or reliability. Passive smoking-related videos on Douyin and Bilibili provide moderate-quality health information. Videos from science communicators and doctors were of higher quality than those from lay users. Video popularity does not reflect information reliability.
This is a systematic review of methodological and reporting quality of CHD guidelines and consensus statements.To systematically appraise the methodological and reporting quality of global congenital heart disease (CHD) guidelines and consensus statements, identifying key areas for improvement with implications for international guideline development. We searched Chinese and English databases up to November 2025. Four appraisers independently evaluated documents using AGREE II and RIGHT tools. Inter-rater reliability was assessed via ICC; subgroup analyses examined document type, methodology, developer number, and region. The systematic review protocol was registered with PROSPERO (CRD420261415315). Among 33 included documents (17 CPGs, 16 ECSs), AGREE II scores varied substantially, highest in "Scope and Purpose" (58.42%) and lowest in "Applicability" (32.35%). RIGHT assessment showed sufficient basic reporting but critical gaps in evidence summaries, benefit-harm analyses, and update plans. Guidelines, evidence-based documents, and those with ≥50 developers scored higher. International guidelines outperformed Chinese ones in all quality domains (ICCs > 0.75). Current CHD guidance documents are purposeful but deficient in rigor, applicability, and transparency. Chinese guidelines lag behind international standards. Future development must adopt evidence-based methods, emphasize applicability, mandate patient and family engagement and improve reporting to effectively translate evidence into practice. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261415315, PROSPERO CRD420261415315.
We aimed to evaluate the tolerance of preoperative chord mu (angle kappa) after cataract or clear lens exchange surgery and implantation of AcrySof IQ PanOptix and PanOptix Toric in a Chinese cohort. This prospective observational study consecutively enrolled patients undergoing PanOptix/PanOptix Toric implantation at Peking Union Medical College Hospital. Eyes were analyzed by chord mu (< 0.3 mm vs. ≥ 0.3 mm), lens opacity (clear lens or cataract), and intraocular lens (PanOptix or PanOptix Toric). Visual acuity was assessed at 1 and 3 months. Patient-reported outcomes were assessed at 3 months using the IOLSAT and the QUVID. A total of 122 eyes from 62 patients were analyzed. Seventy-nine eyes received PanOptix Toric lenses, and 43 eyes received non-toric PanOptix lenses. The κ ≥ 0.3 mm group had less myopic spherical equivalent (P = 0.004) than the κ < 0.3 mm group. At 1 and 3 months, the uncorrected and corrected distance, intermediate, and near visual acuity outcomes were excellent and did not differ significantly between κ groups in the overall cohort (all P > 0.05). In the toric subgroup,1-m UNVA was better in eyes with κ < 0.3 mm (P < 0.001, adj. P = 0.024) than in those with κ ≥ 0.3 mm. Overall spectacle independence was 90% (45/50), with 100% for distance and intermediate vision in both κ groups; near spectacle independence was similar between groups (P = 0.797). The most frequent visual disturbances were halos (78%, 39/50), starbursts (60%, 30/50), and glare (42%, 21/50), with no significant differences between the κ groups (all P > 0.05). Patient-reported outcomes and disturbance frequencies were similar between PanOptix and PanOptix Toric (all P > 0.05). Compared with cataract surgery, clear lens exchange resulted in increased rates of halos (92.3% vs. 62.5%, P = 0.016). In this carefully selected, small sample Chinese cohort implanted with PanOptix/PanOptix Toric lense and restricted to eyes with chord mu ≤ 0.5 mm, a κ ≥ 0.3 mm was not associated with worse overall visual acuity, spectacle independence, or the likelihood/severity of visual disturbances. The PanOptix Toric lens demonstrated patient-reported outcomes comparable to those of the non-toric PanOptix. Patients who underwent clear lens exchange reported more visual disturbances than those who underwent cataract surgery, suggesting a need for careful candidate selection and preoperative counseling.
