ObjectiveBy establishing a light sleep deprivation （SD） model and using the traditional Chinese medicine （TCM） compound Sancao Anshen prescription for intervention， this study aims to observe one of the effects of Sancao Anshen prescription on the sleep and depressive states of zebrafish in the SD model and explore the mechanism of action of this drug in regulating the cyclic adenosine monophosphate （cAMP）/protein kinase A （PKA） signaling pathway. MethodsA total of 240 six-month-old wild-type AB zebrafish were randomly divided into a blank group， a model group， low-dose， medium-dose， and high-dose groups of Sancao Anshen prescription （0.28， 0.83， 2.48 g·L^-1）， and a melatonin group （0.2 g·L^-1）， with 40 fish in each group. Except for the blank group， all others were exposed to LED lights （150 lux） for three days to construct the sleep deprivation model， and were treated with the corresponding doses of Sancao Anshen decoction and melatonin solution for three days. 24 h movement behavior was used to detect diurnal movement trajectories. A T-shaped maze was employed to detect learning and memory functions， and a new tank experiment was conducted to detect depression-like behaviors in zebrafish. Hematoxylin-eosin （HE） staining was used to observe the morphology of hypothalamic neurons， and transmission electron microscopy was utilized to observe the ultrastructure of hypothalamic cells. Immunohistochemical （IHC） was used to measure the positive expression of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β） in the hypothalamus， and enzyme-linked immunosorbent assay （ELISA） was employed to determine the content of cAMP， 5-hydroxytryptamine （5-HT）， gamma-aminobutyric acid （GABA）， and glutamic acid （Glu） in brain tissue. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to measure the expression of PKA， cAMP response element-binding （CREB）， and brain-derived neurotrophic factor （BDNF） mRNAs and proteins and their phosphorylation levels （p-PKA， p-CREB） in brain tissue. ResultsCompared with those in the blank group， the resting time and resting count in the model group decreased significantly （P<0.01）， while the gross motor time and gross motor count increased significantly （P<0.01）. The latency time to enter the EC region in each administration group increased significantly （P<0.01）. The exploration time towards the top and the number of times entering the top decreased significantly （P<0.01）， and the incubation period of the first ascent increased significantly （P<0.01）. The number of hypothalamic neurons decreased significantly， and the neurons exhibited irregular shapes， sparse arrangement， and nuclear condensation. Nuclear collapse， nuclear membrane rupture and dissolution， chromatin condensation， mitochondrial swelling and deformity， and plate-like cristae rupture or disappearance were observed. The positive expression of TNF-α and IL-1β in the hypothalamus was significantly decreased （P<0.01）. The content of cAMP， GABA， and 5-HT in brain tissue was significantly downregulated， while the content of Glu was significantly upregulated （P<0.01）. The mRNA of PKA， CREB， and BDNF was significantly downregulated （P<0.01）， and the protein expression of p-PKA， p-PKA/PKA， p-CREB， p-CREB/CREB， and BDNF was significantly decreased （P<0.05， P<0.01）. Compared with those in the model group， the resting time in the medium-dose and high-dose groups of Sancao Anshen prescription and the melatonin group increased （P<0.05， P<0.01）， and the resting count in each administration group significantly increased （P<0.05， P<0.01）. The gross motor time and gross motor count significantly decreased （P<0.05， P<0.01）. The latency time to enter the EC region decreased （P<0.01）， and the exploration time towards the top increased （P<0.01）. The time for the first ascent in the high-dose group of Sancao Anshen prescription and the melatonin group was shortened （P<0.05， P<0.01）， and the number of times entering the top increased （P<0.01）. The morphology of neurons in each administration group improved， with the gap decreased， the nuclear membrane relatively intact， and mitochondrial swelling improved. The positive expression of IL-1β in each administration group significantly decreased （P<0.01）. The positive expression of TNF-α in the medium-dose and high-dose groups of Sancao Anshen prescription and the melatonin group significantly decreased （P<0.01）. The Glu content in the low-dose group of Sancao Anshen prescription decreased， while cAMP and GABA levels increased （P<0.05， P<0.01）. There was no statistically significant difference in 5-HT content. The medium-dose and high-dose groups of Sancao Anshen prescription and the melatonin group all showed significant increases in cAMP， 5-HT， and GABA levels （P<0.01）， and a significant decrease in Glu content （P<0.01）. The mRNA of CREB in the low-dose group of Sancao Anshen prescription was significantly upregulated （P<0.01）， while there was no statistically significant difference in the mRNA of PKA and BDNF. The mRNA of PKA， CREB， and BDNF in the medium-dose and high-dose groups of Sancao Anshen prescription and the melatonin group were all significantly upregulated （P<0.01）. The protein expression of p-PKA， p-PKA/PKA， p-CREB， p-CREB/CREB， and BDNF in the high-dose group of Sancao Anshen prescription and the melatonin group increased significantly （P<0.05， P<0.01）， and the protein expression of p-PKA， p-CREB， and BDNF in the medium-dose group of Sancao Anshen prescription increased （P<0.05）. ConclusionThe improvement of sleep and depressive states in zebrafish with the SD model by Sancao Anshen prescription may be related to the inhibition of inflammatory factors such as TNF-α and IL-1β， the reduction in Glu， and the elevation in the content of neurotransmitters such as GABA and 5-HT via the cAMP/PKA signaling pathway.

