AIM:To investigate the visual development of children under 6 years old in Wuhan, and provide evidence-based support for the formulation and optimization of regional policies for children's eye health care.METHODS:Suresight refractive screener was applied to rapid refractive status examination in 4 989 preschool children under 6 years old in Wuhan City, with results determined according to the manufacturer's age-specific referral criteria. All screened pre-school children completed vision screening and comprehensive ophthalmic examination.RESULTS: A total of 4 989 children under 6 years old were screened out, including 2 641 males and 2 348 females. They were divided into 6 groups according to age: 426 aged from 6-month to 1-year-old, 903 aged >1 to 2 years old, 1 078 aged >2 to 3 years old, 442 aged >3 to 4 years old, 808 aged >4 to 5 years old, and 1 332 aged >5 to 6 years old. The abnormal rate in the 6-month to 1-year-old group was 44.60%, in the >1 to 2 years old group was 26.02%, in the >2 to 3 years old group was 15.58%, in the >3 to 4 years old group was 10.86%, in the >4 to 5 years old group was 21.91%, in the >5 to 6 years old group was 23.27%, and the total refractive abnormal rate for children aged 6 mo to 6 years old was 22.61%. The refractive abnormal rate generally showed a decreasing trend with increasing age(P<0.001); the refractive abnormal rate in boys aged 6-month to 6 years old was 12.33%, and in girls was 10.28%, with no statistically significant difference in the abnormal rate between boys and girls(P>0.05); among children aged 6-month to 6 years old, the abnormal rate of single-eye myopia was 0.98%, of single-eye hyperopia was 5.41%, of single-eye astigmatism was 9.92%, of binocular myopia was 0.98%, of binocular hyperopia was 2.79%, and of binocular astigmatism was 8.14%; the prevalence of astigmatism in children aged 6-month to 1-year-old was 40.38%, in those aged >1 to 2 years old was 19.82%, in those aged >2 to 3 years old was 12.34%, in those aged >3 to 4 years old was 9.05%, in those aged >4 to 5 years old was 18.81%, and in those aged >5 to 6 years old was 16.89%; the prevalence of astigmatism in children aged 6-month to 6 years old was 18.06%. The abnormal rate of astigmatism in the four age groups ranging from 6-month to 4 years old decreased continuously with age(P<0.001). There was no statistically significant difference in the abnormal rate of astigmatism between the >4 to 5 years old group and the >5 to 6 years old group(P>0.05).CONCLUSION:Refractive error has become a common eye disease among preschool children. Through early vision screening, establishing a systematic refractive management file, and early intervention, the best treatment period can be seized to avoid missing it and causing adverse consequences.

OBJECTIVE To investigate the correlation of component content with colorimetric values during the roasting process of Ziziphus jujuba ， and to provide criteria for discriminating the roasting degree of Z. jujuba . METHODS Samples were prepared by dry stir-frying for different roasting times. The eight main components in raw Z. jujuba and the samples stir-fried for different roasting times-namely adenosine， magnoflorine， jujuboside A， spinosin， 6-feruloylspinosin， betulinic acid， oleic acid， and linoleic acid-were quantitativel y analyzed using ultra-performance liquid chromatography. The chromaticity values were determined using a UV spectrophotometer. The correlation and differences between the chromaticity values of Z. jujuba at different roasting times and their components content were analyzed by Pearson correlation analysis， linear regression analysis， principal component analysis （PCA） ， cluster heatmap analysis （CHA）， and partial least squares discriminant analysis （PLS-DA） to clarify the processing endpoint. RESULTS As the roasting time increased， the contents of linoleic acid and oleic acid decreased， while the contents of other components exhibited an increasing trend. Concurrently， the colorimetric value L* and E*ab were observed to decline， whereas the a* value demonstrated a gradual increase. Pearson correlation analysis revealed that L* and E*ab exhibited a significant negative correlation with the contents of adenosine， spinosin， 6-feruloylspinosin， jujuboside A， betulinic acid and magnoflorine （ P ＜0.05）. The results of linear regression analysis indicate that the content of six components, including adenosine， in the medicinal material can be preliminarily predicted by analyzing the colorimetric values of Z. jujuba powder. PCA and CHA successfully classified raw and stir-fried samples. The PLS-DA results indicated that L*， E*ab， a*， linoleic acid content， and oleic acid content were the main parameters that differentiated the color and quality of Z. jujuba at different roasting times. After frying for 9 to 10 minutes， the colorimetric values L* and E*ab decreased to their minimum values and stabilized， while a* remained consistently high with little variation；simultaneously， the concentrations of the six major components， excluding linoleic acid and oleic acid， reached their peak levels. CONCLUSIONS A significant correlation between the colorimetric values of Z. jujuba and the contents of six components， including adenosine， is confirmed. The optimal roasting time range is determined to be 9-10 minutes. Furthermore， the colorimetric value-component content correlation analysis method established in this study proved to be practical and applicable for discriminating the roasting degree of Z. jujuba .