This study describes dental care access among individuals with head and neck cancer (HNC) at Zuckerberg San Francisco General Hospital (ZSFG), a large, public, safety-net hospital that serves a substantial underserved population. We identified a convenience sample of participants ≥ 18 years of age through review of routine outpatient HNC surveillance visits. Surveys were translated to Spanish and Simplified Chinese by certified medical interpreters. We used descriptive statistics to summarize findings and logistic regression to analyze predictors of dental care access, represented with odds ratios (ORs), 95% confidence intervals (CIs), and p-values. Statistical significance was defined as a two-sided p-value < 0.05. Among 41 participants, the majority were male (63%) with a median age of 59 years [interquartile range (IQR) 48-64]. The most represented race/ethnicity was Asian (37%). 63% reported seeing a dentist only annually or less frequently both before and after cancer diagnosis. Prescription fluoride product use was reported by 15% of participants (n = 6). On univariate analysis, a non-English primary language was significantly associated with lower odds of dental visits at least twice a year pre-diagnosis (OR 0.19, 95% CI 0.05-0.78; p = 0.021). Participants who reported challenges finding a dentist had lower odds of dental visits at least twice a year post-diagnosis (OR 0.17, 95% CI 0.04-0.77; p = 0.022). Our findings suggest that HNC survivors in low-resource settings may experience limited access to routine dental care. Targeted interventions to support access to dental care in higher-risk populations may improve adherence to guideline-recommended care at all stages of cancer treatment. 3.
To report the clinical features, diagnostic workup, and management of Epstein-Barr virus (EBV)-associated retinitis in a patient without overt clinical evidence of severe immunodeficiency. A 33-year-old Chinese man presented with a 1-month history of blurred vision, redness, and photophobia in the left eye. Ocular examination revealed vitritis, white snowball-like vitreous deposits, optic disc edema, yellow-white retinal lesions, and tortuous retinal veins. Optical coherence tomography and fluorescein angiography supported active posterior segment inflammation. Initial vitreous smear and bacterial and fungal cultures were negative. Polymerase chain reaction testing of a vitreous sample detected EBV DNA at 123 copies/mL, whereas herpes simplex virus (HSV), varicella-zoster virus (VZV), and cytomegalovirus (CMV) were negative. The patient received systemic acyclovir combined with corticosteroid therapy. Intraocular inflammation improved markedly, but pars plana vitrectomy was later performed because of persistent organized vitreous opacity and retinal traction. At the 4-month follow-up, retinal lesions had largely resolved and best-corrected visual acuity improved to 0.2. This case suggests that EBV should be considered in the differential diagnosis of atypical infectious retinitis. Vitreous PCR may provide important etiological evidence, and timely combined medical and surgical management may contribute to a favorable outcome.
With broad-spectrum, low resistance, and multifunctional properties, antimicrobial peptides (AMPs) are promising therapeutic agents against drug-resistant pathogens, yet their discovery and optimization still remain challenging due to the complexity of sequence-function associations. Artificial intelligence (AI), through the construction of comprehensive data-driven models that assisted with miscellaneous learning strategies, enables de novo peptide design by learning latent representations inherent in peptide sequences as well as their biological properties to ensure physically plausible and biologically relevant predictions. Consequently, this paradigm enhances the likelihood of designing peptide candidates with significantly improved therapeutic potential, reducing resource-intensive trial-and-error processes and revealing the transformative impact of computational innovation in advancing next-generation therapeutics. Here, we provide a snapshot of this field and survey two modes of AI-driven technologies for AMP design, one concentrated on identifying whether current data possess antimicrobial activity (identification-oriented) and the other on generating AMP candidates with potential therapeutic properties (generation-oriented). We also highlight the challenges and limitations that still hinder AMP development even accelerated by AI, as well as the foreseeable prospects, from finer-grained explorations to model-driven data enrichment and model enhancement.
This pilot randomized controlled trial evaluated the feasibility and preliminary effects of a Coping-Focused Dyadic Family Resilience Intervention (CFFRI) for Chinese breast cancer survivor-caregiver dyads. A randomized, single-blind controlled trial was conducted. Sixty dyads were randomly assigned to the CFFRI group (six sessions plus usual care; n = 30) or the control group (usual care alone; n = 30). Outcomes included family resilience, coping style, family disease burden, and social support, assessed at baseline (T0), one-week post-intervention (T1), and three-month follow-up (T2). Data were analyzed using t-tests and generalized estimating equations (GEE). Feasibility was assessed via recruitment, retention, and adherence rates, and intervention satisfaction. For the primary outcome, family resilience, the between-group mean difference at T1 was 20.08 (95% CI: 14.61-25.55) for patients and 19.85 (95% CI: 13.65-26.04) for caregivers in the per-protocol analysis, with effects sustained at T2 (patients: 14.69, 95% CI: 10.71-18.68; caregivers: 15.73, 95% CI: 11.08-20.38). Similar patterns were observed in intention-to-treat analyses. For secondary outcomes, the CFFRI group showed improvements in coping style, reduced family disease burden, and enhanced social support. Feasibility outcomes were favorable: recruitment rate 75.00%, retention rate 91.67%, high adherence rate 90.00%, and mean satisfaction score of 4.52 (SD = 0.57) out of 5. The CFFRI is a feasible intervention that shows promise in enhancing family resilience, improving dyadic coping, alleviating family disease burden, and strengthening social support for both patients and caregivers, with benefits sustained at 3 months. These preliminary findings provide support for its preliminary efficacy and form the basis for a future fully powered randomized controlled trial. https://www.chictr.org.cn/showproj.html?proj=135318, identifier [ChiCTR2100052108].
