Objective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.

ObjectiveTo analyze the influencing factors for recurrence in successfully treated pulmonary tuberculosis patients with isoniazid-resistant and rifampicin-sensitive in Shaoxing City, Zhejiang Province. MethodsData on general demographic information, treatment information and drug susceptibility test results for pulmonary tuberculosis patients admitted to the designated tuberculosis medical institutions and registered in the tuberculosis information management system was collected in Shaoxing City from January 2011 to August 2024. A total of 428 patients with isoniazid resistance (including isoniazid single resistance and multiple resistance) but who were successfully treated were included in the study. Information for the recurrence after successful treatment of the patients was analyzed. The Cox proportional hazards models were used to analyze the influencing factors of recurrence in patients. ResultsAmong the 428 successfully treated patients included in the study, 31 cases (accounting for 7.24%) had recurrence by the end of the observation period, with a recurrence rate density of 1.31 per 100 person-years and a median recurrence time of 0.99 (0.08, 8.27) years. Among the relapsed population, 51.61% of the patients relapsed within one year after successful treatment. 77.42% of the patients relapsed within two years after successful treatment. Multivariate Cox regression analysis showed that when isoniazid resistance was discovered, the diagnosis classification of relapse (HR=4.115, 95%CI: 1.734‒9.767) and positive 0-month sequence smear (HR=4.457, 95%CI: 1.053‒18.866) were risk factors for recurrence after successful treatment in patients. ConclusionRegular follow-up should be strengthened for at least two years after the successful treatment of isoniazid-resistant pulmonary tuberculosis patients. Special attention should be paid to the treatment effect and regular re-examination and monitoring after the end of the treatment course of isoniazid-resistant pulmonary tuberculosis patients who have been re-treated and were sputum smear positive at baseline, so as to prevent recurrence and disease progression in high-risk populations.

Objective To determine the material basis of the antioxidant activity of Mori Folium by examining the spec-trum-effect relationship.Methods High-performance liquid chromatography(HPLC)was utilized to establish the fingerprints of Mori Folium.The antioxidant activity of Mori Folium was assessed using the 1,1-diphenyl-2-picrylhydrazyl(DPPH)radical scavenging assay and other related indicators.The spectrum-effect relationship of antioxidation was analyzed using gray relational analysis,bivariate correlation analysis,and partial least squares regression analysis.Molecular docking techniques were employed to predict potential interaction targets.Results HPLC fingerprints for 13 batches of Mori Folium were established,and thirteen common peaks were marked,with similarities ranging from 0.932 to 0.998.Nine common peaks were identified by comparing them to reference substances.Differences in antioxidant activity were observed among the different batches of Mori Folium.Based on the analysis of the spectrum-effect relationship,chemical components such as chlorogenic acid,cryptochlorogenic acid,rutin,and iso-chlorogenic acid B were found to contribute significantly to the antioxidant activity.These components may exert their effects by binding to several antioxidant protein targets,such as XOD,NO-1,and PPAR-α.This implies that Mori Folium might exert its an-tioxidant action via multiple components and targets.Conclusions By integrating the fingerprint and antioxidant activity of Mori Folium,the contributions of individual components to its antioxidant activity were determined.This study provides an experi-mental basis for elucidating the substances responsible for the antioxidant activity of Mori Folium and for establishing quality con-trol methods.

Objective: To investigate the status of tuberculin skin test (TST) results and the influencing factors among student close contacts with pulmonary tuberculosis, so as to provide the evidence for developing prevention and control strategies for pulmonary tuberculosis among students. Methods: The students aged 15 years and above who had close contact with pulmonary tuberculosis cases in Yuecheng District, Shaoxing City, Zhejiang Province, from October 2016 to December 2023 were recruited and investigated using questionnaires and TST to collect demographic information, contact history, and TST results. The influencing factors for TST positivity among student close contacts with pulmonary tuberculosis were analyzed using a multivariable logistic regression model. Results: A total of 5 507 student close contacts were investigated, including 2 982 males and 2 525 females, with a male-to-female ratio of 1.18∶1. The mean age was (19.10±1.71) years. Among them, 397 (7.21%) were technical secondary school students, 766 (13.91%) were senior high school students, 2 556 (46.41%) were junior college students, and 1 788 (32.47%) were college students or above. A total of 958 students tested positive for TST, with a positivity rate of 17.40%. The rates of general positivity, moderate positivity, and strong positivity were 10.53%, 4.98% and 1.89%, respectively. Multivariable logistic regression analysis showed that senior high school students (OR=1.473, 95%CI: 1.009-2.152) and junior college students (OR=1.467, 95%CI: 1.074-2.005), as well as those with an exposure-to-screening interval of ≥46 days (46-<61 days, OR=2.043, 95%CI: 1.478-2.826; ≥61 days, OR=1.291, 95%CI: 1.018-1.637) had a higher risk of TST positivity. Female student close contacts had a lower risk of TST positivity (OR=0.753, 95%CI: 0.649-0.873). Conclusion The TST positivity rate was relatively high, and gender, school type, and exposure-to-screening interval were influencing factors for TST positivity among student close contacts with pulmonary tuberculosis.

