Objective: To understand the trends of classroom lighting and illumination of primary and secondary schools in Beijing from 2016 to 2023, so as to provide a scientific basis for targeted improvement measures. Methods: A sampling survey was conducted on the lighting and illumination indicators of 8 390 classrooms in primary and secondary schools in Beijing from 2016 to 2023. The survey included classroom daylight factor, window to floor area ratio, average illuminance and illuminance uniformity on the desks, average illuminance and illuminance uniformity on blackboards, as well as classroom lighting and blackboard illumination sources. Intergroup comparisons were performed using the Kruskal-Wallis H test and the Chi square test, and Spearman correlation analysis was used to examine the trend of classroom lighting and illumination changes. Results: Except the window to floor area ratio, the measured values and compliance rates of all lighting and illumination indicators showed an overall upward trend from 2016 to 2023 (daylight factor r = 0.27, χ 2 trend =206.80, average illuminance on the desk surface r =0.30, χ 2 trend =87.97, illuminance uniformity on the desk surface r =0.14, χ 2 trend =73.59, average illuminance on the blackboard r =0.33, χ 2 trend =477.43, illuminance uniformity on the blackboard r = 0.09, χ 2 trend =50.76) (all P ＜0.01). The lighting and illumination indicators of classrooms (included classroom daylight factor, average illuminance and illuminance uniformity on the desks, average illuminance and illuminance uniformity on blackboards) in urban schools, primary schools, and secondary schools from 2016 to 2023 showed an upward trend (urban r =0.23-0.40, χ 2 trend =88.66-392.18; primary school r =0.12-0.36, χ 2 trend =39.50-281.44; secondary schools r =0.06-0.31, χ 2 trend =11.79-213.73) (all P ＜ 0.01 ). The illuminance uniformity on the blackboard in suburban schools showed a downward trend ( r = -0.09, χ 2 trend =31.53, both P ＜0.01). The illuminance uniformity on the desk surface in suburban schools showed no significant change ( r =0.03, χ 2 trend =1.23, both P ＞0.05). The other indicators showed an upward trend (daylight factor r =0.28, χ 2 trend =40.69, average illuminance on the desk surface r =0.24, χ 2 trend =16.35, average illuminance on the blackboard r =0.25, χ 2 trend =118.05, all P ＜0.01). The trends of classroom and blackboard illumination sources were that fluorescent lamps decreased year by year and LED lamps increased by year (classroom illumination sources χ 2 trend =1 059.82, blackboard illumination sources χ 2 trend =1 070.25, both P ＜0.01). Conclusions The classroom lighting and illumination in primary and secondary schools in Beijing has shown an overall improving trend from 2016 to 2023. However, problems remain, such as limited improvement of illuminance uniformity indicators, late start and poor effect of reconstruction in suburban schools. Further improvements are still needed.

OBJECTIVE To investigate the current career development status and existing bottlenecks among graduates of clinical pharmacist training bases， and to provide evidence for optimizing the training system， enhancing trainees’ job competency， and promoting the sound development of the clinical pharmacy discipline. METHODS Graduates from a clinical pharmacist training base in a tertiary class A hospital were selected as survey subjects. A six-dimensional questionnaire was designed using “Wenjuanxing” platform， distributed and collected via a mobile APP and E-mail. The survey analyzed participants’ basic characteristics， the impact of training on their professional roles， as well as their satisfaction regarding professional sentiment， competence， career status， professional recognition， the current state of the clinical pharmacist workforce， and the teaching model of the training base. The reliability of the questionnaire responses was assessed using Cronbach’s α coefficient. RESULTS A total of 164 questionnaires were distributed， and 147 valid responses were recovered， yielding a valid response rate of 89.63%. The Cronbach’s α coefficient for the questionnaire content was 0.943. The surveyed trainees were primarily employed at general hospitals （81.63%） and tertiary class A hospitals （72.11%）， with women constituting the majority （79.59%）. Their ages were concentrated between 26 and 35 years old （63.27%）， and most of them were supervising pharmacists（59.86%）. After training， 96.60% of graduates returned to their original institutions， and the proportion working in clinical pharmacist positions increased from 52.38% to 84.35%. Trainees’ overall satisfaction rate with the training model was 84.35%. However， their satisfaction with innovation and research capacity in clinical pharmacy was only 42 .18%， the satisfaction with salary and benefits was 35.37%， and the satisfaction with both occupational recognition and rationality of staffing was less than 50%. CONCLUSIONS Clinical pharmacist training bases can effectively promote trainees’ career transition， enhance job competency， and stabilize the talent pool among trainees. Nonetheless， the profession still faces bottlenecks such as relatively weak research capacity， low compensation， insufficient professional recognition， and unreasonable staffing. These issues require a multi-pronged， collaborative approach involving the optimization of training systems， the enhancement of career support， and the improvement of industry policies.

