Objective:To assess the current clinical application status of provocation/stress echocardiography in hypertrophic cardiomyopathy（HCM）among echocardiography physicians from large grade A tertiary hospitals，located in 24 provinces or directly administered municipalities，and to achieve a relatively clear and comprehensive overview of the current clinical application status of provocation/stress echocardiography in HCM. This study was conducted by the Chinese Society of Ultrasound in Medicine（CSUM）and Chinese Society of Echocardiography（CSE）.Methods:An online survey was anonymously conducted using Question Star application from 20 March to 30 September 2023. The survey covered the following topics including the echocardiographic diagnostic overview，the selection of views and measurement parameter of echocardiography，and the cognition and application，awareness and management of risk，and clinical demand of provocation/stress echocardiography.Results:A total of 337 valid responses were included in the final statistical analysis. The study revealed that the number of HCM patients seen by echocardiography physicians was very few（0-10%），with a low proportion of diagnosed obstructive HCM patients. There was incomplete mastery of the left ventricular outflow tract（LVOT）obstruction criteria（68.25%），insufficient awareness of the importance of LVOT pressure gradient measurement（7.12% echocardiographic doctors routinely performed LVOT gradient measurement for suspect HCM patients），non-standardized selection of echocardiographic views and measurement parameters for HCM，and significant deficiencies in knowledge and application of Valsalva provocation/stress echocardiography（17.21% and 79.23% doctors were quite aware of the principles of Valsalva provocation/stress echocardiography，respectively）. The risk awareness of provocation/stress echocardiography（13.65% physicians were fully aware of the potential risk）and the ability to manage associated risks（19.29% physicians were able to handle all emergencies）were lacking. Existing guidelines did not sufficiently standardize the clinical practice of provocation/stress echocardiography（23.44%），and there was diversity in learning formats requirements and unmet clinical needs.Conclusions:This survey revealed insufficient fundamental theoretical knowledge and a need for further standardization and training in the application of provocation/stress echocardiography for HCM among echocardiography physicians. Additionally，risk awareness and adequate response skills need improvement. There is a need for more practical and guiding guidelines for clinical practice，as well as numerous unmet clinical needs.

Objective:To assess the current clinical application status of provocation/stress echocardiography in hypertrophic cardiomyopathy（HCM）among echocardiography physicians from large grade A tertiary hospitals，located in 24 provinces or directly administered municipalities，and to achieve a relatively clear and comprehensive overview of the current clinical application status of provocation/stress echocardiography in HCM. This study was conducted by the Chinese Society of Ultrasound in Medicine（CSUM）and Chinese Society of Echocardiography（CSE）.Methods:An online survey was anonymously conducted using Question Star application from 20 March to 30 September 2023. The survey covered the following topics including the echocardiographic diagnostic overview，the selection of views and measurement parameter of echocardiography，and the cognition and application，awareness and management of risk，and clinical demand of provocation/stress echocardiography.Results:A total of 337 valid responses were included in the final statistical analysis. The study revealed that the number of HCM patients seen by echocardiography physicians was very few（0-10%），with a low proportion of diagnosed obstructive HCM patients. There was incomplete mastery of the left ventricular outflow tract（LVOT）obstruction criteria（68.25%），insufficient awareness of the importance of LVOT pressure gradient measurement（7.12% echocardiographic doctors routinely performed LVOT gradient measurement for suspect HCM patients），non-standardized selection of echocardiographic views and measurement parameters for HCM，and significant deficiencies in knowledge and application of Valsalva provocation/stress echocardiography（17.21% and 79.23% doctors were quite aware of the principles of Valsalva provocation/stress echocardiography，respectively）. The risk awareness of provocation/stress echocardiography（13.65% physicians were fully aware of the potential risk）and the ability to manage associated risks（19.29% physicians were able to handle all emergencies）were lacking. Existing guidelines did not sufficiently standardize the clinical practice of provocation/stress echocardiography（23.44%），and there was diversity in learning formats requirements and unmet clinical needs.Conclusions:This survey revealed insufficient fundamental theoretical knowledge and a need for further standardization and training in the application of provocation/stress echocardiography for HCM among echocardiography physicians. Additionally，risk awareness and adequate response skills need improvement. There is a need for more practical and guiding guidelines for clinical practice，as well as numerous unmet clinical needs.