[Objective]To summarize Professor SHEN Minhe's clinical experience in treating tumors under the guidance of the therapeutic concept of"heart governs as sovereign,medicine acts as general and diet functions as minister".[Methods]By studying with the teacher,sorting out and summarizing Professor SHEN Minhe's clinical tumor cases,this paper expounds in detail the unique treatment concept of"heart governs as sovereign,medicine acts as general and diet functions as minister",and verifies it with medical records.[Results]Professor SHEN Minhe thinks that the treatment of tumor should pay attention to the organic combination of mind,medicine and food.Heart governs as sovereign means:emphasizing the compatibility between doctors and patients,attaching importance to spirit,and coordinating form and mind;Medicine acts as general:emphasizing chronic diseases,keeping the body safe from evil,eliminating evil at the right time,and adding and subtracting herbs with the syndrome;Diet functions as minister:emphasizing that if diet is self-doubling,stomach will be injured,reasonable diet and three-factor adaptation are suitable.The attached medical record was a case with lung cancer,which was mainly caused by stagnation of liver-Qi and phlegm.The case was treated by soothing the liver and clearing heat,reconciling Shaoyang,resolving phlegm and dredging collaterals,regulating Qi and dredging Fu-organs,calming the heart and the nerves,with revised Chaihu and Longgu Muli Decoction,Little Chaihu Decoction and Weijing Decoction,and instructed to eat and live regularly,adjust breathing and standing as stake in the morning,and follow the way of healthy preservation,finally the patient returned to balance,with good effect.[Conclusion]Professor SHEN treats tumors with the concept of"heart governs as sovereign,medicine acts as general and diet functions as minister",which has remarkable curative effect and certain clinical guiding significance.

Objective To evaluate the benefits of physical activity on the physical health,mental health and health behaviors related to physical activity in obese and overweight children and adolescents.Methods Following the PRISMA guidelines,a systematic search was conducted in Web of Science,PubMed,Scopus,PsycINFO,Cochrane Library and CNKI for systematic reviews or meta-analyses published between 2016 and 2024 in Science Citation Index Q4 or higher journals,related to physical activity or exercise for physical and mental health in obese and overweight children and adolescents.They were assessed using AMSTAR 2 tool to en-sure that the methodological quality was medium to high.Results A total of eight systematic reviews and meta-analyses involving 24 567 participants were included.Six studies were of high quality,and two were of moderate quality.In terms of physical health,combined aerobic and resis-tance exercise interventions demonstrated the most significant improvements in reducing body mass index(BMI)and body fat percentage.Moderate-to-high-intensity exercise performed three times per week,at least 60 minutes per session,over twelve weeks or longer significantly reduced BMI and body fat percentage in obese and over-weight children while improving cardiorespiratory endurance and muscular strength.In terms of mental health,physical activity was positive in reducing depression and anxiety,and improving self-esteem in children and ado-lescents.Activities such as dance,outdoor adventure programs and team sports notably enhanced social skills and emotional well-being.For neurodevelopmental disorders,low-intensity activities like aquatic walking and yoga significantly improved self-regulation and social interaction abilities.In terms of health-related behaviors,physi-cal activity interventions promoted the development of exercise habits,improved social interaction skills,in-creased physical activity participation,reduced sedentary behavior,and enhanced health and physical activity knowledge.In terms of multi-modal interventions,programs combining aerobic exercise with nutrition education or psychological counseling were more effective in improving overall health compared to single-modal interven-tions.Health-promoting schools(HPS)approach,integrating school,family and community involvement,effec-tively increased students'physical activity levels,reduced obesity rates,and improved mental health outcomes.Conclusion Physical activity is benefit in physical and mental health for obese and overweight children and adolescents.Moderate-to-high-intensity aerobic and resistance training,dance,and outdoor activities are effective interven-tions for improving body composition and mental health.Multi-modal interventions and HPS strategies can yield sustained health benefits.

