Introduction.Well-designed,strictly implemented,and fully standardized randomized controlled trials(RCTs)are a prerequisite for developing reliable scientific evidence,which can improve clinical practice,health outcom...Introduction.Well-designed,strictly implemented,and fully standardized randomized controlled trials(RCTs)are a prerequisite for developing reliable scientific evidence,which can improve clinical practice,health outcomes,and ultimately benefit patients.Suboptimal reporting is pervasive in medical research,resulting in biased research records and persistent uncertainty about the quality of available evidence.1,2,3,4 The standardization of research reports has attracted considerable attention.In 1996,the Consolidated Standards of Reporting Trials(CONSORT)was first published to improve the quality of RCTs and enhance the reproducibility of trial methods,results,and inferences.展开更多
The important work of Yu,et al.[1]who presented one of the first randomized controlled trials(RCTs)to directly compare robot-assisted and manual percutaneous coronary intervention(PCI),is commendable;offering importan...The important work of Yu,et al.[1]who presented one of the first randomized controlled trials(RCTs)to directly compare robot-assisted and manual percutaneous coronary intervention(PCI),is commendable;offering important insights into the feasibility and outcomes of this emerging technology.While the analysis is timely,several issues warrant further consideration.展开更多
The satellite-based augmentation system(SBAS)provides differential and integrity augmentation services for life safety fields of aviation and navigation.However,the signal structure of SBAS is public,which incurs a ri...The satellite-based augmentation system(SBAS)provides differential and integrity augmentation services for life safety fields of aviation and navigation.However,the signal structure of SBAS is public,which incurs a risk of spoofing attacks.To improve the anti-spoofing capability of the SBAS,European Union and the United States conduct research on navigation message authentication,and promote the standardization of SBAS message authentication.For the development of Beidou satellite-based augmentation system(BDSBAS),this paper proposes navigation message authentication based on the Chinese commercial cryptographic standards.Firstly,this paper expounds the architecture and principles of the SBAS message authentication,and then carries out the design of timed efficient streaming losstolerant authentication scheme(TESLA)and elliptic curve digital signature algorithm(ECDSA)authentication schemes based on Chinese commercial cryptographic standards,message arrangement and the design of over-the-air rekeying(OTAR)message.Finally,this paper conducts a theoretical analysis of the time between authentications(TBA)and maximum authentication latency(MAL)for L5 TESLA-I and L5 ECDSA-Q,and further simulates the reception time of OTAR message,TBA and MAL from the aspects of OTAR message weight and demodulation error rate.The simulation results can provide theoretical supports for the standardization of BDSBAS message authentication.展开更多
Surgical navigation has evolved significantly through advances in augmented reality,virtual reality,and mixed reality,improving precision and safety across many clinical applications,including neurosurgery,maxillofaci...Surgical navigation has evolved significantly through advances in augmented reality,virtual reality,and mixed reality,improving precision and safety across many clinical applications,including neurosurgery,maxillofacial,spinal,and arthroplasty procedures.By integrating preoperative imaging with real-time intraoperative data,these systems provide dynamic guidance,reduce radiation exposure,and minimize tissue damage.Key challenges persist,including intraoperative registration accuracy,flexible tissue deformation,respiratory compensation,and real-time imaging quality.Emerging solutions include artificial intelligence-driven segmentation,deformation-field modeling,and hybrid registration techniques.Future developments will include lightweight,portable systems,improved non-rigid registration algorithms,and greater clinical adoption.Despite advances in rigid-tissue applications,soft-tissue navigation requires additional innovation to address motion variability and registration reliability,ultimately advancing minimally invasive surgery and precision medicine.展开更多
The current inertial measurement unit(IMU)and odometry fusion navigation algorithms often incorporate non-holonomic constraints(NHC)to obtain three-dimensional velocity in the navigation frame.However,due to the integ...The current inertial measurement unit(IMU)and odometry fusion navigation algorithms often incorporate non-holonomic constraints(NHC)to obtain three-dimensional velocity in the navigation frame.However,due to the integral nature of the dead reckoning algorithm,the attitude errors of the IMU accumulate over time,causing the velocity transformation results to fail to accurately reflect the threedimensional velocity in the navigation frame.Based on the fact that during a vehicle's horizontal and uniform motion,the vertical acceleration is consistent with gravitational acceleration,this paper proposes an IMU/odometry fusion navigation algorithm based on horizontal attitude constraints(HAC).Building on non-holonomic constraints,this algorithm determines the motion state of the vehicle through accelerometer output and zeroes out the pitch and roll angles during horizontal and uniform motion.Verified through two sets of real-world vehicle test data,this algorithm improves horizontal positioning accuracy by approximately 63%and 70%,and vertical positioning accuracy by 98%and 97%,compared with the traditional NHC IMU/odometer fusion algorithm.展开更多
