Didangtang is a classic formula for treating blood stasis and heat， as recorded in the Treatise on Febrile Diseases， and it has been highly praised by medical practitioners throughout history. It has been recorded in many traditional Chinese medical texts and used to this day. This article comprehensively examined the records of Didangtang in different ancient versions of Treatise on Febrile Diseases by excavating and sorting out related ancient medical books and modern literature. It also investigated the dosage unit measurement， preparation method， and content of the formula in medical books throughout history. The article provided a detailed summary and exploration of the origins and processing methods of rhubarb， peach kernels， leeches， and flies in the formula. At the same time， it reviewed the clinical practice of Didangtang by medical practitioners throughout history in relevant medical books， mainly including the adjustment of dosage forms， the increase or decrease in medicinal taste and dosage， the expansion of clinical application， and the creation and elucidation of similar formulas. Although there may be differences in the above information among medical practitioners throughout history， the basic idea of attacking blood stasis and heat is consistent. In addition， based on clinical practice， the author adhered to the principle of treating stasis and heat disease as the first reference when using Didangtang. It was suggested that blood should be circulated instead of stopping in the treatment of stasis and heat accumulation syndrome. At the same time， it was believed that the use of the method of attacking stasis and heat to regulate brain diseases and mental illnesses derives from the fact that removing stasis and generating new energy can nourish the heart and mind， providing ideas for the treatment of such diseases with Didangtang. On this basis， modern clinical and animal experiments have shown that Didangtang has certain effects in improving microcirculation disorders， regulating blood rheology and hemodynamics， enhancing insulin resistance， and inhibiting inflammatory reactions. This may be an important mechanism for the formula to ''conquer blood stasis and heat''. This article explored the textual research and clinical mechanism of Didangtang， presenting facts and evidence， so as to provide a reference for the clinical application of Didangtang and the research on other prescriptions.

Objective: To explore the association between mental health and muscle strength among Chinese adolescents aged 13- 18, providing a theoretical foundation and intervention strategies for mental health promotion. Methods: Data were obtained from the 2019 Chinese National Survey on Students Constitution and Health, including 98 631 Chinese adolescents aged 13- 18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well being was measured with the Warwick-Edinburgh Mental Well being Scale (WEMWBS). Based on the gender and age specific Z scores of various test items [grip strength, standing long jump, pull ups (for males), and sit ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual factor Model (DFM) of mental health, participants were categorized into four groups:troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents. Results: In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance ( χ 2=176.13, 780.42, both P <0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age ( χ 2 trend = 258.47) and a gradual upward trend with increasing muscle strength levels ( χ 2 trend =123.14)，and both boys and girls exhibited similar trends ( χ 2 trend =103.83, 168.46; 57.00 , 67.34) (all P <0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% ( OR = 1.29); for every unit increase in the Z-score for pull ups, the likelihood of being in a completely mental health state increased by 6% ( OR =1.06) among boys; for every 1 unit increase in sit up Z score, the likelihood of being in a completely mental health state increased by 19% ( OR =1.19) among girls (all P <0.05). Conclusions The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.

ObjectiveTo understand the epidemic characteristics of influenza in Beijing from 2023 to 2024, and to provide a scientific basis for the prevention and control of influenza. MethodsData on influenza-like illness (ILI) from secondary level and above hospitals, etiology surveillance data, and influenza clusters outbreaks data from 2023‒2024 were used to analyze the epidemic trend and pathogenic characteristics of influenza. Furthermore, an influenza comprehensive index was used to categorize the epidemic intensity at the severity level. ResultsA total of 2 065 857 ILI cases were reported in 2023‒2024 epidemic season, and the percentage of ILI was 3.67%. The age group of 5‒14 years accounted for the highest proportion of ILI (30.48%). A total of 41 766 throat swabs from ILI were detected, with a positive rate of 17.28%.A (H3N2) (51.86%) and B Victoria (41.93%) were the most prevalent subtypes of influenza virus. Clustered influenza outbreaks occurred mainly in primary schools (57.78%) and middle schools (35.55%), mainly caused by the influenza A (H3N2) subtype (85.93%). According to the influenza comprehensive index (I), the period of influenza activity and above (I>0.5) lasted for a total of 37 weeks, accounting for 71.15% of the entire influenza season. ConclusionCompared with previous years, the epidemic level of influenza in Beijing was increased in 2023‒2024, and the peak time became earlier. The comprehensive index method can objectively evaluate the level of influenza epidemic and provide suggestions for the future prevention and control of influenza in Beijing.

