Objective: To investigate the correlation between sleep fragmentation and body composition/blood pressure in female students of middle school, so as to provide theoretical guidance for preventing health risks associated with sleep fragmentation. Methods: From September 2022 to December 2023, 505 female students aged 12-15 years in Nanyang City were selected through stratified cluster random sampling and conducted Pittsburgh Sleep Quality Index(PSQI) survey. Participants were divided into Q 1- Q 4 groups based on sleep fragmentation index (SFI) quartiles. Body composition and blood pressure measurements were measured by adopting body composition analyzer and traditional mercury sphygmomanometer, and data were analyzed using χ 2 tests and linear regression. Results: Significant intergroup differences for Q 1- Q 4 were observed with increasing SFI levels for body mass index(BMI), fat percentage, muscle mass, bone mass, trunk fat percentage, systolic blood pressure, diastolic blood pressure, and PSQI total scores ( F =15.25,7.33,8.38,5.97,11.24,16.85,6.87,15.73, all P <0.05). SFI showed positive correlations with BMI, fat percentage, trunk fat percentage, and blood pressure( β =0.37,0.45,0.34,0.42,0.38), but negative correlations with muscle mass and bone mass( β =-0.35,-0.48) (all P <0.05). The χ 2 trend test revealed a significant increase in hypertension detection rates with elevated SFI ( χ 2=42.75, P <0.05). The χ 2 testing demonstrated statistically significant differences in hypertension incidence among different quartiles groups ( χ 2=14.16, P <0.05). After adjusting the significance level, hypertension incidence differences remained significant between Q 1and Q 4 ( χ 2=10.77), Q 2 and Q 4 groups ( χ 2=6.28) (both P <0.008 3). Conclusions Sleep fragmentation correlates significantly with body composition and blood pressure indicators in female students of middle school. Implementing sleep fragmentation interventions is essential for safeguarding female students health in middle school.

Objective To explore the effect of home-based pharmaceutical care for patients with stable chronic obstruc-tive pulmonary diseases(COPD)based on a digital remote management applet.Methods A total of 237 patients with stable COPD from a hospital pharmaceutical outpatient service from March 2022 to March 2023 were divided into a control group,a home visit group,and a remote management group according to the random number table method.Patients in the home visit and re-mote management groups received home-based pharmaceutical interventions such as health science popularization,medication con-sultation,medication guidance,effect evaluation of pharmacotherapy,prescription simplification,and reorganization.Such interven-tions were not provided in the control group.Regular follow-up was performed for 12 months.Results After a pharmaceutical intervention,the operating scores of the inhalation device and medication compliance scores of the home visit and remote manage-ment groups were significantly better than the control group(P＜0.05).The improvement in medication compliance was greater in the remote management group than in the home visit group(54.3％ vs.44.6％).In the three groups between enrollment and 12 months follow-up,CAT scores decreased by 0.78,6.16,and 7.30 points in the control group,home visit group,and remote manage-ment group,respectively.The mean scores of SGRQ symptom decreased by 1.19,4.24,and 6.10 points,the mean activity scores decreased by 1.65,3.56,4.80 points,the impact mean score decreased by 1.08,4.19,5.16 points,and the mean score of the total score decreased by 1.29,4.00,4.80 points in the control group,home visit group,and remote management group,respectively.The remote management group showed dia better decline in CAT score and SGRQ score than the home visit group,and there were sig-nificant differences between the two groups compared with the control group after intervention(P＜0.05).Conclusions Digital remote management of home-based pharmaceutical care mode can effectively improve medication compliance,operation accuracy of inhalation devices,clinical symptoms,and the patient quality of life.This is an effective and efficient pharmaceutical care mode for the long-term home medication management of stable COPD patients.