OBJECTIVE:To assess the efficacy of point application therapy(PAT)in alleviating the exacerbation of chronic respiratory diseases represented by bronchial asthma.METHODS:In this multicenter randomized placebocontrolle...OBJECTIVE:To assess the efficacy of point application therapy(PAT)in alleviating the exacerbation of chronic respiratory diseases represented by bronchial asthma.METHODS:In this multicenter randomized placebocontrolled trial,eligible bronchial asthma patients received placebo PAT on the dog days of the first summer to establish a baseline,and then patients who continued to participate in the trial and repassed the eligibility review were randomized to receive regular or placebo PAT in the next two consecutive summers.The primary outcome was the change from baseline in the number of asthma exacerbations at 24 months.Secondary outcomes included severity of asthma exacerbation,asthma control test(ACT)score,percentage of forced expiratory volume in 1 s(FEV1)to the predicated value(FEV1%pred),peak expiratory flow(PEF),ratio of FEV1 to forced vital capacity(FEV1/FVC),and use of palliative drugs during bronchial asthma exacerbations at 12 and 24 months.The adverse events(AEs)were also assessed.RESULTS:A total of 835 patients with bronchial asthma were randomized in this trial.Compared with the placebo control,the PAT significantly decreased the mean number of asthma exacerbations(1.42;95%confidence interval,0.69 to 2.14;P<0.001),and increased the FEV1%pred at 24 months(P=0.039)and FEV1/FVC at 12 months(P=0.01)and 24 months(P=0.01).There were no significant differences between the groups in PEF or ACT score at 12 and 24 months,or in FEV1%pred at 12 months.Treatment-related AEs were mild and more common in the PAT group than in the placebo PAT group.No serious AEs were reported.CONCLUSION:PAT conducted on dog days could reduce asthma exacerbations in patients with bronchial asthma.展开更多
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of U...Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of UC remain elusive. Currenttherapeutic approaches, including anti-inflammatory, immunosuppressiveand immunomodulating agents, are often limited in efficacy and frequently associatedwith adverse drug reactions. Therefore, there is an urgent need to developsafer and more effective treatment strategies to address the limitations of existingtherapies. Scutellaria baicalensis Georgi (HQ), a traditional Chinese medicinal herb,has been employed in the treatment of UC for over 2000 years. Recent studieshave demonstrated that HQ contains multiple active components capable oftreating UC through anti-inflammation, immune modulation, intestinal barrierprotection, antioxidant activity, and regulation of the gut microbiota. This paperreviews recent studies on the mechanism of action and clinical trials of HQ intreating UC based on relevant literature, with the aim of providing valuable insightsinto future treatment approaches.展开更多
Background:Most sepsis patients develop sepsis-associated acute kidney injury(SA-AKI),which poses a significant threat to survival and lacks specific treatment.To date,there are no published randomized controlled tria...Background:Most sepsis patients develop sepsis-associated acute kidney injury(SA-AKI),which poses a significant threat to survival and lacks specific treatment.To date,there are no published randomized controlled trials that have established a link between albumin use and SA-AKI development in sepsis.Therefore,it is unclear whether albumin use may influence the risk of SA-AKI.Methods:The present study employed a target trial emulation using observational data to track adult sepsis patients initially admitted to the intensive care unit at Beth Israel Deaconess Medical Center,Boston,Massachusetts,for a period of 7 d from 2008 to 2022.Immortal time bias was controlled using the clone-censor-weight(CCW)method,along with a new-user design to address current user bias.The exposure variable was the early administration of albumin following the onset of sepsis.Based on albumin use,patients were classified into two groups:the albumin group(n=27,088)and the no albumin group(n=27,088).The primary outcome was the development of SA-AKI,and the secondary outcome was 7-day all-cause mortality.The primary outcome was analyzed using competing risk analyses.Furthermore,sensitivity and subgroup analyses were also performed.Results:Among the 27,088 patients analyzed,albumin administration was associated with a significantly higher SA-AKI risk(relative difference=3.47%,95%CI 1.76-5.23)compared to non-administration.There was no clinically meaningful difference in 7-day survival(relative difference=0.05%,95%CI-2.30 to 2.45).Sensitivity analyses consistently supported these results.All these analyses were conducted on data that were collected after CCW.Conclusions:Early albumin administration may increase the risk of SA-AKI in sepsis patients without conferring a short-term survival benefit.These results underscore the need for a rigorous risk-benefit assessment when incorporating albumin into sepsis resuscitation protocols and highlight the need for further clinical validation.However,it is important to exercise caution when interpreting the conclusions of this study,given its exploratory and preliminary nature.展开更多
With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Lap...With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC.展开更多
Iron deficiency anemia affects approximately 1.62 billion people worldwide,yet traditional iron supplements present bioavailability limitations and gastrointestinal side effects.This randomized,double-blind clinical t...Iron deficiency anemia affects approximately 1.62 billion people worldwide,yet traditional iron supplements present bioavailability limitations and gastrointestinal side effects.This randomized,double-blind clinical trial investigated a novel Auricularia auricula polysaccharide-iron complex(AAPIC)compared with heme iron and ferrous glycinate in 180 iron-deficient adults receiving 30 mg elemental iron daily for 12 weeks.AAPIC achieved comparable hemoglobin improvements(from 98.3±8.7 to 126.5±9.2 g/L)to heme iron(from 97.8±9.1 to 128.3±8.6 g/L)and was significantly superior to ferrous glycinate(from 98.6±8.9 to 119.7±10.3 g/L;p<0.001).Iron absorption efficiency showed AAPIC at 23.7±4.2%,heme iron at 25.1±3.8%,and ferrous glycinate at 18.4±5.1%.Toxicological assessments revealed no hepatotoxicity,nephrotoxicity,or mutagenicity.Gastrointestinal adverse events occurred in 8.3%of AAPIC recipients versus 15.0%with ferrous glycinate and 10.0%with heme iron.The polysaccharide component facilitates iron transport through enhanced intestinal uptake mechanisms.AAPIC represents a promising,well-tolerated alternative with clinical efficacy comparable to established iron formulations.展开更多