Objective The existing dyeing methods of myocardial fibrosis were optimized to make up for the problems of missing and misreading of collagen fibers in the quantitative analysis of the current common dyeing methods of myocardial fibers,and to provide a reference for the semi-quantitative and diagnosis of myocardial fibrosis.Methods Paraffin sections of cardiac tissue were prepared using a transgenic mouse model of cardiomyopathy with a specific laboratory-constructed cTnTR141W gene mutation.Four staining method were performed for comparative observations:Masson's trichrome(Masson)staining,picrosirius red(PSR)staining,van Gieson(VG)staining,and Sirius red/fast green(SR/FG)staining.Image J 2.1.0 software was used to quantitatively compare the areas of collagen fibers.SR/FG was optimized from three aspects:dye concentration,staining time,and acid solution prestaining,and the quantitative analysis of collagen fibers was then verified.Results The collagen fiber distribution was observed by the four staining method,among which SR/FG was notable.It involved prestaining with a 0.1%Sirius red-picric acid acidic solution for 5 min,adjusting the concentration of the dye solution to 0.1%Sirius red-picric acid and 0.04%fast green mixture,and incubating the sections in the mixed staining solution for 1 h.This method exhibited the lowest incidence of missed readings and loss in determining the proportion of collagen fibers.Conclusions Compared with other traditional collagen fiber staining method,the optimized SR/FG technique described in this paper produces bright coloring of collagen fibers and myocardial tissue,obvious color contrast,and high stability,convenience,and speed.It is suitable for subsequent quantitative analysis and determination of the collagen fiber proportion.

Sedentary bad habits and unhealthy diets in modern lifestyles have led to an upward trend in the incidence of obesity, and a series of diseases related to obesity have also gradually received attention. Multiple sclerosis is a chronic inflammatory disease of the central nervous system, and obesity has a common inflammatory component with most chronic diseases. Therefore, this paper reviews the research progress on the relationship between obesity and multiple sclerosis in order to better understand the role of obesity in the management of multiple sclerosis.

Objective:To describe the current distribution of daily physical activity time among ele-mentary and junior high school students in Beijing,and to analyze the influencing factors and pathways at the individual,family,school and community levels.Methods:Data were drawn upon from a cross-sectional investigation in Beijing in 2023,and a total of 3 157 elementary and junior high school students were included in the final analysis.Questionnaire was used to collect data on basic characteristics,over-all and in-school physical activity time per day,the number of sports mastered,perceived physical activi-ty benefits and barriers scales,perceived family,school,and community physical activity supportive en-vironment scales.Log-binomial regression model was used to analyze the associations between physical activity time and influencing factors,and structural equation modeling was used for the path analysis of the influencing factors.Results:The reported rates of ≥ 2 hours of overall physical activity per day and≥1 hour of physical activity in school per day among elementary and junior high school students in Beijing in 2023 were 33.1％and 64.8％,respectively.The associations between the number of sports mastered by students and the reported rate of ≥2 hours of overall physical activity per day showed a typical dose-response relationship(P-trend＜0.001).The perceived physical activity benefits-to-barriers ratio(PR=1.24,95％CI:1.20-1.28),scores of perceived family,school,and community physical acti-vity supportive environment scales were all positively associated with the reported rate of≥2 hours of overall physical activity per day(PR=1.51,95％CI:1.38-1.66;PR=1.50,95％CI:1.37-1.64;PR=1.21,95％CI:1.16-1.27).The structural equation modeling showed that the number of sports mastered by the students(β=0.11,P＜0.001),perceived physical activity benefits-to-barriers ratios(β=0.15,P＜0.001),and scores of supportive environment scales consisting of family,school,and community(β=0.13,P＜0.001)were associated with the reported rates of ≥2 hours of overall physi-cal activity per day directly.In addition,the scores of supportive environment scales could indirectly in-fluence the reported rates of ≥2 hours of overall physical activity per day by influencing the number of sports mastered by the students(β=0.21,P＜0.001)and the perceived physical activity benefits-to-barriers ratio(β=0.56,P＜0.001),while the number of sports mastered by the students could indi-rectly influence the reported rates of ≥2 hours of overall physical activity per day by influencing the per-ceived physical activity benefits-to-barriers ratios(β=0.05,P=0.003).The influencing factors and pathways of the reported rates of ≥ 1 hour of physical activity in school per day were similar with those of the reported rates of ≥2 hours of overall physical activity per day described above.Conclusion:The dai-ly physical activity time among elementary and junior high school students in Beijing in 2023 fell short of meeting the national requirement.There was a need to build a supportive environment consisting of fami-ly,school,and community for physical activity,to promote the students'sports skills,to establish the idea of independent physical activity,and to ensure that primary and secondary school students were given one hour of physical activity time every day,both inside and outside the school.

