Pulmonary sarcoidosis is an immune system disease with an unclear etiology. Guided by the yang-reinforcing method， it is believed that the fundamental pathogenesis of pulmonary sarcoidosis lies in the disharmony between water and fire and the reckless movement of the ministerial fire. The failure of the spleen and stomach to maintain warmth， leading to the production of phlegm and blood stasis， is an important pathogenesis. The invasion of external pathogenic toxins， deeply penetrating into the interior， is considered a triggering factor for the disease. The treatment focuses on supplementing the yang， consolidating the kidney， drawing fire back to its source， warming the yang， benefiting the kidney， and nourishing the spleen to generate metal. It also emphasizes unblocking the yang， transforming turbidity， and eliminating phlegm and blood stasis.

Objective The aim of this study was to analysis the incidence and mortality of malignant tumors in the cancer registration area of Kunming City in 2020,as well as the trend of changes from 2016 to 2020.Methods The malignant tumor data of 12 cancer registration areas in Kunming in 2020 that met the quality criteria were used to analyze the crude incidence,crude mortali-ty,age-standardized incidence/mortality rate by Chinese standard population(ASIRC/ASMRC)of malignant tumors in different gen-ders and regions.The annual percentage change(APC)was calculated using Joinpoint 5.3.0.0 software,the incidence and mortality trends of malignant tumors from 2016 to 2020 were evaluated.Results In 2020,the crude incidence and ASIRC of malignant tumors in cancer registration areas of Kunming City were 234.27/100,000 and 141.68/100,000,respectively.The ASIRC of males was high-er than that of females(146.94/100,000 vs.137.33/100,000,Z=3.459,P<0.001),and that of rural areas was higher than that of urban areas(146.37/100,000 vs.134.09/100,000,Z=-4.462,P<0.001).The crude mortality and ASMRC of malignant tumors were 135.67/100,000 and 73.18/100,000,respectively.The ASMRC of males was higher than that of females(91.65/100,000 vs.55.43/100,000,Z=19.260,P<0.001),and that of rural areas was higher than that of urban areas(76.27/100,000 vs.70.00/100,000,Z=-3.359,P<0.001).There were 81.39%of new cases and 90.36%of deaths of malignant tumors occurred in the popu-lation aged 50 and above.The top 5 cancer incidence in the Kunming City were lung cancer,colorectal cancer,breast cancer,liver cancer and prostate cancer.The top 5 cancer mortality were lung cancer,liver cancer,colorectal cancer,prostate cancer and stomach cancer.The ASIRC(APC=-3.05%,95%CI:-5.91%--0.10%,P=0.046)and ASMRC(APC=-5.47%,95%CI:-8.52%--2.32%,P=0.012)of malignant tumors in urban areas of Kunming showed a downward trend.Conclusions From 2016 to 2020,the ASIRC and ASMRC of malignant tumors in urban areas of Kunming showed a downward trend,but there was no significant changing trend in rural tumor registration areas.Rural areas are key areas for the prevention and treatment of malignant tumors in Kunming city;Lung cancer,colorectum cancer,liver cancer and prostate cancer are the key types of cancer for prevention and treatment.

