Objective: To evaluate the classroom environmental management and CO 2 volume concentration in primary and secondary schools from Liaoning, Tianjin, and Shanghai, thereby providing a scientific basis for developing targeted strategies to improve classroom air quality. Methods: From December 16 to 26, 2024, by using stratified random cluster sampling method, the questionnaire survey was conducted in 72 primary and secondary schools (24 each of primary, junior high, and regular high schools) across Liaoning, Tianjin and Shanghai. Information on heating, ventilation and other classroom environmental management was collected. Additionally, 108 classrooms were selected for on site microclimate measurements, including temperature, humidity, wind speed and CO 2 volume concentration. Univariate analysis and multiple linear regression models were employed to explore related factors of classroom CO 2 volume concentration. Results: Among the three provinces/municipalities, 20.8% of schools regularly monitored the microclimate. The overall compliance rate for classroom CO 2 volume concentration was 17.6%. Multiple linear regression analysis showed that CO 2 volume concentration in regular and junior high school classrooms were higher than in primary school classrooms ( β=0.067, 0.046, 95%CI =0.036-0.099, 0.013-0.080); classrooms ventilated regularly in the morning and afternoon had higher CO 2 volume concentration than those ventilated during every break between classes ( β=0.043, 95%CI = 0.007- 0.080); both temperature ( β=0.010, 95%CI =0.004-0.016) and humidity ( β=0.003, 95%CI =0.002-0.004) were positively correlated with CO 2 volume concentration (all P <0.05). Conclusions Excessive CO 2 volume concentration in primary and secondary school classrooms is a prominent issue, and ventilation frequency is a key intervenable factor for controlling CO 2 levels. It is recommended to promote ventilation during every break between classes as a core management measure and to emphasize air quality supervision in regular high school classrooms.

Objective: To evaluate the current situation of thermal environment in primary and secondary school classrooms during winter, and to analyze students thermal comfort needs, so as to provide a basis for improving classroom thermal environment. Methods: From December 16 to 26, 2024, a stratified cluster random sampling method was used to select 90 classrooms from 15 primary and secondary schools in centralized/air conditioned heating areas(Liaoning Province, Tianjin City, Shanghai City) and naturally ventilated areas(Anhui Province and Jiangxi Province)for on site environmental measurement. A questionnaire survey was conducted among 743 students. The differences between groups using the χ 2 test were compared. Based on actual measurement data, a predicted mean vote prepared percentage of dissatisfied (PMV-PPD) model for centralized/air conditioned classrooms and an adaptive model for naturally ventilated classrooms were established, and the thermal neutral temperature and comfort interval were calculated. Results: The average outdoor temperature during on site measurement was 4.00(0.20，7.00)℃. In classrooms with centralized or air conditioned heating systems, the measured average temperature was (19.33±2.59)℃, with a thermal comfort range of 20.35-25.35 ℃ and a thermal neutral temperature of 22.85 ℃. And 13.92% of students reported feeling cold, while 80.80% felt comfortable. In classrooms with natural ventilation, the measured average temperature was (12.26±1.83)℃, with a thermal neutral temperature of 19.67 ℃ and a thermal comfort range of 16.17-23.17 ℃. About 48.33% of students reported feeling cold, and 49.81 % felt comfortable.The results of univariate analysis showed that there were statistically significant differences in shoe thickness, temperature sensation, relative humidity sensation and wind speed sensation between centralized/air conditioned heating areas ( χ 2= 7.01 , 31.47, 13.57, 13.80,all P <0.05). There were also statistically significant differences in school stage for primary and secondary school students, body mass index, classroom location for seat, temperature sensation, relative humidity sensation and wind speed sensation between naturally ventilated areas ( χ 2=42.13, 11.13, 11.04, 60.39, 29.27, 38.46,all P <0.05). Conclusions There are differences in thermal environment and students subjective thermal comfort in primary and secondary schools under different ventilation modes in winter. The temperature standards for heated classrooms should be revised, and differentiated environmental regulation strategies should be adopted based on different ventilation methods to improve students health and comfort levels.