Objective:To analyze the effect of deep brain electrical stimulation therapy on Parkinson's disease patients with frozen gait and explore its prognostic factors.Methods:A retrospective study was conducted on 86 Parkinson's disease patients with frozen gait admitted to our hospital from January 2020 to December 2022.All patients received deep brain electrical stimulation therapy.Conduct a 2-year outpatient follow-up for all patients,and analyze the scores of the Parkinson's Disease Rating Scale Part 2(UPDRS Ⅱ),Parkinson's Disease Rating Scale Part 3(UPDRS Ⅲ),Fugl Meyer Lower Limb Motor Function Assessment Scale(FMA),and Schwab&England Daily Activity Scale(S&E)before and after medication opening and closing,6 months after surgery,1 year after surgery,and 2 years after surgery.And based on the 2-year follow-up results of the patients,the prognosis level of the patients was evaluated according to the S&E score during drug closure.60 patients with drug closure S&E score＞70 were divided into a good prognosis group,and 26 patients with drug closure S&E score≤70 were divided into a poor prognosis group.Logistic regression model was used to analyze the influencing factors of deep brain electrical stimulation therapy in Parkinson's disease gait freezing patients.Results:At 6 months,1 year,and 2 years after surgery,the UPDRS Ⅱ and UPDRS Ⅲ scores of all patients were lower than those before surgery(P＜0.05).The UPDRS Ⅱ and UPDRS Ⅲ scores of patients before surgery,6 months,1 year,and 2 years after surgery were lower than those of patients before surgery(P＜0.05);At 6 months,1 year,and 2 years after surgery,the FMA and S&E scores of all patients were higher than those before surgery(P＜0.05).There was no significant difference in the FMA and S&E scores between 6 months,1 year,and 2 years after surgery(P＞0.05).However,the FMA and S&E scores at 6 months,1 year,and 2 years after surgery were lower than those at the end of surgery(P＜0.05);There was no significant difference between the gender,BMI,combined underlying disease,levodopa equivalent dose,preoperative UPDRSⅢ score before the on and off periods,and FMA scores before the on and off periods(P＞0.05),Age,Parkinson's disease stage,preoperative UPDRS Ⅱ score between open and off period,and preoperative S&E score between the good prognosis and off prognosis groups(P＜0.05);The UPDRS Ⅱ score(95％CI:1.353～5.782,OR value:2.462),S&E score(95％CI:1.658～4.687,OR value:2.789),and S&E score(95％CI:1.265～6.879,OR value:3.645)before opening surgery are independent influencing factors on deep brain electrical stimulation therapy in Parkinson's disease gait freezing patients(P＜0.05).Conclusion:Deep brain electrical stimulation therapy can improve the condition and motor function of Parkinson's disease patients with frozen gait,but some patients may have poor prognosis due to the influence of UPDRS Ⅱ score before surgery and S&E scores during the opening and closing phases.