: To analyze the prevalence of anemia and iron deficiency among primary and secondary school students in Rural Nutrition Improvement Program areas of Guizhou Province in 2023, and to explore the related factors, so as to provide evidence for Rural Nutrition Improvement Program optimization. Methods: In September 2023, a stratified random cluster sampling strategy was used to select 40 rural compulsory education schools with rural nutrition improvement program in five counties of Guizhou Province. School level questionnaire was employed to collect information of basic characteristics and school meal implementation. A total of 7 826 primary and secondary school students aged 6-16 underwent anthropometry and hemoglobin (Hb) determination; serum ferritin (SF) was additionally measured in a random subsample of 1 795 pupils. Students in Grade 3 and above also completed a questionnaire covering demographic characteristics, dietary behaviours and nutrition knowledge. Group comparisons were conducted by Chi square test or Fisher s exact test, and multivariable Logistic regression models were constructed to identify factors associated with anemia and iron deficiency. Results: The overall Hb level was (133.21±12.95)g/L, with an anemia prevalence of 7.17%. The overall SF level was (69.58±59.01)μg/L, with an iron deficiency prevalence of 2.73%. Multivariable analysis showed that stunting ( OR =1.88), school menus without nutrient calculation ( OR =1.61) and absence of menu planning software in the current semester ( OR =2.34) independently increased anemia risk, whereas obesity reduced it ( OR =0.54) (all P <0.05). Girls ( OR =4.16) and Grades 7-9 ( OR =5.93) increased iron deficiency risk (both P <0.05). Compared with rarely eating fresh vegetables, students with consuming <3 kinds per day ( OR =0.08) or exactly 3 kinds per day ( OR =0.06) had lower iron deficiency risks (both P <0.05). Conclusions Anemia and iron deficiency are prevalent among primary and secondary school students in Guizhou. Targeted intervention measures should be implemented for key populations to enhance the effectiveness of nutrition improvement program.

