The onset and progression of chronic heart failure （CHF） are closely associated with myocardial energy metabolism disorders， and this pathological process significantly affects patient prognosis. Traditional Chinese medicine （TCM）， grounded in time-based medical theories such as the correspondence between humans and nature and the theory of circadian flow of meridians （Ziwu Liuzhu）， exhibits intrinsic consistency with modern circadian rhythm theory， providing a unique theoretical framework for understanding and intervening in CHF from a temporal perspective. This article systematically explores the impact of circadian rhythms on energy metabolism and the potential mechanisms by which TCM active ingredients intervene in CHF through a review of relevant literature. It is found that various TCM active ingredients， including flavonoids （such as nobiletin）， alkaloids （such as berberine）， and polyphenols （such as resveratrol）， can improve mitochondrial function， promote fatty acid oxidation， enhance glucose uptake and utilization efficiency， maintain metabolic balance， and alleviate oxidative stress and inflammatory responses in myocardial cells by regulating the expression and rhythms of core circadian clock genes such as CLOCK， BMAL1， PER， and CRY. These actions thereby correct energy metabolism disorders and improve cardiac function. Further exploration of the interaction mechanisms between these components and the circadian rhythms holds promise for providing novel theoretical foundations and potential intervention strategies for the prevention and treatment of CHF.

Objective To explore the effect of step frequency-controlled walking exercise on vascular endothelial injury in postmenopausal patients with essential hypertension.Methods According to the screening criteria,postmenopausal women aged 55～60 years with essential hypertension and age-matched healthy women with normal blood pressure were recruited.The hypertensive patients were fur-ther divided into an exercise training group(ET)(n=23)that received step frequency-based walking intervention,and a positive control group(PC)(n=23)without exercise intervention.The normotensive healthy subjects were assigned to a negative control group(NC)(n=23).The exercise training lasted 45 to 60 minutes every other day,at least three times a week,for 12 weeks.Before and after the in-tervention,the following parameters were measured:morphological indices[body fat percentage and waist-to-hip ratio(WHR)],blood pressure indicators[systolic blood pressure(SBP)and diastolic blood pressure(SDP)],lipid metabolism markers consisting of the total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-c),and high-density lipoprotein cholesterol,and vascular en-dothelial injury parameters such as endothelial microparticles(EMPs),high-sensitivity C-reactive pro-tein(hs-CRP),and superoxide dismutase(SOD).Results After the intervention,the ET group exhibit-ed significant improvements compared to baseline(P<0.05).Specifically,reductions were observed in body fat percentage,WHR,SBP,TC,TG,LDL-c,EMPs,and hs-CRP(P<0.05).Meanwhile,HDL-c and SOD levels increased significantly(P<0.05).Most of the above indicators demonstrated sig-nificant improvements in the ET group compared to the PC group after the intervention(P<0.05).Con-clusion A 12-week step frequency-controlled walking exercise at moderate intensity improves body com-position,SBP,lipid metabolism,and vascular endothelial function in postmenopausal patients with hy-pertension,suggesting its potentialto reduce cardiovascular risk in this population.

Objective To explore the effect of step frequency-controlled walking exercise on vascular endothelial injury in postmenopausal patients with essential hypertension.Methods According to the screening criteria,postmenopausal women aged 55～60 years with essential hypertension and age-matched healthy women with normal blood pressure were recruited.The hypertensive patients were fur-ther divided into an exercise training group(ET)(n=23)that received step frequency-based walking intervention,and a positive control group(PC)(n=23)without exercise intervention.The normotensive healthy subjects were assigned to a negative control group(NC)(n=23).The exercise training lasted 45 to 60 minutes every other day,at least three times a week,for 12 weeks.Before and after the in-tervention,the following parameters were measured:morphological indices[body fat percentage and waist-to-hip ratio(WHR)],blood pressure indicators[systolic blood pressure(SBP)and diastolic blood pressure(SDP)],lipid metabolism markers consisting of the total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-c),and high-density lipoprotein cholesterol,and vascular en-dothelial injury parameters such as endothelial microparticles(EMPs),high-sensitivity C-reactive pro-tein(hs-CRP),and superoxide dismutase(SOD).Results After the intervention,the ET group exhibit-ed significant improvements compared to baseline(P<0.05).Specifically,reductions were observed in body fat percentage,WHR,SBP,TC,TG,LDL-c,EMPs,and hs-CRP(P<0.05).Meanwhile,HDL-c and SOD levels increased significantly(P<0.05).Most of the above indicators demonstrated sig-nificant improvements in the ET group compared to the PC group after the intervention(P<0.05).Con-clusion A 12-week step frequency-controlled walking exercise at moderate intensity improves body com-position,SBP,lipid metabolism,and vascular endothelial function in postmenopausal patients with hy-pertension,suggesting its potentialto reduce cardiovascular risk in this population.