BackgroundThe issue of school absenteeism due to school refusal in adolescents has become increasingly prominent. Acceptance and Commitment Therapy （ACT） has been applied successfully to improve depression， anxiety， and psychological flexibility in adolescents， while few studies have tested the effect of ACT intervention on above-mentioned psychological aspects and return-to-school rate in adolescents with school absenteeism. ObjectiveTo explore the effect of ACT on depression， anxiety， psychological flexibility and return-to-school rate in school absenteeism adolescents， and to provide a broader evidence base for clinical interventions. MethodsFrom May to June 2024， a sample of 50 adolescents with Shenzhen school registration who had been suspended from school for more than a consecutive month for school refusal were recruited based on Wechat official account platform. The adolescents were divided into study group and control group by random number table method. Both groups received psychological education with the theme of 'Causes and Coping Strategies of School Refusal'， and study group added a 6-week ACT intervention with weekly 1-hour sessions. At baseline and after treatment， Patients’ Health Questionnaire Depression Scale-9 item （PHQ-9）， Generalized Anxiety Disorder Scale-7 item （GAD-7） and Comprehensive assessment of Acceptance and Commitment Therapy processes （CompACT） were used for the clinical evaluation. ResultsA total of 45 （90.00%）adolescents completed the study， including 25 in study group and 20 in control group. Analysis revealed that study group scored higher on PHQ-9 and GAD-7， while lower on total CompACT score， openness dimension and awareness dimension compared with control group， with statistical significance （F=7.786， 10.334， 12.922， 14.374， 3.075， P<0.05 or 0.01）. After intervention， the rate of return-to-school was higher in study group than in control group （40.00% vs 10.00%， χ²=5.114， P<0.05）. ConclusionACT intervention for adolescents with school absenteeism may alleviate depression and anxiety， improve their psychological flexibility and increase return-to-school rate.［Funded by the "14^th Five Year Plan" for Social Sciences Project in Jiangxi Province （number， 24JY41D）； Science and Technology Planning Project of Shenzhen Municipality （number， 20210617155253001）］

Objective The aim of this study was to analyze the proportion of disability adjusted life years(DALYs)attributed to aging population in common digestive system malignancies in China,and predict the proportion and the trends of DALYs attributed to aging proportion from 2022 to 2046.Methods Based on the Global Burden of Disease Study 2021,the DALY data of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gallbladder and biliary tract cancer of Chinese people aged≥25 years from 1990 to 2021 were selected.The age-period-birth models were used to predict the DALY of malignant tumors from 2022 to 2046.The changes of DALY from 1990 to 2046 were decomposed into population growth,population aging,and age-specific DALY rate changes,and analyze the proportion of DALY changes attributable to population aging and its change trend.Results From 1990 to 2021,the DALY change rates of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gall-bladder and biliary tract cancer in Chinese people aged≥25 years were 18.20％,-0.34％,98.10％,164.16％,58.21％and 90.62％,respectively.Compared with 2021,the proportion of DALY changes attributed to population aging for six types of malignant tumors in 1990 was from-38.32％to-19.72％.The top three cancer types with the highest attribution ratios were stomach cancer(-38.32％),esophageal cancer(-38.07％),gallbladder and biliary tract cancer(-29.78％).The expected change rates of DALY for the six types of malignant tumors from 2021 to 2046 were 20.72％,11.50％,58.19％,57.38％,21.36％and 48.39％,respective-ly.By compared with 2021,the proportion of DALY changes of six malignant tumors attributed to population aging in 2046 was from 18.82％to 47.83％,and the top three cancers attributed to the proportion were gallbladder and biliary tract cancer(47.83％),color-ectal cancer(43.07％)and pancreatic cancer(38.76％).From 2022 to 2046,the proportion of DALY changes attributed to aging pop-ulation for the six types of malignant tumors would continue to rise(P＜0.001).The proportions of colorectal cancer and pancreatic cancer attributed to population aging and the proportion of age-specific DALY rate were both positive and rising(P＜0.001),which would eventually promote the further increase of DALY.Conclusion Population aging has become the main driving factor for the growth of DALY in digestive system malignant tumors in China.The impact on DALY of colorectal cancer and pancreatic cancer will be prominent in the future.Targeted prevention and control strategies should be developed to actively respond to population aging.

