Objective: To evaluate the current situation of thermal environment in primary and secondary school classrooms during winter, and to analyze students thermal comfort needs, so as to provide a basis for improving classroom thermal environment. Methods: From December 16 to 26, 2024, a stratified cluster random sampling method was used to select 90 classrooms from 15 primary and secondary schools in centralized/air conditioned heating areas(Liaoning Province, Tianjin City, Shanghai City) and naturally ventilated areas(Anhui Province and Jiangxi Province)for on site environmental measurement. A questionnaire survey was conducted among 743 students. The differences between groups using the χ 2 test were compared. Based on actual measurement data, a predicted mean vote prepared percentage of dissatisfied (PMV-PPD) model for centralized/air conditioned classrooms and an adaptive model for naturally ventilated classrooms were established, and the thermal neutral temperature and comfort interval were calculated. Results: The average outdoor temperature during on site measurement was 4.00(0.20，7.00)℃. In classrooms with centralized or air conditioned heating systems, the measured average temperature was (19.33±2.59)℃, with a thermal comfort range of 20.35-25.35 ℃ and a thermal neutral temperature of 22.85 ℃. And 13.92% of students reported feeling cold, while 80.80% felt comfortable. In classrooms with natural ventilation, the measured average temperature was (12.26±1.83)℃, with a thermal neutral temperature of 19.67 ℃ and a thermal comfort range of 16.17-23.17 ℃. About 48.33% of students reported feeling cold, and 49.81 % felt comfortable.The results of univariate analysis showed that there were statistically significant differences in shoe thickness, temperature sensation, relative humidity sensation and wind speed sensation between centralized/air conditioned heating areas ( χ 2= 7.01 , 31.47, 13.57, 13.80,all P <0.05). There were also statistically significant differences in school stage for primary and secondary school students, body mass index, classroom location for seat, temperature sensation, relative humidity sensation and wind speed sensation between naturally ventilated areas ( χ 2=42.13, 11.13, 11.04, 60.39, 29.27, 38.46,all P <0.05). Conclusions There are differences in thermal environment and students subjective thermal comfort in primary and secondary schools under different ventilation modes in winter. The temperature standards for heated classrooms should be revised, and differentiated environmental regulation strategies should be adopted based on different ventilation methods to improve students health and comfort levels.

This paper outlines the development of artificial intelligence （AI） and its applications in traditional Chinese medicine （TCM） research， and elucidates the roles and advantages of large language models， knowledge graphs， and natural language processing in advancing syndrome identification， prescription generation， and mechanism exploration. Using spleen-stomach diseases as an example， it demonstrates the empowering effects of AI in classical literature mining， precise clinical syndrome differentiation， efficacy and safety prediction， and intelligent education， highlighting an upgraded research paradigm that evolves from data-driven and knowledge-driven approaches to intelligence-driven models. To address challenges related to privacy protection and regulatory compliance in cross-institutional data collaboration， a "trusted federated evidence-based analysis platform for TCM spleen-stomach diseases" is proposed， integrating blockchain-based smart contracts， federated learning， and secure multi-party computation. The deep integration of AI with privacy-preserving computing is reshaping research and clinical practice in TCM spleen-stomach diseases， providing feasible pathways and a technical framework for building a high-quality， trustworthy TCM big-data ecosystem and achieving precision syndrome differentiation.

