Objective: To develop a 24 hour physical activity index for school aged children, and to analyze the association of 24 hour physical activity index with screening myopia and obesity, so as to provide a more effective assessment tool for student health risk screening. Methods: From April to June 2024, a total of 451 students in Grades 3-4 from two monitored primary schools in Shanghai were selected using stratified cluster random sampling method. Data on eight core indicators, including daily moderate to vigorous physical activity time, total physical activity time, outdoor activity time, screen time, sleep duration, sleep efficiency, social jetlag and daytime sleepiness, were collected through questionnaires and accelerometer monitoring. Each indicator was standardized and synthesized into a 0-80 point school aged children s 24 hour physical activity index. Spearman correlation analysis and t-test were used to assess consistency between questionnaire and accelerometer derived indices. Multivariate Logistic regression was applied to analyze the association of strength of the composite index with single behavior indicators in screening myopia and overweight/obesity. Results: The compliance rates were higher for moderate to vigorous physical activity time and screen time (50.8%, 98.7%), while the compliance rate for outdoor activity time was only 42.6%, and that for sufficient sleep duration was merely 10.2%. There was no significant difference between the total scores derived from the questionnaire and accelerometer methods (45.13±5.83, 45.05±6.87, t=0.29, P >0.05), but they showed a strong positive correlation ( r=0.58, P <0.01). Multivariate Logistic regression revealed that adjusting for individual behaviors such as grade, gender and both parents being myopic, among single behavior indicators of 24 hour physical activity index, only insufficient outdoor activity time was significantly associated with screening myopia among school aged children ( OR=1.50, 95%CI =1.01-2.21); the detection risk of screening myopia and obesity in the low index group were higher than those in the high index group ( OR=2.47, 95%CI =1.02-5.96; OR=16.63,95%CI = 5.99- 46.20) (all P <0.05). Conclusion The developed 24 hour physical activity index for school aged children demonstrates good measurement accuracy and shows stronger associations with screening myopia and obesity than single behavior indicator.

Breast cancer has become the malignant tumor with the highest incidence rate among women， seriously threatening the life and health of women all over the world. The pathogenic factors and development mechanisms of breast cancer are complex and diverse. The development of breast cells from ordinary hyperplasia to atypical hyperplasia， and from pre-cancerous lesions to cancerous lesions， is a long-term progressive process. Therefore， early screening and prevention of breast cancer is particularly important. Western medicine has a relatively mature treatment program for breast cancer， which is mainly based on surgery and systemic treatment， whereas the ensuing complications and adverse reactions often bring a heavy burden to patients. For the precancerous lesions of breast cancer， surgery is also the mainstay of treatment. In recent years， traditional Chinese medicine （TCM） has increasingly highlighted its advantages in the prevention and treatment of breast cancer. Increasing studies have shown that in the prevention and treatment of breast cancer and pre-cancerous lesions， TCM compound prescriptions， single herbs or herb pairs， and active components are able to regulate a variety of intracellular signaling pathways through multi-targets to inhibit the proliferation and invasion， promote the apoptosis and autophagy of tumor cells， and regulate the cell cycle and the immune microenvironment， thus exerting anti-tumor effects. At the same time， they can significantly attenuate the toxic side effects of radiotherapy and drug resistance of patients. However， the specific mechanisms of TCM in the prevention and treatment of breast cancer and precancerous lesions have not been fully clarified. The available studies are tanglesome regarding the TCM inhibition of tumor development through the regulation of classical signaling pathways such as phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， Wnt/β-catenin， and Notch， which still need to be verified by a large number of clinical and experimental studies. Therefore， this paper reviews the research progress in the prevention and treatment of breast cancer and precancerous lesions by TCM through interfering with the relevant signaling pathways in recent years， aiming to summarize the possible mechanisms of TCM in the prevention and treatment of breast cancer and provide references for subsequent studies.