Objective:To analyze the effect of deep brain electrical stimulation therapy on Parkinson's disease patients with frozen gait and explore its prognostic factors.Methods:A retrospective study was conducted on 86 Parkinson's disease patients with frozen gait admitted to our hospital from January 2020 to December 2022.All patients received deep brain electrical stimulation therapy.Conduct a 2-year outpatient follow-up for all patients,and analyze the scores of the Parkinson's Disease Rating Scale Part 2(UPDRS Ⅱ),Parkinson's Disease Rating Scale Part 3(UPDRS Ⅲ),Fugl Meyer Lower Limb Motor Function Assessment Scale(FMA),and Schwab&England Daily Activity Scale(S&E)before and after medication opening and closing,6 months after surgery,1 year after surgery,and 2 years after surgery.And based on the 2-year follow-up results of the patients,the prognosis level of the patients was evaluated according to the S&E score during drug closure.60 patients with drug closure S&E score＞70 were divided into a good prognosis group,and 26 patients with drug closure S&E score≤70 were divided into a poor prognosis group.Logistic regression model was used to analyze the influencing factors of deep brain electrical stimulation therapy in Parkinson's disease gait freezing patients.Results:At 6 months,1 year,and 2 years after surgery,the UPDRS Ⅱ and UPDRS Ⅲ scores of all patients were lower than those before surgery(P＜0.05).The UPDRS Ⅱ and UPDRS Ⅲ scores of patients before surgery,6 months,1 year,and 2 years after surgery were lower than those of patients before surgery(P＜0.05);At 6 months,1 year,and 2 years after surgery,the FMA and S&E scores of all patients were higher than those before surgery(P＜0.05).There was no significant difference in the FMA and S&E scores between 6 months,1 year,and 2 years after surgery(P＞0.05).However,the FMA and S&E scores at 6 months,1 year,and 2 years after surgery were lower than those at the end of surgery(P＜0.05);There was no significant difference between the gender,BMI,combined underlying disease,levodopa equivalent dose,preoperative UPDRSⅢ score before the on and off periods,and FMA scores before the on and off periods(P＞0.05),Age,Parkinson's disease stage,preoperative UPDRS Ⅱ score between open and off period,and preoperative S&E score between the good prognosis and off prognosis groups(P＜0.05);The UPDRS Ⅱ score(95％CI:1.353～5.782,OR value:2.462),S&E score(95％CI:1.658～4.687,OR value:2.789),and S&E score(95％CI:1.265～6.879,OR value:3.645)before opening surgery are independent influencing factors on deep brain electrical stimulation therapy in Parkinson's disease gait freezing patients(P＜0.05).Conclusion:Deep brain electrical stimulation therapy can improve the condition and motor function of Parkinson's disease patients with frozen gait,but some patients may have poor prognosis due to the influence of UPDRS Ⅱ score before surgery and S&E scores during the opening and closing phases.

Objective:Analyze the influencing factors of postoperative recurrence of common bile duct stones in patients with gallstones and multiple common bile duct stones,and evaluate the application value of nomogram predic-tion models.Methods:Collected clinical data of 587 patients with gallstones and multiple common bile duct stones who underwent surgical treatment at Beijing Fengtai Hospital from January 2022 to January 2024.They were divided into a training cohort(n=410)and a validation cohort(n=177)according to a 7∶3 ratio.Analyzed the influencing factors of postoperative recurrence of common bile duct stones in patients with gallstones and multiple common bile duct stones,and constructed a nomogram prediction model based on this.Results:The recurrence rate of postoperative common bile duct stones in the training queue was 38.05％(156/410).Age,BMI,intrahepatic bile duct stones,initial course of dis-ease,duodenal diverticulum,biliary tract infection,history of biliary surgery,thickness of the common bile duct wall,num-ber of multiple stones in the common bile duct,diameter of the common bile duct,and dysfunction of the Oddis sphincter in the duodenal papilla during ERCP examination are independent risk factors for postoperative recurrence in patients with gallbladder stones combined with multiple stones in the common bile duct(P＜0.05).The AUC of the constructed nomo-gram prediction model in the training queue and validation queue were 0.854 and 0.889,respectively.The Hosmer Lem-eshow fitting test results showed that there was no statistically significant difference between the predicted probability and the actual probability of the prediction model(x2=3.952,P=0.865),indicating that this model has good predictive abil-ity.Conclusion:The nomogram prediction model based on various risk factors can effectively predict the risk of post-operative common bile duct stone recurrence in patients with gallstones and multiple common bile duct stones.

