Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A total of 2874 patients from the large prospective, observational perioperative lung symptom study cohort (CN-PRO-Lung 3) in the Department of Thoracic Surgery at Sichuan Cancer Hospital between April 7, 2021, and January 31, 2024, were selected as the survey subjects. A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of (52.4±10.2) years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers for postoperative exercise were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.

OBJECTIVE To explore the risk factors for the recurrent asthma in children with bronchopneumonia un-der 6 years of age in Fuyang City.METHODS A total of 368 children with bronchopneumonia who were less than 6 years old and treated in Fuyan Cancer Hospital from Jan.2021 to Jan.2023 were recruited as the research sub-jects and were divided into the asthma group with 130 cases and non-asthma group with 238 cases according to the status of recurrent asthma.The characteristics of seasonal distribution of the bronchopneumonia were analyzed.The predictive factors were screened out by the least absolute shrinkage and selection operator(LASSO)regression analysis,and multivariate logistic regression analysis was performed for the risk factors for the recur-rent asthma in children.RESULTS There was significant difference in the number of cases among the seasons(P＜0.05),and it was most prevalent in winter.Three non-zero predictive factors were screened out by LASSO regres-sion analysis.The result of multivariate logistic regression analysis showed that family history of asthma,contact with dust or pollen and weather change were risk factors for the recurrent asthma in children with bronchopneu-monia(P＜0.05).CONCLUSIONS The change of temperature makes the probability of bronchopneumonia display a remarkable feature of seasonal distribution,which is highly prevalent in cold winter and less prevalent in summer.The family history of asthma,contact with dust or pollen and weather change are the major factors for the recurrent asthma in children with bronchopneumonia.It is of great significance to take targeted prevention and control measures based on the above risk factors so as to reduce the risk of recurrent asthma in children with bron-chopneumonia.

OBJECTIVE To explore the risk factors for the recurrent asthma in children with bronchopneumonia un-der 6 years of age in Fuyang City.METHODS A total of 368 children with bronchopneumonia who were less than 6 years old and treated in Fuyan Cancer Hospital from Jan.2021 to Jan.2023 were recruited as the research sub-jects and were divided into the asthma group with 130 cases and non-asthma group with 238 cases according to the status of recurrent asthma.The characteristics of seasonal distribution of the bronchopneumonia were analyzed.The predictive factors were screened out by the least absolute shrinkage and selection operator(LASSO)regression analysis,and multivariate logistic regression analysis was performed for the risk factors for the recur-rent asthma in children.RESULTS There was significant difference in the number of cases among the seasons(P＜0.05),and it was most prevalent in winter.Three non-zero predictive factors were screened out by LASSO regres-sion analysis.The result of multivariate logistic regression analysis showed that family history of asthma,contact with dust or pollen and weather change were risk factors for the recurrent asthma in children with bronchopneu-monia(P＜0.05).CONCLUSIONS The change of temperature makes the probability of bronchopneumonia display a remarkable feature of seasonal distribution,which is highly prevalent in cold winter and less prevalent in summer.The family history of asthma,contact with dust or pollen and weather change are the major factors for the recurrent asthma in children with bronchopneumonia.It is of great significance to take targeted prevention and control measures based on the above risk factors so as to reduce the risk of recurrent asthma in children with bron-chopneumonia.

Objective To establish a pediatric rare disease catalog,analyze the current status of therapeutic drugs and their coverage of the medical insurance in China,and propose strategies to enhance drug accessibility.Methods Pediatric rare diseases were identified from China's two national rare disease catalogs combined with the EU Orphanet database,US FDA orphan drug database,and the Diagnosis and Treatment Standards for Rare Diseases in Children.We created a specialized drug catalog for pediatric rare diseases,then analyzed drug types(ATC classification),pricing,and medical insurance coverage using descriptive statistics based on Yaozhi.com drug bidding prices and the 2024 Drug of List National Basic Medical Insurance(NBMIDL).Drug affordability was assessed through annual treatment cost calculations.Results The national catalogs included 151 pediatric rare diseases(72.95%of listed conditions),spanning 13 disease systems.We identified 94 dedicated orphan drugs(by generic name)for these conditions,among which 43 were approved internationally but unavailable in China.The average unit price per package was 6 113.53 yuan.Overall NBMIDL coverage was 68.83%,but drugs priced above 7 000 yuan per unit had only 7.69%coverage.Annual treatment costs reached 4.54 million for laronidase(mucopolysaccharidosis).Conclusions Critical gaps persist in China's pediatric rare disease treatment landscape,including catalog deficiencies,inadequate coverage for high-cost drugs and insufficient domestic innovation.It is recommended to establish a list of orphan drugs for pediatric rare diseases,accelerate the import of foreign drugs and the local innovative drugs through policy incentives,optimizing medical insurance reimbursement mechanisms for pediatric rare disease drugs to comprehensively improve therapeutic accessibility.