To reduce drug prices and improve access to essential medicines, the Chinese government implemented the National Volume-Based Procurement (NVBP) policy, leveraging economies of scale. Montelukast sodium, widely prescribed for respiratory diseases, was included in the first round. This study evaluates the impact of the NVBP policy, offering insights for global pharmaceutical policy reform. Utilizing national procurement data from the National Healthcare Security Administration (January 2019 to December 2020), we conducted an interrupted time-series analysis, employing autoregressive integrated moving average models to correct for autocorrelation. We evaluated changes in procurement volume (in defined daily doses), procurement expenditures, and defined daily dose costs of montelukast sodium before and after NVBP implementation. The NVBP policy triggered a substantial decline in total procurement expenditures and defined daily dose costs, significantly improving drug affordability. Unlike the volume surge observed in other NVBP-covered drugs, the total procurement volume of montelukast sodium remained stable, suggesting rational clinical demand. Structurally, the policy successfully drove a "generic substitution" effect, where bid-winning generics rapidly replaced high-priced originators. The market share of non-equivalent generics contracted significantly, marking a quality consolidation of the market. The NVBP successfully achieved cost containment for chronic respiratory disease medications. By promoting high-quality generic substitution and reducing the market share of high-priced originators and low-quality generics, the policy effectively optimized the market structure. These findings provide a replicable China Model for low- and middle-income countries seeking to balance affordability and accessibility in chronic disease management.
To investigate the performance and clinical application potential of an improved YOLOv5-based deep learning model for automated detection and classification of pulmonary adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA), with particular emphasis on attention mechanisms and multiscale feature fusion for small pulmonary nodule detection. CT images of 225 pathologically confirmed AIS or MIA lesions treated at the Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine between December 2019 and June 2025 were retrospectively collected. In the deep learning workflow, the 225 lesions were first divided at the lesion level: 27 lesions (11 MIA and 16 AIS) were set aside, and the 218 original PNG images derived from these lesions were reserved as an independent test set that was excluded from all data augmentation and model training. The remaining lesions were converted into PNG format and further augmented using horizontal flipping, yielding a final dataset of 3,000 images for training and validation. Subsequently, the dataset was partitioned into training and validation sets at an 8:2 ratio. During this process, the origins of the augmented lesion images were manually verified to ensure that an original image and its corresponding augmented variants were not assigned to different subsets simultaneously. YOLOv5s was used as the baseline model. Local contrast-spatial attention modules (LCSA and LCSAv2), BiFPN, and ASFF were incorporated for attention enhancement and multiscale feature fusion. Five-fold cross-validation was performed. Mean average precision (mAP), precision, and recall were evaluated across IoU thresholds from 0.6 to 0.9, and ablation experiments were conducted to quantify the contribution of each module. In the baseline model selection stage, comparison under identical conditions showed that YOLOv5s achieved detection performance comparable to YOLOv11s while reducing GFLOPs by approximately 25%; therefore, YOLOv5s was selected as the improvement baseline. In five-fold cross-validation at IoU = 0.6, baseline YOLOv5s achieved an mAP@50 (AP at the matching IoU of 0.6) of 0.947, precision of 0.849, and recall of 0.932. After LCSA x ASFF was introduced, recall increased to 0.941 and mAP@50 was maintained at 0.946. Under the stringent localization criterion of IoU = 0.9, LCSA × ASFF achieved an mAP@50 of 0.878, a 3.8-percentage-point higher value than the baseline (0.846); precision (0.879) and recall (0.773) were also the highest among all models, with the smallest performance attenuation in the high-IoU range. Ablation experiments showed that the combined use of LCSA and ASFF produced stronger synergistic effects in the high-IoU range than either module alone, whereas LCSAv2 combined with ASFF did not show the expected synergistic gain. On the independent test set, baseline YOLOv5s achieved precision, recall, and mAP@50 values of 0.747, 0.715, and 0.753, respectively; the improved LCSA × ASFF model achieved corresponding values of 0.693, 0.753, and 0.788. Recall and mAP@50 increased simultaneously, indicating better overall detection performance than the baseline. The improved YOLOv5s-based deep learning model performed better in automated detection, and the LCSA × ASFF combination improved localization accuracy while maintaining recall through the synergy between local contrast enhancement and adaptive scale fusion. The improved YOLOv5s model achieved automated detection and classification of small pulmonary nodules through end-to-end training, showing clear advantages in clinical workflow automation without manual intervention. The synergistic effect of local contrast enhancement and adaptive scale fusion effectively improved AIS/MIA localization precision and classification accuracy, supporting its potential as an assistive tool for early lung adenocarcinoma screening, pending external multi-centre validation.
