Abstract Recently, the Ministry of Education issued Guiding Opinions on Comprehensively Promoting the Construction of Healthy Schools hereinafter referred to as the Guiding Opinions, which systematically established the goal system, key tasks, critical measures, and safeguard mechanisms for the construction of healthy schools in the new era. Against the backdrop, comprehensively promoting the construction of healthy schools has become a core project for implementing the concept of "Health First", carrying out joint prevention and control of multiple diseases, and responding to national action plans. Based on a systematic analysis of the internal logic between healthy school construction and the "education powerhouse strategy", the study deeply expounds on its core mission as a "foundational project for talent cultivation" and a "hub for the integration of five educations". Combining the eight key tasks and three critical measures clarified in the Guiding Opinions, it constructs a multi dimensional, systematic, and operable implementation path from the aspects of concept leadership and practice internalization, data monitoring and closed loop management, team support and environmental optimization, literacy promotion and evaluation innovation, innovation drive and characteristic development,digital empowerment and smart governance. The study provides a forward looking and strategic comprehensive solution for improving the collective health literacy of students and building a comprehensive prevention and control system for common campus diseases in the new era.

Objective To assess mid- and long-term outcomes of ascending aortic wrapping (AAW) in adult patients undergoing aortic valve replacement (AVR). Methods We retrospectively analyzed clinical data of adult patients who underwent AVR and AAW in Fuwai Hospital from January 2010 to August 2019. Ascending aorta diameter (AAD) was measured by echocardiography or CT scan preoperatively and postoperatively. Results A total of 33 patients were enrolled, including 23 males and 10 females aged 22-73 (51.06±12.61) years. There was no perioperative death. The mean preoperative, postoperative and follow-up AAD of the patients were (46.06±3.54) mm, (34.55±5.17) mm, and (37.12±5.64) mm, respectively. The differences in the AAD between pre-operation and post-operation, and between pre-operation and the last follow-up were both statistically significant (P<0.05). The median follow-up time was 38.20 (18.80-140.30) months. The median increase rate of diameter was 0.63 (−0.11, 1.36) mm per year after the surgery. The increase rate was >5 mm per year in 1 patient, and >3 mm in another one. Conclusion The mid- and long-term outcomes of AAW in adult patients undergoing AVR are satisfactory and encouraging.

The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

Objective:Based on the theoretical framework of policy innovation diffusion,it systematically explores the diffusion mechanism and core influencing factors of national regional medical centers,and reveals their internal diffusion laws and key driving factors,so as to provide theoretical basis and practical guidance for the rational expansion,precise sinking and scientific layout of high-quality medical resources.Methods:Based on the panel data related to the construction of national medical centers in 31 provincial-level administrative regions of China from 2019 to 2023,the random effect and fixed effect models were used for benchmark regression analysis,and the spatial Durbin model was innovatively introduced to explore the influencing factors and internal mechanisms of the expansion of high-quality medical resources.Results:The degree of population aging,the level of regional education development and the intensity of medical financial expenditure showed a significant positive correlation with the layout of national regional medical centers,which has become the key strategic fulcrum driving the construction of national regional medical centers.Conclusion:In order to improve the efficiency of medical resource allocation and promote the expansion and balanced distribution of high-quality resources,it is necessary to accurately meet the demand for health services brought about by the evolution of population structure,systematically promote the upgrading of national education quality,and continue to increase the allocation of financial resources in the field of medical and health care,and establish a multi-institutional collaboration mechanism to promote the integration and sharing of resources to ensure the accessibility and equitable development of medical resources.

Objective:It aims to reveal the direct and indirect effects of the configuration of multiple influencing factors on the expansion and downward transfer of high-quality medical resources on medical expenses,providing a scientific basis for formulating differentiated policies based on local conditions.Methods:Based on the policy diffusion theory,combined with qualitative comparative analysis and regression analysis methods,a complex mediation model is constructed to deeply analyze the complex relationship and mechanism between the expansion and downward transfer of high-quality medical resources and the control of per capita medical expenses.Results:(1)There are multiple equivalent configuration paths that can promote the expansion and downward transfer of high-quality medical resources,among which three configuration paths are driven by public demand,government attention,and financial guarantee,and two configuration paths are driven by infrastructure and financial guarantee;(2)The expansion and downward transfer of high-quality medical resources play a complex mediating role in the impact of multiple equivalent configuration paths on per capita medical expenses.Conclusion:In the process of implementing the expansion and downward transfer of high-quality medical resources,localities should scientifically choose implementation paths suitable for local conditions;build a multi-level and multi-dimensional policy combination system;strengthen financial input and fund guarantee to provide a solid economic foundation for the expansion and downward transfer of high-quality medical resources.

