Objective To evaluate the safety of the 13-valent pneumococcal polysaccharide conjugate vaccine (tetanus toxoid/diphtheria toxoid) (PCV13-TT/DT) among age-eligible children in Tianjin through a combination of active and passive surveillance methods. Methods From July 15, 2023, to August 31, 2024, active surveillance for adverse events following immunization (AEFI) was conducted among recipients of PCV13-TT/DT at 18 selected vaccination clinics in Tianjin. Recipients were monitored through on-site observation or telephone follow-up within 30 minutes after vaccination and on days 1, 3, 7, and 28. Passive surveillance for AEFI was conducted among recipients of PCV13-TT/DT at other vaccination clinics across the city. The incidence of AEFI was analyzed using descriptive epidemiological methods. Results A total of 24 916 recipients of PCV13-TT/DT were observed, with 440 AEFI cases reported, resulting in an overall incidence rate of 176.59 per 10 000. The incidence rate of AEFI in active surveillance was 813.79 per 10 000, significantly higher than that in passive surveillance (20.49 per 10 000; P< 0.001). The incidence rates of general reactions, abnormal reactions, and coincidental cases in active surveillance were 744.44 per 10 000, 8.16 per 10 000, and 61.19 per 10 000, respectively, all of which were higher than those in passive surveillance (18.49 per 10 000, 0.50 per 10 000, and 1.50 per 10 000), with P values < 0.05. General reactions were mainly characterized by fever, local redness, and local induration. Abnormal reactions included angioedema and allergic rash. Coincidental cases were mainly infections. No severe adverse reactions occurred. Conclusion The large-scale vaccination of PCV13-TT/DT after its launch has good safety, and continuous strengthening of vaccine safety monitoring is needed.