Objective:This study aimed was to analyze the disease progression of postoperative recurrence/me-tastasis of pancreatic ductal adenocarcinoma(PDAC)and provide clinical evidence for evaluating the difference in prog-nosis between site and pattern of recurrence/metastasis.Methods:The clinical data of 167 patients with PDAC who underwent pancreatectomy in Panjin Liao-Oil Gem Flower Hospital from January 2011 to June 2019 were retrospec-tively analyzed.Kaplan-Meier curves and Cox-regression analyses were applied to assess survival outcomes.Results:In this study,96 patients(57.5%)recurred within 12 months after surgery,and the median recurrence time was 10.9 months.Compared to patients without recurrence,patients with recurrence/metastasis had higher baseline CA19-9>100 IU/mL and were treated more often with neoadjuvant chemotherapy(P<0.05).In the no recurrence group,patients had histopathological analyses yielded lower less poorly differentiated tumors,less positive margin,less pT3+4 stages and pN1+2 stages(P<0.05).In a multivariate Cox regression analysis,receipt of neoadjuvant chemotherapy,poor tumor differ-entiation and positive margin were independent predictors for recurrence/metastasis within 12 months after surgery(P<0.05).Neoadjuvant treated patients had less pT1+2 stages(P=0.015),a lower lymph node ratio,less perineural invasion,less positive margin,and were less likely to be treated with adjuvant chemotherapy compared to upfront surgery treated patients(P<0.05).Recurrence/metastasis rates were higher in the neoadjuvant treated cohort versus the upfront surgery cohort(P=0.014).There was no statistical difference in the recurrence/metastasis rate distribution between neoadjuvant therapy and upfront surgery,and neoadjuvant therapy exhibited no significant impact on recurrence/metastasis patterns in PDAC(P>0.05).The overall survival period of patients without recurrence/metastasis within 12 months was signifi-cantly longer than that of patients with recurrence/metastasis after PDAC resection(P<0.001).Conclusion:The varying site recurrence/metastasis rates and time to recurrence/metastasis,underline the inherent heterogeneity of PDAC and the specific interactions in the tumor microenvironments at the recurrence/metastasis sites.Further research is essential to establish optimal personalized treatment strategies for patients with recurrent PDAC.

Myocardial fibrosis(MF)is the leading cause of car-diac insufficiency.Its complex pathogenesis and lack of effective treatment are key issues to be addressed in the cardiovascular field.Mitochondrial quality control system(MQC)is an impor-tant mechanism for eukaryotic cells to maintain the stability of mitochondrial form,quantity and quality.MQC disorders,which are characterized by low level of mitochondrial biogenesis,exces-sive mitochondrial oxidative stress,mitochondrial autophagy de-fect and mitochondrial dynamics disorder,play a crucial role in mediating the pathophysiological process of MF.Consequently,this article reviews the role of MQC in MF pathogenesis and the latest research,in order to better understand the molecular mech-anism of MF and provide reference for the development of more natural drugs in the future.

Obesity represents a complex, heritable condition shaped by interactions among genetic, epigenetic, metagenomic, and environmental factors. Nevertheless, the mechanistic contributions of genetic variation and epigenetic regulation to obesity pathogenesis remain incompletely elucidated. Advances in molecular profiling technologies have enabled the identification of numerous biomarkers associated with childhood obesity phenotypes. These discoveries facilitate understanding of obesity etiology and its links to chronic diseases. This review synthesizes current research on genomic and epigenomic biomarkers influencing childhood obesity susceptibility, advances our comprehension of etiological heterogeneity and intervention strategies, and offers conceptual frameworks for precision prevention based on epigenetic mechanisms.