Beverage consumption is a common dietary behavior that may be associated with adiposity and urinary biomarker profiles, yet population-based evidence in young adults remains limited. This study aimed to examine associations between beverage consumption patterns and adiposity indicators and urinary biomarkers among young adults in China. This multicenter cross-sectional study included 3,198 university students aged 18-25 years from seven geographic regions in China. Daily fluid intake (DFI) was assessed using a validated 7-day fluid intake diary with calibrated cups. Body mass index (BMI) and waist circumference (WC) and urinary biomarkers (creatinine, uric acid, uric acid-to-creatinine ratio, and urea) were obtained. Multivariable regression models adjusted for predefined covariates were used to evaluate associations. Plain water contributed the largest proportion of DFI (83.9%), followed by sugar-sweetened beverages (SSBs), with substantial regional variation in beverage consumption patterns. Higher plain water intake was positively associated with BMI (β = 0.06, 95% CI: 0.02, 0.10, p = 0.009) and WC (β = 0.14, 95% CI: 0.02, 0.27, p = 0.022), but inversely associated with urinary creatinine (β = -148.05, 95% CI: -197.52, -98.59, p < 0.001), urinary uric acid (β = -9.90, 95% CI: -17.58, -2.22, p = 0.012), and urinary urea (β = -3.69, 95% CI: -4.74, -2.63, p < 0.001). In contrast, SSB intake was positively associated with WC (β = 1.00, 95% CI: 0.62, 1.38, p < 0.001), urinary uric acid (β = 45.15, 95% CI: 21.40, 68.89, p < 0.001), and urinary uric acid-to-creatinine ratio (p < 0.001). Coffee/tea (β = -1.12, 95% CI: -2.18, -0.06, p = 0.038), 100% fruit juice (β = -0.86, 95% CI: -1.70, -0.02, p = 0.046), and other beverages (β = -1.13, 95% CI: -2.19, -0.07, p = 0.037) were inversely associated with waist circumference. Beverage consumption patterns were associated with adiposity indicators and urinary biomarker profiles among Chinese university students, and these associations differed according to beverage type.
With increasing health awareness among Chinese residents, the demand for health examinations has continued to grow, placing mounting pressure on hospitals and health examination centers. This problem is particularly evident in group batch health examinations, where a large instantaneous flow of examinees and numerous examination items can easily lead to disorder in the examination process. This study aimed to optimize scheduling for this type of health examination, improve examination efficiency, and shorten total examination time. A health examination scheduling optimization model was developed with the objective of minimizing the maximum examination duration. The model incorporated path-dependent transition time between examination items and sex-related differences, and a genetic algorithm was designed to obtain scheduling solutions. For special group examination populations with precedence constraints among examination items, the model was modified, and a controlled experiment was designed to quantitatively evaluate the effects of introducing constraints on algorithm efficiency and optimization performance. Finally, experimental analyses were conducted, including model verification using small-scale benchmark examples, case analysis, AnyLogic simulation, and sensitivity analysis, to validate the effectiveness of the model and algorithm and the stability of the solutions. Introducing constraints had only a minor effect on algorithm efficiency, although it reduced the optimization effect. Model verification showed that the differences in examination duration and transfer time were both 0, and the scheduling results satisfied the inter-item constraints, indicating that the model correctly implemented the predefined scheduling logic. In the case analysis, the optimized scheduling scheme yielded a maximum examination duration of 197.06 min, while the simulation result was 195.57 min, with a difference of only 1.49 min. Compared with the pre-optimization duration of 220 min, the simulation result represented an 11.10% reduction (24.43 min/220 min), confirming the effectiveness of the model and algorithm. Sensitivity analysis showed that, when service durations varied within ±5% and ±10%, most item-duration changes except ultrasound could be absorbed by the system buffer and had limited influence on the total examination duration, demonstrating a certain degree of stability in the model and algorithm solutions. The proposed mathematical programming model and genetic algorithm can significantly improve scheduling efficiency for batch centralized health examinations, substantially shorten overall examination duration, and have strong practical application value.