ObjectiveTo systematically compare the differential regulation of the maternal-fetal interface cell lineages and communication networks in the CBA/J×DBA/2 mouse model of recurrent pregnancy loss （RPL） by the two classic therapeutic methods-tonifying the kidney to stabilize the fetus and invigorating the spleen to stabilize the fetus （Shoutai Wan， Juyuan Jian）-of traditional Chinese medicine （TCM） at the single-cell resolution and clarify their modern scientific connotations. MethodsFemale non-pregnant CBA/J mice were caged with male BALB/c （blank group） and DBA/2 （modeling group） mice separately. Pregnant mice in the modeling group were randomly grouped as follows： high/low-dose Shoutai Wan， high/low-dose Juyuan Jian， model （RPL）， and positive control （dydrogesterone）， with 10 mice in each group. Starting from the day after the detection of the vaginal plug， mice were administrated with drugs or an equal volume of normal saline by gavage for 10 consecutive days. After the intervention， the following indicators were measured. ① Macroscopic evaluation： general conditions， uterine wet weight， embryo loss rate， four coagulation parameters ［prothrombin time （PT）， activated partial thromboplastin time （APTT）， fibrinogen （FIB）， and thrombin time （TT）］， and peripheral blood estradiol （E₂） and progesterone （Pg） levels. The decidua with embryos was stained with hematoxylin-eosin （HE） and evaluated by transmission electron microscopy （TEM）. The expression of B-cell lymphoma-2 （Bcl-2）， vascular endothelial growth factor （VEGF）， angiotensin Ⅱ （AngⅡ）， matrix metalloproteinase-2 （MMP-2）， interleukin-6 （IL-6）， leukemia inhibitory factor （LIF）， CXC chemokine ligand 12 （CXCL12）， and microtubule-associated protein 1 light chain 3 homolog （LC3）Ⅰ/Ⅱ was quantified by Western blot. ② Mechanism analysis at the single-cell level： The decidua with embryos from the blank， model， high-dose Shoutai Wan， and high-dose Juyuan Jian groups （6 mice per group， with 3 single-cell samples per group， totaling 24 mice） were analyzed by the BD Rhapsody™ platform， and the whole-cell atlas was drawn by uniform manifold approximation and projection （UMAP） dimensionality reduction clustering combined with the single-cell mouse cell atlas （scMCA）. The differentially expressed genes （DEGs） and cell interaction networks were analyzed via Gene Ontology （GO）， Kyoto Encyclopedia of Genes and Genomes （KEGG）， and CellChat， and the protein-protein interaction （PPI） map of subtype cells was constructed. The CytoTRACE pseudo-temporal analysis was performed to explore the developmental trajectories of core immune cells （natural killer cells， NK cells） from maternal and fetal sources. Results① Pathological and Western blot results indicated that compared with the blank group， the RPL group showed an increase in the embryo loss rate （P<0.01）， down-regulated expression of Bcl-2， LIF， MMP-2， and Vegf in the decidua with embryos （P<0.05）， up-regulated protein levels of CXCL-12， AngⅡ， and IL-6 （P<0.05）， blocked angiogenesis， apoptosis-inflammation imbalance， and coagulation dysfunction. Both prescriptions dose-dependently reduced the abortion rate and restored the angiogenesis-inflammation balance， and Shoutai pill showed superior performance in restoring the E₂ level to the Pg level （P<0.05）. ② Single-cell transcriptome analysis indicated that compared with the blank group， the RPL group showed differences in multiple key cell populations such as decidual cells， trophoblast cells， endothelial cells， erythroblasts， NK cells， and macrophages at the maternal-fetal interface. Immunity and angiogenesis were the key links in RPL. Compared with the RPL group， high-dose Shoutai Wan reversed the changes of NK cells in the embryonic layer （upregulating the mRNA levels of 17 genes and downregulating the mRNA levels of 29 genes） and macrophages （upregulating the mRNA levels of 117 genes and downregulating the mRNA levels of 53 genes） through the regulation of gene expression. High-dose Shoutai pill regulated the immune cells to affect unfolded proteins， cell adhesion， and programmed cell death， thereby promoting decidualization and angiogenesis and modulating embryo-membrane development. High-dose Juyuan Jian regulated the key subgroups of NK cells （up-regulating the mRNA levels of 9 genes and down-regulating the mRNA levels of 17 genes） and macrophages （up-regulating the mRNA levels of 110 genes and down-regulating the mRNA levels of 81 genes）， which affected decidual inflammation and apoptosis and intervened in glycolysis. ③ The pseudo-temporal analysis and communication network indicated that the communication frequency of the RPL group decreased. High-dose Shoutai Wan restored maternal-fetal tolerance through pathways such as NKG2D， CDH5， GDF， and FASLG. High-dose Juyuan Jian enhanced the IL-6/LIFR/JAK/signal transducer and activator of transcription 3 （STAT3） and desmosome/SEMA6/tumor necrosis factor-like weak inducer of apoptosis （TWEAK） signaling to improve endometrial receptivity. The RPL group showed an increased proportion of toxic dNK7， a decreased proportion of reparative dNK4， and blocked embryo fNK1. High-dose Shoutai Wan down-regulated dNK7 and up-regulated dNK4. High-dose Juyuan Jian inhibited the terminal differentiation of dNK7 and up-regulated LILRB1， thus restoring the balance of cytotoxicity and repair. ConclusionBoth the kidney-tonifying and spleen-invigorating methods are effective in treating RPL. NK and macrophages are the key immune cells in the interaction between the embryo and the membrane. The kidney-tonifying method （Shoutai Wan） has an advantage in regulating the phenotypes of unfolded protein， cell adhesion， and programmed cell death， and shows expression characteristics closer to the physiological state in the regulation of NKG2D and CDH5 signals. The spleen-invigorating method （Juyuan Jian） has an advantage in regulating epithelial-mesenchymal transition （EMT）， angiogenesis， and glycolysis and shows higher communication intensity in the IL-6 and LIFR pathways.

Abstract The prevention and control of myopia in children and adolescents has become a national health strategy in China, and its prevention and management are transitioning from experience driven approaches to precise and intelligent strategies. Understanding the role of artificial intelligence (AI) in myopia prevention and control can provide a foundation for a comprehensive myopia prevention and control system. AI, with its powerful capabilities in data analysis and pattern recognition, shows significant potential in myopia risk prediction, screening and diagnosis, intervention support and behavior monitoring in children and adolescents. The article systematically summarizes the scientific evidence and consensus on the application of AI for myopia prevention and control in children and adolescents. From the perspective of public health practice, it proposes hierarchical expert recommendations for multiple scenarios including schools, families, communities and medical institutions, as well as policy and research with development. Furthermore, it discusses current challenges and future directions, aiming to provide a reference for building an intelligent, precise and fully covered comprehensive myopia prevention and control system in children and adolescents.