Objective:Accelerating the cultivation and development of new quality productive forces is an inherent requirement for the coordinated development of health care industry and economic society in the new era.Methods:Based on the technology-organization-environment framework,it explores the complex causal mechanism of multi-factor synergy affecting the allocation of medical resources and the coordinated development of economy and society driven by new quality productive forces.By constructing the"time+space"two-dimensional dynamic coupling coordination degree model and grey prediction model,the specific improvement path of the allocation of medical resources and the coordinated development of economy and society in the"13th Five-Year Plan","14th Five-Year Plan"and"15th Five-Year Plan"periods are explored from the perspective of configuration.Results:During the period from the"13th Five-Year Plan"to the"15th Five-Year Plan",the degree of coordination between medical resource allocation and economic and social coupling 31 provinces(cities)generally showed an upward trend,but there were large regional disparities.From the grouping results,it can be seen that the grouping path of the coordinated development of medical resource allocation and economy and society in the"13th Five-Year Plan"and"14th Five-Year Plan"periods shows significant differences.It is expected that technology-organization-driven,technology-environment-driven and organization-environment-driven paths will be formed in the"15th Five-Year Plan"period.Conclusion:It is necessary to accelerate the formation of the agglomeration advantage of technology and talent factors,appropriately increase the financial support for the western region,and achieve coordinated development of regional integration.

Objective:By analyzing the spatio-temporal evolution and driving factors of the adaptation of high-quality medical resources to the elderly population in the Yangtze River Delta Region of China,it explored the development trend and leading driving factors of the adaptation of high-quality medical resources to the elderly population in the Yangtze River Delta Region of China,and the decision references were provided for further optimizing the allocation of high-quality medical resources in the Yangtze River Delta Region and improving the health service level of the elderly population in the Yangtze River Delta Region.Methods:The spatial dislocation index was employed to measure and analyze the spatio-temporal evolution of the adaptation of high-quality medical resources for the elderly population in prefecture-level cities in the Yangtze River Delta Region from 2016 to 2023,and the leading driving factors of the adaptation were further analyzed by using the geographical detector method.Results:The adaptability of high-quality medical resources to the aged population in the Yangtze River Delta Region showed a trend of steady improvement,and implied the spatial characteristics of"insufficient in the northwest,redundant in the southeast"and"inter-provincial differences greater than intra-provincial differences".Scientific and technological innovation ability plays a leading driving role in the adaptation of high-quality medical resources to the elderly population in the Yangtze River Delta region.Conclusion:In order to deepen the reform of the allocation of high-quality medical resources in the Yangtze River Delta Region and effectively improve the level of regional health services for the elderly population,it is recommended to build a regional medical collaborative development mechanism,promote the gradient sinking and balanced allocation of high-quality medical resources,strengthen the scientific and technological innovation support system in the medical and health field,and further promote the efficiency of medical resources integration and the innovation of medical resources development.

Objective To investigate the protective effects and potential mechanisms of tetrahydrocurcumin(THC)on thoracic aortic aneurysm and dissection(TAAD)in mice.Methods TAAD was induced in 3-week-old C57BL/6J mice by oral administration of β-aminopropionitrile(BAPN)(diluted in drinking water,1 g/(kg·d)).Eighty mice were divided randomly into Con,BAPN,BAPN+THC,and BAPN+THC+3-TYP(SIRT3 inhibitor)groups(n=20 mice per group).The survival rate of mice in each group was recorded after 4 weeks.The maximum diameter of the aorta was measured and the histomorphology and aortic wall elastin integrity were evaluated by hematoxylin and eosin and elastin van Gieson staining.Macrophage infiltration was detected by immunohistochemical staining and α-smooth muscle actin(α-SMA)and osteopontin(OPN)expression were detected by immunofluorescence staining.The production of reactive oxygen species(ROS)was measured by dihydroethidium staining and superoxide dismutase(SOD)activity and malondialdehyde(MDA)levels were determined using kits.Protein expression levels of matrix metalloproteinase(MMP)2,MMP9,interleukin(IL)-6,tumor necrosis factor(TNF)-α,nuclear factor erythroid 2-related factor 2(NRF2),NADPH oxidase 2(NOX2),α-SMA,OPN,sirtuin 3(SIRT3),Ac-SOD2,and SOD2 were measured by Western Blot.Results Mice in the BAPN+THC group showed significantly higher survival and a lower incidence of TAAD compared with the BAPN group and the degree of aortic dilatation and morphology and structure were improved(P＜0.05).Infiltration of CD68-positive macrophages and MMP2,MMP9,IL-6,and TNF-α expression levels were lower(P＜0.05),ROS generation,MDA content,and NOX2 expression in aortic tissue were also significantly decreased,while SOD activity and NRF2 expression were increased(P＜0.05).α-SMA expression was also increased,while OPN expression was reduced(P＜0.05).SIRT3 expression was increased while the Ac-SOD2/SOD2 ratio was decreased(P＜0.01).Treatment with the SIRT3-specific inhibitor and silencing of SIRT3 counteracted the ability of THC to resist TAAD via the SIRT3 signaling pathway(all P＜0.05).Conclusions THC alleviated inflammation and oxidative stress in aortic tissues by activating the SIRT3 signaling pathway,thus inhibiting the phenotypic transformation of vascular smooth muscle cells and resisting the formation of TAAD in mice.