This study establishes an integrated research paradigm based on traditional Chinese medicine （TCM） theory， guided by pathological characteristics， centered on formula compatibility principles， and supported by multidisciplinary technologies， to systematically analyze the mechanisms of hepatotoxicity induced by toxic Chinese herbal medicinals and strategies for reducing toxicity through compatibility. The findings revealed that the pathomechanism aligns closely with the "liver aversion to acute irritation" theory from Inner Canon of Yellow Emperor （《黄帝内经》）. The core pathology involves an imbalance between liver's form and function， which is characterized by malnourishment of liver form due to yin-blood depletion and dysfunction in ascending-dispersing and free-flowing activities， and closely linked to modern pathological mechanisms such as microcirculatory disturbances， oxidative stress， inflammatory response， metabolic disorder and gut-liver axis dysregulation. Based on this， a multi-layered compatibility strategy for toxicity reduction is put forward， which involves using sweet medicinals to alleviate urgency， balancing the liver form and its function， and pre-regulating other organs. This provides a theoretical basis for the safe application of toxic Chinese herbal medicinals.

Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

Pan-vascular diseases are a group of diseases involving the systemic vascular system， with vascular lesions （especially atherosclerosis） as a common pathological feature. Pan-vascular diseases have attracted widespread attention due to the high healthcare burden that accompanies high morbidity. Inflammation is the core pathogenesis of pan-vascular diseases. Targeted anti-inflammatory strategies have achieved certain success in basic research. However， due to the increased risk of infection， their clinical application has been hindered. Simiao Yong'an Tang （SMYAT）， which has the effects of nourishing Yin， detoxifying， and activating blood， demonstrates unique therapeutic advantages. Clinical evidence indicates that SMYAT alone or in combination with conventional Western Medicine/other compound formulas/non-drug therapies can effectively alleviate the clinical symptoms and traditional Chinese medicine （TCM） syndromes of pan-vascular diseases. At the same time， it can reduce the serum levels of inflammatory factors and the risk of infection， improve glucose and lipid metabolism and blood viscosity， and promote wound healing， thereby enhancing the quality of life. The research on the pharmacological material basis indicates that when SMYAT enters the bloodstream， it can be converted into various active components such as harpagide， harpagoside， and chlorogenic acid. Basic research suggests that SMYAT can exert anti-inflammatory effects through multiple pathways and targets， such as interfering with immune cell adhesion and aggregation， macrophage polarization， foam cell autophagy， neovascularization in the outer membrane and plaque， lipid metabolism and cholesterol reverse transport. The current research lacks comprehensive discussion on vascular diseases. In-depth studies on the effects and mechanisms of SMYAT can provide new therapeutic approaches for pan-vascular diseases. Moreover， they help to gain an overall understanding of the disease progression， demonstrating the superiority of the TCM concept of treating different diseases with the same method. This paper provides a systematic overview of the TCM and Western Medicine understanding of pan-vascular diseases， the theoretical framework and material basis of SMYAT， and the progress of clinical and basic research on SMYAT treatment of pan-vascular diseases. The ultimate goal is to provide theoretical evidence and guidance for the development and application of SMYAT in the field of pan-vascular diseases. In the future， further research should be conducted to standardize the compound formula and explore the mechanism of treatment with integrated TCM and Western Medicine.