ObjectiveMagnetoencephalography (MEG), a non-invasive neuroimaging technique, meticulously captures the magnetic fields emanating from brain electrical activity. Compared with MEG based on superconducting quantum interference devices (SQUID), MEG based on optically pump magnetometer (OPM) has the advantages of higher sensitivity, better spatial resolution and lower cost. However, most of the current studies are clinical studies, and there is a lack of animal studies on MEG based on OPM technology. Pain, a multifaceted sensory and emotional phenomenon, induces intricate alterations in brain activity, exhibiting notable sex differences. Despite clinical revelations of pain-related neuronal activity through MEG, specific properties remain elusive, and comprehensive laboratory studies on pain-associated brain activity alterations are lacking. The aim of this study was to investigate the effects of inflammatory pain (induced by Complete Freund’s Adjuvant (CFA)) on brain activity in a rat model using the MEG technique, to analysis changes in brain activity during pain perception, and to explore sex differences in pain-related MEG signaling. MethodsThis study utilized adult male and female Sprague-Dawley rats. Inflammatory pain was induced via intraplantar injection of CFA (100 μl, 50% in saline) in the left hind paw, with control groups receiving saline. Pain behavior was assessed using von Frey filaments at baseline and 1 h post-injection. For MEG recording, anesthetized rats had an OPM positioned on their head within a magnetic shield, undergoing two 15-minute sessions: a 5-minute baseline followed by a 10-minute mechanical stimulation phase. Data analysis included artifact removal and time-frequency analysis of spontaneous brain activity using accumulated spectrograms, generating spectrograms focused on the 4-30 Hz frequency range. ResultsMEG recordings in anesthetized rats during resting states and hind paw mechanical stimulation were compared, before and after saline/CFA injections. Mechanical stimulation elevated alpha activity in both male and female rats pre- and post-saline/CFA injections. Saline/CFA injections augmented average power in both sexes compared to pre-injection states. Remarkably, female rats exhibited higher average spectral power 1 h after CFA injection than after saline injection during resting states. Furthermore, despite comparable pain thresholds measured by classical pain behavioral tests post-CFA treatment, female rats displayed higher average power than males in the resting state after CFA injection. ConclusionThese results imply an enhanced perception of inflammatory pain in female rats compared to their male counterparts. Our study exhibits sex differences in alpha activities following CFA injection, highlighting heightened brain alpha activity in female rats during acute inflammatory pain in the resting state. Our study provides a method for OPM-based MEG recordings to be used to study brain activity in anaesthetized animals. In addition, the findings of this study contribute to a deeper understanding of pain-related neural activity and pain sex differences.

Objective:To investigate the applicability and surgical effect of direct horizontal suture in the repair of defects after the excision of eyelid nevus.Methods:The clinical data of patients with eyelid nevus who were admitted to Department of Facial and Neck Plastic Surgery, Plastic Surgery Hospital of Chinese Academy of Medical Sciences from March 2015 to March 2023 were retrospectively analyzed. After the eyelid nevus was removed, the defect was closed by horizontal suture parallel to the eyelid margin. In the preoperative simulation suture scheme, one or more horizontal lines were marked on the eyelid skin according to the scope of the nevus. The intersection points of the horizontal lines and the edges of the nevus were marked for simulated suturing. If the marked points aligned horizontally, direct suturing was applied. After 3 months of postoperative follow-up, the therapeutic effect was evaluated based on eyelid function (classified as excellent, good and poor), cosmetic effects (classified as excellent, good and poor) and patient satisfaction (classified as very satisfactory, satisfactory and dissatisfactory). At the same time, the effect of different wound length (<1 cm, 1-2 cm, >2 cm) on the therapeutic effect was also analyzed. SPSS 27.0 software was used for statistical analysis of the data. The counting data were represented by examples and percentages, and Kruskal-Wallis H test was used for comparison between groups. P<0.05 indicated that the difference was statistically significant. Results:A total of 71 patients were enrolled, including 30 males and 41 females. Aged 4 to 35 years old, with an average age of 15 years old. The lesions involved the upper eyelid in 47 cases, the lower eyelid in 14 cases, and co-involved in 10 cases. Lesion areas ranged from 0.5 cm×0.5 cm to 2.3 cm×2.0 cm. None of the lesions involved the palpebral margin and conjunctiva, and the depth did not reach the orbicularis oculi muscle. Immediately after the operation, all the patients had different degrees of eyelid deformation, and some severe patients had difficulty opening their eyes. The above symptoms were relieved within 7 days to 3 months after the operation, and eventually the eyelid movement returned to normal, leaving only mild scarring. In cases where the eyelid nevus was close to or involved the eyebrow area, eyebrow shape changed after surgery, and it gradually returned to normal after 1 month. Some patients with part of the eyebrow defect were able to improve their appearance through eyebrow tattoos, eyebrow transplatation and other methods. The eyelid function of 71 patients was excellent. The evaluation of cosmetic effect, 41 cases (58%) were excellent, and 30 cases (42%) were good. The evaluation of patient satisfaction, 56 cases (79%) were very satisfied, and 15 cases (21%) were satisfied. Statistical analysis showed that with the increase of the horizontal length of the wound, the cosmetic effect and patient satisfaction would be affected to a certain extent, but the differences were not statistically significant ( P>0.05). Conclusion:For eyelid nevus excision defects that can be closed horizontally, direct suturing method should be considered priority. This method is simple to perform, offers stable postoperative effects, and leads to high patient satisfaction.