Background Per- and poly-fluoroalkyl substances (PFAS) can influence gestational diabetes mellitus (GDM); however, current studies on their association are limited and have yielded inconsistent findings. Objective To investigate the association between maternal exposure to PFAS, as measured by urinary concentrations in early pregnancy, and the risk of developing GDM. Methods Based on the Wuhu Birth Cohort in Anhui Province conducted between 2020 and 2023, this study included 1910 pregnant women. Urine samples were collected during the first trimester, and a 75 g oral glucose tolerance test (OGTT) was completed at 24–28 gestational weeks. The concentrations of six PFAS in urine were measured using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Participants were categorized into low, medium, and high exposure groups according to tertiles of individual PFAS concentrations. Logistic regression analysis was employed to assess the potential impact of early-pregnancy PFAS exposure levels on the risk of GDM, with stratified analyses by maternal age and fetal sex. A generalized weighted quantile sum regression (gWQS) model was applied to evaluate the relative weight distribution of the six PFAS in their mixture effect. Results The logistic regression results revealed that both medium exposure to perfluorohexane sulfonate (PFHxS) (OR=1.475, 95%CI: 1.040, 2.093) and high exposure to perfluorononanoic acid (PFNA) (OR=1.430, 95%CI: 1.013, 2.018) were positively associated with diagnosed GDM. This association was more pronounced among women older than 28 years. Among pregnant women carrying male fetuses, high-level exposures to per fluorohexanoic acid (PFHxA) (OR=1.708, 95%CI: 1.006, 2.899) and PFHxS (OR=2.116, 95%CI: 1.247, 3.584) showed positive associations with diagnosed GDM. In contrast, among those carrying female fetuses, moderate perfluorooctanesulfonic acid (PFOS) exposure was associated with a lower risk of GDM (OR=0.542, 95%CI: 0.311, 0.946). The gWQS results demonstrated that PFOS (0.48) and perfluorobutane sulfonate (PFBS) (0.34) contributed the most to the mixture effect. Conclusion Early-pregnancy exposure to PFAS (particularly PFHxS and PFNA) may be an etiological factor for GDM, with maternal age and fetal sex potentially acting as effect modifiers in this association.

Background Depressive symptoms have become a significant factor affecting the physical and mental health of the occupational population, and workers in petroleum refining enterprises face multiple stressors in their work environment. Objective To explore the impact of occupational noise exposure on depressive symptoms among workers in a petroleum refining enterprise. Methods This cross-sectional study was conducted in July 2024 using a questionnaire survey among workers of a petroleum refining enterprise in Hainan Province. Basic information of the subjects was collected. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms, the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) scale was used to assess sleep quality, and the Chinese version of the Effort-Reward Imbalance (ERI) scale was used to evaluate occupational stress. Chi-square test was employed to compare the differences in reporting depressive symptoms among populations with different characteristics. Binary logistic regression models were used to analyze the impact of occupational noise exposure and other factors on depressive symptoms. Results The overall positive rate of depressive symptoms in the study population was 42.7%. The results of the multifactor analysis indicated that compared with the control group, employees in both the low-exposure and high-exposure groups had elevated odds of depressive symptoms, with OR (95%CI) of 2.244 (1.131, 4.454) and 1.970 (1.009, 3.850), respectively. This association remained robust after adjusting for potential confounders, including gender, age, work tenure, and other occupational exposures. Additionally, female [OR (95%CI)=1.483 (1.039, 2.118)], exposure to benzene, toluene, or xylene [OR (95%CI)=1.621 (1.208, 2.174)], sleep disturbance [OR (95%CI)=3.772 (2.942, 4.838)], and occupational stress [OR (95%CI)=2.018 (1.575, 2.585)] were also significantly associated with higher odds of depressive symptoms. Conclusion The positive rate of depressive symptoms is relatively high among employees in this petrochemical enterprise, and occupational noise exposure may be a risk factor for depressive symptoms.

Objective: On 27 June 2023, the Thailand Department of Disease Control was notified of an incident of carbon monoxide poisoning related to a Thai-style hotpot restaurant. An outbreak investigation was performed to describe the incident, confirm its cause and sources of exposure, and provide preventive measures. Methods: The restaurant owner, restaurant guests and waiting staff were interviewed, and the medical records of hospitalized cases were reviewed. In an environmental survey, air quality parameters were measured, including temperature, relative humidity, carbon dioxide and carbon monoxide. Additionally, a simulation of the incident was conducted, and data were reviewed from previous poisoning incidents in Thailand. Results: There were 11 cases, all of whom were guests who dined in the same private dining room. The median age of cases was 28 years (range 2–62 years). Three cases were hospitalized and received hyperbaric oxygen therapy. The air changes in the dining rooms were below the recommended level. The incomplete combustion of charcoal in a poorly ventilated room led to carbon monoxide build-up, which caused the incident. The simulation experiment showed a high concentration of carbon monoxide (mean 183.16 ± 55.15 parts per million), above the standard level. Ten similar poisoning incidents occurred between 2019 and June 2023, totalling 23 cases and 2 deaths; none occurred in a restaurant. Discussion: Charcoal use in poorly ventilated areas poses a health risk, especially for children. The use of charcoal stoves for hotpot cooking indoors is prohibited. Public health policy should mandate regular restaurant inspections to ensure compliance with occupational and environmental health standards.