Abstract The study examines the development and application of microclimate standards for primary and secondary school classrooms, so as to ensure and promote the healthy growth of primary and secondary school students. The paper systematically reviews relevant domestic and international standards, analyzes the problems and shortcomings arising from their practical application and proposes effective countermeasures, in order to provide robust references aimed at optimizing the classroom environment in primary and secondary schools for student health, as well as offering practical support to advance the construction of a healthy China.

Objective: To understand the microclimate in primary and secondary school classrooms for the study period during the winter heating season, so as to provide a reference for the revision and improvement of relevant health standards. Methods: In December 2024, stratified random sampling was used to select 30 primary and secondary schools and 180 classrooms from the northern regions with centralized heating (Liaoning Province, Tianjin City) and the southern regions without centralized heating (Shanghai City, Anhui Province, and Jiangxi Province). Indoor temperature, relative humidity, wind speed, CO 2 and other indicators were measured on site. Variance analysis, t-test, Mann-Whitney U test and Kruskal-Wallis H test were used to analyze the differences in the microclimate of classrooms among regions and urban and rural differences. Results: The average temperature in the middle of the classrooms tested on site was (16.47±4.72)℃, and the variance analysis showed that the difference between the regions was statistically significant ( F=27.80, P <0.01). Among them, Tianjin had the highest average temperature of (20.43± 2.12 )℃, followed by Liaoning (19.03±2.23)℃, Shanghai (15.33±5.32)℃, Anhui (12.79±1.74)℃, and Jiangxi (11.69± 1.68 )℃. Horizontal temperature difference was 0.90 (0.50, 1.60)℃, the vertical temperature difference was 0.20 (0.10,0.60)℃, the average relative humidity was (44.39±16.16)%, the wind speed was 0.03(0.01,0.11)m/s, and the differences among different provinces and cities were statistically significant ( H/F =40.62, 82.69, 95.06, 55.28, all P <0.01). The average CO 2 volume concentration in urban areas of Tianjin, Liaoning, and Shanghai was 0.21(0.16,0.30)%, and there was no statistically significant difference ( H=4.65, P =0.10). There were grade differences in relative humidity ( F =3.71, 6.21) and CO 2 ( H =14.72, 12.92) in the north and the south (all P <0.05). In addition, the temperature, relative humidity, wind speed and CO 2 in the middle of the classroom were 42.8%, 67.8%, 100.0% and 22.2% respectively. Conclusions The temperature in the middle of the classroom in the non centralized heating area is lower than the standard, the relative humidity of classroom in the centralized heating area is lower than the standard，and the CO 2 in the classroom in winter is lower than the standard. It is recommended to install heating facilities in schools with low temperatures to increase the temperature and increase the frequency of ventilation in classrooms or adopt mechanical ventilation strategies to reduce CO 2 volume concentration.

OBJECTIVE To explore the effects of leonurine on growth arrest-specific protein-6 (GAS6)/Axl signaling pathway,and clarify its mechanism of alleviating myocardial injury in rats with coronary heart disease.METHODS The rat model of coronary heart disease was constructed;successfully modeled rats were randomly separated into model group,leonurine low-dose and high-dose groups (intragastric administration of leonurine 25,100 mg/kg+intraperitoneal injection of normal saline 75 mg/kg),and leonurine high-dose+GAS6/Axl signaling pathway inhibitor group (intragastric administration of leonurine 100 mg/kg+intraperitoneal injection of R42875 mg/kg),with 12 rats in each group.Additional 12 normal rats were selected as control group.Each administration group was given relevant medicine;control group and model group were given a constant volume of normal saline intragastrically and intraperitoneally,once a day,for 48 consecutive days.After administration,the heart function of rats,and serum levels of inflammatory factors and myocardial injury markers were detected;the pathological morphology of myocardial tissue was observed;the myocardial cell apoptosis rate,the expressions of apoptosis and GAS6/Axl signaling pathway-related proteins were determined.RESULTS Compared with control group,model group showed disorders in the arrangement of myocardial cells and myocardial fibers,hypertrophy of myocardial cells,and nuclear condensation;left ventricular ejection fraction,left ventricular fractional shortening,ratio of early-diastolic and late-diastolic motion velocity of the mitral ring,the protein expression of GAS6,B-cell lymphoma 2/B-cell lymphoma 2 associated X protein and phosphorylated Axl/Axl ratios were decreased significantly (P<0.05).The levels of tumor necrosis factor-α,interleukin-1β,interleukin-6,creatine kinase isoenzyme,troponin Ⅰ and myoglobin,the cell apoptosis rate,and cleaved caspase-3/caspase-3 ratio were increased significantly (P<0.05).Leonurine could obviously improve the above pathological conditions and detection indicators (P<0.05),and the effect of leonurine high-dose group was more significant than that of leonurine low-dose group (P<0.05);R428 treatment could reverse the ameliorating effect of high-dose of leonurine on myocardial injury in rats with coronary heart disease (P<0.05).CONCLUSIONS Leonurine can alleviate myocardial injury in rats with coronary heart disease,and its mechanism of action is related to the activation of the GAS6/Axl signaling pathway.