Objectives This study aimed to design and evaluate a detection system for the accidental dislodgement of head-and-neck medical supplies through hand position recognition and tracking in Intensive Care Unit(ICU)patient...Objectives This study aimed to design and evaluate a detection system for the accidental dislodgement of head-and-neck medical supplies through hand position recognition and tracking in Intensive Care Unit(ICU)patients.Methods We conducted a single-center,prospective,parallel-group feasibility randomized controlled trial.We recruited 80 participants using convenience sampling from the ICU of a hospital in Ningbo City,Zhejiang Province,between March 2025 and June 2025,and they were randomly assigned to either the control group(routine care)or the intervention group(routine care plus image recognition-based detection system).The system continuously tracked patients’hand positions via bedside cameras and generated real-time alarms when hands entered predefined risk zones,notifying on-duty nurses to enable early intervention.System stability was assessed by continuous system uptime;system performance and clinical feasibility were evaluated by the frequencies of risk actions and accidental dislodgement of medical supplies(ADMS).Results All 80 participants completed the intervention,with 40 patients in each group.The baseline characteristics and median observation time of the two groups were balanced(intervention group:48 h/patient vs.control group:49 h/patient).Compared with the control group,the intervention group showed fewer ADMS(2/40 vs.9/40)and detected more risk actions per 100 h(36 vs.25);all system-detected events had corroborating images with complete concordance on manual review,and all nurse-recorded hand-contact events were accurately captured.Conclusions The study demonstrated that the image recognition-based detection system can function stably in clinical settings,providing accurate and continuous surveillance while supporting the early detection of risk actions.By reducing the observation burden and offering real-time cognitive support,the system complements routine nursing care and serves as an additional safety measure in ICU practice.With further optimization and larger multicenter validation,this approach could have the potential to make a significant contribution to the development of smart ICUs and the broader digital transformation of nursing care.展开更多
Unmanned Aerial Vehicle(UAV)plays a prominent role in various fields,and autonomous navigation is a crucial component of UAV intelligence.Deep Reinforcement Learning(DRL)has expanded the research avenues for addressin...Unmanned Aerial Vehicle(UAV)plays a prominent role in various fields,and autonomous navigation is a crucial component of UAV intelligence.Deep Reinforcement Learning(DRL)has expanded the research avenues for addressing challenges in autonomous navigation.Nonetheless,challenges persist,including getting stuck in local optima,consuming excessive computations during action space exploration,and neglecting deterministic experience.This paper proposes a noise-driven enhancement strategy.In accordance with the overall learning phases,a global noise control method is designed,while a differentiated local noise control method is developed by analyzing the exploration demands of four typical situations encountered by UAV during navigation.Both methods are integrated into a dual-model for noise control to regulate action space exploration.Furthermore,noise dual experience replay buffers are designed to optimize the rational utilization of both deterministic and noisy experience.In uncertain environments,based on the Twin Delay Deep Deterministic Policy Gradient(TD3)algorithm with Long Short-Term Memory(LSTM)network and Priority Experience Replay(PER),a Noise-Driven Enhancement Priority Memory TD3(NDE-PMTD3)is developed.We established a simulation environment to compare different algorithms,and the performance of the algorithms is analyzed in various scenarios.The training results indicate that the proposed algorithm accelerates the convergence speed and enhances the convergence stability.In test experiments,the proposed algorithm successfully and efficiently performs autonomous navigation tasks in diverse environments,demonstrating superior generalization results.展开更多
OBJECTIVE:To investigate Acupuncture-herb therapy modulates gut microbiota in abdominal obesity.METHODS:A randomized controlled trial was designed in accordance with standard protocols.Abdominally obese subjects were ...OBJECTIVE:To investigate Acupuncture-herb therapy modulates gut microbiota in abdominal obesity.METHODS:A randomized controlled trial was designed in accordance with standard protocols.Abdominally obese subjects were randomized into four groups:A2(Control):double placebo,A1(Needle):press needle+placebo herb,A3(herb):herbal medicine(Huatan Lishi Fang化痰利湿方)+placebo needle,A4(Combination):press needle+herbal medicine.After 12 weeks of treatment,groups were relabeled B1-B4.Weight,waist circumference,and body mass index were measured monthly.Gut microbiota was analyzed via 16S rRNA sequencing for diversity and abundance.RESULTS:Combined needle-herb therapy significantly reduced waist circumference(P<0.05).All treatments altered gut microbiota composition.The combination group showed significant changes in diversity(Chao1,Shannon,Simpson;P<0.05).Needle therapy increased Bacteroidia;herbs reduced Lachnospiraceae and Megamonas.All results were significant(P<0.05).CONCLUSION:Combined needle-herb treatment modulated 25 key gut flora across multiple taxonomic levels in abdominal obesity.It reduced Firmicutes and Bacteroidota.Bacteroidota,Actinobacteriota,and Prevotellaceae may suppress obesity,whereas Proteobacteria,Lachnospiraceae,and Megamonas may promote it.The combination specifically altered Bacteroidaceae,Lachnospiraceae,Bacteroidia,and Megamonas.展开更多
Unresectable hepatocellular carcinoma(HCC)remains a global challenge,with limited effective treatment options for advanced-stage disease.The HIMALAYA trial(phase III randomized study that evaluated the STRIDE regimen)...Unresectable hepatocellular carcinoma(HCC)remains a global challenge,with limited effective treatment options for advanced-stage disease.The HIMALAYA trial(phase III randomized study that evaluated the STRIDE regimen)introduced the Single Tremelimumab Regular Interval Durvalumab(STRIDE)regimen,an immunotherapy-based approach that achieved a median overall survival(OS)of 16.43 months compared to 13.77 months with sorafenib.While statistically significant,this~2.7 months OS gain warrants scrutiny in light of STRIDE’s increased immune-related toxicity and cost.This commentary evaluates STRIDE’s impact within the broader landscape of first-line systemic therapy for unresectable HCC,alongside other regimens such as atezolizumab plus bevacizumab and nivolumab plus ipilimumab.We explore STRIDE’s mechanism of action,safety profile,modest progression-free survival(PFS)improvement,and implementation challenges,incorporating insights from 2023-2025 research.In addition,we discussed its limitations in non-viral HCC and Child-Pugh B patients,the role of emerging biomarkers,and the potential of radiation to enhance immunotherapy efficacy.As a dual immune checkpoint inhibitor(ICI)strategy,STRIDE offers an important advance that may not only extend survival but also open the door to future curative approaches.However,optimizing its use will require refined patient selection and further investigation of synergistic combination therapies.展开更多