Abstract To achieve identification and intervention synergy with regards to critical windows for the prevention and control of childhood hypertension, the study adopts a life course perspective to systematically review the developmental pathways of childhood hypertension, identify key challenges facing current prevention and control efforts, and discuss monitoring and intervention strategies during critical windows of opportunity. By promoting continuous, multi setting screening and dynamic monitoring, improving measurement standardization and diagnostic feasibility, developing child specific risk assessment tools and strengthening coordinated interventions across families, schools, communities and individuals, the prevention of childhood hypertension can shift away from passive detection toward proactive risk management and primary prevention, thereby providing robust evidence and practical pathways to reduce the lifelong burden of cardiovascular disease.

Objective: To systematically evaluate the association between random urinary electrolyte levels and hypertension among children and adolescents in Guizhou Province, so as to provide evidence for region specific dietary guidance and interventions. Methods: In 2023, a total of 2 480 children and adolescents aged 6 to 17 years were recruited from a nine-year coherent style school in Guizhou Province in a children health cohort, with follow ups conducted in 2024 and 2025. Random urine samples were collected to measure urinary sodium, potassium, calcium, and chloride, and the urinary sodium to potassium ratio (Na/K) was calculated. The diagnosis of hypertension was based on the criteria established by the Chinese Guidelines for Hypertension Prevention and Treatment (2024 revised edition) and relevant research. Linear mixed models and multinomial Logistic regression were used to assess the associations of urinary electrolytes with systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and the risk of hypertension. Results: At baseline, SBP, DBP, and MAP were 102.33 (94.33, 110.33), 61.33 (56.33, 67.00) and 75.22 (69.67, 81.33)mmHg among children and adolescents, respectively. After adjusting for potential confounders and two follow-ups, higher urinary Na/K ratio was positively associated with higher of SBP ( β=0.054, 95%CI =0.028- 0.081 ) and MAP ( β=0.038, 95%CI =0.010-0.066), as well as higher risks of hypertension ( OR=1.248, 95%CI =1.006-1.548) (all P <0.05). Higher of urinary chloride levels were positively associated with higher of SBP ( β=0.088, 95%CI = 0.009- 0.167), whereas higher of urinary potassium (SBP: β=-0.062, 95%CI =-0.096 to -0.028; MAP: β=-0.041, 95%CI = -0.078 to -0.005) and calcium levels (SBP: β=-0.036, 95%CI =-0.065 to -0.007) were negatively associated with blood pressure (all P < 0.05 ). Conclusion The urinary Na/K, as a comprehensive electrolyte marker, more stably reflects sodium load and excretory pressure in children and adolescents, and may serve as an early predictor of hypertension risk.

Objective: To explore the latent profile characteristics of regulatory emotional self-efficacy and its relationship with non-suicidal self-injurious (NSSI) behavior among junior and senior high school students, so as to provide a basis for effectively reducing NSSI behaviors. Methods: From April to October 2023, a total of 1 217 junior and senior high school students were selected from Tongren City, Zunyi City and Qiannan Prefecture of Guizhou Province by stratified cluster random sampling method. The Scale of Regulatory Emotional Self-efficacy and the Adolescent Self-injury Scale were administered. Latent profile analysis (LPA) was employed to explore distinct profiles of regulatory emotional self-efficacy, and the Lanza, Tan, and Bray s method (LTB) was used to analyze the relationship between these profiles and NSSI behavior. Results: The prevalence rate of NSSI behavior among junior and senior high school students was 28.6%. Among males, regulatory emotional self-efficacy was categorized into two types: moderate positive expression-low negative management group (59.1%, n =353) and high efficacy group (40.9%, n =244); among females, regulatory emotional self-efficacy was classified into three categories: low efficacy group (18.4%, n =114), high positive expression-low negative management group (56.3%, n =349), and high efficacy group (25.3%, n =157). There were statistically significant differences in total NSSI scores across different potential categories of regulatory emotional self-efficacy within both males and females ( Z/H = -5.75 , 57.58, both P <0.01). The differences in NSSI prevalence rates across the potential categories of regulatory emotional self-efficacy were statistically significant for both males and females ( χ 2=38.00, 69.14, both P <0.01), and among females, the differences in NSSI prevalence rates between the high efficacy group and the low efficacy group ( χ 2=60.01) and between the high efficacy group and the high positive expression-low negative management group ( χ 2=31.34) were also statistically significant (both P < 0.016 7 ). Binary Logistic regression analysis revealed that, compared with the high efficacy group within each gender, the moderate positive expression-low negative management group among males ( OR =2.36), and both the low efficacy group and the high positive expression-low negative management group among females ( OR =6.19, 2.97), were at an increased risk of engaging in NSSI (all P <0.01). Conclusion Different latent profiles of regulatory emotional self efficacy among junior and senior high school students are associated with NSSI behavior.