Pan-vascular diseases are a group of diseases involving the systemic vascular system， with vascular lesions （especially atherosclerosis） as a common pathological feature. Pan-vascular diseases have attracted widespread attention due to the high healthcare burden that accompanies high morbidity. Inflammation is the core pathogenesis of pan-vascular diseases. Targeted anti-inflammatory strategies have achieved certain success in basic research. However， due to the increased risk of infection， their clinical application has been hindered. Simiao Yong'an Tang （SMYAT）， which has the effects of nourishing Yin， detoxifying， and activating blood， demonstrates unique therapeutic advantages. Clinical evidence indicates that SMYAT alone or in combination with conventional Western Medicine/other compound formulas/non-drug therapies can effectively alleviate the clinical symptoms and traditional Chinese medicine （TCM） syndromes of pan-vascular diseases. At the same time， it can reduce the serum levels of inflammatory factors and the risk of infection， improve glucose and lipid metabolism and blood viscosity， and promote wound healing， thereby enhancing the quality of life. The research on the pharmacological material basis indicates that when SMYAT enters the bloodstream， it can be converted into various active components such as harpagide， harpagoside， and chlorogenic acid. Basic research suggests that SMYAT can exert anti-inflammatory effects through multiple pathways and targets， such as interfering with immune cell adhesion and aggregation， macrophage polarization， foam cell autophagy， neovascularization in the outer membrane and plaque， lipid metabolism and cholesterol reverse transport. The current research lacks comprehensive discussion on vascular diseases. In-depth studies on the effects and mechanisms of SMYAT can provide new therapeutic approaches for pan-vascular diseases. Moreover， they help to gain an overall understanding of the disease progression， demonstrating the superiority of the TCM concept of treating different diseases with the same method. This paper provides a systematic overview of the TCM and Western Medicine understanding of pan-vascular diseases， the theoretical framework and material basis of SMYAT， and the progress of clinical and basic research on SMYAT treatment of pan-vascular diseases. The ultimate goal is to provide theoretical evidence and guidance for the development and application of SMYAT in the field of pan-vascular diseases. In the future， further research should be conducted to standardize the compound formula and explore the mechanism of treatment with integrated TCM and Western Medicine.

This article reports a 14-year-old boy who presented with "a nearly 7-year history of a right upper arm mass and a more than 1-year history of cervical lymphadenopathy". His main clinical manifestations included a subcutaneous mass in the right upper arm, bilateral eyelid and submandibular masses, and multiple enlarged cervical lymph nodes, accompanied by persistent peripheral blood eosinophilia. Biopsies of the right upper arm lesion and a left submandibular lymph node showed lymphoid hyperplasia with prominent eosinophilic infiltration, vascular and fibrous tissue proliferation, and eosinophilic microabscess formation in the left submandibular lymph node, confirming the diagnosis of Kimura′s disease. The lesions regressed markedly after glucocorticoid therapy but recurred after treatment discontinuation. Because the patient and his family were concerned about long-term glucocorticoid therapy, mepolizumab was subsequently administered. Peripheral eosinophil counts normalized, whereas the local tissue lesions showed limited improvement. A multidisciplinary team comprehensively evaluated the diagnosis, the need for repeat biopsy of atypical lymph nodes on imaging, the possible association between the cardiac valve abnormalities and the underlying disease, and subsequent treatment options. The patient is currently receiving methotrexate with folic acid supplementation and remains under regular follow-up. This case indicates that the diagnosis of Kimura′s disease relies on clinical manifestations and histopathological findings. Once diagnosed, comprehensive evaluation, individualized treatment, and long-term management should be implemented.

Objective To analyze the main epidemiological characteristics of fungal infection in this hospital in the past 7 years,and to provide reference for clinical treatment and prevention and control strategies of fun-gal infection.Methods The fungal data and clinical data of related patients isolated from clinical samples in Peking Union Medical College Hospital from early January 2018 to the end of May 2024 were selected,and the main epidemiological characteristics of fungal infection in this hospital were identified and described through multi-angle statistical analysis.Results A total of 4 479 patients with filamentous fungal infection were en-rolled.The proportion of male patients[57.5％(2 576/4 479)]was higher than that of female patients[42.5％(1 903/4 143)],mainly distributed in internal medicine,Intensive Care Unit(ICU)and emergency de-partment,among which internal medicine accounted for the highest proportion[50.0％(2 241/4 479)].About 90.0％of the specimens were from the lower respiratory tract,in addition to specimens from skin and soft tis-sue,tissue,ear and blood culture.In terms of seasonal distribution,there are more patients in winter.The fun-gi were mainly composed of Aspergillus,Mucor,Cerdosporium,Fusarium and Penicillium,among which As-pergillus was the most abundant,accounting for 74.6％of the total.Aspergillus fumigatus was the most a-bundant Aspergillus,accounting for 42.5％of the total Aspergillus(1 418/3 340).Among the related infec-tions caused by mold,Aspergillus was the most common in the lower respiratory tract,accounting for 76.8％.Among them,Aspergillus fumigatus accounted for the highest proportion(33.6％).98.6％of the molds infected the ear were Aspergillus,of which Aspergillus niger and Aspergillus terreus were the most common.Skin infections are mainly caused by Sporothrix schenckii,Trichophyton rubrum,Microsporum ca-nis.The results of in vitro drug sensitivity test showed that the four common Aspergillus isolated in this hos-pital were sensitive to voriconazole,and amphotericin B had better antifungal activity against Mucorales in vitro.Conclusion Based on the main epidemiological characteristics of fungal infections in this hospital,it is recommended that special attention be paid to the admission of patients in the respiratory department during the peak infection period in autumn and winter.In the treatment of fungal infections in different regions and on different body parts,attention should be paid to the differences in the distribution of bacterial species.