This quasi-experimental study aimed at looking into the effectiveness of PBL （problem-based learning） in improving the performance in Navigation 3 （terrestrial and coastal navigation） of BSMT （Bachelor of Science...This quasi-experimental study aimed at looking into the effectiveness of PBL （problem-based learning） in improving the performance in Navigation 3 （terrestrial and coastal navigation） of BSMT （Bachelor of Science in Marine Transportation） second year students at JBLFMU-Arevalo during the first semester of school year 2016-2017. The respondents of this research were the two sections comparable with each other who was enrolled in the subject Navigation 3. There were 60 student respondents composed of 30 in the experimental group and 30 in the control group. A validated three item teacher-made problem solving test with 10 points for each correct answer was used as an instrument. The dependent variable was the scores in Navigation 3 and independent variable was the PBL approach. The statistical tools used were mean, standard deviation, Mann-Whitney test, and Wilcoxon-Signed ranks test set at 0.05 level of significance. The effect size was computed to determine the effectiveness of the PBL approach in terms of students＇ performance in Navigation 3. Results showed that in the pretest, though the experimental group had a higher mean than the control group, the Mann-Whitney test showed that the mean scores of the two groups were comparable because the significant value was greater than 0.05. When the treatment was introduced, findings showed that there were significant differences in the Navigation 3 performance in the pretest and posttest of experimental and control groups as well as in the posttests of both groups. It could be inferred that the better performance of the experimental group could be attributed to the intervention where the students were actively involved in the learning process.展开更多
Background and Objective Electromagnetic navigation technology has demonstrated significant potential in enhancing the accuracy and safety of neurosurgical procedures.However,traditional electromagnetic navigation sys...Background and Objective Electromagnetic navigation technology has demonstrated significant potential in enhancing the accuracy and safety of neurosurgical procedures.However,traditional electromagnetic navigation systems face challenges such as high equipment costs,complex operation,bulky size,and insufficient anti-interference performance.To address these limitations,our study developed and validated a novel portable electromagnetic neuronavigation system designed to improve the precision,accessibility,and clinical applicability of electromagnetic navigation technology in cranial surgery.Methods The software and hardware architecture of a portable neural magnetic navigation system was designed.The key technologies of the system were analysed,including electromagnetic positioning algorithms,miniaturized sensor design,optimization of electromagnetic positioning and navigation algorithms,anti-interference signal processing methods,and fast three-dimensional reconstruction algorithms.A prototype was developed,and its accuracy was tested.Finally,a preliminary clinical application evaluation was conducted.Results This study successfully developed a comprehensive portable electromagnetic neuronavigation system capable of achieving preoperative planning,intraoperative real-time positioning and navigation,and postoperative evaluation of navigation outcomes.Through rigorous collaborative testing of the system’s software and hardware,the accuracy of electromagnetic neuronavigation has been validated to meet clinical requirements.Conclusions This study developed a portable neuroelectromagnetic navigation system and validated its effectiveness and safety through rigorous model testing and preliminary clinical applications.The system is characterized by its compact size,high precision,excellent portability,and user-friendly operation,making it highly valuable for promoting navigation technology and advancing the precision and minimally invasive nature of neurosurgical procedures.展开更多
OBJECTIVE To investigate the intervention effects of tissue-bone homeostasis manipulation(TBHM)on peripatellar biomechanical parameters and knee joint function in knee osteoarthritis(KOA)patients.METHODS Sixty patient...OBJECTIVE To investigate the intervention effects of tissue-bone homeostasis manipulation(TBHM)on peripatellar biomechanical parameters and knee joint function in knee osteoarthritis(KOA)patients.METHODS Sixty patients with KOA(Kellgren-Lawrence gradeⅡ-Ⅲ)were recruited from the Acupuncture-Moxibustion Rehabilitation Department,Anhui University of Chinese Medicine between October 2024 and May 2025.Participants were randomized into a TBHM group(n=30)or a transcutaneous electrical neuromuscular stimulation(TENS)group(n=30).Using two-way repeated measures ANOVA,biomechanical indicators,including rectus femoris tension,vastus medialis tension,vastus lateralis tension,patellar ligament tension,lateral patellar displacement(LPD),medial patellar displacement(MPD),normalized patellar mobility(LPD/patellar width[PW],MPD/PW),knee flexion range of motion,and functional indicators,including KOOS subscales,time up and go test(TUGT),were compared between groups at baseline and after 6 weeks of intervention.RESULTS After intervention,all biomechanical and knee joint function indicators in the TBHM group were significantly improved(P<0.05,P<0.01),while only the vastus medialis tension,TUGT and KOOS Pain,ADL and QoL scores in the control group were significantly improved(P<0.01).The improvement amplitudes of biomechanical indicators in the TBHM group,including rectus femoris tension,vastus lateralis tension,patellar ligament tension,MPD/PW,LPD/PW and knee flexion range of motion were better than those in the control group(P<0.05,P<0.01).In the functional evaluation,the interaction effects of the TBHM group in all dimensions of the KOOS score and TUGT were statistically significant(P<0.05,P<0.01).Post-hoc simple effect analysis confirmed that there were significant differences in the above indicators between the two groups after intervention(P<0.05),and all indicators showed a significant main effect of time(P<0.01),suggesting that the intervention measures had continuous and cumulative curative effects.CONCLUSION TBHM effectively improves joint function and quality of life in KOA patients by restoring dynamic equilibrium in soft tissue tension and patellar mobility,ultimately achieving the therapeutic goal of concurrent tissue-bone management.展开更多
基金supported by the Talent Development Plan for High-level Public Health Technical Personnel Project in Beijing,Beijing Municipal Health Commission[No.XKGG-02-03].
