ObjectiveTo investigate the potential mechanism of action of the Qufeng Tongqiao Cough-relieving Decoction （祛风通窍止咳方， QTCD） in the treatment of upper airway cough syndrome （UACS）. MethodsTwenty-four guinea pigs were randomly divided into blank group， model group， traditional Chinese medicine （TCM） group， and inhibitor group， with six guinea pigs in each group. Except for the blank group， guinea pigs were sensitized with ovalbumin and aluminum hydroxide via intraperitoneal injection， followed by ovalbumin nasal drops combined with smoke exposure to establish the UACS model. After modeling， the TCM group was administered QTCD 0.9 g/（100 g·d） by gavage， the inhibitor group received the transient receptor potential vanilloid receptor 4 （TRPV4） inhibitor GSK2193874 1 mmol/L， 5 min by nebulisation， and the blank group and model group were given 2 ml/（100 g·d） normal saline by gavage once daily. After 7 days of treatment， a cough provocation test was performed using 0.4 mol/L citric acid. The levels of IgE in serum and inflammatory cytokines， including interleukin-6 （IL-6）， interleukin-8 （IL-8） in serum， bronchoalveolar lavage fluid （BALF）， and nasal lavage fluid （NLF） were detected by enzyme-linked immunosorbent assay （ELISA）. Histopathological changes in lung and nasal mucosal tissues were observed by hematoxylin-eosin （HE） staining. Immunohistochemistry was used to detect the protein levels of TRPV4， substance P （SP）， and calcitonin gene-related peptide （CGRP） in lung and nasal mucosal tissues. Real-time polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of TRPV4， SP， and CGRP in lung tissues. ResultsHE staining showed significant structural damage and infiltration of inflammatory cells in the lung and nasal mucosal tissues in the model group， while the TCM group and inhibitor group showed improved pathological changes. Compared with the blank group， the model group showed increased cough frequency， serum IgE level， and IL-6 and IL-8 levels in serum， BALF， and NLF. The protein levels of TRPV4， SP， and CGRP in lung and nasal mucosal tissues and their mRNA expression were elevated （P＜0.05 or P＜0.01）. Compared with the model group， the TCM group and inhibitor group showed reduced cough frequency， serum IgE level， and TRPV4 and SP mRNA expression in lung tissues. The TCM group showed reduced IL-6 and IL-8 levels in serum， BALF， and NLF， and reduced TRPV4 and CGRP protein levels in lung and nasal mucosal tissues. The inhibitor group showed reduced IL-6 and IL-8 levels in serum， BALF， and NLF， reduced IL-6 in BALF， reduced IL-8 in NLF， and decreased TRPV4， SP， and CGRP protein levels in lung tissues and SP and CGRP protein levels in nasal mucosal tissues （P＜0.05 or P＜0.01）. Compared with the TCM group， the inhibitor group had increased serum IgE， IL-6， and IL-8 levels， increased IL-6 level in BALF， and increased IL-8 levle in NLF， but decreased SP protein level in lung tissues and increased TRPV4 and SP mRNA expression in lung tissues （P＜0.01）. ConclusionQTCD effectively reduces cough frequency in the UACS guinea pig model. Its mechanism may involve inhibiting the activation of the TRPV4 pathway， improving airway neurogenic inflammation， alleviating inflammatory responses， and reducing cough hypersensitivity.

Objective: To analyze high myopia and dioptre changes in middle school students in Beijing from 2019 to 2022, so as to provide a basis for formulating preventive and control measures. Methods: Using stratified cluster random sampling, 16 districts of Beijing were divided into four groups, each of which was respectively composed of 83, 83, 84, and 84 middle schools, in order to examine non cycloplegic auto refraction among the senior grades 1 to 3 students from September to October in each year (from 2019 to 2022). Finally, the dataset results of each of the four groups (21 589, 21 161, 21 561, 21 123) were compared by the Chi square test and trend Chi square test. Trend changes were evaluated by annual percentage change (APC). Results: The rates of high myopia were higher in female students than in males from 2019 to 2022 (15.60%,14.59%; 15.33%, 14.44%; 14.65 %, 14.17%; 14.63%,13.84%), and the difference in 2019 was statistically significant ( χ 2=4.93, P <0.05). The rates of high myopia in middle school students in urban areas were significantly higher than those in rural areas(16.45%, 13.78%; 16.81 %, 13.00%; 15.84%, 13.06%; 15.85%, 12.72%), and the differences were statistically significant ( χ 2=30.18, 60.43, 33.92 , 42.23, P <0.05). With the increase of grade, the rates of high myopia increased ( χ 2 trend =674.56, 608.38, 655.21, 676.89, P <0.05), with junior grade 3 students being the most robust. The rate of high myopia in middle school students from 2019 to 2022 decreased from 15.09 to 14.22%, with an average annual rate of 2.08% ( APC=-2.08, t=-7.99, P ＜0.05). The refractive error of high myopia middle school students in 2019 and 2022 were -7.44(-10.25, -6.00) and -7.38(-10.00, -6.00)D, respectively, with no statistically significant difference ( H=4.30, P >0.05). Conclusions The rate of high myopia in middle school students in Beijing shows a decreasing trend, but it remains at a high level. It is necessary to classify the prevention and control strategy, and standardize the measures in order to manage early onset, high incidence rates, and severe myopia.

