Objective: To examine the associations of pet ownership and daily outdoor activity duration with depressive symptoms in middle school students, so as to provide evidence for targeted prevention strategies of depressive symptoms in middle school students. Methods: Using a stratified cluster random sampling method, 83 601 middle and high school students from 103 districts and counties in Inner Mongolia Autonomous Region were selected in 2024. A questionnaire survey was conducted to collect demographic data, household pet ownership, outdoor activity duration, and depressive symptoms of the research subjects. The comparison of reporting rates of depressive symptoms among different groups of middle school students was conducted using a χ 2 test. The association between pet ownership and outdoor activity duration and depressive symptoms among middle school students was evaluated using a Logistic regression model, and stratified analysis was conducted among different genders and regions to control for potential confounding factors and evaluate the stability of the association. Results: The prevalence of depressive symptoms among middleschool students in Inner Mongolia was 17.2%. Significant differences in depressive symptom reporting rates were observed across sex, grade, ethnicity, surveillance site, parental education, menarche/spermarche status, boarding status, smoking and alcohol use, daily breakfast consumption, school bullying, continuous 30 minute headphone use in a noisy environment, and often use the Internet ( χ 2=8.07-2 672.57, all P <0.01). Both pet ownership ( OR =0.78, 95% CI =0.75-0.81) and ≥2 h/d of outdoor activity( OR =0.81, 95% CI =0.78-0.84) were inversely associated with depressive symptoms;compared to the without owning pets and < 2 h of outdoor activity daily group, students who both owned pets and engaged in ≥2 h of outdoor activity daily had an even lower risk ( OR =0.83, 95% CI =0.78-0.87)(all P <0.05). Conclusion Pet ownership and increased daily outdoor activity duration may help mitigate depressive symptoms among middle school students.

Objective: To analyze the prevalence trends of different types of elevated blood pressure and their association with nutritional status among primary and secondary school students in Inner Mongolia from 2019 to 2024, providing references for targeted prevention strategies. Methods: From September 2019 to 2024, a stratified random cluster sampling method was used to select 12 primary and secondary schools from each league city in Inner Mongolia Autonomous Region. A total of 177 108, 137 758, 190 182, 180 084 , 188 056, 180 351 primary and secondary school students (excluding grades one to three of primary school) were included for physical examination. The correlation between their nutritional status and high blood pressure was analyzed based on the basic situation of 129 821 primary and secondary school students who completed a questionnaire survey at the same time in 2024. Statistical analysis was conducted using a Chi-square test and multiple Logistic regression model. Results: From 2019 to 2024, the detection rates of elevated blood pressure were 13.60%, 13.68%, 17.60%, 17.24%, 14.77% and 15.96%, respectively. The rates for isolated systolic hypertension were 4.24%, 5.83%, 7.26%, 7.19%, 6.24% and 6.93%; isolated diastolic hypertension rates were 6.38%, 4.99%, 6.23 %, 6.41%, 5.39% and 5.66%; and combined systolic and diastolic hypertension rates were 2.97%, 2.86%, 4.11%, 3.65%, 3.14 % and 3.36%. Multivariate Logistic regression analysis showed that girls, junior high school, senior high school, overweight, and obesity were positively associated with elevated blood pressure risk ( OR =1.27, 1.25, 1.32, 1.66, 3.07, all P <0.05); conversely, county residence, Mongolian ethnicity, and other ethnicities showed negative associations ( OR =0.90, 0.93, 0.90, all P <0.05). Conclusions Overweight and obesity among children and adolescents are closely related to various types of elevated blood pressure. Prevention strategies should prioritize effectively controlling weight issues among children and adolescents, thereby effectively reducing the incidence of elevated blood pressure.

OBJECTIVE To investigate the effect and mechanism of gracillin from Reineckia carnea on autophagy in non- small cell lung cancer A549 cells. METHODS Using A549 cells as subjects， the effects of different concentrations of gracillin （0.25， 0.5， 1， 2， 4 μmol/L） on the proliferation of cells were detected by CCK-8 after being treated for different time （12， 24， 48 h）. Compared with the control group without medication， the effect of gracillin （2 μmol/L） on the formation of autophagosomes in cells was observed by transmission electron microscope after 24 h of exposure. The aggregation of GFP-LC3 on autophagosome membrane was detected by GFP-LC3 plasmid transfection after being treated with gracillin （0.25， 0.5， 1， 2 μmol/L） for 24 h. Quantitative real-time PCR and Western blot assay were used to detect the mRNA and protein expressions of family with sequence similarity 102 member A（FAM102A）， the expressions of autophagy-related proteins [p62， Beclin-1， microtubule-associated protein 1 light chain 3B （LC3B）]， and the expressions of phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway-related proteins in A549 cells after being treated with gracillin （0.25， 0.5， 1 and 2 μmol/L） for 24 h. RESULTS Gracillin significantly inhibited the proliferation of A549 cells in a concentration- and time-dependent manner. The IC50 was 2.55 μmol/L at 24 h. After 24 h of gracillin treatment， autophagosomes with bilayer membrane structure were found in the cell cytoplasm， and GFP-LC3 green fluorescent spots on autophagosome membrane were obvious， representing an increasing trend as drug concentration. Compared with the control group， mRNA and protein expressions of FAM102A （0.5， 1， 2 μmol/L groups）， protein expression of Beclin-1 （1， 2 μmol/L groups） and LC3B-Ⅱ/LC3B-Ⅰ ratio （2 μmol/L group） were significantly increased in different concentrations of gracillin groups， while the protein expression of p62 （1， 2 μmol/L groups）， and the protein phosphorylations of Akt （1， 2 μmol/L groups） and PI3K （2 μmol/L group） were all decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS Gracillin can promote excessive autophagy in A549 cells by up-regulating mRNA and protein expressions of FAM102A and inhibiting PI3K/Akt signaling pathway， thus inhibiting cell proliferation.