Objective:This study aimed was to analyze the disease progression of postoperative recurrence/me-tastasis of pancreatic ductal adenocarcinoma(PDAC)and provide clinical evidence for evaluating the difference in prog-nosis between site and pattern of recurrence/metastasis.Methods:The clinical data of 167 patients with PDAC who underwent pancreatectomy in Panjin Liao-Oil Gem Flower Hospital from January 2011 to June 2019 were retrospec-tively analyzed.Kaplan-Meier curves and Cox-regression analyses were applied to assess survival outcomes.Results:In this study,96 patients(57.5%)recurred within 12 months after surgery,and the median recurrence time was 10.9 months.Compared to patients without recurrence,patients with recurrence/metastasis had higher baseline CA19-9>100 IU/mL and were treated more often with neoadjuvant chemotherapy(P<0.05).In the no recurrence group,patients had histopathological analyses yielded lower less poorly differentiated tumors,less positive margin,less pT3+4 stages and pN1+2 stages(P<0.05).In a multivariate Cox regression analysis,receipt of neoadjuvant chemotherapy,poor tumor differ-entiation and positive margin were independent predictors for recurrence/metastasis within 12 months after surgery(P<0.05).Neoadjuvant treated patients had less pT1+2 stages(P=0.015),a lower lymph node ratio,less perineural invasion,less positive margin,and were less likely to be treated with adjuvant chemotherapy compared to upfront surgery treated patients(P<0.05).Recurrence/metastasis rates were higher in the neoadjuvant treated cohort versus the upfront surgery cohort(P=0.014).There was no statistical difference in the recurrence/metastasis rate distribution between neoadjuvant therapy and upfront surgery,and neoadjuvant therapy exhibited no significant impact on recurrence/metastasis patterns in PDAC(P>0.05).The overall survival period of patients without recurrence/metastasis within 12 months was signifi-cantly longer than that of patients with recurrence/metastasis after PDAC resection(P<0.001).Conclusion:The varying site recurrence/metastasis rates and time to recurrence/metastasis,underline the inherent heterogeneity of PDAC and the specific interactions in the tumor microenvironments at the recurrence/metastasis sites.Further research is essential to establish optimal personalized treatment strategies for patients with recurrent PDAC.

Objective: To study the correlation between short sleep duration and screening myopia among primary and middle school students in Beijing, so as to provide a scientific basis for the comprehensive prevention and control of myopia among students. Methods: Using a stratified cluster random sampling, 25 593 primary and middle school students from 16 districts of Beijing were selected from September to November 2023. The National Common Diseases and Health Influencing Factors Monitoring Survey Questionnaire was used to conduct a questionnaire survey, and visual acuity was tested according to the Specification for the Screening of Refractive Error in Primary and Middle School Students. The reporting rates of short sleep duration and detection rates of screening myopia among primary and middle school students were compared using the Chi square test. Binary Logistic regression was used to analyze the correlation between short sleep duration and screening myopia. Results: About 68.63% of students reported short sleep duration. There was a statistically significant difference in the reporting rate of short sleep duration among students in different school stages ( χ 2=981.18, P <0.01), with the lowest reporting rate of vocational high school students (47.07%) and the highest reporting rate of ordinary high school students (76.17%). The detection rates of screening myopia among primary school students ( 57.09% ) and middle school students (76.53%) who reported short sleep duration were higher than those who reported enough sleep duration (52.65%, 71.94%), with satistically significant differences ( χ 2=14.83, 17.96, P <0.01). The results of binary Logistic regression analysis showed that primary and middle school students with short sleep duration had a higher risk of developing screening myopia, compared to students with enough sleep duration ( OR =1.25); after adjusting for confounding factors such as educational stage, gender, region, boarding situation, primary and secondary school students with short sleep duration still had a higher risk of screening myopia ( OR =1.26) ( P <0.01). The analysis results stratified by educational stage showed that primary school students from grades 4-6 and middle school students with short sleep duration had a higher risk of screening myopia ( OR=1.18, 1.20, P <0.01). Conclusions Primary and secondary school students in Beijing with short sleep duration sleep have a higher risk of developing screening myopia. Families, schools, and society should ensure enough sleep duration to reduce the occurrence of myopia among students.