Objective The aim of this study was to analyze the proportion of disability adjusted life years(DALYs)attributed to aging population in common digestive system malignancies in China,and predict the proportion and the trends of DALYs attributed to aging proportion from 2022 to 2046.Methods Based on the Global Burden of Disease Study 2021,the DALY data of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gallbladder and biliary tract cancer of Chinese people aged≥25 years from 1990 to 2021 were selected.The age-period-birth models were used to predict the DALY of malignant tumors from 2022 to 2046.The changes of DALY from 1990 to 2046 were decomposed into population growth,population aging,and age-specific DALY rate changes,and analyze the proportion of DALY changes attributable to population aging and its change trend.Results From 1990 to 2021,the DALY change rates of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gall-bladder and biliary tract cancer in Chinese people aged≥25 years were 18.20％,-0.34％,98.10％,164.16％,58.21％and 90.62％,respectively.Compared with 2021,the proportion of DALY changes attributed to population aging for six types of malignant tumors in 1990 was from-38.32％to-19.72％.The top three cancer types with the highest attribution ratios were stomach cancer(-38.32％),esophageal cancer(-38.07％),gallbladder and biliary tract cancer(-29.78％).The expected change rates of DALY for the six types of malignant tumors from 2021 to 2046 were 20.72％,11.50％,58.19％,57.38％,21.36％and 48.39％,respective-ly.By compared with 2021,the proportion of DALY changes of six malignant tumors attributed to population aging in 2046 was from 18.82％to 47.83％,and the top three cancers attributed to the proportion were gallbladder and biliary tract cancer(47.83％),color-ectal cancer(43.07％)and pancreatic cancer(38.76％).From 2022 to 2046,the proportion of DALY changes attributed to aging pop-ulation for the six types of malignant tumors would continue to rise(P＜0.001).The proportions of colorectal cancer and pancreatic cancer attributed to population aging and the proportion of age-specific DALY rate were both positive and rising(P＜0.001),which would eventually promote the further increase of DALY.Conclusion Population aging has become the main driving factor for the growth of DALY in digestive system malignant tumors in China.The impact on DALY of colorectal cancer and pancreatic cancer will be prominent in the future.Targeted prevention and control strategies should be developed to actively respond to population aging.

Objective The aim of this study was to analysis the incidence and mortality of malignant tumors in the cancer registration area of Kunming City in 2020,as well as the trend of changes from 2016 to 2020.Methods The malignant tumor data of 12 cancer registration areas in Kunming in 2020 that met the quality criteria were used to analyze the crude incidence,crude mortali-ty,age-standardized incidence/mortality rate by Chinese standard population(ASIRC/ASMRC)of malignant tumors in different gen-ders and regions.The annual percentage change(APC)was calculated using Joinpoint 5.3.0.0 software,the incidence and mortality trends of malignant tumors from 2016 to 2020 were evaluated.Results In 2020,the crude incidence and ASIRC of malignant tumors in cancer registration areas of Kunming City were 234.27/100,000 and 141.68/100,000,respectively.The ASIRC of males was high-er than that of females(146.94/100,000 vs.137.33/100,000,Z=3.459,P<0.001),and that of rural areas was higher than that of urban areas(146.37/100,000 vs.134.09/100,000,Z=-4.462,P<0.001).The crude mortality and ASMRC of malignant tumors were 135.67/100,000 and 73.18/100,000,respectively.The ASMRC of males was higher than that of females(91.65/100,000 vs.55.43/100,000,Z=19.260,P<0.001),and that of rural areas was higher than that of urban areas(76.27/100,000 vs.70.00/100,000,Z=-3.359,P<0.001).There were 81.39%of new cases and 90.36%of deaths of malignant tumors occurred in the popu-lation aged 50 and above.The top 5 cancer incidence in the Kunming City were lung cancer,colorectal cancer,breast cancer,liver cancer and prostate cancer.The top 5 cancer mortality were lung cancer,liver cancer,colorectal cancer,prostate cancer and stomach cancer.The ASIRC(APC=-3.05%,95%CI:-5.91%--0.10%,P=0.046)and ASMRC(APC=-5.47%,95%CI:-8.52%--2.32%,P=0.012)of malignant tumors in urban areas of Kunming showed a downward trend.Conclusions From 2016 to 2020,the ASIRC and ASMRC of malignant tumors in urban areas of Kunming showed a downward trend,but there was no significant changing trend in rural tumor registration areas.Rural areas are key areas for the prevention and treatment of malignant tumors in Kunming city;Lung cancer,colorectum cancer,liver cancer and prostate cancer are the key types of cancer for prevention and treatment.