Objective To establish a pediatric rare disease catalog,analyze the current status of therapeutic drugs and their coverage of the medical insurance in China,and propose strategies to enhance drug accessibility.Methods Pediatric rare diseases were identified from China's two national rare disease catalogs combined with the EU Orphanet database,US FDA orphan drug database,and the Diagnosis and Treatment Standards for Rare Diseases in Children.We created a specialized drug catalog for pediatric rare diseases,then analyzed drug types(ATC classification),pricing,and medical insurance coverage using descriptive statistics based on Yaozhi.com drug bidding prices and the 2024 Drug of List National Basic Medical Insurance(NBMIDL).Drug affordability was assessed through annual treatment cost calculations.Results The national catalogs included 151 pediatric rare diseases(72.95%of listed conditions),spanning 13 disease systems.We identified 94 dedicated orphan drugs(by generic name)for these conditions,among which 43 were approved internationally but unavailable in China.The average unit price per package was 6 113.53 yuan.Overall NBMIDL coverage was 68.83%,but drugs priced above 7 000 yuan per unit had only 7.69%coverage.Annual treatment costs reached 4.54 million for laronidase(mucopolysaccharidosis).Conclusions Critical gaps persist in China's pediatric rare disease treatment landscape,including catalog deficiencies,inadequate coverage for high-cost drugs and insufficient domestic innovation.It is recommended to establish a list of orphan drugs for pediatric rare diseases,accelerate the import of foreign drugs and the local innovative drugs through policy incentives,optimizing medical insurance reimbursement mechanisms for pediatric rare disease drugs to comprehensively improve therapeutic accessibility.

Objective To enhance the qualified rate of preoperative bladder filling and improve the experience of embryo transfer by implementing a nursing intervention based on the root cause analysis and plan-do-check-act(RCA-PDCA)cycle.Methods A before-after comparative study was conducted among the patients who received embryo transfer at a Tire-ⅢA specialist hospital between January and April 2024.The patient who received embryo transfer between January and February 2024(n=130)were assigned to the control group with routine nursing.Those who received embryo transfer between March and April 2024 were assigned to the trial group(n=136)with nursing intervention based on RCA-PDCA.The two groups were compared in terms of the qualified rate of bladder filling,endometrial visualisation rate,instrument-assisted transfer rate and level of comfort.Results A total of 126 women in the control group and 131 in the trial group completed the study.The patient in the trial group demonstrated significantly higher qualified rate of bladder filling and endometrial visualisation rate in comparison with those in the control group(70.2％vs.38.1％,81.7％vs.51.6％,respectively).The trial group also had lower rates in both of the instrument-assisted transfer and the incidence of mild pain than those in the control group(2.3％vs.7.9％,32.1％vs.53.2％,respectively;P<0.05).Conclusion RCA-PDCA is effective in improving preoperative bladder filling and endometrial visualisation,reducing instrument-assisted transfer and enhancing preoperative bladder comfort in the women receiving embryo transfer.