With the rising prevalence of chronic diseases and an aging population,China's traditional segmented health-care delivery model is increasingly inadequate for meeting the growing demand for long-term,systematic health management.In response,the"Physician-Pharmacist Co-management"model has emerged,aiming to enhance the quality and continuity of care through close collaboration between physicians and pharmacists.This paper starts from the concept and origin of"Physician-Phar-macist Co-management"model,focusing on its China-specific advantages shaped by national healthcare policies and clinical real-ities.Unlike the internationally recognized Collaborative Drug Therapy Management(CDTM)model,the Chinese approach re-flects local healthcare structures and needs.Using obstructive pulmonary disease(COPD)as a case study,we examine the mod-el's application and value in managing chronic respiratory diseases.Data indicate that,after the implementation of"physician-pharmacist co-management"model in COPD patients,the CAT score decreased by approximately 24％,the annual rate of acute exacerbation-related hospitalizations declined by about 72％,and the proportion of patients with regular pulmonary rehabilitation exercise habits increased by roughly 3.3-fold.Additionally,the percentage of patients without adverse reactions rose from 47.37％to 64.41％,and the vaccination rate increased by about 2.7-fold.These findings demonstrate the model's significant advantages in improving clinical outcomes,enhancing patient adherence,and reducing healthcare costs.Despite benefits,howev-er,the"Physician-Pharmacist Co-management"model in China faces several challenges,including limited public awareness,gaps in pharmacist training,and insufficient policy support.To address these challenges,this study recommends strengthening public education,establishing comprehensive evaluation systems for pharmaceutical professionals,and improving incentive mech-anisms.Overall,the findings suggest that the"Physician-Pharmacist Co-management"model holds considerable promise for im-proving the quality of chronic disease management,enhancing patient adherence,and optimizing healthcare resource utilization in China.

With the rising prevalence of chronic diseases and an aging population,China's traditional segmented health-care delivery model is increasingly inadequate for meeting the growing demand for long-term,systematic health management.In response,the"Physician-Pharmacist Co-management"model has emerged,aiming to enhance the quality and continuity of care through close collaboration between physicians and pharmacists.This paper starts from the concept and origin of"Physician-Phar-macist Co-management"model,focusing on its China-specific advantages shaped by national healthcare policies and clinical real-ities.Unlike the internationally recognized Collaborative Drug Therapy Management(CDTM)model,the Chinese approach re-flects local healthcare structures and needs.Using obstructive pulmonary disease(COPD)as a case study,we examine the mod-el's application and value in managing chronic respiratory diseases.Data indicate that,after the implementation of"physician-pharmacist co-management"model in COPD patients,the CAT score decreased by approximately 24％,the annual rate of acute exacerbation-related hospitalizations declined by about 72％,and the proportion of patients with regular pulmonary rehabilitation exercise habits increased by roughly 3.3-fold.Additionally,the percentage of patients without adverse reactions rose from 47.37％to 64.41％,and the vaccination rate increased by about 2.7-fold.These findings demonstrate the model's significant advantages in improving clinical outcomes,enhancing patient adherence,and reducing healthcare costs.Despite benefits,howev-er,the"Physician-Pharmacist Co-management"model in China faces several challenges,including limited public awareness,gaps in pharmacist training,and insufficient policy support.To address these challenges,this study recommends strengthening public education,establishing comprehensive evaluation systems for pharmaceutical professionals,and improving incentive mech-anisms.Overall,the findings suggest that the"Physician-Pharmacist Co-management"model holds considerable promise for im-proving the quality of chronic disease management,enhancing patient adherence,and optimizing healthcare resource utilization in China.

Objective To explore the effect of home-based pharmaceutical care for patients with stable chronic obstruc-tive pulmonary diseases(COPD)based on a digital remote management applet.Methods A total of 237 patients with stable COPD from a hospital pharmaceutical outpatient service from March 2022 to March 2023 were divided into a control group,a home visit group,and a remote management group according to the random number table method.Patients in the home visit and re-mote management groups received home-based pharmaceutical interventions such as health science popularization,medication con-sultation,medication guidance,effect evaluation of pharmacotherapy,prescription simplification,and reorganization.Such interven-tions were not provided in the control group.Regular follow-up was performed for 12 months.Results After a pharmaceutical intervention,the operating scores of the inhalation device and medication compliance scores of the home visit and remote manage-ment groups were significantly better than the control group(P＜0.05).The improvement in medication compliance was greater in the remote management group than in the home visit group(54.3％ vs.44.6％).In the three groups between enrollment and 12 months follow-up,CAT scores decreased by 0.78,6.16,and 7.30 points in the control group,home visit group,and remote manage-ment group,respectively.The mean scores of SGRQ symptom decreased by 1.19,4.24,and 6.10 points,the mean activity scores decreased by 1.65,3.56,4.80 points,the impact mean score decreased by 1.08,4.19,5.16 points,and the mean score of the total score decreased by 1.29,4.00,4.80 points in the control group,home visit group,and remote management group,respectively.The remote management group showed dia better decline in CAT score and SGRQ score than the home visit group,and there were sig-nificant differences between the two groups compared with the control group after intervention(P＜0.05).Conclusions Digital remote management of home-based pharmaceutical care mode can effectively improve medication compliance,operation accuracy of inhalation devices,clinical symptoms,and the patient quality of life.This is an effective and efficient pharmaceutical care mode for the long-term home medication management of stable COPD patients.