Objective : To investigate the effects of D ⁃allose on the restoration of neurological function , Galectin⁃3 (Gal⁃3) , adenosine monophosphate⁃activated protein kinase/mammalian target of rapamycin (AMPK/mTOR) and the expression of some inflammatory factors in ischemia⁃reperfusion injury ( CIRI) mice . Methods : A total of 50 male mice were randomly divided into control group (Con group) , sham group (Sham group) , cerebral ischemia⁃reperfusion injury group (MCAO group) , cerebral ischemia⁃reperfusion injury + D ⁃alolose group (MCAO + D ⁃allose group) and cerebral ischemia⁃reperfusion injury + modified citrus pectin group (MCAO + MCP group) . The middle cerebral artery occlusion/reperfusion (MCAO/R) model (reperfusion after 2 hours of MCA ischemia) was established by thread embolism . After successful modeling , the neurological function of mice was evaluated Longa score and rotated rod walking . TTC staining was used to observe the volume of cerebral infarction foci . The expression levels of Gal⁃3 and autophagy⁃related molecules were detected by Western blot and RT⁃PCR . Immunofluorescence was applied to detect the distribution of Gal⁃3 in brain tissue , and TNF⁃α , IL⁃8 secretion was detected with ELISA KIT . Results : Compared with Con group and Sham group , the MCAO model represented significant increase in the Longa neurofunction score (P < 0. 01) , cerebral infarction volume ( P < 0. 01) , Gal⁃3 expression and manifasted enhanced autophagy (P < 0. 01) . After treatment with D ⁃allose , it could significantly improve neurological dysfunction , reduce cerebral infarction volume (P < 0. 01) , reduce the expression of Gal⁃3 ( P < 0. 01) , inhibit AMPK phosphorylation , promote mTOR phosphorylation , and inhibit autophagy (P < 0. 01) . The use of the Gal⁃3 inhibitor MCP alone could also achieve the effect of inhibiting autophagy . Conclusion D ⁃allose can effectively promote the recovery of neurological function and reduce the volume of infarct foci in CIRI mice . The mechanism may involve inhibiting excessive cell autophagy by downregulating the expression of Gal⁃3 , and reducing the release of inflammatory factors such as TNF⁃α and IL⁃8 , thereby exerting neuroprotective effects .

Bronchiectasis is a refractory chronic airway disease characterized by chronic cough and phlegm production. Airway mucus hypersecretion is one of the important causative factors for acute exacerbation of bronchiectasis. Thus， reducing airway mucus secretion during the stable phase of bronchiectasis is the key to the treatment. Phlegm-dispelling therapy is commonly used in modern medicine， which， however， fails to radically reduce mucus secretion. At the moment， it is difficult and urgent to find an intervention that can improve the quality of life of patients and reduce the recurrence of disease during the stable phase of bronchiectasis. Chinese medicine shows remarkable efficacy in reducing airway mucus secretion. Nonetheless， there is a lack of research on the airway mucus hypersecretion of bronchiectasis， and no registered research outcome is available. Traditional Chinese medicine boasts a lot of experience in the treatment of phlegm. It combines clearing and tonifying methods and identifies Yin and Yang and internal organs， thus being advantageous in the treatment of airway mucus hypersecretion of bronchiectasis. Therefore， it is an important topic to improve the effectiveness of Chinese medicine on airway mucus hypersecretion of bronchiectasis by focusing on the "generation"， "transformation" and "excretion" of phlegm.

