Objective: To explore the effects of the school based integrated horticulture curriculum intervention on 24 hour activity behaviors among third grade primary school students, so as to provide reference for promoting children s health. Methods: In September 2023, a convenience sampling method was used to select 90 third grade primary school students from a primary school in Changsha. Participants were randomly assigned to an intervention group ( n =45) and a control group ( n =45) using a random number table. From February to May 2024, the intervention group received a 12 week integrated curriculum intervention, consisting of two 60 minute sessions per week and covering horticultural practice, home-school collaborative tasks and nutrition knowledge education. The control group continued with routine labor education courses. The triaxial accelerometer and multi sensor sleep monitoring device were used to objectively measure light intensity physical activity (LPA), moderate to vigorous physical activity (MVPA), screen based sedentary behavior (SSB) and sleep (SLP), durations in both groups. Data were analyzed using generalized estimating equations (GEE) and Mann-Whitney U tests. Results: The time, group and interaction effects of MVPA time and SLP time before and after intervention in two groups of primary school students were not statistically significant (Wald χ 2=1.54, 2.97, 0.85 ; 0.75, 1.05, 0.48), and the group effect of LPA time (Wald χ 2=1.24) and the time and group effects (Wald χ 2=3.02, 1.18 ) were not statistically significant (all P >0.05). There were statistically significant time and interaction effects for LPA time, as well as interaction effect for SSB time in two groups of primary school students before and after intervention (Wald χ 2=4.78, 3.95, 12.60, all P <0.05). After intervention, LPA time of intervention group [152.23(59.15, 245.80)min] was higher than that of control group [120.70(29.90, 201.20)min], and SSB time of intervention group [55.50(30.00, 125.50)min] was lower than that of control group [220.00(60.00, 285.00)min], with statistically significant differences ( Z =-2.46, -4.48, both P <0.05). Conclusion The school horticulture curriculum effectively enhances daily LPA and reduces SSB among third grade primary school students.

With the deepening of population aging and the rising prevalence of chronic diseases among the elderly in China， the traditional elderly care models are facing challenges. This paper proposed a community-integrated medical-nursing-rehabilitation-care service model， characterized by “integration， flexibility， community orientation， and demand orientation.” This model optimizes and combines various service resources such as healthcare， elderly care， rehabilitation， and nursing at the community level， providing more comprehensive and targeted services for the elderly with chronic diseases in the community. However， a series of challenges existed in dimensions such as the service integration， benefit distribution， resources and funds， as well as policies and systems， hindering the sustainable development of the community-integrated medical-nursing-rehabilitation-care service model. Future efforts should focus on constructing a more standardized collaborative system， clarifying standards for resource investment and benefit distribution， as well as strengthening policy guidance， financial support， and talent team development.

Colorectal cancer has an insidious onset， and some patients have already developed local invasion or metastasis at the time of diagnosis， which affects treatment strategy selection and survival prognosis. The tumor microenvironment is not only the basic condition for tumor cell survival but also the core regulatory factor driving their local invasion and distant metastasis. This article reviewed the mechanisms by which traditional Chinese medicine regulates the tumor microenvironment to inhibit colorectal cancer metastasis. It was found that traditional Chinese medicine active ingredients such as astragalus polysaccharides， leonurine， kaempferol， etc.， as well as traditional Chinese medicine formulas such as Jianpi jiedu formula， can inhibit colorectal cancer metastasis by regulating key links of the tumor microenvironment， including immunosuppression， inflammatory response， intestinal microecological disorder， abnormal angiogenesis， and extracellular matrix homeostasis imbalance. However， current related research was still mainly based on cell and animal experiments， with limited clinical evidence-based data， and mechanistic studies mostly focued on single signaling pathways. Future research should integrate multi-omics technologies and systems biology methods to systematically elucidate the key targets and action networks through which traditional Chinese medicine regulates the colorectal cancer tumor microenvironment to combat metastasis.