ObjectiveTo explore the effectiveness of health information dissemination and its influencing factors using the "Shanghai CDC" WeChat public account as a case study, providing references for public health institutions to optimize the use of official new media platforms for effective publicity. MethodsA total of 1 030 headline articles published on the "Shanghai CDC" WeChat public account between 2016 and 2019 were analyzed using content analysis and non-parametric tests to examine the impact of factors such as titles and content categories. ResultsFrom 2016 to 2019, the number of WeChat public account followers increased by 280 000, with the articles accumulating over 8.8 million views. The median (P₂₅, P₇₅) open rate of articles was 5.90% (3.69%, 10.31%), and the median (P₂₅, P₇₅) sharing and forwarding rate was 6.60% (4.25%, 9.17%). Factors such as the use of first- and second-person pronouns, degree adverbs, negative adverbs, explicit viewpoints, and title length all significantly affected the open rate of articles, with OR (95%CI) values of 0.175 (0.041‒0.756), 32.606 (2.350‒452.432), 4.079 (1.093‒15.230), 0.106 (0.028‒0.409), and 1.184 (1.063‒1.319),respectively (all P<0.05). In terms of content, statistical significant differences in dissemination effectiveness were observed across article categories and themes (P<0.05). In terms of article categories, articles related to news hotspots and service information had higher open rates of 9.58% and 14.00%, respectively. These two types of articles also obtained higher sharing and forwarding rates of 7.65% and 9.16%, respectively. In terms of article topics, compared with healthy life and health products, among the top four topics in terms of publication volume, the open rates of articles about infectious diseases and disease-causing biology and immunization programs were higher, accounting for 7.88% and 6.88%, respectively, with no significant difference in sharing and forwarding rates. ConclusionThe "Shanghai CDC" WeChat public account demonstrated good dissemination effectiveness. Enhancing article titles by increasing informational content and degree adverbs (e.g., "highly," "most," and "extremely") and negative adverbs (e.g., "no") can improve dissemination reach. Public health WeChat accounts should incorporate news hotspots or service information in their articles. While maintaining their strengths in disseminating knowledge on infectious diseases and immunization programs, they should also enhance public education in other professional fields within their scope of responsibility to improve the overall dissemination impact of health information.

Esophageal carcinoma is a malignant disease with a high incidence rate and poor prognosis. The mitochondrial apoptosis pathway plays a pivotal role in the regulation of cell death and has become a focal point in current cancer therapeutics research. Various active components from traditional Chinese medicine （TCM） can target the mitochondrial apoptosis pathway to inhibit esophageal carcinoma， presenting as potential therapeutic agents for this disease. This paper summarizes relevant research on the inhibition of esophageal carcinoma by active components in TCM via targeting the mitochondrial apoptosis pathway. It has been found that flavonoids （casticin， icariin， luteolin， kaempferol， hesperetin， deguelin， etc.）， terpenoids （oridonin， Jaridonin， artesunate， ethyl acetate fraction of pleurotus ferulatus triterpenoid， etc.）， alkaloids （matrine， swainsonine， etc.）， polyphenols （curcumin， epigallocatechin-3-gallate， corilagin， etc.）， steroids （α-hederin， polyphyllin Ⅵ， etc.）， phenols （optimized scorpion venom peptide CT-K3K7， gecko active polypeptide， etc.）， volatile oils （cinnamaldehyde， α -asarone， etc.） and other active components from TCM can target the intrinsic mitochondrial apoptosis pathway， induce apoptosis in esophageal carcinoma cells， and inhibit their proliferation， invasion and migration by regulating oxidative stress， blocking the cell cycle， regulating signaling pathways such as PI3K/Akt and MAPK.

Deep learning-based polyp image segmentation is helpful for assessing precancerous lesions. A colorectal polyp image segmentation model (RDG-Net) based on a dual-stage decoder is proposed to addresses the issues of poor segmentation performance due to unclear boundaries in colorectal polyp images and insufficient generalization ability for new samples. The model uses Res2Net-50 as the encoder to enhance the precision of image segmentation. The decoder has two stages:the first stage utilizes a 4-layer multi-scale feature aggregation module to integrate features extracted by the encoder at different stages,while the second stage enhances the image features output by the first stage of the decoder through a 3-layer parallel convolution fusion module and decodes them to a higher resolution as the model's final output. The model is trained using the CVC-ClinicDB and Kvasir-SEG training datasets,and tested using the CVC-ClinicDB and Kvasir-SEG test datasets,as well as the CVC300 and ETIS-LaribPolypDB datasets that are not involved in the training. The test results show that the proposed method has an average accuracy,precision,recall rate,Dice similarity coefficient,intersection over union and F2 score of 98.41％,94.25％,92.62％,93.42％,87.69％and 92.93％on the CVC-ClinicDB and Kvasir-SEG datasets,while 99.05％,87.79％,89.13％,88.39％,79.33％ and 88.82％ on the CVC300 and ETIS-LaribPolypDB datasets,respectively,demonstrating that RDG-Net model performs well in colorectal polyp region segmentation and has a high generalization performance on new datasets.