文摘Introduction.Well-designed,strictly implemented,and fully standardized randomized controlled trials(RCTs)are a prerequisite for developing reliable scientific evidence,which can improve clinical practice,health outcomes,and ultimately benefit patients.Suboptimal reporting is pervasive in medical research,resulting in biased research records and persistent uncertainty about the quality of available evidence.1,2,3,4 The standardization of research reports has attracted considerable attention.In 1996,the Consolidated Standards of Reporting Trials(CONSORT)was first published to improve the quality of RCTs and enhance the reproducibility of trial methods,results,and inferences.
文摘The important work of Yu,et al.[1]who presented one of the first randomized controlled trials(RCTs)to directly compare robot-assisted and manual percutaneous coronary intervention(PCI),is commendable;offering important insights into the feasibility and outcomes of this emerging technology.While the analysis is timely,several issues warrant further consideration.
基金supported by National Natural Science Foundation of China:Space-based occultation detection with ground-based GNSS atmospheric horizontal gradient model(41904033).
文摘The satellite-based augmentation system(SBAS)provides differential and integrity augmentation services for life safety fields of aviation and navigation.However,the signal structure of SBAS is public,which incurs a risk of spoofing attacks.To improve the anti-spoofing capability of the SBAS,European Union and the United States conduct research on navigation message authentication,and promote the standardization of SBAS message authentication.For the development of Beidou satellite-based augmentation system(BDSBAS),this paper proposes navigation message authentication based on the Chinese commercial cryptographic standards.Firstly,this paper expounds the architecture and principles of the SBAS message authentication,and then carries out the design of timed efficient streaming losstolerant authentication scheme(TESLA)and elliptic curve digital signature algorithm(ECDSA)authentication schemes based on Chinese commercial cryptographic standards,message arrangement and the design of over-the-air rekeying(OTAR)message.Finally,this paper conducts a theoretical analysis of the time between authentications(TBA)and maximum authentication latency(MAL)for L5 TESLA-I and L5 ECDSA-Q,and further simulates the reception time of OTAR message,TBA and MAL from the aspects of OTAR message weight and demodulation error rate.The simulation results can provide theoretical supports for the standardization of BDSBAS message authentication.
基金Supported by the National Natural Science Foundation of China(NSFC)under Grants 62025104,62422102,62331005,62301034,and U22A2052the Beijing Natural Science Foundation-Daxing Innovation Joint Fund(L256040).
文摘Surgical navigation has evolved significantly through advances in augmented reality,virtual reality,and mixed reality,improving precision and safety across many clinical applications,including neurosurgery,maxillofacial,spinal,and arthroplasty procedures.By integrating preoperative imaging with real-time intraoperative data,these systems provide dynamic guidance,reduce radiation exposure,and minimize tissue damage.Key challenges persist,including intraoperative registration accuracy,flexible tissue deformation,respiratory compensation,and real-time imaging quality.Emerging solutions include artificial intelligence-driven segmentation,deformation-field modeling,and hybrid registration techniques.Future developments will include lightweight,portable systems,improved non-rigid registration algorithms,and greater clinical adoption.Despite advances in rigid-tissue applications,soft-tissue navigation requires additional innovation to address motion variability and registration reliability,ultimately advancing minimally invasive surgery and precision medicine.
基金from the National Key Research and Development Program project"Adaptive Navigation Software and Hardware Technology(2018YFB0505200)."。
文摘The current inertial measurement unit(IMU)and odometry fusion navigation algorithms often incorporate non-holonomic constraints(NHC)to obtain three-dimensional velocity in the navigation frame.However,due to the integral nature of the dead reckoning algorithm,the attitude errors of the IMU accumulate over time,causing the velocity transformation results to fail to accurately reflect the threedimensional velocity in the navigation frame.Based on the fact that during a vehicle's horizontal and uniform motion,the vertical acceleration is consistent with gravitational acceleration,this paper proposes an IMU/odometry fusion navigation algorithm based on horizontal attitude constraints(HAC).Building on non-holonomic constraints,this algorithm determines the motion state of the vehicle through accelerometer output and zeroes out the pitch and roll angles during horizontal and uniform motion.Verified through two sets of real-world vehicle test data,this algorithm improves horizontal positioning accuracy by approximately 63%and 70%,and vertical positioning accuracy by 98%and 97%,compared with the traditional NHC IMU/odometer fusion algorithm.
基金Supported by“12th Five-year” National Science and Technology Pillar Program by the Ministry of Science and Technology of the People’s Republic of China:Clinical Evaluation and Technical Operation Specification Research on Preventing Bronchial Asthma Attacks by Acupoint Application in Winter Disease Summer Treatment(No. 2015BAI04B11)。
文摘OBJECTIVE:To assess the efficacy of point application therapy(PAT)in alleviating the exacerbation of chronic respiratory diseases represented by bronchial asthma.METHODS:In this multicenter randomized placebocontrolled trial,eligible bronchial asthma patients received placebo PAT on the dog days of the first summer to establish a baseline,and then patients who continued to participate in the trial and repassed the eligibility review were randomized to receive regular or placebo PAT in the next two consecutive summers.The primary outcome was the change from baseline in the number of asthma exacerbations at 24 months.Secondary outcomes included severity of asthma exacerbation,asthma control test(ACT)score,percentage of forced expiratory volume in 1 s(FEV1)to the predicated value(FEV1%pred),peak expiratory flow(PEF),ratio of FEV1 to forced vital capacity(FEV1/FVC),and use of palliative drugs during bronchial asthma exacerbations at 12 and 24 months.The adverse events(AEs)were also assessed.RESULTS:A total of 835 patients with bronchial asthma were randomized in this trial.Compared with the placebo control,the PAT significantly decreased the mean number of asthma exacerbations(1.42;95%confidence interval,0.69 to 2.14;P<0.001),and increased the FEV1%pred at 24 months(P=0.039)and FEV1/FVC at 12 months(P=0.01)and 24 months(P=0.01).There were no significant differences between the groups in PEF or ACT score at 12 and 24 months,or in FEV1%pred at 12 months.Treatment-related AEs were mild and more common in the PAT group than in the placebo PAT group.No serious AEs were reported.CONCLUSION:PAT conducted on dog days could reduce asthma exacerbations in patients with bronchial asthma.