Objective: To understand the prevalence and related factors of tobacco use among junior high school students in Beijing, so as to provide evidence to effectively conduct tobacco control intervention strategy. Methods: From April to June in 2019 and 2023, 6 489 and 6 898 junior high school students were selected by the probability proportion to size(PPS) method, and a total of 13 387 questionnaires were completed. Questionnaire on tobacco monitoring among junior high school students in Beijing was completed by selffilling. The monitoring content included demographic information, secondhand smoke exposure, tobacco product use, tobacco awareness, etc. Chisquare test was used to compare the difference of various indicators in different groups, and multivariate Logistic regression analysis was adopted to analysis the influencing factors related to the current smoking among junior high school students. Results: In 2019,the current traditional cigarettes and ecigarette smoking rates among junior high school students in Beijing were 1.34%, 1.88%, respectively, and decreased to 0.81%, 1.06% in 2023 (χ2=8.36, 15.17, P＜0.01). The attempted traditional cigarettes and ecigarette smoking rates among junior high school students in Beijing decreased from 6.67%, 6.47% in 2019 to 3.93%, 4.16% in 2023 (χ2=49.99, 35.26, P＜0.01). In 2019, the secondhand smoke exposure rates of junior high school students at homes, indoor public places, and outdoor public places were 31.04%, 44.94%, and 49.88% respectively which decreased to 22.59%, 30.23%, and 36.14% in 2023 (χ2=121.63, 308.60, 257.41, P<0.01). In 2023, male students (OR=2.88), senior students (grade 2 and 3) (OR=4.37, 4.92), disposable pocket money>20 yuan/week (OR=2.01), secondhand smoke exposure at home (OR=2.74), indoor public places (OR=2.64), perception that smoking makes young people more attractive (OR=6.29), and perception that ecigarettes help quit smoking (OR=4.31) were associated with higher tobacco use (P<0.05). Conclusions Tobacco use and secondhand smoke among junior high school students in Beijing decrease significantly. Tobacco control interventions should be provided for junior high school students continuously with a focus on ecigarettes use to promote physical and mental health development among students.

Objective: To explore the association between parental myopia and extracurricular activities before school age with myopia among lower grade students, so as to provide evidence for myopia prevention on low grade students. Methods: From November 2020 to June 2022, a total of 8 368 students of grade 1-3 were selected from Beijing, Liaoning, Zhejiang, Henan, Chongqing, Shaanxi Province by the stratified cluster random sampling and probability sampling methods, and were administered with a questionnaire survey and eye examinations. Multivariate Logistic regression was used to analyze the association between parental myopia and extracurricular activities before school age with myopia among lower grade students. Results: The prevalence of myopia in grade 1-3 was 23.7% in 6 provinces in China. Students who in central area, grade 3, boarding at school, doing homework/reading/writing time ≥1 h/d after school, extracurricular activities ≥1 h in the past week, extracurricular activities before school age, parental myopia, poor reading and writing posture, sleeping time <10 h/d, less exercise time because of homework or extracurricular activities, having annual vision examination had a higher myopia detection rate, with statistically significant differences ( χ 2=36.41, 487.72, 15.97, 21.35, 43.95, 15.33, 54.04, 6.67, 3.88, 20.02, 20.06, P <0.05). After adjusted for the confounding factors, there was a significant interaction between parental myopia and extracurricular activities before school age with myopia ( P interaction <0.01). After adjusting for confounding factors, Logistic regression analysis showed that those having extracurricular activities before school age had a higher risk of myopia ( OR=1.33, 95%CI =1.19-1.56), compared with those who did not. Compared with children without nearsighted parents, children with nearsighted parents had higher prevalence of myopia ( OR=1.64, 95%CI = 1.45- 1.84) ( P <0.05); and the values of indicators ( RERI, API, Index S ) for interaction between parental myopia and extracurricular activities before school age were 0.35, 0.27, 1.37, respectively. Conclusion Both parental myopia and extracurricular activities before school age are associated with myopia among lower grade students, with interactive effects.