Objective:To systematically analyze the current research landscape and development trends of 0.05% cyclosporine A (CsA) in the field of ocular surface diseases using bibliometric methods.Methods:Relevant literature on 0.05% CsA published between January 2000 and September 2024 was retrieved from the Web of Science Core Collection.A total of 244 articles that met the inclusion criteria were analyzed using the bibliometric visualization tool CiteSpace.The analysis included publication volume, core authors, research institutions and country distribution, keyword co-occurrence, burst detection, clustering, and co-citation patterns.Results:From January 2000 to September 2024, the overall number of publications showed a fluctuating upward trend, peaking in 2022.A total of 513 authors were identified, with Yoon Kyung Chul contributing the most publications.The research involved 331 institutions, with Chonnam National University and Harvard University showing outstanding performance.A total of 39 countries were involved, with the United States leading in publication volume (93 articles) and demonstrating high centrality and collaboration strength.China ranked fifth with 19 articles and has shown rapid growth in recent years.Keyword co-occurrence analysis revealed that the most central research themes were dry eye disease and 0.05% CsA.Other hotspots included allergic conjunctivitis, meibomian gland dysfunction, Sj?gren syndrome, and postoperative dry eye management.Clustering and timeline analyses indicated that research directions have expanded from basic therapy to novel formulations, combination treatments, and personalized approaches.Co-citation analysis showed that highly cited references had a significant influence om the field.Highly cited publications from the past three years reflected a sustained focus on novel formulations and long-term efficacy evaluation.Conclusions:0.05% CsA plays a crucial role in the treatment of various ocular surface diseases.Future research should focus on developing novel formulations, combination therapy strategies, and conducting large-scale, long-term clinical trials to optimize treatment outcomes and advance the field.

Objective To conduct a rapid health technology assessment(rHTA)of the efficacy,safety,and cost-effectiveness of tirzepatide for the treatment of type 2 diabetes mellitus(T2DM),and to provide evidence for clinical medication.Methods PubMed,Web of Science,Embase,Cochrane Library,WanFang Data,CNKI databases,and health technology assessment(HTA)websites were searched to collect systematic reviews/Meta-analysis,pharmacoecomic literature and HTA reports of tirzepatide in the treatment of T2DM from inception to February 28,2025.Two researchers independently conducted literature screening,data extraction,and quality assessment,and then summarized and analyzed the results.Results A total of 13 articles were included,comprising 2 HTA reports,8 systematic reviews/Meta-analyses,and 3 pharmacoeconomic studies.In terms of efficacy,tirzepatide outperformed placebo or other antidiabetic drugs in reducing glycated hemoglobin(HbA1c),increasing the rate of HbA1c＜7％,lowering blood glucose,and reducing weight.The antihyperglycemic and weight-loss effects of tirzepatide were dose-dependent,and it also had certain advantages in reducing the risk of cardiovascular events and renal composite endpoint events.Regarding safety,the incidence of gastrointestinal adverse events in the tirzepatide group was higher than that in the placebo group and the insulin group,mainly manifested as diarrhea,nausea,and vomiting.However,it did not increase the risk of serious gastrointestinal adverse events,nor did it increase the risk of hypoglycemia and pancreatitis.In terms of cost-effectiveness,tirzepatide had cost-utility and cost-effectiveness advantages compared with semaglutide and other antidiabetic drugs.Conclusion Compared with other antidiabetic drugs,tirzepatide has better efficacy,safety,and cost-effectiveness in the treatment of T2DM.

Sudden sensorineural hearing loss(SSNHL)is an idiopathic sensorineural hearing loss of at least 30 dB over three consecutive frequencies in less than 3 days.However,its pathogenesis is still unknown.Recent re-searches suggest that inflammation plays a very important role in its development and prognosis.For this reason,we reviewed the relationship between inflammation and SSNHL from the perspective of development and prognosis,and further discussed the role of inflammation in the pathogenesis of SSNHL.

Objective:To investigate the related factors of hyperuricemia(HUA)in adolescents with bipolar disorder.Methods:Fifty-nine adolescent patients with bipolar disorder and 60 normal controls were select-ed.General demographic and clinical data were collected.Serum uric acid(UA),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FPG),fructosamine(FA)and other physiological indices were detected.The Hamilton Depression Scale 17(HAMD-17)and Bech-Rafaelsen Mania Scale(BRMS)were used to evaluate the emotional symptoms of the patients.Results:The detection rate of HUA was higher in the adolescent patients with bipolar disorder than in the normal control group(30.5％vs.18.3％,P＜0.05),and was higher in manic episode than in depressive episode(48.2％vs.20.8％,P＜0.05).Unconditioned logistic regression analysis showed that high level of TG and high BMI were risk factors for hyperuricemia in adolescents with bipolar disorder(OR=2.51,1.34).Conclusion:This study shows that adolescents with bipolar disorder may have a higher risk of HUA than normal controls,and its oc-currence is associated with high TG level and BMI.