基金Supported by National Natural Science Foundation of China,No.82374200Construction of Traditional Chinese Medicine Inheritance and Innovation Development Demonstration Pilot Projects in Pudong New Area-High-Level Research-Oriented Traditional Chinese Medicine Hospital Construction,No.YC-2023-0901.
文摘Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of UC remain elusive. Currenttherapeutic approaches, including anti-inflammatory, immunosuppressiveand immunomodulating agents, are often limited in efficacy and frequently associatedwith adverse drug reactions. Therefore, there is an urgent need to developsafer and more effective treatment strategies to address the limitations of existingtherapies. Scutellaria baicalensis Georgi (HQ), a traditional Chinese medicinal herb,has been employed in the treatment of UC for over 2000 years. Recent studieshave demonstrated that HQ contains multiple active components capable oftreating UC through anti-inflammation, immune modulation, intestinal barrierprotection, antioxidant activity, and regulation of the gut microbiota. This paperreviews recent studies on the mechanism of action and clinical trials of HQ intreating UC based on relevant literature, with the aim of providing valuable insightsinto future treatment approaches.
基金supported by grants from the National Institute of Biomedical Imaging and Bioengineering(NIBIB)of the National Institutes of Health(NIH)under award numbers R01-EB001659(2003-2013)and R01-EB017205(2014-2018)approved by the Institutional Review Boards of Beth Israel Deaconess Medical Center(Boston,MA)and the Massachusetts Institute of Technology(Cambridge,MA).
文摘Background:Most sepsis patients develop sepsis-associated acute kidney injury(SA-AKI),which poses a significant threat to survival and lacks specific treatment.To date,there are no published randomized controlled trials that have established a link between albumin use and SA-AKI development in sepsis.Therefore,it is unclear whether albumin use may influence the risk of SA-AKI.Methods:The present study employed a target trial emulation using observational data to track adult sepsis patients initially admitted to the intensive care unit at Beth Israel Deaconess Medical Center,Boston,Massachusetts,for a period of 7 d from 2008 to 2022.Immortal time bias was controlled using the clone-censor-weight(CCW)method,along with a new-user design to address current user bias.The exposure variable was the early administration of albumin following the onset of sepsis.Based on albumin use,patients were classified into two groups:the albumin group(n=27,088)and the no albumin group(n=27,088).The primary outcome was the development of SA-AKI,and the secondary outcome was 7-day all-cause mortality.The primary outcome was analyzed using competing risk analyses.Furthermore,sensitivity and subgroup analyses were also performed.Results:Among the 27,088 patients analyzed,albumin administration was associated with a significantly higher SA-AKI risk(relative difference=3.47%,95%CI 1.76-5.23)compared to non-administration.There was no clinically meaningful difference in 7-day survival(relative difference=0.05%,95%CI-2.30 to 2.45).Sensitivity analyses consistently supported these results.All these analyses were conducted on data that were collected after CCW.Conclusions:Early albumin administration may increase the risk of SA-AKI in sepsis patients without conferring a short-term survival benefit.These results underscore the need for a rigorous risk-benefit assessment when incorporating albumin into sepsis resuscitation protocols and highlight the need for further clinical validation.However,it is important to exercise caution when interpreting the conclusions of this study,given its exploratory and preliminary nature.
基金supported by National Key Research and Development Program of China(No.2023YFC2507406)National Natural Science Foundation of China(No.82300646)+6 种基金Beijing Natural Science Foundation(No.7232334)Beijing Municipal Administration of Hospitals Incubating Program(No.PX2024002,PX2020001)Capital Fund for Health Development Scientific Research(No.2024-2-2028)Beijing Municipal Science&Technology Commission AI+Health Collaborative Innovation Cultivation Project(No.Z241100007724004)Research Ward Excellence Program of Beijing Municipal Health Commission(No.BRWEP2024W162020100,BRWEP2024W162020112,BRWEP2024W162020114)Excellent Plan for Capital Medicine Scientific and Technological Innovation Achievement Transformation Promotion Plan(No.YC202401QX0824)Clinical Scientific Research Fund of Beijing Integrated Medical Association[No.ZHKY-2025-1869(B012)]。
文摘With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC.
文摘Iron deficiency anemia affects approximately 1.62 billion people worldwide,yet traditional iron supplements present bioavailability limitations and gastrointestinal side effects.This randomized,double-blind clinical trial investigated a novel Auricularia auricula polysaccharide-iron complex(AAPIC)compared with heme iron and ferrous glycinate in 180 iron-deficient adults receiving 30 mg elemental iron daily for 12 weeks.AAPIC achieved comparable hemoglobin improvements(from 98.3±8.7 to 126.5±9.2 g/L)to heme iron(from 97.8±9.1 to 128.3±8.6 g/L)and was significantly superior to ferrous glycinate(from 98.6±8.9 to 119.7±10.3 g/L;p<0.001).Iron absorption efficiency showed AAPIC at 23.7±4.2%,heme iron at 25.1±3.8%,and ferrous glycinate at 18.4±5.1%.Toxicological assessments revealed no hepatotoxicity,nephrotoxicity,or mutagenicity.Gastrointestinal adverse events occurred in 8.3%of AAPIC recipients versus 15.0%with ferrous glycinate and 10.0%with heme iron.The polysaccharide component facilitates iron transport through enhanced intestinal uptake mechanisms.AAPIC represents a promising,well-tolerated alternative with clinical efficacy comparable to established iron formulations.