Bridging bronchus is a rare group of congenital airway malformations. In most cases, bridging bronchus is often combined with tracheal stenosis and other cardiovascular malformations, which often presents a wide spectrum of symptoms and prone to develop cardiopulmonary dysfunction, and therefore poses a challenge to the diagnosis and the choice of appropriate surgical management. This review provides a snapshot of the classification, diagnosis and surgical management of bridging bronchus.

Objective    To systematically evaluate the risk factors for postoperative pulmonary infection in patients with esophageal cancer. Methods    CNKI, Wangfang Data, VIP, CBM, PubMed, EMbase, The Cochrane Library were searched from inception to January 2021 to collect case-control studies, cohort studies and cross-sectional studies about risk factors for postoperative pulmonary infection in patients with esophageal cancer. Two researchers independently conducted literature screening, data extraction and quality assessment. RevMan 5.3 software and Stata 15.0 software were used for meta-analysis. Results    A total of 20 articles were included, covering 5 409 patients of esophageal cancer. The quality score of included studies was 6-8 points. Meta-analysis results showed that age (MD=1.99, 95%CI 0.10 to 3.88, P=0.04), age≥60 years (OR=2.68, 95%CI 1.46 to 4.91, P=0.001), smoking history (OR=2.41, 95%CI 1.77 to 3.28, P<0.001), diabetes (OR=2.30, 95%CI 1.90 to 2.77, P<0.001), chronic obstructive pulmonary disease (OR=3.69, 95%CI 2.09 to 6.52, P<0.001), pulmonary disease (OR=2.22, 95%CI 1.16 to 4.26, P=0.02), thoracotomy (OR=1.77, 95%CI 1.32 to 2.37, P<0.001), operation time (MD=14.08, 95%CI 9.64 to 18.52, P<0.001), operation time>4 h (OR=3.09, 95%CI 1.46 to 6.55, P=0.003), single lung ventilation (OR=3.46, 95%CI 1.61 to 7.44, P=0.001), recurrent laryngeal nerve injury (OR=5.66, 95%CI 1.63 to 19.71, P=0.006), and no use of patient-controlled epidural analgesia (PCEA) (OR=2.81, 95%CI 1.71 to 4.61, P<0.001) were risk factors for postoperative pulmonary infection in patients with esophageal cancer. Conclusion    The existing evidence shows that age, age≥60 years, smoking history, diabetes, chronic obstructive pulmonary disease, pulmonary disease, thoracotomy, operation time, operation time>4 h, single lung ventilation, recurrent laryngeal nerve injury, and no use of PCEA are risk factors for postoperative pulmonary infection in patients with esophageal cancer. Due to the limitation of the quantity and quality of included literature, the conclusion of this study still needs to be confirmed by more high-quality studies.

Objective: To investigate the current situation and associated factors of computer vision syndrome (CVS) among college freshmen in Tianjin during the COVID-19 epidemic, and to provide a reference for visual comfort of college students. Methods: A total of 868 college freshmen from one university in Tianjin were administered with CVS qualitative analysis questionnaire, eye health status questionnaire and eye health examination during Oct to Dec 2021. Chi square test and multivariate Logistic regression were used for data analysis. Results: The detection rate of CVS among the included students was 68.5% ( n =595) and was higher in females (72.2%) than in males (61.7%). The CVS detection rate in girls, students without myopia, >30 min sleep onset, >1 h mobile phone usage, and ≤8 h sleep duration (72.2%, 70.4%, 81.1%, 72.7%, 71.2%) were significantly higher than boys, students with low grade myopia, sleep onset required ≤30 min, use mobile phone for ≤1 h, and sleep duration >8 h(61.7%, 63.3 %, 67.4%, 65.9%, 61.1%) ( χ 2=10.08, 3.94, 5.89, 4.40, 7.94, P ＜0.05). Differences in CVS detection rates varied significantly by daily electronic device usage and academic stress students ( χ 2=22.03, 21.24, P ＜0.05). Multivariate Logistic regression analysis showed that daily use of electronic devices 4-6, 7-9, ≥10 h, sleep onset required >30 min, moderate to higher academic pressure were positively associated with CVS ( OR=1.95, 2.94, 2.30, 2.39, 3.51, 4.41, P ＜0.05), boys, low grade myopia, night sleep time >8 h were negatively associated with CVS ( OR=0.65, 0.70, 0.65, P ＜0.05). Conclusion The detection rate of CVS among freshmen in a university in Tianjing is high. Attention should be paid to the CVS situation of students with e learning, and general public should also be educated to reduce the time of unnecessary electronic product use and ensure night sleep to reduce the prevalence of CVS.