Objective:To systematically evaluate the intervention effect of acceptance commitment therapy on anxiety disorder.Methods:The full-text databases of Web of Science Core Collection, MEDLINE, KCI-Korean Journal Database, SciELO Citation Index, SpringerLink, Pubmed, EMBASE, Cochrane Library, CNKI Wanfang and Weipu were searched and randomized controlled studies related to acceptance commitment therapy for patients with anxiety disorder were collected.All randomized controlled studies met the criterion were included.Meanwhile, the literature quality of the included literatures was evaluated.The outcome indicators such as anxiety index, psychological flexibility and quality of life index were selected, and RevMan 5.3 software was used to analyze the literature data that met the inclusion criteria.Results:A total of 12 studies with 1 062 patients were included, including 513 cases in ACT group and 549 cases in control group.Meta analysis showed that ACT can effectively reduce anxiety level of patients with anxiety disorder (MD=-0.58, 95% CI: -0.85- -0.32, P<0.001), anxiety level in follow-up period (MD=-0.42, 95% CI: -0.75- -0.08, P=0.01), improving psychological flexibility (MD=0.46, 95% CI: 0.24~0.68, P<0.001); In the study of CBT(cognitive behavioral therapy) as the control group, there was no significant difference between ACT group and control group, among which after intervention (MD =-0.06, 95% CI: -0.47- 0.36, P=0.79), follow-up period (MD = 0.17, 95% CI: -0.07-0.41, P=0.16) .In the study with the control group as the blank control, ACT can reduce the anxiety level of patients with anxiety disorder (MD =-0.76, 95% CI: -0.97- -0.56, P<0.001), and the difference is statistically significant.Excluding the non-blank control study, ACT can reduce the anxiety level of patients with anxiety disorder (MD =-0.82, 95% CI: -1.09--0.55, P<0.001) in the studies where the proportion of women is greater than or equal to 70%.In the study of 50%-70% females, ACT can reduce the anxiety level of patients with anxiety disorder (MD =-0.68, 95% CI: -1.09 --0.28, P=0.01). All the differences were statistically significant.There was no significant difference between ACT and the control group for quality of life(MD=0.24, 95% CI: -0.01-0.49, P=0.06). Conclusion:ACT has a certain effect on patients with anxiety disorder, which not only improves the anxiety level of patients, but also keeps the effect of anxiety improvement during the follow-up period, and the improvement of psychological flexibility has also been verified.The immediate and long-term efficacy of ACT is similar to that of CBT, which further improve the reliability of ACT curative effect.Gender difference has not been confirmed for the therapeutic effect.ACT has no obvious improvement on the quality of life, and the conclusion of this study needs more randomized controlled studies with large samples and high quality to verify it.

Objective: To understand the characteristics of injury deaths of children and adolescents aged 0 to 19 years in Kunming during 2010-2019,and to provide injury prevention and control basis. Methods: Injury mortality data in 2010-2019 were from Kunming population based mortality surveillance system. The characteristics of injury death of children and adolescents were analyzed by descriptive statistical analysis, including mortality rate, composition ratio, the annual percent change,etc. Results: Child and adolescent injury mortality was 23.18/10 5,decreasing by year(t=7.13,P<0.05). Male mortality(31.59/10 5) was higher than female(14.27/10 5)(χ2=376.24,P<0.05),the APC of male was -8.82% and -7.48% in female.The injury mortality of male was higher than that of female at all age group. The injury mortality rate of rural children and adolescents(28.65/10 5) was higher than that of urban children(12.37/10 5)(χ2=297.30,P<0.05),the APC was -8.53% in urban areas and -7.78% in rural areas.The top five causes of injury death of children and adolescents were traffic accident drowning, accidental fall, suicide and accidental mechanical suffocation, accounting for 80.88% of the total injury deaths of children and adolescents.In urban and rural areas,injury death by traffic accident, drowning and rural unintentional falls decreased significantly(t urban=3.17,3.20,t rural=5.66,3.12,4.42,P<0.05). The leading cause of death varied by different age groups. Conclusion The injury mortality rate of children and adolescents in Kunming city is on the decline. Rural children and adolescents, as vulnerable population to injury death, should receive protective strategies according to their specific characteristics of injuries and deaths in different age groups.