Purpose/Significance To understand the current status and influencing factors of residents'utilization and dissemination of online dietary health information in the Yangtze River Delta region,so as to provide theoretical references for strengthening education on online dietary health information,and eliminating misinformation related to online dietary health.Method/Process The purposive sam-pling method is used to investigate residents in the Yangtze River Delta region,and the data is analyzed by descriptive analysis,inde-pendent sample t-tests,and multiple linear regression analysis.Result/Conclusion The dissemination of online dietary health informa-tion presents interactive characteristics of interpersonal communication and online communication.WeChat and Sina Weibo are the main sources of dietary health information.In addition to information screening,information search,systematic information processing,demand degree,information sharing intention and information concern motivation have significant and positive effects on the public's willingness to receive information.

Objective: To analyze the policies that are aimed at the prevention and control of myopia in children and adolescents, and to provide a reference for the adjustment and optimization of follow up policies. Methods: Based on policy tool theory, content analysis was performed to construct a two dimensional framework of "policy tools-policy objects" and a quantitative analysis of 43 national level policy texts related to the prevention and control of myopia in children and adolescents. Results: From the perspective of policy tools, environment oriented policy tools were the most widely applied (48.36%), followed by supply oriented tools (26.39%) and demand oriented tools (25.25%) which were used closely in frequency. From the perspective of policy objects, the texts put forward requirements in schools (26.15%) were the most and in society the least (6.18%). Conclusion The policies for the prevention and control of myopia in children and adolescents should aim to improve the efficacy of supply based policy tools and increase the frequency with which demand based policy tools are adopted, while scientific research should be applied to optimize the quality of environment based policy tools.

Cyperi Rhizoma is a common Chinese medicine in clinical practice， which has a long history of processing. In order to sort out the process of its processing， starting with the angle of processing excipients， the historical evolution and developmental venation of Cyperi Rhizoma processing were analyzed and summarized by consulting relevant literature of ancient medical records and modern codes. After combing the ancient and modern literature， it was found that there were many processing methods of Cyperi Rhizoma， the processing methods without auxiliary materials included frying， boiling， steaming and so on， and the adding auxiliary materials included vinegar， ginger， salt， multiple excipients， etc. However， with the evolution of history， some characteristic excipients have gradually disappeared， while vinegar-processed products are mainly used in modern times. Meanwhile， processing methods of Cyperi Rhizoma are well documented in various processing standards， the phenomenon of multiple methods adopted in one place and different methods in different places exists， which lacks unified quality standards and leads to uneven quality of Cyperi Rhizoma decoction pieces， which may even affect the safety and effectiveness of its clinical medication. Based on this， the problems existing in the processing research of Cyperi Rhizoma were analyzed in this paper， and made an outlook on the inheritance of the ancient processing methods and the quality standard improvement of the decoction pieces， in order to provide important literature evidence and theoretical support for the study of processing process and mechanism of Cyperi Rhizoma.

Objective:To assess the efficacy of the newly constructed system for screening, managing and monitoring congenital heart disease (CHD) in neonates of Hainan Province, thus providing references for a further promotion.Methods:Clinical data of neonatal CHD in Hainan Province from January 1, 2019 to December 31, 2021 were retrospectively analyzed, including screening, diagnosis and treatment, prognosis and follow-up.Relying on Hainan Women and Children′s Medical Center as the leading unit, a neonatal CHD screening, diagnosis, treatment, and monitoring system was established.A dual-indicator method was adopted, that was, screening staffs in Hainan Province performed CHD screening in living neonates by cardiac auscultation and pulse oximetry (POX) within 6-72 h after birth.Echocardiographic examinations for the screened living neonates were performed in the 31 authorized diagnosis institutions.Evaluations, interventions and treatment of living neonates with CHD were performed in 6 authorized tertiary hospitals.Data of screening, diagnosis, evaluation and treatment were filled in, uploaded and managed online through the neonatal CHD screening information management system.The research team of our hospital was responsible for the data management and monitoring.Results:From January 1 st, 2019 to December 31 st, 2021, there were 329 387 living neonates in Hainan Province, and 321 447 (97.59%) were screened for CHD, and the annual screening rate increased year by year.The positive rate of CHD screening was 2.50%(8 032/321 447). The rate of cardiac ultrasound examination within 1 week of CHD positive screening was 94.66%(7 603/8 032). The referral rate of severe CHD was 100.00%(154/154). The overall prevalence of CHD in neonates of Hainan Province was 3.419‰ (1 099/321 447). Atrial septal defect was the most common CHD lesion, with a proportion of 38.40%(422/1 099). The sensitivity of cardiac auscultation, POX and their combination for CHD detection were 69.15%, 33.49% and 91.90%, respectively, and the specificity were 98.36%, 99.43% and 97.81%, respectively.At the initial screening, the ratio of dual-positive of cardiac auscultation and POX in neonates with severe CHD (serious and critical CHD) was significantly higher than that of a single positive indicator ( χ2=36.502, 46.214, respectively; all P<0.001). All neonates with CHD were evaluated.Fifteen neonates with severe CHD died.From 2019 to 2021, the standardized mortality rate of children aged 0-1 years with CHD in Hainan province was 4.67/100 000 (15/321 447). Conclusions:Dual-indicator screening for CHD (cardiac auscultation plus POX) is reliable, non-invasive, and simple, which is conducive to be clinically promoted.Introducing and promoting an appropriate technology for screening, diagnosis, and evaluation of neonatal CHD are extremely significant since they may have contributed to the timely diagnosis and treatment of CHD, especially severe CHD, thus lowering the mortality.