Objective To investigate the therapeutic effects and mechanism of Qidan Granules(QDG)on glucose and lipid metabolism disorders in type 2 diabetes mellitus(T2DM).Methods Rats were randomly divided into normal group,model group,QDG low-dose group,QDG high-dose group,and QDG high-dose+PI3K inhibitor group.The normal group received standard chow,while other groups were fed a high-fat/high-sugar diet and injected with streptozotocin(STZ)to establish T2DM.After modeling,rats received corresponding treatments.General conditions were monitored,with body mass,fasting blood glucose(FBG),lipid profiles[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],and fasting insulin levels recorded.Homeostatic model assessment of insulin resistance(HOMA-IR)was calculated.Hepatic mRNA expression of PI3K,AKT,and GSK3β was quantified via qRT-PCR,while protein levels of PI3K,AKT,GSK3β were measured by Western Blot.Results Compared with the model group,the QDG high-dose group showed reduced body mass(P＜0.05),reduced FBG(P＜0.05),decreased TC,TG,and LDL-C,elevated HDL-C,and lower HOMA-IR;mRNA levels of hepatic PI3K,AKT,and GSK3β and protein expression of p-PI3K,p-AKT,p-GSK3β were significantly upregulated,the differences being statistically significant(P＜0.05).The QDG low-dose and QDG high-dose+PI3K inhibitor groups exhibited attenuated improvements in these parameters versus the QDG high-dose group.Conclusion QDG ameliorates body mass loss,glucose/lipid metabolism,and insulin resistance in T2DM rats,likely by activating the PI3K/AKT/GSK3β pathway.

Objective To explore the reproductive health literacy of young female sailors,investigate the influence of long voyage on the health,and propose strategies on health education.Methods A total of 49 young female sailors were enrolled.Their healthy status was evaluated by annual medical records.The questionnaire survey was also conducted to evaluate general status related to reproductive health,knowledge pertaining to reproductive health,and health status after long voyage.Results Some female sailors had symptoms of thyroid diseases,such as hypothyroidism(32.65%),benign thyroid nodules(59.18%),and suspected papillary carcinoma(in one sailor,2.04%).Ultrasonography revealed breast nodules in 5 subjects(10.00%),mammary gland hyperplasia in 46 subjects(93.88%)and reproductive benign diseases in 6 subjects(12.24%).The physical and mental states significantly changed in the late stage of long voyage.The changes in work and living environment were the main factors affecting the emotional and psychological status in the long voyage.The discomfort in menstrual cycle piled up with the above-mentioned changes during a long voyage,and the menstruation significantly affected the duty of 36.73%of female sailors during a long voyage.Female sailors had little knowledge about the prevention and examination of breast cancer and thyroid cancer.Conclusion The living and work environment during a long voyage may affect the health of the thyroid,mammary gland and reproductive system of young female sailors.Active health education via online and offline ways is helpful to improve the health literacy and self-care of female sailors,subsequently enhancing the combat effectiveness.