Chronic heart failure （CHF） is the final stage of cardiovascular diseases. It is a complex syndrome， with dyspnea and edema as the main clinical manifestations， and it is characterized by complex disease conditions， difficult cure， and high mortality. Ferroptosis， a new type of programmed cell death， is different from other types of programmed cell death. Ferroptosis is iron-dependent， accompanied by lipid peroxide accumulation and mitochondrial shrinkage， becoming a hot research topic. Studies have confirmed that ferroptosis plays a key role in the occurrence and development of CHF. The regulation of ferroptosis may become a potential target for the treatment of CHF in the future. The theory of Qi deficiency and stagnation refers to the pathological state of original Qi deficiency and abnormal transportation and distribution of Qi， blood， and body fluid， which has guiding significance for revealing the pathogenesis evolution of some chronic diseases. We believe that Qi deficiency and stagnation is a summary of the pathogenesis of ferroptosis in CHF. Deficiency of Qi （heart Qi） is the root cause of CHF， and stagnation （phlegm turbidity and blood stasis） is the branch of this disease. The two influence each other in a vicious circle to promote the development of this disease. Traditional Chinese medicine （TCM） plays an important role in the treatment of CHF， improving the prognosis and quality of life of CHF patients. This paper explores the correlation between the theory of Qi deficiency and stagnation and the mechanism of ferroptosis in CHF. Furthermore， this paper reviews the mechanism of Chinese medicines and compound prescriptions in preventing and treating CHF by regulating ferroptosis according to the principles of replenishing Qi and dredging to remove stagnation， aiming to provide new ideas and methods for the treatment of CHF with TCM.

BackgroundIn recent years， the incidence of non-suicidal self-injury （NSSI） behaviors among adolescents has been increasing annually. Self-esteem and alexithymia are strongly associated with NSSI behaviors， and alienation is closely linked to both self-esteem and alexithymia. However， there is limited research on the relationship between alienation and NSSI behaviors among adolescents in China. ObjectiveTo analyze the relationship between alienation and NSSI behaviors among adolescents， and to explore the factors influencing NSSI behaviors in this population， so as to provide insights for the prevention and treatment of NSSI behaviors in adolescents. MethodsAdolescents admitted to the Department of Psychiatry and Psychology at the 923^rd Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from September 1， 2021 to March 1， 2023， who met the diagnostic criteria for NSSI in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， were selected as the study group （n=60）. Concurrently， middle school students from Nanning were recruited as the control group （n=60）. Participants were assessed using Adolescent Self Harm Scale （ASHS）， Rosenberg Self-Esteem Scale （RSES）， Toronto Alexithymia Scale （TAS） and Adolescent Students′ Alienation Scale （ASAS）. Pearson correlation analysis was employed to examine the relationships between scale scores in the study group， and Logistic regression analysis was used to identify the influencing factors of NSSI behaviors among adolescents. ResultsThe RSES score of the study group was significantly lower than that of the control group （t=-7.033， P<0.01）. The TAS and ASAS scores of the study group were significantly higher than those of the control group （t=5.591， 8.124， P<0.01）. The ASHS score was negatively correlated with RSES score （r=-0.410， P<0.01） and positively correlated with ASAS score （r=0.555， P<0.01）. The RSES scores of the study group were negatively correlated with TAS and ASAS scores （r=-0.317， -0.590， P<0.05 or 0.01）. Logistic regression analysis showed that being female （OR=0.714， 95% CI： 0.042~0.709） was a protective factor for NSSI behaviors among adolescents， while high alienation （OR=1.028， 95% CI： 1.013~1.043） and residing in rural areas （OR=6.692， 95% CI： 2.038~21.967） were risk factors for NSSI behaviors among adolescents. ConclusionAlienation was positively correlated with NSSI behaviors in adolescents. Female adolescents had a lower risk of NSSI behaviors， while those with higher levels of alienation or residing in rural areas were more prone to NSSI behaviors. ［Funded by Self-financed Scientific Research Project of the Health Commission of Guangxi Zhuang Autonomous Region （number， Z20210656）； Self-financed Scientific Research Project of the Health Commission of Guangxi Zhuang Autonomous Region （number， Z-A20231057）］