Objective To understand the current status of knowledge-attitude-practice(KAP)regarding risk of medication safety behavior among cancer patients in western Yunnan and the related influencing factors,and to provide a basis for conducting rational medication education.Methods Using an approximate random sampling method,a KAP survey on medication safety behavior was conducted among inpatients and outpatients with cancer(aged over 18 years)in multiple hospitals in western Yunnan through online and offline questionnaires.Multiple linear regression analysis was used to explore the impact of different characteristics of the research objects on the KAP scores concerning medication knowledge,behavior,and attitude.Results A total of 512 valid questionnaires were collected.The average scores of medication knowledge,attitude,and behavior among cancer patients were(82.53±23.07),(41.98±8.64),and(67.88±10.08),respectively.Medication knowledge and behavior were at a good level,while medication attitude was at a qualified level.The multiple linear regression results showed that the educational level was a significant influencing factor of the medication knowledge and attitude scores(P＜0.001).Conclusion The overall medication safety among cancer patients in western Yunnan is in a good state,however,there is a need for improvement in medication attitudes.Educational level is the main factor affecting medication safety risk.Pharmacy services should be focused on cancer patients with lower educational levels to enhance their medication safety.

Objective To evaluate the benefits of physical activity on the physical health,mental health and health behaviors related to physical activity in obese and overweight children and adolescents.Methods Following the PRISMA guidelines,a systematic search was conducted in Web of Science,PubMed,Scopus,PsycINFO,Cochrane Library and CNKI for systematic reviews or meta-analyses published between 2016 and 2024 in Science Citation Index Q4 or higher journals,related to physical activity or exercise for physical and mental health in obese and overweight children and adolescents.They were assessed using AMSTAR 2 tool to en-sure that the methodological quality was medium to high.Results A total of eight systematic reviews and meta-analyses involving 24 567 participants were included.Six studies were of high quality,and two were of moderate quality.In terms of physical health,combined aerobic and resis-tance exercise interventions demonstrated the most significant improvements in reducing body mass index(BMI)and body fat percentage.Moderate-to-high-intensity exercise performed three times per week,at least 60 minutes per session,over twelve weeks or longer significantly reduced BMI and body fat percentage in obese and over-weight children while improving cardiorespiratory endurance and muscular strength.In terms of mental health,physical activity was positive in reducing depression and anxiety,and improving self-esteem in children and ado-lescents.Activities such as dance,outdoor adventure programs and team sports notably enhanced social skills and emotional well-being.For neurodevelopmental disorders,low-intensity activities like aquatic walking and yoga significantly improved self-regulation and social interaction abilities.In terms of health-related behaviors,physi-cal activity interventions promoted the development of exercise habits,improved social interaction skills,in-creased physical activity participation,reduced sedentary behavior,and enhanced health and physical activity knowledge.In terms of multi-modal interventions,programs combining aerobic exercise with nutrition education or psychological counseling were more effective in improving overall health compared to single-modal interven-tions.Health-promoting schools(HPS)approach,integrating school,family and community involvement,effec-tively increased students'physical activity levels,reduced obesity rates,and improved mental health outcomes.Conclusion Physical activity is benefit in physical and mental health for obese and overweight children and adolescents.Moderate-to-high-intensity aerobic and resistance training,dance,and outdoor activities are effective interven-tions for improving body composition and mental health.Multi-modal interventions and HPS strategies can yield sustained health benefits.

Objective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.

Objective To understand the current status of knowledge-attitude-practice(KAP)regarding risk of medication safety behavior among cancer patients in western Yunnan and the related influencing factors,and to provide a basis for conducting rational medication education.Methods Using an approximate random sampling method,a KAP survey on medication safety behavior was conducted among inpatients and outpatients with cancer(aged over 18 years)in multiple hospitals in western Yunnan through online and offline questionnaires.Multiple linear regression analysis was used to explore the impact of different characteristics of the research objects on the KAP scores concerning medication knowledge,behavior,and attitude.Results A total of 512 valid questionnaires were collected.The average scores of medication knowledge,attitude,and behavior among cancer patients were(82.53±23.07),(41.98±8.64),and(67.88±10.08),respectively.Medication knowledge and behavior were at a good level,while medication attitude was at a qualified level.The multiple linear regression results showed that the educational level was a significant influencing factor of the medication knowledge and attitude scores(P＜0.001).Conclusion The overall medication safety among cancer patients in western Yunnan is in a good state,however,there is a need for improvement in medication attitudes.Educational level is the main factor affecting medication safety risk.Pharmacy services should be focused on cancer patients with lower educational levels to enhance their medication safety.