Implementing the reform of outpatient mutual-aid is a crucial measure to improve China's medical security system.Based on the policy diffusion theory,we took 228 prefecture-level cities across the country as the research objects and used the event history method to analyze the diffusion mode and influencing factors of the general outpatient pooling policy for employees'basic medical insurance,and divided into three types:the type of reducing the stock of Medical Savings Accounts(MSA),the welfare increment type I and type II for separate analysis.We found that the diffusion of the general outpatient pooling policy presented an"S"-shaped curve over time,and was mainly horizontally diffused in space,with a neighboring effect and a regional demonstration effect.The type of reducing the stock of MSA policy diffuses horizontally;the welfare increment type I is mainly horizontal diffusion,supplemented by vertical diffusion;the welfare increment type II is not affected by the pressure from higher-level governments,and mainly adopts the horizontal diffusion mode.In terms of the influencing factors of policy diffusion,the diffusion of the general outpatient pooling policy was affected by multiple factors such as policy issues,legitimacy,and government capacity.The diffusion of the type of reducing the stock of MSA policy was not affected by the pressure from higher-level governments,but was influenced by policy issues and government capacity.The diffusion of the welfare increment type I policy was most affected by policy issues,and the welfare increment type II was most affected by government capacity.

Aim To clarify the mechanism by which Qishen Yixin Granules improved microcirculation vas-cular endothelial dysfunction(VED)in mice,through activating the Nrf2/HO-1 signaling pathway to regulate oxidative stress.Methods C57 mice were randomly divided into six groups:blank group,model group,pos-itive drug group,and low-,medium-,and high-dose groups of Qishen Yixin Granules.The VED model was established by long-term infusion of Ang Ⅱ combined with a high-fat diet.Each treatment group received the corresponding drug intervention.After four weeks of drug intervention,cardiac function was assessed by echocardiography.Carstairs staining was used to ob-serve the formation of microthrombi in myocardial tis-sue.The micro vascular ischemia was evaluated by Hei-denhain staining.The ultrastructure of endothelial cells was observed by electron microscopy.The levels of EMPs,ROS,NO,ET-1,TF,TM,VWF,and TXA2 in serum were measured by ELISA.The expression levels of MDA,SOD,and GSH-Px in mouse heart tissue were determined by chemical methods.Cardiac microvascu-lar density and the expression of Nrf2,Keap1,and HO-1 proteins were detected by Immunohistochemical stai-ning.The protein expressions of Keap1,cytoplasmic Nrf2,nuclear Nrf2,and HO-1 in myocardial tissue were detected by Western blot.Results Qishen Yixin Granules could effectively improve the cardiac function of mice,alleviate the damage of endothelial cells and endothelial function.They could up-regulate serum NO levels and the activities of antioxidant enzymes SOD and GSH-Px,while down-regulating the expression of ROS and vascular inflammatory injury factors such as ET-1,VWF,TXA2,TF,TM,and EMPs.Qishen Yixin Granules also increased the positive counts of CD34,Nrf2,and HO-1,as well as microvessel density.Fur-thermore,they inhibited the expression of MDA,Keap1,and cytoplasmic Nrf2 protein in myocardial tis-sue,while increasing the expression of nuclear proteins HO-1 and Nrf2.Conclusions Qishen Yixin Granules may inhibit oxidative stress and inflammatory response by regulating the Nrf2/HO-1 signaling pathway,thereby improving vascular endothelial damage and cardiac function in VED mice.

Objective To establish a rapid on-site detection method for methamphetamine(MA)based on surface-enhanced Raman spectroscopy(SERS).Methods Laboratory-synthesized colloidal silver nanoparticles(AgNPs)were employed as SERS substrates to rapidly detect methamphetamine in typical crime scene matrices,including beer,cigarette ash,and plastic containers.Results The method requires no sample pretreatment,is simple to operate,and offers high sensitivity with fast detection speed.The limit of detection(LOD)reached 10 ppb(signal-to-noise ratio,S/N＞3).The qualitative results of methamphetamine analysis from forensic case samples were highly consistent with gas chromatography-mass spectrometry(GC-MS)findings.Conclusion Methamphetamine is frequently encountered in illicit settings and criminal activities.This study achieved rapid detection of methamphetamine in complex matrices(beer,cigarette ash,and plastic containers),demonstrating good application prospects in practice and providing important value for law enforcement,public safety,and criminal investigation.