ObjectiveTo investigate the effect of Fuzheng Huayu prescription on hepatocyte extinction and regeneration in fibrotic liver and its mechanism of action in promoting hepatocyte regeneration. MethodsMice were given intraperitoneal injection of CCl₄ for 6 weeks to establish a model of liver cirrhosis， and there were 10 mice in the model group， 10 in the sorafenib group， 10 in the Fuzheng Huayu prescription group， and 9 in the normal control group. Since week 4 of modeling， the mice in the Fuzheng Huayu prescription group and the sorafenib group were given the corresponding drug by gavage at a dose of 4.8 g/kg and 4 mg/kg， respectively， for three consecutive weeks， and those in the normal group and the model group were given an equal volume of sodium carboxymethyl cellulose. Serum liver function parameters were measured； the METAVIR scoring system was used to evaluate liver inflammation and fibrosis stage； Sirius Red staining and hydroxyproline （Hyp） content in liver tissue were used to evaluate collagen deposition； immunohistochemistry was used to measure the protein expression levels of type IV collagen， CD31， CD32b， Ki67， CyclinD1， glutamine synthetase， Wnt2， and HGF， and Western blot was used to measure the expression levels of Wnt2， LRP6， β-catenin， p-β-catenin， and CyclinD1 in liver tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the model group， the Fuzheng Huayu prescription group and the sorafenib group showed the following changes： significant reductions in the serum levels of alanine aminotransferase and aspartate aminotransferase and the content of Hyp in liver tissue （all P<0.01）； a significant reduction in METAVIR score； significant reductions in the expression levels of type Ⅳ collagen and CD31 （all P<0.05） and a significant increase in the expression level of CD32b （P<0.01）； significant reductions in the number of parenchymal extinction lesions and significant increases in the expression levels of Ki67 and CyclinD1 in liver tissue （all P<0.01）； significant increases in the protein expression levels of Wnt2， LRP6， β-catenin， and CyclinD1 and a significant reduction in the protein expression level of p-β-catenin （all P<0.05）； significant increases in the number of cells stained positive for both CD32b and Wnt2. ConclusionFuzheng Huayu prescription can inhibit hepatic sinusoidal capillarization， improve the Wnt2 exocrine function of liver sinusoidal endothelial cells， activate the Wnt/β-catenin signaling pathway associated with hepatocyte regeneration， and finally reverse liver cirrhosis.

Objective:To explore the diagnostic value of the nomogram constructed based on multi-modal ultrasound features combined with inflammatory complex indicators for benign and malignant nodules in breast imaging reporting and data system (BI-RADS) .Methods:102 female patients with breast BI-RADS type 4 nodules who were treated in Northwest Women’s and Children’s Hospital from Jan. 2021 to Mar. 2024 were included as study objects, and benign and malignant nodules were determined according to postoperative pathological examination results. Conventional ultrasound, shear-wave elastography and contrax-ultrasound were performed in each breast BI-RADS patient with Class 4 nodules using Mindray resona7 ultrasonic diagnostic instrument within 1 week before surgery to record the ultrasonic characteristics. According to the results of laboratory examination, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (NLR), PLR, the systemic immune inflammation index (SII), and the systemic inflammatory response index (SIRI) were calculated and recorded.Results:There were 42 cases of malignant nodules and 60 cases of benign nodules. Compared with the benign group, there were significant differences in nodule boundary, internal echo, Alder blood flow grading, hard ring sign, area expansion after enhancement, peripheral radial enhancement and perfusion defect in the malignant group ( χ2 value was 5.83, 9.31, 5.20, 10.25, 6.99, 7.24, 4.90, P < 0.05). Compared with the benign group, NLR and SIRI in the malignant group were significantly increased, with statistical difference (t-value 3.13 and 4.33, P < 0.05). The results of multi-factor Logistics regression analysis show that breast BI-RADS were characterized by blurred nodule boundary (X1), Alder blood flow grade 2-3 (X3), hard ring sign (X4), enlarged area after enhancement (X5), peripheral radial enhancement (X6), NLR≥2.29 (X8), SIRI≥0.91 (X9) were independent risk factors for malignant nodules ( P < 0.05). Based on these factors, the Logistics regression model was established as Logit (P) = -3.217 + 0.291X1 + 1.051X3 + 0.354X4 + 0.360X5 + 0.524X6 + 0.513X8 + 0.726X9. The results of calibration curve and clinical decision curve evaluation showed that the model had good accuracy and high predictive value. ROC curve analysis results showed that the area under the curve of the nomogram model for predicting benign and malignant nodules of category 4 breast BI-RADS was 0.925 (0.877-0.974), the sensitivity was 88.6%, and the specificity was 86.1%. Conclusion:The nomogram model constructed by multi-modal ultrasound combined with inflammatory complex index NLR and SIRI has certain application value in the differential diagnosis of benign and malignant breast BI-RADS 4 nodules.