Abstract In the context of frequent public health events, effective school health education is an important measure to improve students health literacy and public health system of China. The study examined the National Health Education Standards in the U.S., based on a literature review and comparative analysis, to provide guidance for China. Using the method of liberature riview paper interprets the curriculum of National Health Education Standards in the U.S. and provides a mirror for China. Health Education standards in the U.S. are characterized by their academic quality, standardized framework, assessment program, equity principles, and other components. A mirror for China includes promoting the construction of the standards based health education curriculum, developing the skills based health education curriculum system, and constructing a performancebased comprehensive evaluation system.

Abstract To develop a health education curriculum model with Chinese characteristics, literature method and comparative analysis method are used to interpret the U.S. health education curriculum analysis tool (HECAT). HECAT consists of an access component, a design component and an implementation component, which is able to provide a clear and complete analysis of health education curricula, and assists localities in selecting or developing health education curricula. HECAT is characterized by diversified participating entities, structured analysis content, scientific indicator establishment, and systematic practice process. Based on the experience of developing HECAT and building a systematic health education model in the United States, structured thinking to promote the analysis of health education courses, emphasizing the systematic and scientific development of health education courses and establishing an open system for promoting school health education should be applied in China.

Abstract Brain Breaks is a physical activity program that combines cultural classroom based physical activity with modern technology while providing children with multi level guidance. As an intervention for intermittent sedentary activities, Brain Breaks can improve students physical activity level, thereby improving their physical fitness and positively affecting their motivation to participate in physical activities and positive learning behaviors. The paper understands this intervention from the connotation, implementation basis, and application effect of Brain Breaks, and then proposes practical application suggestions and future research directions.When Brain Breaks in the cultural classroom is promoted and practiced in China in the future, attention should be paid to the means of implementation by the teachers, the selection of representative target groups, and the precise implementation plan.At the research level, the effects of motor skills, special group interventions, gender differences, environmental changes, and physiological mechanisms of the Brain Breaks are to be explored.

Objective:To study the relationship between the symptoms and medication law of fever treated with modified Zhuye Shigao Decoction by means of data mining.Methods:Clinical medical records of modified Zhuye Shigao Decoction for the treatment of fever were retrieved from CNKI, VIP, Wanfang Data, CBM from the establishment of the databases to October 31, 2022. Excel 2019 was used to conduct statistics on symptoms and drug frequency. SPSS Modeler 18.0 and SPSS Statistics 25.0 were used to build complex networks and system clusters, and R 4.2.1 was used to analyze the association rules of the database. Results:A total of 163 medical records were included, involving 143 symptoms, mainly fever, anorexia, thirst, upset, sweating, etc; 40 tongue and pulse conditions, mainly including pulse number and red tongue; 163 kinds of Chinese materia medica were involved, including 9 main kinds of Chinese materia medica. The frequency and complex network of Chinese materia medica indicated that the main medicines for fever were the original prescriptions of Zhuye Shigao Decoction, and the commonly used doses were Folium Phyllostachydis Henonis 10 g, Gypsum Fibrosum 30 g, Ginseng Radix et Rhizoma or Codonopsis Radix 10 g, Ophiopogonis Radix 15 g, Pinelliae Rhizoma 10 g, Glycyrrhizae Radix et Rhizoma 6 g, and Oryzae Semen 15g; According to the clustering analysis of compatibility drugs, five core compatibility combinations were obtained. "Forsythiae Fructus→Lonicerae Japonicae Flos", "Adenophorae Radix→dry mouth" had strong correlation.Conclusion:The syndrome types of fever treated by Zhuye Shigao Decoction were unclear exogenous heat-qi and yin injury, phlegm and heat obstructing the lung, excessive heat in the interior-fluid deficiency and heat stagnation, stomach yin deficiency and fire hyperactivity, spleen and stomach weakness-edema due to yang deficiency; the cause of fever treated by Zhuye Shigao Decoction could originate from any of the three energizers, and the disease location was mainly in the stomach.

