Abstract The cooccurrence of multi disease among children and adolescents has become increasingly prominent, necessitating a shift from "single disease separate treatment" to "multi disease co prevention". Focusing on four common health problems in children and adolescents, namely, myopia, depression, overweight/obesity, and spinal abnormalities, the paper systematically reviews the association between four categories of factors, society, environment, family, and individual behavior, and the co occurrence of the aforementioned health problems. The findings indicate that particulate matter 2.5 exposure, light at night, physical inactivity, excessive screen time, and unhealthy diet constitute the primary cross dimensional risk network. Based on these findings, the paper proposes a collaborative action framework involving family, school, and society, emphasizing systematic strategies ranging from upstream environmental governance to downstream behavioral intervention, so as to provide evidence for the practice and policy making of multi disease co-prevention in children and adolescents.

Autoimmune hepatitis (AIH) is a kind of immune-mediated chronic liver disease, and its specific pathogenesis has not yet been fully elucidated. In recent years, the International Autoimmune Hepatitis Expert Group has revised histology and autoantibody evaluation criteria for diagnosing AIH and has clarified the definition of treatment response. The current standard treatment regimen is still glucocorticoids and azathioprine, but novel biological agents offer new therapeutic options for patients with refractory AIH. This article reviews the new progress in the diagnosis and treatment of AIH and explores the current challenges and future research directions.

Objective To investigate the mechanism and optimal concentration of anrotinib on ovarian clear cell carcinoma.Methods Ovarian clear cell carcinoma cells were cultured in vitro,by using renal clear cell carcinoma cells and renal papillary cell carcinoma cells as control cancer cells,and the effects of different concentrations of anlotinib(5,10,15,20μmol/L)on the proliferation,migration,and invasion capabilities of three cancer cell lines were investigated.Compared with the experimental results of renal clear cell carcinoma cells and renal papillary cell carcinoma cells,the advantages of anlotinib on ovarian clear cell carcinoma cells were investigated and advanced its position in clinical practice.Results Anlotinib at the concentrations of 5,10,15,and 20μmol/L can effectively inhibit the proliferation,migration,and invasion ability of ovarian clear cell carcinoma cells,renal clear cell carcinoma cells,and renal papillary cell carcinoma cells.Among them,the optimal action concentration of anlotinib on all three cancer cells fell in the range of 5-10 μmol/L.However,in the three cancer cells,anlotinib was more potent in ovarian clear cell carcinoma cells.Conclusion The effect of anlotinib on ovarian clear cell carcinoma cells has obvious advantages over renal clear cell carcinoma cells and renal papillary cell carcinoma cells,with the optimal concentration of 5-10 μmol/L.

Objective:To determine the diagnosis of microtia-associated syndrome through genetic testing.Methods:Peripheral venous blood samples were collected from members of a two-generation family with a syndrome associated with ear malformations (3 patients and 1 normal control). Pathogenic mutations were identified using whole exome sequencing analysis, Sanger sequencing validation, and bioinformatics analysis. Based on the genetic diagnosis and a review of the literatures, the patients′ clinical phenotypes were thoroughly evaluated to confirm the clinical diagnosis.Results:All three patients carried a novel heterozygous insertion mutation (c.1171_1172insGGCC: p.Pro391fs) in the paired box 1 ( PAX1) gene. This mutation showed genotype-phenotype co-segregation within the family and was predicted to be pathogenic. Consequently, the family was diagnosed with autosomal dominant otofaciocervical syndrome 2. The clinical phenotypes of the patients included not only ear malformations and conductive hearing loss but also branchial cleft fistula, preauricular fistula, bilateral facial asymmetry, spinal deformities, and short stature, which were major symptoms of otofaciocervical syndrome 2. Imaging also revealed previously unreported phenotypes, including parotid gland malformation and facial nerve dysplasia. Conclusion:The heterozygous insertion in PAX1 (c.1171_1172insGGCC: p.Pro391fs) found in this family causes otomandibular-cervical syndrome type 2 in an autosomal dominant manner, leading to congenital anomalies affecting external and middle ear, craniofacial region, and spine.