The paper reported a patient under maintained hemodialysis for 11 years, with a large mass appeared in the right thigh after local injury. The mass was clinically considered as tumoral calcinosis combined with clinical, imaging and pathological findings. Several treatments such as enhancing dialysis adequacy, low calcium dialysate, calcimimetic agent, non-calcium- phosphorus binding agents, parathyroidectomy and intravenous infusion of sodium thiosulfate could not vanish the mass. Finally, the lump was surgically removed. The treatment of tumoral calcinosis in the hemodialysis patient can provide a instruction for similar situations in clinical practice.

Objective:To investigate the clinical characteristics and therapeutic effect of adult primary hemophagocytic syndrome (HPS).Methods:The clinical data of a patient with primary HPS in the Third Affiliated Hospital of Southern Medical University in July 2017 were retrospectively analyzed, and the related literature was reviewed.Results:The patient was a 53-year-old female without history of basic disease, presenting as repeated high fever, with mutation of STXBP2 (FHL5), and was diagnosed as HPS according to hemophagocytic lymphohistiocytosis (HLH)-2004 criteria. The patient was treated with HLH-2004 regimen, and the efficacy was good. The patient was followed up until May 2021, and the overall survival time was 45 months.Conclusions:The atypical primary HPS and delayed primary HPS are rare, with mild clinical symptoms and only manifested by repeated high fever. Therefore, the gene mutations associated with HPS should be detected as soon as possible to confirm the diagnosis and to treat the disease early.

Objective:To analyze the risk factors for patellar clunk syndrome after total knee arthroplasty (TKA) without patellar surface replacement.Methods:Retrospectively analyzed were a total of 222 patients who had undergone TKA without patellar surface replacement at Department of Joint Surgery, The Second Hospital of Shanxi Medical University from June 2020 to June 2021. There were 43 males and 179 females, and 38 cases of rheumatoid arthritis and 184 cases of arthritis. They were divided into a patellar clunk syndrome group ( n = 56) and a non-patellar clunk syndrome group ( n = 166) according to the occurrence of patellar clunk after TKA. The incidence of early patellar clunk syndrome after TKA was 25.2% (56/222). The patient gender, arthritis type, prosthesis type, postoperative range of knee motion, postoperative patellar thickness, Insall-Salvati index, postoperative joint line height, lower extremity muscle strength, and the distance from the tibial plateau to the patellar tendon were recorded. The risk factors for patellar clunk syndrome were determined by univariate analysis and logistic analysis. Results:The univariate analysis showed significant differences between the 2 groups in prosthesis type, postoperative joint line height, postoperative lower extremity muscle strength, and the distance from the tibial plateau to the patellar tendon ( P < 0.05). The logistic analysis showed that the posterior cruciate substituting (PS) prosthesis was an independent risk factor compared with the cruciate-retaining (CR) prosthesis ( OR = 2.791, 95% CI: 1.411 to 5.521, P = 0.003), and the increased lower extremity muscle strength was an independent protective factor ( OR = 0.295, 95% CI: 0.148 to 0.587, P = 0.001). Conclusions:The incidence of patellar clunk syndrome is relatively high. The PS prosthesis may be an independent risk factor relative to the CR prosthesis. As the increased lower extremity muscle strength may be an independent protective factor, the recovery and strengthening of the muscle strength after TKA require more attention.