Objective:To explore the diagnostic value of the nomogram constructed based on multi-modal ultrasound features combined with inflammatory complex indicators for benign and malignant nodules in breast imaging reporting and data system (BI-RADS) .Methods:102 female patients with breast BI-RADS type 4 nodules who were treated in Northwest Women’s and Children’s Hospital from Jan. 2021 to Mar. 2024 were included as study objects, and benign and malignant nodules were determined according to postoperative pathological examination results. Conventional ultrasound, shear-wave elastography and contrax-ultrasound were performed in each breast BI-RADS patient with Class 4 nodules using Mindray resona7 ultrasonic diagnostic instrument within 1 week before surgery to record the ultrasonic characteristics. According to the results of laboratory examination, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (NLR), PLR, the systemic immune inflammation index (SII), and the systemic inflammatory response index (SIRI) were calculated and recorded.Results:There were 42 cases of malignant nodules and 60 cases of benign nodules. Compared with the benign group, there were significant differences in nodule boundary, internal echo, Alder blood flow grading, hard ring sign, area expansion after enhancement, peripheral radial enhancement and perfusion defect in the malignant group ( χ2 value was 5.83, 9.31, 5.20, 10.25, 6.99, 7.24, 4.90, P < 0.05). Compared with the benign group, NLR and SIRI in the malignant group were significantly increased, with statistical difference (t-value 3.13 and 4.33, P < 0.05). The results of multi-factor Logistics regression analysis show that breast BI-RADS were characterized by blurred nodule boundary (X1), Alder blood flow grade 2-3 (X3), hard ring sign (X4), enlarged area after enhancement (X5), peripheral radial enhancement (X6), NLR≥2.29 (X8), SIRI≥0.91 (X9) were independent risk factors for malignant nodules ( P < 0.05). Based on these factors, the Logistics regression model was established as Logit (P) = -3.217 + 0.291X1 + 1.051X3 + 0.354X4 + 0.360X5 + 0.524X6 + 0.513X8 + 0.726X9. The results of calibration curve and clinical decision curve evaluation showed that the model had good accuracy and high predictive value. ROC curve analysis results showed that the area under the curve of the nomogram model for predicting benign and malignant nodules of category 4 breast BI-RADS was 0.925 (0.877-0.974), the sensitivity was 88.6%, and the specificity was 86.1%. Conclusion:The nomogram model constructed by multi-modal ultrasound combined with inflammatory complex index NLR and SIRI has certain application value in the differential diagnosis of benign and malignant breast BI-RADS 4 nodules.

Objective: To study the correlation between electronic screen use and myopia among primary and secondary school students in six provinces and cities in China, in order to provide a scientific basis for comprehensive prevention and control of myopia. Methods: From November 2020 to June 2022, a total of 16 557 primary and secondary school students from six provinces and cities in China (Beijing City, Liaoning Province, Zhejiang Province, Henan Province, Shaanxi Province, Chongqing City) were selected by stratified cluster random sampling and probability smampling methods, and a questionnaire prepared by Beijing Center for Disease Control and Prevention was used to investigate their electronic screen use. According to Screening Criteria for Myopia in Children and Adolescents, 0.5% mass concentration of compound topicamide eye drops was used to paralyze the ciliary muscle and undergo slit lamp optometry. Chisquare test was used to compare the differences between groups, and binary Logistic regression was used to analyze the association between electronic screen use and myopia. Results: About 58.3% of primary and secondary school students used electronic screens for more than two hours a day on average, and 63.4% of primary and secondary school students used continuously electronic products for more than 15 minutes at a time for nonstudy purposes. After adjusting for confounding factors, parents unrestricted use of electronic screen time and electronic screen time ≥2 h/d were positively correlated with myopia (OR=1.27, 1.13, P<0.05). Gender stratified analysis showed that boys who used electronic screen time ≥2 h/d had a higher risk of myopia (OR=1.15, P<0.05). The results of grade stratification analysis showed that parents unrestricted electronic screen use time and electronic screen time ≥2 h/d were positively correlated with myopia in the lower grade of primary school students (OR=1.34, 1.18, P<0.05). Among the higher grade of primary school students, continuous use of electronic screens for nonstudy purposes for more than 15 minutes at one time was positively correlated with myopia (OR=1.18, P<0.05). There was a multiplicative interaction between total screen time and one continuous screen time (OR=1.04, P<0.05). Conclusions Primary and secondary students in six provinces and cities in China reports excessive electronic screen usage which is associated with myopia. Schools and parents should jointly limit the use of electronic screen among primary and secondary students to reduce the occurrence of myopia.