Background Exposure to air pollutants increases the risk of diseases in multiple systems, including respiratory and cardiovascular systems, yet its association with neurological diseases remains unclear. Objective To quantitatively evaluate the association between short-term exposure to air pollutants and outpatient and emergency visits for neurological diseases, identify potential susceptible populations, and quantify associated disease burden. Methods Daily 24-hour average concentrations of fine particulate matter (PM_2.5), inhalable particulate matter (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and carbon monoxide (CO), daily maximum 8-hour average concentration of ozone (O₃), daily meteorological data (24-hour average temperature, 24-hour average relative humidity), and data on daily outpatient and emergency department visits for neurological diseases from two hospitals in Conghua District, Guangzhou, China, were collected from 2015 to 2022. A time-stratified case-crossover design was adopted, and a conditional Poisson regression model was constructed to analyze the association between air pollution exposure and neurological disease visits. Two-pollutant models and sensitivity analysis were used to validate model stability. Stratified analyses by season (cold season: from November to March; warm season: from April to October), sex (male, female), and age (≤45 years, 46–60 years, ≥61 years) were performed to identify vulnerable group. Additionally, the number and proportion of neurological disease visits attributable to short-term air pollutant exposure were calculated. Results A total of 72 673 outpatient and emergency department visits for neurological diseases were included during the study period. Most of the patients were middle-aged and elderly individuals (69.89% were over 45 years old) and females (60.25%). The results of single-pollutant models showed that for each interquartile range (IQR) increase in exposure to PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃, the risk of outpatient and emergency department visits for neurological diseases increased by 7.54% (95%CI: 4.69%, 10.46%), 6.66% (95%CI: 3.92%, 9.46%), 16.72% (95%CI: 10.58%, 23.19%), 8.12% (95%CI: 4.82%, 11.53%), 5.60% (95%CI: 2.34%, 8.97%), and 6.11% (95%CI: 2.91%, 9.40%), respectively. The results of the two-pollutant model showed that the association between PM_2.5 and SO₂ exposure and outpatient and emergency department visits for neurological diseases were relatively stable. The stratified analyses showed that the effect of SO₂ was stronger in the cold season. It was estimated that 8.32% (95%CI: 5.55%, 10.96%) and 6.65% (95%CI: 4.27%, 8.96%) of the outpatient and emergency department visits were attributable to short-term exposure to SO₂ and PM_2.5, respectively. Conclusion Exposure to PM_2.5 and SO₂ is associated with increased risks of outpatient and emergency visits for neurological diseases. SO₂ shows stronger effects during the cold season, and exposure to air pollution contributes to up to 8.32% of neurological disease visits.

Objective To quantitatively assess the association of short-term exposure to polycyclic aromatic hydrocarbons (PAHs) in ambient fine particulate matter (PM2.5) with residents mortality. Methods A time-stratified case-crossover study was conducted from 2020 to 2022 among 10606 non-accidental residents by using the Guangzhou Cause of Death Surveillance System in Conghua District, Guangzhou. Exposure levels of PAHs in PM_2.5 and meteorological data during the study period were obtained from the Center for Disease Control and Prevention in Conghua District and the China Meteorological Administration Land Data Assimilation System (CLDAS-V2.0), respectively. Conditional Poisson regression model was used to estimate the exposure-response association between PAHs and the mortality risk. Results Fluoranthene, chrysene, benzo[k]fluoranthene, benzo[a]pyrene, and indeno[1,2,3-cd]pyrene were significantly associated with an increased risk of mortality. For every one interquartile range increase in exposure levels, the non-accidental mortality risks increased by 8.33% (95% CI: 1.80%, 15.27%), 4.67% (95% CI: 1.86%, 7.57%), 6.07% (95% CI: 2.08%, 10.21%), 4.62% (95% CI: 1.85%, 7.47%), and 4.70% (95% CI: 0.53%, 9.03%), respectively. The estimated non accidental deaths attributable to exposure to fluoranthene, chrysene, benzo[k]fluorine, benzo[a]pyrene and indine[1,2,3-cd]pyrene were 5.91%, 6.08%, 6.51%, 6.46%, and 4.21%, respectively. Conclusions Short-term exposure to PAHs in PM_2.5, including fluoranthene, chrysene, benzo[k]fluoranthene, benzo[a]pyrene and indine[1,2,3-cd]pyrene, was significantly associated with an increased risk of mortality among residents.