Objective: To analyse the correlation between unhealthy lifestyles and anxiety symptoms among high school students in Inner Mongolia Region, so as to provide a scientific basis for the prevention of anxiety symptoms among high school students. Methods: From September to November 2023, 35 362 high school students were selected by stratified cluster random sampling method from 12 cities (103 counties) in Inner Mongolia Region, and the survey was conducted by using the questionnaire on student health status and influencing factors. The χ2 test and multivariate Logistic regression analyses were used to determine the influencing factors of anxiety symptoms. Results: The total number of students with anxiety symptoms was 2 747, and the detection rate of anxiety symptoms was 7.77%. The results of multivariate Logistic regression analyses showed that female students, father having higher education background, never eating breakfast, being overweight and obese, sleeping <8 h/d, being scolded by parents in the past 30 days, and depressive symptoms were positively correlated with the anxiety symptoms of the high school students (OR=1.31, 1.23, 1.53, 1.14, 1.22, 1.51,28.92); nonsmoking, having no alcohol consumption, no Internet addiction and no use of sedatives without doctors permission were all negatively correlated with anxiety symptoms of high school students (OR=0.84, 0.73, 0.57,0.40) (P<0.05). Conclusions Anxiety symptoms of high school students are closely related to unhealthy lifestyle. Measures should be taken to improve unhealthy lifestyle, so as to reduce the occurrence of anxiety symptoms in high school students.

Objective: To understand smoking behavior and related factors among college and middle school students in Inner Mongolia Autonomous Region, so as to provide a technical basis for targeted tobacco control interventions. Methods: In September 2023, a total of 93 647 students in Inner Mongolia Autonomous Region were randomly selected by stratified cluster sampling from 12 league cities and 103 banner counties (cities districts) to conduct a questionnaire survey. The χ2 test and binary Logistic regression analyses were used to explore the current situation of adolescent smoking and its related factors. Results: The prevalence of college and middle school students who tried smoking was 10.2%, and the prevalence of current smokers was 4.4%. The binary Logistic regression model showed that students in high school, vocational high school, university, males, those from unstable family, boarders, individuals who sew someone smoking at home, at school, in public places, drinking alcohol, inhaling volatile solvents for pleasure, using cough suppressant except for coughing, using sedative without a doctors permission, being scolded by parents, experiencing school bullying, being addicted to the Internet, having depressive symptoms, anxiety symptoms, and low selfesteem were more likely to attempt smoking and currently smoke (attempt smoking:OR=1.38, 2.59, 1.75, 3.24, 1.18, 1.43, 1.25, 1.43, 1.43, 0.79, 9.18, 1.42, 1.17, 1.65, 1.52, 1.31, 1.58, 1.41, 1.11, 1.17； current smoking:OR=1.61, 4.76, 3.76, 4.45, 1.17, 1.44, 1.27, 1.58, 1.69, 0.68, 7.99, 1.64, 1.12, 2.31, 1.48, 1.37, 1.26, 1.31, 1.35, P<0.05). Teenagers with parents who had graduated from high school and eat breakfast every day had a relatively low risk of trying and current smoking (OR=0.78, 0.83, 0.79, 0.84, 0.78, 0.68, P<0.05). Conclusions Adolescent smoking behaviours in Inner Mongolia Autonomous Region exhibit obvious clustering pattern in the school setting. Associated factors includes demographic characteristics, secondhand smoke exposure, daily behaviours and substance abuse, and psychological behaviours. Schools, families and society should work together to create a smokefree environment to protect adolescents from the harms of tobacco.