文摘Objectives This study aimed to design and evaluate a detection system for the accidental dislodgement of head-and-neck medical supplies through hand position recognition and tracking in Intensive Care Unit(ICU)patients.Methods We conducted a single-center,prospective,parallel-group feasibility randomized controlled trial.We recruited 80 participants using convenience sampling from the ICU of a hospital in Ningbo City,Zhejiang Province,between March 2025 and June 2025,and they were randomly assigned to either the control group(routine care)or the intervention group(routine care plus image recognition-based detection system).The system continuously tracked patients’hand positions via bedside cameras and generated real-time alarms when hands entered predefined risk zones,notifying on-duty nurses to enable early intervention.System stability was assessed by continuous system uptime;system performance and clinical feasibility were evaluated by the frequencies of risk actions and accidental dislodgement of medical supplies(ADMS).Results All 80 participants completed the intervention,with 40 patients in each group.The baseline characteristics and median observation time of the two groups were balanced(intervention group:48 h/patient vs.control group:49 h/patient).Compared with the control group,the intervention group showed fewer ADMS(2/40 vs.9/40)and detected more risk actions per 100 h(36 vs.25);all system-detected events had corroborating images with complete concordance on manual review,and all nurse-recorded hand-contact events were accurately captured.Conclusions The study demonstrated that the image recognition-based detection system can function stably in clinical settings,providing accurate and continuous surveillance while supporting the early detection of risk actions.By reducing the observation burden and offering real-time cognitive support,the system complements routine nursing care and serves as an additional safety measure in ICU practice.With further optimization and larger multicenter validation,this approach could have the potential to make a significant contribution to the development of smart ICUs and the broader digital transformation of nursing care.
基金the Collaborative Innovation Project of Shanghai,China for the financial support。
文摘Unmanned Aerial Vehicle(UAV)plays a prominent role in various fields,and autonomous navigation is a crucial component of UAV intelligence.Deep Reinforcement Learning(DRL)has expanded the research avenues for addressing challenges in autonomous navigation.Nonetheless,challenges persist,including getting stuck in local optima,consuming excessive computations during action space exploration,and neglecting deterministic experience.This paper proposes a noise-driven enhancement strategy.In accordance with the overall learning phases,a global noise control method is designed,while a differentiated local noise control method is developed by analyzing the exploration demands of four typical situations encountered by UAV during navigation.Both methods are integrated into a dual-model for noise control to regulate action space exploration.Furthermore,noise dual experience replay buffers are designed to optimize the rational utilization of both deterministic and noisy experience.In uncertain environments,based on the Twin Delay Deep Deterministic Policy Gradient(TD3)algorithm with Long Short-Term Memory(LSTM)network and Priority Experience Replay(PER),a Noise-Driven Enhancement Priority Memory TD3(NDE-PMTD3)is developed.We established a simulation environment to compare different algorithms,and the performance of the algorithms is analyzed in various scenarios.The training results indicate that the proposed algorithm accelerates the convergence speed and enhances the convergence stability.In test experiments,the proposed algorithm successfully and efficiently performs autonomous navigation tasks in diverse environments,demonstrating superior generalization results.
基金Supported by National Key R&D Program of China:Clinical Evaluation Research on Intervention Technologies for Abdominal Obesitythe Role of Gut Microbiota in the Effects of Combined Acupuncture and Medication on Abdominal Obesity:an Exploration with 16S rRNA Technology(Project Code:2019YFC1710102)。
文摘OBJECTIVE:To investigate Acupuncture-herb therapy modulates gut microbiota in abdominal obesity.METHODS:A randomized controlled trial was designed in accordance with standard protocols.Abdominally obese subjects were randomized into four groups:A2(Control):double placebo,A1(Needle):press needle+placebo herb,A3(herb):herbal medicine(Huatan Lishi Fang化痰利湿方)+placebo needle,A4(Combination):press needle+herbal medicine.After 12 weeks of treatment,groups were relabeled B1-B4.Weight,waist circumference,and body mass index were measured monthly.Gut microbiota was analyzed via 16S rRNA sequencing for diversity and abundance.RESULTS:Combined needle-herb therapy significantly reduced waist circumference(P<0.05).All treatments altered gut microbiota composition.The combination group showed significant changes in diversity(Chao1,Shannon,Simpson;P<0.05).Needle therapy increased Bacteroidia;herbs reduced Lachnospiraceae and Megamonas.All results were significant(P<0.05).CONCLUSION:Combined needle-herb treatment modulated 25 key gut flora across multiple taxonomic levels in abdominal obesity.It reduced Firmicutes and Bacteroidota.Bacteroidota,Actinobacteriota,and Prevotellaceae may suppress obesity,whereas Proteobacteria,Lachnospiraceae,and Megamonas may promote it.The combination specifically altered Bacteroidaceae,Lachnospiraceae,Bacteroidia,and Megamonas.