Objective: To analyze the epidemiological characteristics of hand, foot and mouth disease (HFMD) among children aged 0-9 years in Guangzhou, so as to provide reference basis for further exploring scientifically effective prevention and control measures. Methods: Reported cases of HFMD in children aged 0-9 years in Guangzhou City from 2013-2025 were selected from China disease prevention and control information system, and the incidence in different years was analyzed descriptively; the trends of the composition ratio and incidence in various age groups were analyzed by using the Joinpoint regression model, spatial autocorrelation analyses were performed at the district level, and the seasonal autoregressive integrated moving average model (SARIMA) was applied to predict annual incidence rate for 2026. Results: From 2013 to 2025, the average annual reported incidence rate of HFMD among children aged 0-9 years in Guangzhou was 2 513.98/100 000, showing a fluctuating trend. Peaks of incidence occurred from May to July and from September to October. The male to female ratio was 1.49∶1. The average annual incidence rate was 4 743.99/100 000 in the 0-1 years age group, 3 298.19/100 000 in the 2-5 years age group, and 544.22/ 100 000 in the 6-9 years age group. Joinpoint regression analysis showed a decreasing trend in the proportion of the 0-1 years age group (APC= -6.02 %, t =-3.77) and an increasing trend in the proportion of the 6-9 years age group (APC=16.39%, t =5.67) (both P < 0.05 ). No significant global spatial clustering was observed at the district level; however, local scattered clusters were identified in certain areas. Using the SARIMA(2,0,0)(2,0,0) 12 model, the predicted annual incidence rate of HFMD among children aged 0-9 years in Guangzhou in 2026 was 2 680.56/100 000. Conclusions From 2013 to 2025, the annual incidence rate of HFMD among children aged 0-9 years in Guangzhou exhibited a fluctuating trend; the highest incidence rate is observed in the 0-1 years age group, while the proportion of cases in the 6-9 years age group increase year by year;and local spatial clusters of abnormal distribution are identified. It is essential to enhance risk monitoring and health education in key populations and areas to mitigate the risk of infection in children.

ObjectiveTo investigate the effects of Liuwei Dihuangwan on mammalian target of rapamycin （mTOR）-mediated synaptic plasticity in the prefrontal cortex-hippocampus circuit in the rat model of valproic acid （VPA）-induced autism spectrum disorder （ASD） and to explore its potential mechanism for reducing behavioral abnormalities in ASD rats. MethodsThirteen SD pregnant rats were randomized into the VPA group （10 rats） and the control group （3 rats）. On gestational day 13， the VPA group was intraperitoneally injected with VPA solution （600 mg·kg^-1）， while the control group was injected with an equal volume of normal saline. Male pups of 21 days old from both groups underwent behavioral tests to screen the ASD model rats （32 rats）. These rats were then randomly assigned to the model （distilled water）， vitamin D （1 480 U·kg^-1）， low-dose （0.75 g·kg^-1） Liuwei Dihuangwan， and high-dose （1.5 g·kg^-1） Liuwei Dihuangwan groups， and normal male pups were selected as the blank group （distilled water）， with 8 rats in each group. Each group was treated with the corresponding drug or an equal volume of distilled water via gavage daily. After drug administration， behavioral tests were conducted again， followed by anesthesia and tissue collection. Nissl staining was carried out to observe the morphological changes of neurons in the prefrontal cortex and hippocampus. Transmission electron microscopy was used to observe changes in hippocampal synaptic structure. Immunohistochemistry and Western blot were employed to determine the expression of mTOR， phosphatidylinositol 3-kinase （PI3K）， and protein kinase B （Akt） in the prefrontal cortex， as well as synaptophysin-1 （SYP-1）， postsynaptic density 95 （PSD95）， and N-methyl-D-aspartate receptors （NMDARs） in the hippocampus. ResultsCompared with the control group， the model group exhibited severe growth retardation and developmental deformities， with abnormal behavioral performance and pathological damage to neurons and synapses in the prefrontal cortex and hippocampus. Compared with the model group， all treatment groups showed reduced behavioral abnormalities and pathological damage to neurons and synapses in the prefrontal cortex and hippocampus， with the most significant effects in the high-dose Liuwei Dihuangwan group. Immunohistochemistry and Western blotting results showed that compared with the control group， the model group exhibited significantly increased protein levels and phosphorylation ratios of p-mTOR， p-Akt， and p-PI3K in the prefrontal cortex （P<0.05， P<0.01）， and decreased protein levels of SYP-1 and PSD95 and increased protein level of NMDARs in the hippocampus （P<0.01）. Compared with those in the model group， the protein levels of p-mTOR， p-Akt， and p-PI3K in the prefrontal cortex decreased in the vitamin D and high-dose Liuwei Dihuangwan groups （P<0.05）， and the p-mTOR/mTOR， p-Akt/Akt， and p-PI3K/PI3K ratios in the prefrontal cortex declined in the vitamin D group （P<0.05）. The high-dose Liuwei Dihuangwan group showed a reduction in p-PI3K/PI3K ratio （P<0.05）. The protein level of SYP-1 and PSD95 in the hippocampus increased in the vitamin D， low-dose Liuwei Dihuangwan， and high-dose Liuwei Dihuangwan groups （P<0.05， P<0.01）， while the protein level of NMDARs decreased in the vitamin D and high-dose Liuwei Dihuangwan groups （P<0.01）. ConclusionLiuwei Dihuangwan significantly reduces VPA-induced ASD-like behaviors and enhances the regeneration and repair of neurons in the prefrontal cortex and synaptic structures in the hippocampus by downregulating of PI3K/Akt/mTOR expression in the prefrontal cortex， upregulating SYP-1 and PSD95 expression in the hippocampus， and inhibiting NMDARs expression.