Objective:It aims to reveal the direct and indirect effects of the configuration of multiple influencing factors on the expansion and downward transfer of high-quality medical resources on medical expenses,providing a scientific basis for formulating differentiated policies based on local conditions.Methods:Based on the policy diffusion theory,combined with qualitative comparative analysis and regression analysis methods,a complex mediation model is constructed to deeply analyze the complex relationship and mechanism between the expansion and downward transfer of high-quality medical resources and the control of per capita medical expenses.Results:(1)There are multiple equivalent configuration paths that can promote the expansion and downward transfer of high-quality medical resources,among which three configuration paths are driven by public demand,government attention,and financial guarantee,and two configuration paths are driven by infrastructure and financial guarantee;(2)The expansion and downward transfer of high-quality medical resources play a complex mediating role in the impact of multiple equivalent configuration paths on per capita medical expenses.Conclusion:In the process of implementing the expansion and downward transfer of high-quality medical resources,localities should scientifically choose implementation paths suitable for local conditions;build a multi-level and multi-dimensional policy combination system;strengthen financial input and fund guarantee to provide a solid economic foundation for the expansion and downward transfer of high-quality medical resources.

Objective To investigate the protective effects and potential mechanisms of tetrahydrocurcumin(THC)on thoracic aortic aneurysm and dissection(TAAD)in mice.Methods TAAD was induced in 3-week-old C57BL/6J mice by oral administration of β-aminopropionitrile(BAPN)(diluted in drinking water,1 g/(kg·d)).Eighty mice were divided randomly into Con,BAPN,BAPN+THC,and BAPN+THC+3-TYP(SIRT3 inhibitor)groups(n=20 mice per group).The survival rate of mice in each group was recorded after 4 weeks.The maximum diameter of the aorta was measured and the histomorphology and aortic wall elastin integrity were evaluated by hematoxylin and eosin and elastin van Gieson staining.Macrophage infiltration was detected by immunohistochemical staining and α-smooth muscle actin(α-SMA)and osteopontin(OPN)expression were detected by immunofluorescence staining.The production of reactive oxygen species(ROS)was measured by dihydroethidium staining and superoxide dismutase(SOD)activity and malondialdehyde(MDA)levels were determined using kits.Protein expression levels of matrix metalloproteinase(MMP)2,MMP9,interleukin(IL)-6,tumor necrosis factor(TNF)-α,nuclear factor erythroid 2-related factor 2(NRF2),NADPH oxidase 2(NOX2),α-SMA,OPN,sirtuin 3(SIRT3),Ac-SOD2,and SOD2 were measured by Western Blot.Results Mice in the BAPN+THC group showed significantly higher survival and a lower incidence of TAAD compared with the BAPN group and the degree of aortic dilatation and morphology and structure were improved(P＜0.05).Infiltration of CD68-positive macrophages and MMP2,MMP9,IL-6,and TNF-α expression levels were lower(P＜0.05),ROS generation,MDA content,and NOX2 expression in aortic tissue were also significantly decreased,while SOD activity and NRF2 expression were increased(P＜0.05).α-SMA expression was also increased,while OPN expression was reduced(P＜0.05).SIRT3 expression was increased while the Ac-SOD2/SOD2 ratio was decreased(P＜0.01).Treatment with the SIRT3-specific inhibitor and silencing of SIRT3 counteracted the ability of THC to resist TAAD via the SIRT3 signaling pathway(all P＜0.05).Conclusions THC alleviated inflammation and oxidative stress in aortic tissues by activating the SIRT3 signaling pathway,thus inhibiting the phenotypic transformation of vascular smooth muscle cells and resisting the formation of TAAD in mice.