Ectopic teeth in the maxillary sinus are relatively rare, most commonly seen in the third molars, often accompanied by odontogenic cysts and presenting with symptoms similar to chronic sinusitis, which are easily misdiagnosed or overlooked. A 24-year-old female patient presented with purulent nasal discharge and recurrent swelling of the right side of the face for 2 years. Despite multiple courses of antibiotic treatment, her symptoms showed little improvement. Clinical examination revealed the absence of the right maxillary third molar. Panoramic x-ray showed a tooth-like high-density shadow in the right maxillary sinus, surrounded by soft tissue density. Cone beam computed tomography (CBCT) further confirmed the presence of an ectopic third molar in the right maxillary sinus, accompanied by a cystic lesion. The patient underwent surgical removal of the ectopic tooth and complete excision of the cyst under general anesthesia via an intraoral approach. Postoperative histopathological examination confirmed the diagnosis of odontogenic keratocyst. The patient's symptoms completely resolved after surgery, and a 6-month postoperative CBCT review showed good pneumatization of the right maxillary sinus with no signs of recurrence. For persistent unilateral sinus symptoms that are unresponsive to conventional medical treatment, the presence of an ectopic maxillary third molar with an odontogenic cyst should be considered. Good clinical outcomes can be achieved by surgically removing the ectopic tooth and the associated cyst. This case also suggests that when tooth eruption is abnormal, early imaging evaluation is of significant value.
Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), significantly contributes to morbidity and mortality among hospitalized patients. Despite the existence of various VTE risk assessment models (RAMs), their performance in accuracy, sensitivity and specificity remain suboptimal, highlighting opportunities to improve predictive accuracy for clinical decision-making. We conducted a retrospective multicenter study involving three hospitals, which enrolled patients with VTE from January 1, 2021, to December 30, 2023. A novel RAM (Weng score) was developed through three different strategies: clinical knowledge-driven model (Model A), data-driven model (Model B), and decision tree-based model (Model C). The primary outcome was in-hospital VTE. Prediction of PE alone was examined as a secondary outcome. Model performance was evaluated through discrimination, calibration, precision, and decision curve analysis (DCA). A total of 1,791 patients were analyzed, with 680 VTE events recorded during hospitalization. The Weng score, derived from Model A, demonstrated superior predictive performance for VTE and PE compared to existing RAMs, with an area under the receiver operating characteristic curve (AUROC) of 0.895 (95% confidence interval (CI) [0.880-0.909]) for VTE and 0.877 (95% CI [0.851-0.903]) for PE. In comparison, the AUROCs for existing RAMs (Caprini, Padua, Wells, Geneva, and Autar scores) ranged from 0.687 to 0.789 for VTE prediction and from 0.682 to 0.769 for PE prediction. The Weng score also demonstrated excellent calibration and discrimination, outperforming the Caprini, Padua, Wells, Geneva, and Autar scores in hospitalized patients. The Weng score's clinical utility for relative risk stratification was further supported by DCA within this case-control sampled cohort, showing a higher net benefit in predicting VTE and PE than existing RAMs. We developed and internally validated the Weng score using retrospective data from Chinese hospitals. While it showed more favorable calibration and discrimination than existing RAMs in our cohort, external validation in diverse settings and prospective studies accounting for anticoagulation management are essential before clinical adoption. The Weng score is intended for VTE risk stratification only; clinical decisions regarding thromboprophylaxis should integrate both VTE and bleeding risk assessments using validated tools. Because the current model was derived from a case-control sampled cohort (oversampled VTE events), the absolute risk estimates and net benefit findings reflect relative risk ranking and require external calibration in a representative prospective cohort before any clinical implementation.