ObjectiveTo assess the predictive value of the bladder deformation index (BDI) in determining upper urinary tract (UUT) damage among patients with neurogenic bladder (NB). MethodsClinical data of 132 NB patients admitted to Beijing Bo'ai Hospital from January, 2015 to December, 2018 were retrospectively analyzed. Patients were divided into UUT damage group and normal UUT group according to the presence or absence of hydronephrosis. The demographics, biochemical parameters and video-urodynamics (VUDS) findings were collected, and BDI was calculated. Receiver operating characteristic (ROC) curves were utilized to evaluate the predictive capability. ResultsThere were 54 patients in UUT damage group and 33 in normal UUT group. The course of disease, creatinine level and BDI were siginificantly different between two groups (P < 0.05), while the area under the curve were 0.686, 0.836 and 0.928, respectively. ConclusionCourse of disease, creatinine level and BDI are associated with UUT damage in NB patients, and BDI demonstrates the highest sensitivity and specificity, which may play a role in diagnosis of UUT damage.

Objective: To explore the feasibility of synthetic magnetic resonance imaging (syMRI) combined with clinicopathological characteristics for the pre-treatment prediction of chemoradiotherapy (CRT) response in advanced nasopharyngeal carcinoma (ANPC). Materials and Methods: Patients with ANPC treated with CRT between September 2020 and June 2022 were retrospectively enrolled and categorized into response group (RG, n = 95) and non RGs (NRG, n = 32) based on the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. The quantitative parameters from pre-treatment syMRI (longitudinal [T1] and transverse [T2] relaxation times and proton density [PD]), diffusion-weighted imaging (apparent diffusion coefficient [ADC]), and clinicopathological characteristics were compared between RG and NRG. Logistic regression analysis was applied to identify parameters independently associated with CRT response and to construct a multivariable model. The areas under the receiveroperating characteristic curve (AUC) for various diagnostic approaches were compared using the DeLong test. Results: The T1, T2, and PD values in the NRG were significantly lower than those in the RG (all P < 0.05), whereas no significant difference was observed in the ADC values between these two groups. Clinicopathological characteristics (Epstein–Barr virus [EBV]-DNA level, lymph node extranodal extension, clinical stage, and Ki-67 expression) exhibited significant differences between the two groups. Logistic regression analysis showed that T1, PD, EBV-DNA level, clinical stage, and Ki-67 expression had significant independent relationships with CRT response (all P < 0.05). The multivariable model incorporating these five variables yielded AUC, sensitivity, and specificity values of 0.974, 93.8% (30/32), and 91.6% (87/95), respectively. Conclusion SyMRI may be used for the pretreatment prediction of CRT response in ANPC. The multivariable model incorporating syMRI quantitative parameters and clinicopathological characteristics, which were independently associated with CRT response, may be a new tool for the pretreatment prediction of CRT response.