To investigate the effects and mechanism of bone marrow mesenchymal stem cell (MSC)modified by cytotoxicity T lymphocyte-associated antigen 4-immunoglobulin (CTLA4-Ig)gene on the rejection of orthotopic liver transplantation (OLT)in rats. Methods MSC was infected with recombinant adenoviruses (Ad)5 containing CTLA4-Ig gene. After recombinant Ad-5 containing CTLA4-Ig infected MSC for 72 h,the total proteins were extracted. The protein expression of CTLA4-Ig was assessed by Western-blot.The suppression to lymphocyte proliferation by MSC and transgenic MSC were tested by cell counting kit (CCK)-8 analysis. Forty models of acute rejection after OLT in rats were established by modified Kamada’s two-cuff technique,with male Lewis and BN rats serving as liver donors and recipients respectively. Forty recipient rats were randomly divided into 4 groups with 10 rats in each group including control group (group A, only saline solution was injected into portal venous during transplantation),MSC group (group B,MSC was injected into portal venous during transplantation),transgenic MSC group (group C,transgenic MSC was injected into portal venous during transplantation),immunosuppressant group [group D,saline solution was injected into portal venous during transplantation,and ciclosporin (CsA)was administered intramuscularly at a dose of 1.5 mg /(kg·d) for 8 days]. On the 9 th day after operation,5 rats were killed randomly in every group,then the levels of interleukin (IL)-2,interferon (IFN)-γ,IL-4 in peripheral blood were measured and the pathological changes and rejection expression of liver tissues were observed by light microscope. The survival condition of other 5 rats in 4 groups was observed. Results After recombinant Ad-5 containing CTLA4-Ig infected MSC for 72 h,the protein expression of CTLA4-Ig gene in MSC infected with Ad5-CTLA4-Ig could be detected by Western-blot.When the ratios of MSC∶peripheral blood monouclear cell (PBMC)were 1∶10 and 1∶20,the rates of suppression to lymphocyte proliferation were 85.60% and 76.69% respectively.When the ratios of transgenic MSC∶PBMC were 1∶10 and 1∶20,the rates of suppression to lymphocyte proliferation were 90.50% and 84.20% respectively. Compared with MSC,MSC infected with Ad5-CTLA4-Ig had stronger effect on suppression to lymphocyte proliferation (P <0.05 ). The survival time after liver transplantation of rats in group A,B,C,D was (13 ±3),(41 ±6),(90 ±15),(102 ±18)d respectively.There were significant differences among group A,B,C (P<0.05 )and there was no significant difference between group C and D (P>0.05 ). Compared with group A,the serum levels of IL-4 in group B and C were significantly higher (P<0.05 ). The serum levels of IL-4 in group C were significantly higher than that in group B (P<0.05 ). There was no significant difference in the serum levels of IL-4 between group C and D (P>0.05 ). Compared with group A,the serum levels of IL-2 and IFN-γin group B and C were lower significantly (P<0.05 ). The serum levels of IL-2 and IFN-γin group C were significantly lower than those in group B (both in P<0.05 ). There were no significant differences in the serum levels of IL-2 and IFN-γbetween group C and D (P>0.05 ). The pathological result of liver tissues of rats showed that the grafts of group A developed severe rejection,and the grafts of group B developed moderate rejection. And the grafts of group C and D developed slight rejection. Conclusions MSC infected with recombinant Ad5-CTLA4-Ig can inhabit the rejection in liver transplantation,and the effect is superior to MSC alone.