Objective:To investigate the clinical characteristics of Mycoplasma pneumonia infection in children of different ages, and to provide a basis for precise treatment. Methods:A total of 216 children with Mycoplasma pneumonia infection who were admitted to the Xi 'an Children's Hospital from January 2019 to December 2021 were included in this study. These children consisted of 117 males and 99 females. These children were divided into school-age group (> 6 years old, n = 75), preschool group (3-6 years old, n = 72) and infant and toddler group (< 3 years old, n = 69) according to age. Data on general demographics, clinical manifestations, complications, laboratory indicators, imaging findings, and bronchoscopic results, as well as treatment efficacy and outcomes, were collected and compared among the three groups. Results:There were statistically significant differences among the school-age, preschool, and infant and toddler groups in terms of dry cough [45 (60.00%), 34 (47.22%), 18 (26.08%)], wheezing [13 (17.33%), 19 (26.39%), 41 (59.42%)], concurrent pleural effusion [26 (34.67%), 20 (27.78%), 11 (15.94%)], pulmonary necrosis [12 (16.00%), 3 (4.17%), 0 (0)], pulmonary imaging findings (patchy shadows [12 (16.00%), 22 (30.56%), 46 (66.67%)], ground-glass opacities [11 (14.67%), 18 (25.00%), 40 (57.97%)], consolidation shadows [58 (77.33%), 42 (58.33%), 8 (11.59%)]), fever duration [(9.58 ± 4.85) days, (9.48 ± 4.89) days, (6.58 ± 3.64) days], and cough relief time [9 (8,12) days, 9 (8,11) days, 8 (7,11) days] ( χ2 = 16.94, 31.10, 6.59, 15.53, 41.51, 33.40, 65.12, F = 11.97, H = 6.05, all P < 0.05). However, there were no statistically significant differences in fever, dyspnea, concurrent atelectasis, or prognosis ( χ2 = 0.21, 0.27, 0.61, 1.74, all P > 0.05). The percentage of neutrophils [(63.91 ± 10.96)%, (58.26 ± 13.79)%, (50.98 ± 13.79)%], platelet count [(305.01 ± 96.13) × 10 9/L, (324.91 ± 108.05) × 10 9/L, (342.41 ± 120.50) × 10 9/L], erythrocyte sedimentation rate [(47.07 ± 26.46) mm/h, (48.29 ± 26.33) mm/h, (38.16 ± 18.23) mm/h], creatinine [(39.10 ± 7.02) μmol/L, (31.50 ± 5.43) μmol/L, (25.85 ± 4.57) μmol/L], alanine aminotransferase [14 (11, 21) U/L, 12 (9, 20) U/L, 15 (11, 19) U/L], creatine kinase isoenzyme [17 (14, 21) U/L, 20 (16, 24) U/L, 23 (19, 27) U/L], and lactate dehydrogenase [260.0 (224.5, 343.5) U/L, 294.5 (252.0, 379.3) U/L, 317.0 (266.5, 384.5) U/L] levels in the peripheral blood differed significantly among the school-age, preschool, and infant and toddler groups ( F = 37.07, 4.91, 3.55, 167.22, H = 7.54, 57.34, 33.58, all P < 0.05). However, there were no statistically significant differences in peripheral blood white blood cell count, C-reactive protein, or procalcitonin levels ( H = 1.09, 2.49, 2.21, all P > 0.05). The bronchoscopic examinations revealed mucosal congestion and edema in all three groups ( χ2 = 0.51, P > 0.05). However, the detection of lymphoid follicles [43 (57.33%), 28 (38.89%), 18 (26.09%)], longitudinal folds [58 (77.33%), 34 (47.22%), 10 (14.49%)], mucus plugs [46 (61.33%), 32 (44.44%), 6 (8.70%)], and airway shaping [16 (21.33%), 5 (6.94%), 0 (0.00%)] increased with age, showing statistically significant differences among the three groups ( χ2 = 14.72, 56.94, 43.30, 19.58, all P < 0.05). Conclusions:The clinical characteristics of children with Mycoplasma pneumonia infection vary among children of different ages. In infants and young children, wheezing symptoms are more common, and they are prone to multiple organ dysfunction. Lung imaging primarily shows scattered patchy shadows and ground-glass opacities. In contrast, older children mainly present with dry cough, and lung imaging typically reveals large areas of consolidation. Bronchoscopic examinations reveal characteristic findings such as lymphoid follicles, longitudinal folds, mucus plugs, and airway shaping, with longer durations of fever and cough relief.