Objective:To investigate the effects of echinatin(Ech)on the malignant biological behavior and immune escape of lung cancer A549 cells and its underlying mechanisms.Methods:Normal lung epithelial cells(BEAS-2B)and A549 cells were routinely cultured and treated with different concentrations of Ech for 24h.Cell viability was assessed using the MTT assay,and concentrations of 20,30,and 40 μmol/L were selected for subsequent experiments.A549 cells were divided into the following groups:control group(0 μmol/L Ech),low-(20 μmol/L),medium-(30 μmol/L),and high-concentration(40 μmol/L)Ech groups(Ech-L,Ech-M,Ech-H),and high-dose Ech combined with the pathway inhibitor H-151(1.0 μmol/L)group(Ech-H+H-151).Cell proliferation,migration,and invasion were evaluated using the EdU assay,wound-healing assay,and Transwell assay,respectively.Western blotting(WB)assay was applied to detect the expression of proteins related to proliferation,migration,invasion,and the STING/TBK1/IRF3 signaling pathway.Subsequently,A549 cells were co-cultured with CD8+T cells,and trypan blue staining was used to detect CD8+T cell viability.The levels of type Ⅰ interferon(IFN-Ⅰ)in the co-culture supernatants were detected by WB,while the levels of programmed death ligand 1(PD-L1),interleukin-10(IL-10),interleukin-4(IL-4),and transforming growth factor-β(TGF-β)were determined using ELISA.Results:Ech inhibited the viability of A549 cells in a dose-dependent manner(all P<0.05)but had no significant effect on the viability of BEAS-2B cells.Ech dose-dependently inhibited the proliferation,migration and invasion of A549 cells(all P<0.05),as well as the protein expression of cyclinD1,Ki67,MMP2,MMP9,STING,p-TBK1 and p-IRF3(all P<0.05).These effects were partially reversed by H-151.Ech dose-dependently promoted the survival of CD8+T cells co-cultured with A549 cells(all P<0.05),enhanced IFN-Ⅰexpression(all P<0.05),and inhibited the secretion of PD-L1,IL-10,IL-4,and TGF-β(all P<0.05),with H-151 partially reversing these effects(all P<0.05).Conclusion:Ech inhibits malignant biological behavior and immune escape of lung cancer A549 cells by activating the STING/TBK1/IRF3 signaling pathway.

BACKGROUND:The clearance pathway of metabolic waste in the brain is crucial for maintaining neural homeostasis.The accumulation of metabolic waste disrupts this equilibrium,representing a common pathological feature of many central nervous system diseases.In recent years,research focusing on the glymphatic system has emerged as a hotspot in the nervous system field.OBJECTIVE:To construct a knowledge map of glymphatic system research,visually analyze the current state of research,main hotspots,and future development trends within this area.METHODS:Utilizing CiteSpace,VOSviewer,and the Bibliometrix package in the R language environment,this study conducted an in-depth visual analysis of glymphatic system-related literature from the Web of Science Core Collection database,spanning from January 2012 to March 2024.This analysis included authors,institutions,countries,journals,keywords,and co-citation frequencies.RESULTS AND CONCLUSION:A total of 687 related articles were included in this study.The number of publications in this field increased year by year,showing an explosive growth trend in the past three years.The countries,institutions,and authors with the largest number of publications in this research field were the United States,University of Rochester,and Professor Maiken Nedergaard.The journal with the highest number of publications was JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM.The high-frequent and high-central keywords mainly focused on the mechanism such as cerebrospinal fluid hydrodynamics,neurological diseases such as Alzheimer's disease,and imaging techniques such as diffusion tensor imaging.The literature with the highest co-citation frequency was a classic review of the glymphatic system.The above results show that the research of glymphatic system is an emerging and active field,which has attracted wide attention at home and abroad and gradually expand from theoretical research to clinical practice.