Objective:To explore the effect of modified Simiao Yong'an Decoction combined with conventional western medicine on lower limb hemodynamics in patients with low-risk diabetes foot (DF).Methods:This retrospective cohort study included 70 patients with infectious diabetic foot, between January 2015 and May 2019, and they were divided into control group and study group, with 35 in each group. The control group was treated with conventional western medicine, while the study group was treated with modified Simiao Yong'an Decoction on the basis of the control group. Both groups were treated for 4 weeks and followed up for 1 year. The levels of basic fibroblast growth factor (bFGF) and VEGF were detected by ELISA, the levels of blood viscosity, fibrinogen and HbAlc were detected by automatic hemorheological analyzer, the dorsal artery of foot was detected by color Doppler ultrasound, the diameter and blood flow velocity of dorsal artery of foot were recorded, and the conduction velocity of sural nerve and common peroneal nerve were detected by electromyography for recurrence rate calculation. And the clinical response rates were evaluated.Results:The total clinical response rate was 94.3% (33/35) in the study group and 77.1% (27/35) in the control group, and there was significant difference between the two groups ( χ2=4.20, P=0.040). After treatment, the bFGF [(177.15±7.96)ng/L vs. (158.87±7.21)ng/L, t=10.00], VEGF[(53.77±4.15)ng/L vs. (45.44±4.92)ng/L, t=7.66] levels in the study group were significantly higher than those in the control group ( P<0.01). After treatment, the whole blood viscosity [(3.84±0.86)mPa?s vs. (4.56±0.99)mPa?s, t=3.25], fibrinogen [(3.59±0.78) g/L vs.(4.23±0.97)g/L, t=3.04]and HbAlc[(9.61±1.31)% vs. (10.85±1.82)%, t=3.27] levels in the study group were significantly lower than those in the control group ( P<0.01). After treatment, the sural nerve conduction velocity [(39.42±5.11)m/s vs. (34.22±4.52)m/s, t=4.51], common peroneal nerve conduction velocity [(40.94±4.22)m/s vs. (35.52±3.72)m/s, t=5.70], blood vessel diameter [(2.21±0.60)mm vs. (1.92±0.52)mm, t=2.16], while the blood flow velocity [(55.89±5.84)cm/s vs. (52.95±5.85)cm/s, t=2.10] in the study group were significantly higher than those in the control group ( P<0.05). During the follow-up, the recurrence rate was 21.21% (7/33) in the study group and 29.63% (8/27) in the control group. with out statistical significance between the two groups ( χ2=0.20, P=0.653). Conclusion:Modified Simiao Yong'an Decoction combined with conventional western medicine can improve lower limb blood circulation and nerve conduction velocity of low-risk DF patients, promote rehabilitation and reduce recurrence.

Objective: To compare body composition of girls aged 10 to 15 years with or without onset of menarche in Nanyang, and to provide a reliable basis for effective adolescent health care. Methods: From August to December 2020 and from March to October 2021, cluster random sampling was adopted in 13 areas of Nanyang City to select 1 523 girls. Questionnaire survey and body composition (Japan Bailida MC-180) were conducted. Results: BMI, body fat percentage, trunk fat percentage, muscle mass and bone mass of girls aged 10 to 15 years in Nanyang City gradually increased with age, the water content in the body decreased with age. BMI, fat percentage, trunk fat percentage, muscle mass and bone mass in girls experienced menarche were higher, while water content in the body was lower than those without menarche. Significant difference in BMI between the menarche and without menarche of girls were found in those aged 11 to 15 years( t =2.07, 2.03, 2.43, 2.45, 2.52, P <0.05). Significant differences in fat rate, trunk fat rate, muscle mass and bone mass between the menarche and without menarche were found in girls aged 12 to 15 years fat percentage, trunk fat percentage muscle mass bone mass( P <0.05). Among girls aged 10, 14 and 15 year old, significant difference in body water percentage were observed in the two groups of girls with or without menarche( t =2.75, 2.35, 2.37 , P <0.05). Average age at menarche showed significant urban rural differences among girls aged 10, 11 and 14 year old ( χ 2=4.34, 3.45, 6.73, P <0.05). Conclusion Changes in body composition including BMI, body fat percentage, muscle mass, bone mass and body water percentage during the transition to menarche in girls is helpful to predict menarche in girls. Age of menarche is related to nutritional status, BMI, physical exercise, snack and beverage intake.