Autoimmune hepatitis (AIH) is a kind of immune-mediated chronic liver disease, and its specific pathogenesis has not yet been fully elucidated. In recent years, the International Autoimmune Hepatitis Expert Group has revised histology and autoantibody evaluation criteria for diagnosing AIH and has clarified the definition of treatment response. The current standard treatment regimen is still glucocorticoids and azathioprine, but novel biological agents offer new therapeutic options for patients with refractory AIH. This article reviews the new progress in the diagnosis and treatment of AIH and explores the current challenges and future research directions.

Parkinson′s disease (PD) is a neurodegenerative disorder prevalent among the elderly, characterized by the degeneration of dopaminergic neurons in the substantia nigra. The motor symptoms of PD include resting tremor, bradykinesia, rigidity, and postural gait disturbances. Additionally, non-motor symptoms such as depression, pain, cognitive impairment, sleep disorders, and autonomic dysfunction are gaining increasing attention. Among these, bladder and urethral dysfunction is one of the most common manifestations of autonomic dysfunction and significantly impacts patients′ quality of life in the later stages of the disease. This article provides a review of recent research on the epidemiology, pathogenesis, and treatment of bladder and urethral dysfunction in PD, aiming to enhance the understanding and management of urinary symptoms associated with PD.

Objective To compare the safety and efficacy of directional atherectomy with anti-restenosis therapy(DAART,drug-coated balloon)versus conventional balloon angioplasty(bare-metal stent,BMS)in elderly patients with femoropopliteal artery disease.Methods A retrospec-tive cohort study was conducted on 116 elderly patients undergoing endovascular intervention due to femoropopliteal artery disease in our hospital between May 2016 and September 2019,divided into DAART group(57 cases)and BMS group(59 cases).Results No statistical differences were observed between the DAART and BMS groups in terms of age,risk factors,distribution of Ruth-erford classification,lesion length,lesion type,lesion location,Global Limb Anatomic Staging Sys-tem grade,infra-popliteal runoff status,or preoperative ankle-brachial index(P＞0.05).However,the BMS group had significantly larger proportion of chronic limb-threatening ischemia than the other group(P＜0.05).Both groups achieved a 100％success rate of surgery.The DAART group obtained obviously higher primary patency rates at 1 and 2 years than the BMS group(90.4％vs 75.0％,76.3％vs 57.3％;P＜0.045).There were no significant differences in the rate of freedom from target lesion revascularization at 1 and 2 years between the two group(96.1％vs 88.8％,91.6％vs 77.7％;P＞0.05).In 2 years of follow-up,the incidence of major adverse events was 10.0％(5 cases)in the DAART group and 20.8％(12 cases)in the BMS group,but no obvious difference(P＞0.05).Conclusion DAART demonstrates superior mid-term efficacy than BMS in treating femoropopliteal artery disease in elderly patients.However,comprehensive preoperative assessment is essential to optimize individualized treatment strategies for this population.

Objective To investigate the mechanism and optimal concentration of anrotinib on ovarian clear cell carcinoma.Methods Ovarian clear cell carcinoma cells were cultured in vitro,by using renal clear cell carcinoma cells and renal papillary cell carcinoma cells as control cancer cells,and the effects of different concentrations of anlotinib(5,10,15,20μmol/L)on the proliferation,migration,and invasion capabilities of three cancer cell lines were investigated.Compared with the experimental results of renal clear cell carcinoma cells and renal papillary cell carcinoma cells,the advantages of anlotinib on ovarian clear cell carcinoma cells were investigated and advanced its position in clinical practice.Results Anlotinib at the concentrations of 5,10,15,and 20μmol/L can effectively inhibit the proliferation,migration,and invasion ability of ovarian clear cell carcinoma cells,renal clear cell carcinoma cells,and renal papillary cell carcinoma cells.Among them,the optimal action concentration of anlotinib on all three cancer cells fell in the range of 5-10 μmol/L.However,in the three cancer cells,anlotinib was more potent in ovarian clear cell carcinoma cells.Conclusion The effect of anlotinib on ovarian clear cell carcinoma cells has obvious advantages over renal clear cell carcinoma cells and renal papillary cell carcinoma cells,with the optimal concentration of 5-10 μmol/L.