Objective: To investigate the incidence and associated factors of spinal curvature disorders among primary and middle school students in Hohhot, so as to provide reference for relevant prevention strategies. Methods: According to the monitoring and intervention work of students common diseases in Inner Mongolia Autonomous, 13 586 primary and middle school students in Hohhot were selected by random sampling method to carry out scoliosis examination in September 2021. Results: A total of 538( 4.0% ) students were found to have spinal curvature disorder. Multivariate Logistic regression analysis showed that monitoring site, phases of studying, and persistent back pain in the past 1 month were associated of spinal curvature disorder in primary and middle school students ( OR =0.33, 1.74, 1.28, 1.51, P <0.05). Conclusion Spinal curvature disorder is relatively common in primary and middle school students in Hohhot. Effective measures should be taken to reduce the burden of spinal curvature disorders in primary and middle school students.

The global trends of nontuberculous mycobacteria (NTM) infection and disease are both rising. Nontuberculous mycobacterial disease(NTMD) is a worldwide health burden associated with increasing morbidity, mortality, and economic costs. Antibiotic therapy is the mainstay of treatment for NTMD.Mycobacterial pathogens are intrinsically resistant to many available antibiotics, making treatment extremely challenging, especially in immunocompromised individuals and patients with underlying chronic lung conditions. Even with lengthy therapy and the use of a combination of antibiotics, only less than half NTMD patients can achieve clinical treatment success, so it is urgent to develop novel anti-NTM antibiotics. This article reviews the research progress on the medication of nontuberculous mycobacterial diseases.

Drug-resistant tuberculosis (DR-TB) has been a serious global public health problem. There is an urgent need in new drug development for drug-resistant Mycobacterium tuberculosis (MTB). Bedaquiline (Bdq) is a new antituberculous drug belonging to the diarylquinoline class that efficiently inhibits the adenosine triphosphate synthase enzyme of MTB, now is one of the core drugs for the treatment of DR-TB. Bdq can significantly improve the negative rate of sputum culture and reduce the mortality with good safety and tolerance, and it can also shorten the course of treatment for patients with tuberculosis and save costs. This article reviews the efficacy, safety, tolerability and treatment-related issues of Bdq-containing regimens for DR-TB.

Tuberculous meningitis is the most common and serious type of central nervous system tuberculosis, with high mortality and disability rate, which has attracted extensive attention of global public health. The high mortality rate and disability rate of tuberculosis meningitis may be related to its lack of specific clinical and imaging characteristics, insufficient attention from clinicians, lack of early sensitive and specific diagnostic testing techniques, delay in treatment, and restricted penetration of anti-TB drugs into the blood-brain barrier or/and MDR-TB, etc. This article reviews the disease burden of TBM, chemotherapy drugs and regimens, anti-inflammatory agents, aspirin, interventional and surgical treatment to provide reference for clinical management of this disease.

Objective To evaluate the diagnostic efficacy of Kwak and ACR( 2017 ) thyroid imaging reporting and data systems ( T I‐RADS ) for thyroid nodules . Methods Cases of thyroid nodule who underwent surgery from January 2015 to M arch 2018 in 15 hospitals in Sichuan province were collected and the ultrasonographic features of thyroid nodules were retrospectively analyzed by trained senior ultrasound physicians using Kwak and ACR T I‐RADS classification methods . Totally ,12 712 thyroid nodules were observed ,7 023 thyroid nodules in 7 023 cases with complete ultrasound and surgical and pathological data were eventually enrolled in the study . T hyroid nodules with solid ,hypoechoic or very hypoechoic ,tall/wide ratio ≥ 1 , margin ill‐defined and microcalcification were classified as malignant signs of ultrasound . M alignant percentage was calculated and diagnostic tests were performed . Results ① T here was a statistical difference between the benign and malignant nodules in the two types of T I‐RADS classification ( P＜0 .01) . ② T he area under ROC curve of Kwak and ACR in the diagnosis of malignant nodules were 0 .89 and 0 .84 ,respectively . T he Youden index of Kwak and ACR were 0 .66 and 0 .57 ,respectively . ③Taking Kwak T I4B and ACR T R4 as critical points for malignancy ,the sensitivity ,specificity ,positive predictive value and negative predictive value of Kwak T I 4B were 75 .0% ,90 .9% ,83 .2% ,and 85 .9% , respectively . T he accuracy of Kwak T I4B was 84 .9% ; T he sensitivity ,specificity ,positive predictive value and negative predictive value of ACR T R4 were 88 .2% ,68 .9% ,62 .9% ,and 90 .8% ,respectively . T he accuracy of ACR T R4 was 76 .2% . T he Kappa value of Kwak TI4B and ACR T R4 was 0 .52 . T he χ2 value of Kwak T I4B and ACR T R4 was 2 174 .6 ( P ＜ 0 .01 ) . Conclusions T he diagnostic values of two T I‐RADS classification methods for thyroid malignant nodules are high . T he overall efficiency of Kwak T I‐RADS classification method is better than that of ACR TI‐RADS classification method .