Investigator initiated trial （IIT） represents a primary format for clinical research in traditional Chinese medicine （TCM）. As key implementation sites for TCM-based IIT targeting malignant tumors， western medicine institutions often face unique challenges in conducting such studies， which limit their feasibility and standardization. This paper reviews the registration status of TCM-based IIT for malignancies conducted in western medical institutions and analyzes key difficulties， including complex project initiation and management processes， limited TCM knowledge and skills among western medicine physicians， and relatively low patient acceptance of TCM. From a practical perspective， the study proposes several optimization strategies. These include improving the review and management mechanisms of TCM-related IIT within western medical institutions， establishing multidisciplinary clinical research teams that integrate TCM and western medicine， and enhancing investigators' training in TCM theory and clinical skills. Additionally， the study suggests standardizing IIT operational procedures， objectifying the collection of TCM diagnostic information， refining subject recruitment methods， and increasing TCM involvement in patient follow-up and management. These investigator-oriented， TCM-featured， and operable strategies aim to promote the high-quality development of TCM-based IIT in western medicine institutions and enhance the clinical application of TCM.

Objective:To explore the correlation between the level of T-lymphocyte subsets in peripheral blood and the progression of Alzheimer′s disease (AD).Methods:A cross-sectional study was conducted, including 30 cases of amnestic mild cognitive impairment (aMCI; aMCI group), 30 cases of mild AD (Mi-D; Mi-D group), 30 cases of moderate AD (Mo-D; Mo-D group), who were diagnosed in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from January to December 2023, and 30 normal controls (normal control group) matched by age and gender. The levels of T cell subsets in peripheral blood were detected by flow cytometry, and the subpopulations of CD4 +T cells, Th cells, were examined. Binary Logistic regression was used to explore the correlation between factors affecting patients′ cognitive function and the onset of AD, and Spearman′s correlation analysis was applied to assess the association between the level of peripheral blood immune cells and the severity of AD. Results:There were no statistically significant differences in peripheral blood CD4 +T cells ( F=1.762, P=0.158), CD8 +T cells ( F=0.370, P=0.775), CD4 +/CD8 +ratios ( F=1.976, P=0.121), and regulatory T cells (Tregs) levels ( F=0.232, P=0.874) among the aMCI group, Mi-D group, Mo-D group, and normal control group in the intergroup comparisons (all P>0.05). The study subjects were stratified according to gender, age, body mass index, and years of education affecting the cognitive function of AD patients, and the peripheral blood CD4 +T cells, CD8 +T cells, CD4 +/CD8 + ratios and Tregs levels showed no statistically significant differences among groups (all P>0.05). The results of binary Logistic regression analysis showed that the peripheral blood CD8 +T-cell level ( OR=1.131, 95% CI 1.009-1.268, P=0.035) was a risk factor for the onset of AD. Further analysis of peripheral blood CD4 +T cell subsets revealed that Th1 cell levels were lower in the aMCI group compared to the Mi-D group ( t=-2.354, P=0.036), and the Mo-D group ( t=-2.079, P=0.026). The results of the Spearman′s correlation analysis showed that peripheral blood Th1 cell level was positively correlated with AD progression ( r=0.192, P<0.05). Conclusions:AD patients show peripheral immune imbalance, peripheral blood CD8 +T-cell level is a risk factor for the onset of AD, and peripheral Th1 cell level is positively correlated with the severity of AD. Monitoring the changes in peripheral blood Th1 cell level may have a predictive value for the progression of AD.

Objective To investigate the expressions of IL-18,IL-18 binding protein isoform a(IL-18BPa)and IL-18Rα in blood CD4+Th1 cells of patients with allergic asthma(AA),and with allergic rhinitis and asthma syndrome(ARA),and the effects of allergens on their expressions.Methods Blood samples were collected from patients with AA,ARA and healthy control(HC)subjects.Flow cytometry was used to evaluate the actions of allergens on the expressions of IL-18,IL-18BPa and IL-18Rα in CD4+Th1 cells.Ovalbumin(OVA)-induced AA mouse models were established,and the expression level of IL-18Rα along with the influence of IL-18 on its expression in blood and lung Th1 cells was also explored by flow cytometry.Results Compared with HC,we observed increased IL-18 while decreased IL-18BPa expression in blood Th1 cells of AA and ARA patients.Moreover,allergens upregulated the expression levels of IL-18,IL-18BPa and IL-18Rα in Th1 cells of patients with AA and ARA.Additionally,intratracheal challenge with OVA plus IL-18 increased the proportions of blood and lung Th1 cells of HC and AA mice,and upregulated IL-18Rα expression on blood and lung Th1 cells of HC mice.Conclusion Allergens may be involved in the pathogenesis of airway allergic diseases by inducing the expressions of IL-18 and IL-18Rα in CD4+Th1 cells.