Since the first successful transcatheter aortic valve replacement (TAVR) was performed globally in 2002, the TAVR technology has become increasingly mature. With more than a decade of development in China, its application experience, device research and development, procedural improvements, evidence-based medicine, and guideline updates have continuously progressed, leading to a significant increase in the number of procedures conducted. Compared to traditional surgical operations, TAVR has different postoperative monitoring points and principles for the prevention and management of complications, necessitating the formulation of corresponding monitoring and treatment protocols that align with the technical characteristics of the procedure. This guideline is based on clinical practice and incorporates both domestic and international literature as well as the experiences of Fuwai Hospital. It distills and organizes routine postoperative monitoring practices, process optimization, and complication management for TAVR, establishing a set of practical guidelines for postoperative monitoring in China. These guidelines have strong practical value for optimizing postoperative management strategies and preventing and managing complications, which is beneficial for early functional recovery of patients, shortening hospital stays, and reducing complication rates. They provide guidance and reference for domestic peers and support the standardized development and quality improvement of postoperative management for TAVR in China.

Peri-implant diseases have a relatively high incidence,and immune-inflammatory re-sponses are closely associated with peri-implant mucositis and peri-implantitis.The complement sys-tem is a vital component of the immune system.Its activation not only regulates the initiation and pro-gression of inflammatory responses but also plays a crucial role in bone remodeling.This review sum-marizes the roles of the core complement components C3 and C5 in various stages of bone remodeling after implant placement,as well as in peri-implant mucositis and peri-implantitis.The aim of the pa-per was to provide novel insights for the prevention and treatment of peri-implantitis through targeted regulation of complement protein levels.

Objective:To elucidate the expression of angiopoietin-like protein 4 (ANGPTL4) in LPS-induced septic cardiomyopathy tissue and cardiomyocyte, and to explore the mechanism of ANGPTL4 in septic cardiomyopathy.Methods:Fifty C57BL/6 mice, aged 8 weeks, were randomly(random number) divided into a treatment group (LPS) and a control group ( n = 25 each). The mice in the treatment group were intraperitoneally injected with LPS (10 mg/kg) to establish a sepsis model. After 24 h, the myocardial tissues of the mice in the sepsis group and the control group, which were caused by LPS, were collected for RNA sequencing to pick out the differentially expressed gene of ANGPTL4.Ventricular myocytes of neonatal mice were taken, and the silencing and overexpression vectors of ANGPTL4 were transfected. After 48 hours of transfection, the cells were collected for subsequent detection. Western blot method was used to detect the expression of apoptotic factors Bax, Bcl-2, and Caspase 3 in mouse ventricular myocytes; CCK8 method was used to detect the activity of ventricular myocytes; using the Annexin V-FITC and PI double staining method, the apoptosis of ventricular myocytes was detected. Results:RNA-seq analysis revealed a statistically significant upregulation of ANGPTL4 expression at both transcriptional and translational levels in the ventricular tissue of septic mice, as compared to the control group ( P<0.05). The results of qRT-PCR and Western blot indicated that the mRNA and protein levels of ANGPTL4 in the ventricular tissues and cardiomyocytes of mice treated with LPS were significantly increased ( P<0.05). After transfection of the silencing and overexpression vectors of ANGPTL4 in cardiomyocytes, it was found that compared with NC, the mRNA and protein expression levels of ANGPTL4 in the si-ANGPTL4 group significantly decreased ( P<0.05), the vitality of ventricular myocytes increased ( P<0.05), the expressions of apoptosis-related factors Bax and Caspase 3 significantly decreased ( P<0.05), and the expression of Bcl-2 significantly increased ( P<0.05), and the number of apoptotic cells significantly decreased ( P<0.05); while the transfection of the overexpression vector of ANGPTL4 showed an opposite trend. Conclusions:In septic myocardial tissue and cardiomyocyte, the expression of ANGPTL4 is elevated, resulting in the inhibition of ventricular myocyte viability and the promotion of cardiomyocyte apoptosis.