Colorectal cancer(CRC)is a common malignancy of the digestive system,with increasing morbidity and mortality worldwide.The standard treatment for CRC has,in the past,been surgery,chemotherapy,and radiotherapy.However,these treatments have significant side effects and are particularly challenging for patients with advanced metastatic CRC(mCRC).Therefore,it is crucial to explore alternative and more effective treatments.In recent years,with the development of molecular technology,numerous biomarkers have been identified,and targeted therapy and immunotherapy have achieved surprisingly positive results in the treatment of mCRC.Patients receiving targeted ther-apy and immunotherapy have an improved prognosis and quality of life.On this basis,this article reviews the latest research progress in tar-geted therapy and immunotherapy for mCRC,providing a reference for precision treatment of mCRC.

Objective:To investigate the applicability and surgical effect of direct horizontal suture in the repair of defects after the excision of eyelid nevus.Methods:The clinical data of patients with eyelid nevus who were admitted to Department of Facial and Neck Plastic Surgery, Plastic Surgery Hospital of Chinese Academy of Medical Sciences from March 2015 to March 2023 were retrospectively analyzed. After the eyelid nevus was removed, the defect was closed by horizontal suture parallel to the eyelid margin. In the preoperative simulation suture scheme, one or more horizontal lines were marked on the eyelid skin according to the scope of the nevus. The intersection points of the horizontal lines and the edges of the nevus were marked for simulated suturing. If the marked points aligned horizontally, direct suturing was applied. After 3 months of postoperative follow-up, the therapeutic effect was evaluated based on eyelid function (classified as excellent, good and poor), cosmetic effects (classified as excellent, good and poor) and patient satisfaction (classified as very satisfactory, satisfactory and dissatisfactory). At the same time, the effect of different wound length (<1 cm, 1-2 cm, >2 cm) on the therapeutic effect was also analyzed. SPSS 27.0 software was used for statistical analysis of the data. The counting data were represented by examples and percentages, and Kruskal-Wallis H test was used for comparison between groups. P<0.05 indicated that the difference was statistically significant. Results:A total of 71 patients were enrolled, including 30 males and 41 females. Aged 4 to 35 years old, with an average age of 15 years old. The lesions involved the upper eyelid in 47 cases, the lower eyelid in 14 cases, and co-involved in 10 cases. Lesion areas ranged from 0.5 cm×0.5 cm to 2.3 cm×2.0 cm. None of the lesions involved the palpebral margin and conjunctiva, and the depth did not reach the orbicularis oculi muscle. Immediately after the operation, all the patients had different degrees of eyelid deformation, and some severe patients had difficulty opening their eyes. The above symptoms were relieved within 7 days to 3 months after the operation, and eventually the eyelid movement returned to normal, leaving only mild scarring. In cases where the eyelid nevus was close to or involved the eyebrow area, eyebrow shape changed after surgery, and it gradually returned to normal after 1 month. Some patients with part of the eyebrow defect were able to improve their appearance through eyebrow tattoos, eyebrow transplatation and other methods. The eyelid function of 71 patients was excellent. The evaluation of cosmetic effect, 41 cases (58%) were excellent, and 30 cases (42%) were good. The evaluation of patient satisfaction, 56 cases (79%) were very satisfied, and 15 cases (21%) were satisfied. Statistical analysis showed that with the increase of the horizontal length of the wound, the cosmetic effect and patient satisfaction would be affected to a certain extent, but the differences were not statistically significant ( P>0.05). Conclusion:For eyelid nevus excision defects that can be closed horizontally, direct suturing method should be considered priority. This method is simple to perform, offers stable postoperative effects, and leads to high patient satisfaction.