Objective:With the aging of the population, the health of women's ovarian in China has received increasing attention.Ovarian aging not only affects reproductive health but also increases the risk of chronic diseases.This study aims to systematically explore the relationship between living habits and ovarian aging.Methods:Based on the data from the China Health and Retirement Longitudinal Study(CHARLS)from 2011 to 2018, 8 287 postmenopausal women were included.A retrospective cohort study was conducted using statistical analysis and machine learning methods to evaluate the impact of lifestyle factors such as smoking, drinking, sleep, and dietary patterns on the age of menopause.Results:It was found that adverse lifestyle factors such as reduced daily meal frequency [the early menopause group(2.85±0.38)times/day vs.the normal group(2.89±0.38)times/day, P=0.002], smoking [the smoking rate of the early menopause group(7.75%) vs.that of the normal group(6.15%), P=0.004], and high-frequency drinking [the early menopause rate of people who drink daily(19.76%(33/167)) vs.that of people who rarely or never drink(14.62%(1 162/7 949)), P=0.047]were associated with accelerated ovarian aging. Conclusions:Reasonable adjustment of living habits maybe help to delay the age of menopause and reduce related health risks.This study provides a scientific basis for optimizing women's healthy lifestyles, which is conducive to improving the quality of life and happiness of middle-aged and elderly women in China.

Objective To investigate the expressions of IL-18,IL-18 binding protein isoform a(IL-18BPa)and IL-18Rα in blood CD4+Th1 cells of patients with allergic asthma(AA),and with allergic rhinitis and asthma syndrome(ARA),and the effects of allergens on their expressions.Methods Blood samples were collected from patients with AA,ARA and healthy control(HC)subjects.Flow cytometry was used to evaluate the actions of allergens on the expressions of IL-18,IL-18BPa and IL-18Rα in CD4+Th1 cells.Ovalbumin(OVA)-induced AA mouse models were established,and the expression level of IL-18Rα along with the influence of IL-18 on its expression in blood and lung Th1 cells was also explored by flow cytometry.Results Compared with HC,we observed increased IL-18 while decreased IL-18BPa expression in blood Th1 cells of AA and ARA patients.Moreover,allergens upregulated the expression levels of IL-18,IL-18BPa and IL-18Rα in Th1 cells of patients with AA and ARA.Additionally,intratracheal challenge with OVA plus IL-18 increased the proportions of blood and lung Th1 cells of HC and AA mice,and upregulated IL-18Rα expression on blood and lung Th1 cells of HC mice.Conclusion Allergens may be involved in the pathogenesis of airway allergic diseases by inducing the expressions of IL-18 and IL-18Rα in CD4+Th1 cells.

Objective To investigate the effect of activating the N-type acetylcholine receptor(nAChR)on interleukin-18(IL-18)and PD-1 in mice with acute respiratory distress syndrome(ARDS).Methods Sixty healthy male BALB/c mice(6 weeks of age)were divided into six groups:normal(N),normal saline control(NS),normal saline+bilateral vagectomy(NS+D),ARDS+segmentation of the vagus nerve on both sides of the neck(A+D),ARDS(A),ARDS+vagal amputation,and administration of an acetylcholine receptor agonist(A+J)groups.Each group included ten mice that were fed and housed under normal conditions.Structural changes in the right lower lung were observed using fluorescence microscopy;phosphorylated nuclear factor-KB protein 65(p-NF-κBP65)levels were assessed using Western blotting;serum IL-18 and PD-1 levels were assessed using enzyme-linked immunosorbent assay(ELISA)and the double antibody sandwich method;and the percentages of CD3+and CD25+Foxp3+T lymphocytes in the middle lobe of right lung were determined using flow cytometry.Results No inflammatory cell infiltration was observed in groups N and NS.The interstitial lobes in groups A and A+D showed severe inflammatory infiltration,thickening of the alveolar wall,destruction of the alveolar structure,and loss of the alveolar cavity.Serum IL-18 and PD-1 levels in groups A and A+D were significantly higher than those in the other four groups(P＜0.05).p-NF-κBP65 and PD-1 levels in groups A and A+D were significantly higher than those in groups N,NS,and A+J(P＜0.05).CD3+and CD25+Foxp3+T cells in groups A and A+D were significantly higher than those in the other four groups(P＜0.05).Conclusion Active nAChR can inhibit IL-18 and p-NF-κBP65 through the negative regulation of T lymphocytes,decrease PD-1 expression in lung tissues,and alleviate the pathological changes of ARDS.