文摘Unresectable hepatocellular carcinoma(HCC)remains a global challenge,with limited effective treatment options for advanced-stage disease.The HIMALAYA trial(phase III randomized study that evaluated the STRIDE regimen)introduced the Single Tremelimumab Regular Interval Durvalumab(STRIDE)regimen,an immunotherapy-based approach that achieved a median overall survival(OS)of 16.43 months compared to 13.77 months with sorafenib.While statistically significant,this~2.7 months OS gain warrants scrutiny in light of STRIDE’s increased immune-related toxicity and cost.This commentary evaluates STRIDE’s impact within the broader landscape of first-line systemic therapy for unresectable HCC,alongside other regimens such as atezolizumab plus bevacizumab and nivolumab plus ipilimumab.We explore STRIDE’s mechanism of action,safety profile,modest progression-free survival(PFS)improvement,and implementation challenges,incorporating insights from 2023-2025 research.In addition,we discussed its limitations in non-viral HCC and Child-Pugh B patients,the role of emerging biomarkers,and the potential of radiation to enhance immunotherapy efficacy.As a dual immune checkpoint inhibitor(ICI)strategy,STRIDE offers an important advance that may not only extend survival but also open the door to future curative approaches.However,optimizing its use will require refined patient selection and further investigation of synergistic combination therapies.
文摘This quasi-experimental study aimed at looking into the effectiveness of PBL （problem-based learning） in improving the performance in Navigation 3 （terrestrial and coastal navigation） of BSMT （Bachelor of Science in Marine Transportation） second year students at JBLFMU-Arevalo during the first semester of school year 2016-2017. The respondents of this research were the two sections comparable with each other who was enrolled in the subject Navigation 3. There were 60 student respondents composed of 30 in the experimental group and 30 in the control group. A validated three item teacher-made problem solving test with 10 points for each correct answer was used as an instrument. The dependent variable was the scores in Navigation 3 and independent variable was the PBL approach. The statistical tools used were mean, standard deviation, Mann-Whitney test, and Wilcoxon-Signed ranks test set at 0.05 level of significance. The effect size was computed to determine the effectiveness of the PBL approach in terms of students＇ performance in Navigation 3. Results showed that in the pretest, though the experimental group had a higher mean than the control group, the Mann-Whitney test showed that the mean scores of the two groups were comparable because the significant value was greater than 0.05. When the treatment was introduced, findings showed that there were significant differences in the Navigation 3 performance in the pretest and posttest of experimental and control groups as well as in the posttests of both groups. It could be inferred that the better performance of the experimental group could be attributed to the intervention where the students were actively involved in the learning process.
基金funded by National Natural Science Foundation of China(No.82272134)Innovative Research Group Project of the National Natural Science Foundation of China(No.82272134,Xiao-lei Chen).
文摘Background and Objective Electromagnetic navigation technology has demonstrated significant potential in enhancing the accuracy and safety of neurosurgical procedures.However,traditional electromagnetic navigation systems face challenges such as high equipment costs,complex operation,bulky size,and insufficient anti-interference performance.To address these limitations,our study developed and validated a novel portable electromagnetic neuronavigation system designed to improve the precision,accessibility,and clinical applicability of electromagnetic navigation technology in cranial surgery.Methods The software and hardware architecture of a portable neural magnetic navigation system was designed.The key technologies of the system were analysed,including electromagnetic positioning algorithms,miniaturized sensor design,optimization of electromagnetic positioning and navigation algorithms,anti-interference signal processing methods,and fast three-dimensional reconstruction algorithms.A prototype was developed,and its accuracy was tested.Finally,a preliminary clinical application evaluation was conducted.Results This study successfully developed a comprehensive portable electromagnetic neuronavigation system capable of achieving preoperative planning,intraoperative real-time positioning and navigation,and postoperative evaluation of navigation outcomes.Through rigorous collaborative testing of the system’s software and hardware,the accuracy of electromagnetic neuronavigation has been validated to meet clinical requirements.Conclusions This study developed a portable neuroelectromagnetic navigation system and validated its effectiveness and safety through rigorous model testing and preliminary clinical applications.The system is characterized by its compact size,high precision,excellent portability,and user-friendly operation,making it highly valuable for promoting navigation technology and advancing the precision and minimally invasive nature of neurosurgical procedures.
文摘OBJECTIVE To investigate the intervention effects of tissue-bone homeostasis manipulation(TBHM)on peripatellar biomechanical parameters and knee joint function in knee osteoarthritis(KOA)patients.METHODS Sixty patients with KOA(Kellgren-Lawrence gradeⅡ-Ⅲ)were recruited from the Acupuncture-Moxibustion Rehabilitation Department,Anhui University of Chinese Medicine between October 2024 and May 2025.Participants were randomized into a TBHM group(n=30)or a transcutaneous electrical neuromuscular stimulation(TENS)group(n=30).Using two-way repeated measures ANOVA,biomechanical indicators,including rectus femoris tension,vastus medialis tension,vastus lateralis tension,patellar ligament tension,lateral patellar displacement(LPD),medial patellar displacement(MPD),normalized patellar mobility(LPD/patellar width[PW],MPD/PW),knee flexion range of motion,and functional indicators,including KOOS subscales,time up and go test(TUGT),were compared between groups at baseline and after 6 weeks of intervention.RESULTS After intervention,all biomechanical and knee joint function indicators in the TBHM group were significantly improved(P<0.05,P<0.01),while only the vastus medialis tension,TUGT and KOOS Pain,ADL and QoL scores in the control group were significantly improved(P<0.01).The improvement amplitudes of biomechanical indicators in the TBHM group,including rectus femoris tension,vastus lateralis tension,patellar ligament tension,MPD/PW,LPD/PW and knee flexion range of motion were better than those in the control group(P<0.05,P<0.01).In the functional evaluation,the interaction effects of the TBHM group in all dimensions of the KOOS score and TUGT were statistically significant(P<0.05,P<0.01).Post-hoc simple effect analysis confirmed that there were significant differences in the above indicators between the two groups after intervention(P<0.05),and all indicators showed a significant main effect of time(P<0.01),suggesting that the intervention measures had continuous and cumulative curative effects.CONCLUSION TBHM effectively improves joint function and quality of life in KOA patients by restoring dynamic equilibrium in soft tissue tension and patellar mobility,ultimately achieving the therapeutic goal of concurrent tissue-bone management.