Objective To explore the application value of MR MAGiC sequence reconstructed based on deep learning reconstruction(DLR)for localizing epileptogenic focus of intractable epilepsy.Methods Fifty intractable epilepsy patients(epilepsy group)and 20 healthy controls(control group)were retrospectively collected.Brain MR MAGiC sequence was scanned,then traditional reconstruction(inverse Fourier transform)and DLR algorithm were performed to obtain MAGiC and MAGiC DLR images,respectively.The corresponding quantitative parameter maps were generated after post-processing,including T1 mapping,T2 mapping and proton density(PD)mapping.The subjective scores of noise,artifacts,structural clarity and overall quality were compared between two kinds of quantitative parameter images.The asymmetry index(AI)of quantitative parameters(T1,T2 and PD values)between the affected side and the contralateral side in epilepsy group,the contralateral side or the suspected epileptogenic focus in epilepsy group and HC group were calculated.Then epileptogenic focus were localized based on performance of MAGiC and MAGiC DLR corresponding quantitative parameter maps combining obtained AI of quantitative parameter values.According to surgical results,follow-up review,electroencephalogram or PET results,the accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was calculated.Results Compared with MAGiC quantitative parametric maps,noise of MAGiC DLR quantitative parametric maps reduced,while subjective scores of structure clarity and overall quality improved(all P＜0.05).The accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was 82.00％(41/50)and 88.00％(44/50),respectively.Conclusion MR MAGiC sequence based on DLR was beneficial for improving accuracy of localizing epileptogenic focus in intractable epilepsy.

[Purpose]To analyze the changing trends of the disease burden of liver cancer related to hepatitis B virus(HBV)globally and in China from 1992 to 2021.[Methods]Based on the Global Burden of Disease database in 2021,indicators such as the age-standardized incidence rate and mortality rate of HBV-related liver cancer globally and in China from 1992 to 2021 were collected.The Joinpoint regression model was used to analyze the changing trends of epidemiologi-cal characteristics,and the age-period-cohort model was adopted to analyze the impacts of age,period,and cohort factors on the incidence and mortality risks of HBV-related liver cancer globally and in China.[Results]From 1992 to 2021,the age-standardized incidence rate and age-standardized mortality rate of HBV-related liver cancer globally generally showed a trend of decreasing.The average annual percentage changes were-0.31％and-0.61％,respectively,and all the down-ward trends were statistically significant(both P＜0.05).During the same period,the average annu-al percentage changes of the age-standardized incidence rate and age-standardized mortality rate of HBV-related liver cancer in China were-0.45％and-0.90％,respectively,and all the downward trends were statistically significant(both P＜0.05).The results of the age-period-cohort model anal-ysis showed that from 1992 to 2021,the annual net drift rates of the incidence of HBV-related liver cancer globally and in China were-0.71％(95％CI:-0.84％～-0.57％)and-0.73％(95％CI:-1.01％～-0.44％),respectively.The annual net drift rates of the mortality were-1.15％(95％CI:-1.28％～-1.02％)and-1.42％(95％CI:-1.69％～-1.14％),respectively,all showing an over-all decline.The age effect showed that the risk of HBV-related liver cancer incidence in both the global and Chinese populations began to increase after 30 years of age,peaking in the 70～74 age group,while the risk of mortality surged after 40 years of age and peaked in the population aged 80 and above.The period effect indicated that the incidence and mortality risks were the highest from 1997 to 2001 and the lowest from 2017 to 2021.The cohort effect revealed that the inci-dence and mortality risks gradually decreased in populations born after 1962,with the 2007-2011 birth cohort having the lowest risks.The results of the Wald x2 test showed that there were statistically significant differences in the changing trends of the age,period,and cohort effects on the incidence and mortality of HBV-related liver cancer globally and in China(all P＜0.05).[Con-clusion]From 1992 to 2021,the age-standardized incidence rate and age-standardized mortality rate of HBV-related liver cancer showed a downward trend both globally and in China.The disease burden of HBV-related liver cancer in China was higher than the global level.The age-period-cohort model has revealed the historical changes in the incidence and mortality of HBV-related liver cancer.The current and future situation of the disease burden of HBV-related liver cancer is not optimistic.It is recommended to implement precise stratified interventions for populations of different ages,periods,and birth cohorts,and actively transform the prevention,treatment,and management strategies for HBV-related liver cancer.