Shengyutang is a famous classical formula of tonic， which is made from Siwutang with Ginseng Radix et Rhizoma and Astragali Radix. It is included in the Catalogue of Ancient Famous Classical Formulas（The First Batch）. Based on the Principles of Key Information Research of Ancient Famous Classical Formulas， this paper used bibliometrics to sort out and research the key information of Shengyutang in the aspects of history， composition， origin and processing， dosage， decocting method， efficacy and indications. After research， it has been found that this formula was first recorded in Lanshi Micang written by LI Dongyuan during the Jin dynasty， composed of Rehmanniae Radix， Rehmanniae Radix Praeparata， Chuanxiong Rhizoma， Ginseng Radix et Rhizoma， Astragali Radix and Angelicae Sinensis taproot. The name of the formula passed down through generations was relatively unified， with clear origins and veins. In later generations， this formula was the mainstream， and adjustments were made to the dosage and composition according to the indication. In the formula， Astragalus membranaceus var. mongholicus was selected as the origin of Astragali Radix， and the origins of other medicinal materials were consistent with the 2020 edition of Chinese Pharmacopoeia. Except for Rehmanniae Radix Praeparata， the other medicinal materials were made from raw products， and the dosage form was boiled powder. According to the measurement standard in the Jin dynasty， the recommended usage and dosage were 1.24 g of Rehmanniae Radix， Rehmanniae Radix Praeparata， Chuanxiong Rhizoma， Ginseng Radix et Rhizoma each， 2.07 g of Astragali Radix and Angelicae Sinensis taproot each， crushed into coarse particles that pass through the 4 mesh sieve but can't pass through the 10 mesh sieve， added 1 200 mL of water and boiled to 300 mL， and removed the residue. Shengyutang has the functions of tonifying Qi and blood， and blood intake， treating various sores， and restlessness and insomnia caused by excessive blood flow. In ancient times， this formula was widely used in the treatment of surgical sores， gynecological diseases， deficiency syndrome， etc. In modern clinical practice， it is mostly used to treat gynecological， neurological， musculoskeletal， hematological diseases caused by Qi and blood deficiency. In this paper， the key information of Shengyutang was researched by reviewing relevant ancient literature， in order to provide reference for the modern application and development of this formula.

Objective To compare the safety and efficacy of directional atherectomy with anti-restenosis therapy(DAART,drug-coated balloon)versus conventional balloon angioplasty(bare-metal stent,BMS)in elderly patients with femoropopliteal artery disease.Methods A retrospec-tive cohort study was conducted on 116 elderly patients undergoing endovascular intervention due to femoropopliteal artery disease in our hospital between May 2016 and September 2019,divided into DAART group(57 cases)and BMS group(59 cases).Results No statistical differences were observed between the DAART and BMS groups in terms of age,risk factors,distribution of Ruth-erford classification,lesion length,lesion type,lesion location,Global Limb Anatomic Staging Sys-tem grade,infra-popliteal runoff status,or preoperative ankle-brachial index(P＞0.05).However,the BMS group had significantly larger proportion of chronic limb-threatening ischemia than the other group(P＜0.05).Both groups achieved a 100％success rate of surgery.The DAART group obtained obviously higher primary patency rates at 1 and 2 years than the BMS group(90.4％vs 75.0％,76.3％vs 57.3％;P＜0.045).There were no significant differences in the rate of freedom from target lesion revascularization at 1 and 2 years between the two group(96.1％vs 88.8％,91.6％vs 77.7％;P＞0.05).In 2 years of follow-up,the incidence of major adverse events was 10.0％(5 cases)in the DAART group and 20.8％(12 cases)in the BMS group,but no obvious difference(P＞0.05).Conclusion DAART demonstrates superior mid-term efficacy than BMS in treating femoropopliteal artery disease in elderly patients.However,comprehensive preoperative assessment is essential to optimize individualized treatment strategies for this population.