It is believed that patients with cirrhotic ascites exhibit a pathological mechanism characterized by the decline of healthy qi and the accumulation of pathogenic factors. Clinically， treatment should be based on the theory of tonification and purging， with a staged approach distinguishing between the active phase and the remission phase. The balance between tonification and purging should be adjusted according to the progression of pathogenic and healthy actors. In the acute phase， purging should take precedence over tonification， using purging as a means of tonification to facilitate the flow of water and qi through the triple energizer. The severity of water retention， dampness， blood stasis， and heat should be carefully assessed to ensure thorough elimination of pathogenic factors while avoiding harm to healthy qi. Medication adjustments should be made once the pathogenic factors are significantly weakened. In the remission phase， an integrated approach combining both tonification and purging should be adopted， incorporating purging within tonification to clear residual pathogens and prevent recurrence. Concurrently， proactive treatment of the underlying disease is essential to achieve complete recovery and prevent the recurrence of ascites.

Objective:To explore the association between healthy lifestyle and co-morbidity of overweight/obesity and myopia in adolescents.Methods:Based on the Shanghai Municipal Dynamic Cohort of Student Common Diseases, we used the group-based trajectory model (GBTM) to establish a model for the development of adolescents' healthy lifestyle trajectories aged 11-14 years and the Cox proportional hazard regression model to assess the effects of different healthy lifestyles on the co-morbidity of overweight/obesity and myopia in adolescents.Results:A total of 2 331 adolescents were included in the analysis. The average follow-up time was 1.87 years, with age of (11.44±0.45) years at the initial follow-up, among 1 106 boys and 1 225 girls. During the 2-year follow-up period, the incidence rates of overweight/obesity, myopia, and co-occurrence of overweight/obesity and myopia were 25.9%, 77.0%, and 13.7%, respectively. GBTM identified 3 healthy lifestyles: the unhealthy group (7.3%), the relatively healthy group (50.2%), and the healthy group (42.5%). The risk of overweight/obesity was lower in the relatively healthy group than in the unhealthy group ( HR=0.694, 95% CI: 0.508-0.947). There was no statistically significant association between the GBTM lifestyle subgroups and myopia ( P>0.05). The risk of co-occurrence of overweight/obesity and myopia was lower in both relatively healthy group and healthy group than in the unhealthy group (relatively healthy group: HR=0.515, 95% CI: 0.348-0.763; healthy group: HR=0.571, 95% CI: 0.384-0.849). Sensitivity analyses showed this result to be stable for myopia, overweight/obesity and myopia co-morbidities. Conclusion:Persistent unhealthy lifestyle increases the risk of overweight/obesity and myopia co-occurrence in adolescents.

Premature ovarian failure(POF)is the final stage of diminished ovarian reserve,the pathogenesis of POF is complex and is closely related to the dysfunction of five-zang organs,meanwhile,it is also intertwined with pathological products such as qi stagnation,blood stasis and phlegm-damp,and POF is an obstinate disease clinically.Acupuncture and moxibustion are effective in the treatment of POF,based on the theory of meridian and collateral with zang-fu organs,acupuncture and moxibustion further expanding its connotation of formulating,the foot Jueyin meridian system is closely related to the ovaries and the liver of the five-zang organs,which lays a functional structural foundation for the treatment of POF from the viewpoint of liver meridian of foot Jueyin,and it is a key entry point of syndrome differentiation of meridians and collateral for POF.Therefore,based on the theoretical foundation of"meridian and collateral with zang-fu organs",combining with anatomical knowledge,cellular molecular biology and other modern medical research,this paper explores the distinctive pathological relationship of between liver meridian of foot Jueyin and ovarian disease,and lays the foundation for further research on the pathological mechanism of POF and the point selection rules of acupuncture treatment,so as to expand the theoretical basis of acupuncture treatment of POF,and improve the theoretical connotation of formulating of meridian and collateral with zang-fu organs theory.