Objective To comprehensively explore the Chinese literature on medical insurance drug list,to sort out the research lineage of medical insurance drug list,and to summarize and discuss the future trends of relevant research development.Methods The research literature related to the list of medical insurance drug list in China from 2003 to 2023 were retrieved from databases including CNKI,Wanfang Database and VIP Chinese Journal Database.CiteSpace 6.2.R4 was used to draw a vis-ual graph,and text analysis was carried out according to the release time of relevant important policies.Results A total of 413 articles were included,and the authors of the published articles were relatively independent from each other,and no large aca-demic community has been formed in this field yet;Topics such as adjustment of medical insurance drug list,use of medical in-surance funds,and expert negotiations on medical insurance drugs are hot topics.Conclusions The number of papers pub-lished in this field is generally increasing,and cooperative research,diversified research and empirical research in this field should be strengthened.Focusing on hot topics and improving the quantity and quality of papers are the key factors to develop the literature in this field.

Objective To investigate whether norepinephrine (NE) regulates the oxidative stress in human endom-etrial epithelial cells (hEECs) by activating nuclear factor E2-related factor 2(Nrf2)/ heme oxygenase -1(HO-1) signal pathway.Methods Cultured hEECs were used.The expression of α and β adrenergic receptors was detec-ted by reverse transcription-polymerase chain reaction (RT-PCR).Cell counting kit-8(CCK-8) assay was applied to test the effect of NE on cell viability, then the cells were divided into Control group and NE treatment group, and the appropriate concentrations were chosen.The expression of tight junction proteins Occludin and zona occludens-1(ZO-1), apoptosis-related proteins apoptosis-related protein B-cell lymphoma-2 protein(Bcl-2) and Bcl-2 associ-ated X protein(Bax) , antioxidant proteins Nrf2 and HO-1 were examined by Western blot.The apoptosis was de-tected by flow cytometry.The malonaldehyde (MDA) and superoxide dismutase(SOD) in the cell culture medium were detected by enzyme-linked immunosorbent assays kit (ELISA).Results The mRNA expression of α1 a,α1 b,α2 a,α2 b,α2 c,β1, β3 was detected in the hEECs.After the NE treatment, no significant change in cell viability was observed in low concentration (5 μmol/L and 10 μmol/L) groups, while 15 μmol/L and 20μmol/L NE treatments for 6 h or 24 h promoted the cell viability significantly.The expression of ZO-1 and Occlu-din increased significantly in 15 μmol/L group after 24 h treatment, the expression of ZO-1 decreased in 6 h treat-ment group, significant down regulation was observed after 15 μmol/L NE application, the expression of Occludin increased in 6 h group.The cell apoptosis increased compared with the control group after NE stimulation, espe-cially a significantly increase in 6 h 15 μmol/L group was detected,while the fall in increased apoptosis was ob-served after 24 h treatment.The ration of Bcl-2/Bax>1.The expression of Nrf2 and HO-1 was elevated by NE.There was no obvious change in MDA level while significant elevation in SOD was detected in cell culture medium.Conclusion Nrf2/HO-1 signal is activated after application of NE to the hEECs, which may responsible for the upregulation of SOD, antioxidant and anti-apoptotic effect in the hEECs.

【Objective】 To explore the causal association between the onset of gastroesophageal reflux disease (GERD) and migraine and to provide genetic evidence, a two-sample bidirectional Mendelian randomization (MR) method was used in this study. 【Methods】 Single nucleotide polymorphism (SNP) information for both samples was obtained from publicly available genome-wide association study (GWAS) databases, in which the appropriate SNPs were selected as instrumental variables, and then bidirectional MR analysis used five MR analysis methods including inverse variance weighting (IVW), MR-Egger regression, weighted median, weighted mode and simple mode methods, followed by sensitivity analysis. 【Results】 IVW showed positive results of forward MR analysis with GERD as exposure [OR=1.398 7, 95%CI (1.181 7-1.655 6), P=9.59×10^-5] , while no positive significance of reverse MR analysis results with migraine as exposure (P>0.05). The same results were obtained in methods other than MR-Egger method. Meanwhile, none of the instrumental variables were found to be horizontally polytomous (P=0.92, P=0.64), and the results were robust after the leave-one-out method to exclude single SNPs. 【Conclusion】 There may be a unidirectional causal association between GERD and migraine, and GERD is a risk factor for migraine development.

Objective To study the application effect of quality control circle(QCC)in reducing the dissatisfaction rate of physical examination clients in health management center.Methods To establish QCC,selected the health check-up popula-tion in our hospital in September-2019 and March-2020,through the questionnaire investigation and analysis,compare the dis-satisfaction of the clients before and after the quality control circle.Results After carrying out QCC activities,the dissatisfaction of physical examination clients was significantly lower than that before QCC,and the difference was statistically significant(P＜0.05).Conclusion The activities of QCC in the health management center can effectively improve the quality of the physical examination work and reduce the dissatisfaction of the customers in the physical examination.It is of great significance to the health management.