Abstract The prevalence of hypertension in children and adolescents continues to rise with a trend toward earlier onset, presenting a phenomenon that cannot be fully explained by traditional risk factor frameworks. Circadian rhythm disruption, particularly the dual disturbance of dietary and sleep rhythms, has emerged as a novel risk factor and become a research hotspot. The review systematically summarizes the epidemiological associations, biological mechanisms, and intervention strategies regarding dietary rhythm, sleep rhythm, and their co exposure with blood pressure in children and adolescents. Future research needs to focus on Chinese pediatric populations through longitudinal cohort studies and randomized controlled trials to clarify causal relationships and regulatory mechanisms, thereby providing evidence based guidance for chronic disease prevention and control in children.

Diabetic retinopathy （DR） is a microvascular complication of diabetes and one of its most common complications. Prolonged hyperglycemia induces oxidative stress， inflammatory responses， apoptosis， and pathological angiogenesis， ultimately disrupting the blood-retinal barrier（BRB） and leading to visual impairment or even blindness. Recent studies show that the nuclear factor erythroid 2-related factor 2 （Nrf2） signaling pathway plays an important role in the development of DR's pathological changes. Meanwhile， Chinese herbal monomers have been shown to modulate the Nrf2 signaling pathway， thereby intervening in the development of DR. In terms of inhibiting oxidative stress， saponin compounds such as platycodin-D and ginsenoside Rb1 downregulate the expression of malondialdehyde （MDA）， thereby ameliorating retinal oxidative stress. Flavonoids such as total flavonoids from Pueraria lobata flower and puerarin upregulate the expression of superoxide dismutase （SOD） and glutathione peroxidase （GPx）， effectively clearing lipid peroxides. Regarding the suppression of inflammation， phenolic compounds like resveratrol and chlorogenic acid inhibit the nuclear factor kappa B （NF-κB） pathway， reducing the release of tumor necrosis factor-alpha （TNF-α） and mitigating inflammatory responses. In the context of inhibiting apoptosis， polysaccharides such as Polygonatum sibiricum polysaccharide and Angelica sinensis polysaccharide downregulate the expression of the pro-apoptotic protein Bcl-2-associated X protein （Bax） and suppress the activity of the executioner Caspase-3， thereby reducing the apoptosis rate. As for the inhibition of neovascularization， compounds including bilobalide and physcion significantly decrease the protein expression of vascular endothelial growth factor （VEGF）， leading to a reduction in retinal pathological angiogenesis. Furthermore， Chinese herbal compound prescriptions such as Tongluo Zhujing pills， Yiqi Huoxue Yangyin decoction， Qiming granules， and Danlou tablets can also intervene in the onset and progression of DR through the mechanisms described above. In summary， both Chinese herbal monomers and Chinese herbal compound prescriptions can modulate the Nrf2 signaling pathway to inhibit oxidative stress， alleviate inflammation， and participate in maintaining BRB integrity， suppressing retinal neovascularization， and preventing neurodegeneration， thereby delaying the progression of DR. Therefore， this paper reviews and summarizes recent studies at home and abroad on how traditional Chinese medicine （TCM） works to treat DR， and the relationship between the Nrf2 pathway and DR. It aims to provide research ideas for preventing and treating DR.