Objective: To explore the association between reading and writing posture with the occurrence of myopia in Chinese children and adolescents, so as to provide a reference for reducing its prevalence among primary and secondary school students. Methods: Using data from the 2020 survey on the current status of hyperopia reserve in primary and secondary school students from six provinces/cities, namely Beijing, Zhejiang, Chongqing, Shaanxi, Liaoning, and Henan selected by multi stage stratified cluster probability sampling method during November 2020 to June 2022. A total 16 782 students who completed the optometry examination of cycloplegia according to the Children and Adolescents Myopia Screening Standard and questionnaire survey were included for analyzing analyze the association between reading and writing posture with myopia. Results: The overall detection rate of myopia among primary and secondary school students was 45.7%, of which 35.0% were primary school students, 84.1% junior high school students, and 90.4% senior high school students. Poor reading and writing posture was found in 73.6% of primary and secondary school students. Adjusting for confounding factors such as gender, school period, region, outdoor time every day, and whether parents were myopic, the results of the multilevel Logistic regression showed that the following factors were positively correlated with myopia:poor reading and writing posture ( OR=1.17, 95%CI =1.07-1.28), never/occasionally reading and writing with a reading distance which was more than one foot away between the eyes and book ( OR=1.28, 95%CI=1.08-1.53, OR=1.23, 95%CI = 1.08- 1.40), teachers occasionally reminding the child of their reading and writing posture ( OR=1.13, 95%CI =1.01-1.25), and often/always reading and writing while lying down or with the face on the arm ( OR=1.15, 95%CI=1.01-1.32, OR=1.46, 95% CI = 1.17-1.82), always reading and writing with the head in the hand ( OR=1.56, 95%CI =1.20-2.01). Further, a negative correlation was detected between myopia and parents occasionally reminding their children of their reading and writing posture ( OR= 0.85 , 95%CI =0.76-0.96) ( P <0.05). Conclusion Poor reading and writing posture is a risk factor for the development of myopia in primary and secondary school students, and interventions for reading and writing posture need to be strengthened to reduce the occurrence of myopia among primary and secondary school students.

Objective: To understand the vision status of primary and secondary school students in Beijing, in order to provide scientific reference for myopia prevention and control. Methods: From 2018 to 2021, a stratified cluster sampling method was used to monitor myopia among 191 293 primary and secondary school students selected from 6 urban areas and 10 suburban areas in Beijing. Myopic screening was in accordance with the "standards for children and adolescents myopic screening", and was measured by an automatic desktop computer optometer under non-cycloplegic conditions. Statistical analysis was used by Chi-square test. Results: The total myopia rate of primary and middle school students in Beijing from 2018 to 2021 were 60.7%, 57.6%, 59.2% and 59.7%, respectively. In 2018, the myopia rates of primary school students, middle school students, regular high school students and vocational high school students were 38.3%, 77.3%, 88.3% and 73.2% respectively. In 2019, they were 34.7%, 76.4%, 87.7% and 72.0%, respectively; in 2020, they were 37.5%, 76.8%, 86.8%, 74.9%; in 2021, they were 38.7%, 77.4%, 86.5% and 74.9 % respectively. Significant differences in educational stage were observed ( χ 2=7 386.07, 11 104.28, 9 850.08, 9 714.59, P <0.01). From 2018 to 2021, the overall myopia rate of girls (62.1%) was higher than that of boys (56.5%)( χ 2=613.75, P <0.01). The myopia rate of girls were higher than that of boys in each year, and significant differences in educational stage were observed, respectively( χ 2=120.47, 163.47, 168.01, 162.24, P <0.01). The overall myopia rate of urban students(63.0%) was higher than that of suburban students (56.0%)( χ 2=978.82, P <0.01). The myopia rate of urban students were higher than that of suburban students every year, and significant differences in educational stage were observed, respectively ( χ 2=86.71, 240.96, 302.56, 409.30 , P < 0.01 ). Conclusion The detection rate of myopia rate of primary and middle school students in Beijing is still high. It is necessary to strengthen the publicity and intervention of poor visual acuity in primary and middle school students, especially among urban area students, with the aim of effectively control and reduction in the myopia rate, and the improvement of student visual health.