Objective: To analyze the status of outdoor activities on weekends among children and adolescents of different educational stages in Shanghai and their impact on myopia, so as to provide a basis for formulating more specific prevention and control protocol of myopia. Methods: From September to October 2022, a stratified cluster random sampling method was employed to select 84 schools (27 kindergartens, 21 primary schools, 15 junior high schools and 21 high schools) across Shanghai, enrolling a total of 28 654 children and adolescents aged 4 to 18 for the study. Ophthalmic examinations were conducted to ascertain the prevalence of myopia among children and adolescents. Additionally, a questionnaire survey was administered to collect data on outdoor activity duration and associated factors. Multivariate Logistic regression analysis was utilized to investigate the associated factors of outdoor activity levels on weekends. Results: The overall myopia detection rate among children and adolescents was 58.4%, with a higher rate observed in girls (59.2%) compared to boys (57.6%). The myopia detection rates for children and adolescents with an average daily outdoor activity duration of ≥2 h and <2 h on weekends were 54.6% and 68.8%, and the differences were statistically significant ( χ 2=8.12,460.89, P <0.01). Multivariable Logistic regression analysis revealed that girls ( OR =0.80), those with a myopic parent ( OR =0.68), schools from urban districts ( OR =0.72), higher education stages (primary school: OR =0.65, junior high school: OR =0.24, high school: OR =0.14) and spending≥2 h/d on homework during weekends ( OR =0.57) among children and adolescents were less likely to engage in outdoor activities for ≥2 h on weekends ( P <0.01). After incorporating gender, parental myopia status, educational stage, school location, average daily duration on weekends for spending on homework, electronic product usage and outdoor activities as dependent variables in a multivariate Logistic regression analysis, the results showed that children and adolescents with an average outdoor activity duration for ≥2 h on weekends had a lower risk of myopia ( OR =0.86, P < 0.01). Conclusions The level of outdoor activity among children and adolescents on weekends needs to be improved. Outdoor activities on weekends is an associated factor for myopia among children and adolescents. Particularly, girls, those with myopic parents, schools from urban districts, and spending long hours on homework during weekends among children and adolescents require increased attention.

Objective: To investigate the visual acuity and correction conditions of children and adolescents in Shanghai, so as to provide a scientific basis for developing intervention measures to prevent myopia and protect vision among children and adolescents. Methods: From October to December 2022, a stratified cluster random sampling survey was conducted, involving 47 034 students from 16 municipal districts in Shanghai, covering kindergartens (≥5 years), primary schools, middle schools, general high schools and vocational high schools. According to the Guidelines for Screening Refractive Errors in Primary and Secondary School Students, the Standard Logarithmic Visual acuity Chart was used to examine naked vision and corrected vision of students, and general information was collected. The distribution and severity of visual impairment in different age groups were analyzed, and χ 2 tests and multivariate Logistic regression were used to explore factors associated with visual impairment. Results: The detection rate of visual impairment among children and adolescents was 76.2%, with a higher rate among females (78.8%) than males ( 73.8 %), higher among Han ethic students ( 76.2 %) than minority students (71.2%), and higher among urban students (76.7%) than suburban students (75.8%), all with statistically significant differences ( χ 2=162.6, 10.4, 5.5, P <0.05). The rate of visual impairment initially decreased and then increased with age, reaching its lowest at age 7 (53.8%) and peaking at age 17 (89.6%) ( χ 2 trend = 3 467.0 , P <0.05). Severe visual impairment accounted for the majority, at 56.6%, and there was a positive correlation between the severity of visual impairment and age among children and adolescents ( r =0.45, P <0.05). Multivariate Logistic regression showed that age, BMI, gender, ethnicity and urban suburban status were associated with visual impairment ( OR =1.18, 1.01, 1.38 , 0.79, 0.88, P <0.05). Among those with moderate to severe visual impairment, the rate of spectacle lens usage was 62.8%, yet only 44.8 % of those who used spectacle lens had fully corrected visual acuity. Females (64.9%) had higher spectacle lens usage rates than males (60.6%), and general high school students had the highest spectacle lens usage (83.9%), and there were statistically significant differences in gender and academic stages ( χ 2=57.7, 4 592.8, P <0.05). Conclusions The rate of spectacle lens usage among students with moderate to severe visual impairment is relatively low, and even after using spectacle lens, some students still do not achieve adequate corrected visual acuity. Efforts should focus on enhancing public awareness of eye health and refractive correction and improving the accessibility of related health services.

Objective: To assess the nutritional supply status of school meals for primary and secondary school students in Henan Province, so as to provide a basis for scientific guidance of school meals. Methods: During 2021-2023, 115 lunch and dinner samples were collected from 25 primary and secondary schools in Zhoukou, Anyang and Luoyang of Henan Province by a direct selection method, and 13 nutrients were determined for each sample. The nutrient supply was evaluated based on Nutrition Guidelines of School Meals and Reference Intake of Dietary Nutrients for Chinese Residents (2023 Edition). Mann-Whitney U test was used to compare the differences of nutritional supply between urban and rural schools. Results: The median values for energy (709.77 kcal,1 kcal=4.18 kJ), fat energy supply ratio (0.27) and carbohydrate energy supply ratio (0.55) in the 66 lunches and dinners from primary school were within the recommended range. The supply of protein (28.39 g) and sodium (1 464.59 mg) was excessive. The median values of zinc (2.62 mg) and dietary fiber (5.19 g) were lower than the reference values. No statistically significant differences were observed in the supply of 13 nutrients between urban and rural primary schools( U = 427.00 -633.00, P > 0.05 ). Among 49 samples from secondary schools, the median value of energy supply (930.02 kcal), carbohydrate energy ratio ( 0.54 ) and fat energy supply ratio(0.25) were within the recommended range; and the median values of protein (38.82 g) and sodium (2 556.80 mg) were higher than the standard; and the median values of calcium (250.32 mg) and vitamin B1 (0.16 mg) were lower than the standard. Additionally, the differences in the level of vitamin B2 ( U =372.00) and zinc ( U =375.00) between the urban and rural secondary schools were statistically significant ( P <0.05). Conclusion Nutrient supply of primary and secondary school meals in three cities of Henan Province is inadequate and imbalanced, and the recipe need to be further optimized and improved.

Objective: To analyze the factors related to dual use of traditional cigarettes and e-cigarettes among middle school students in Beijing, in order to provide a scientific basis for adapting to the new situation and carrying out tobacco control among adolescents. Methods: A multi stage cluster random sampling method was used to select 15 688 and 13 607 junior and senior middle school students from 16 districts in Beijing from April to June in 2019 and 2023, respectively. Online self administered questionnaires among middle school students in Beijing were completed, including use of traditional cigarettes and e-cigarettes, exposure to second hand smoke, attitudes and perceptions towards tobacco, etc. The Chi-square test was used to compare rates, and a multiple factors Logistic regression model was used to analyze related factors of traditional cigarettes and e-cigarettes dual use among middle school students. Results: The dual use rate of traditional cigarettes and e-cigarettes in 2023 had decreased to 2.46% from 4.88% in 2019 among middle school students in Beijing. The results of the multiple Logistic regression model analysis showed that among middle school students, tobacco control anywhere at home (boys: OR =0.47, girls: OR =0.34), without anyone smoking on campus in the past month (boys: OR =0.43, girls: OR =0.26) had lower risks of dual use ( P <0.05); and middle school students strongly or slightly agreeing that smoking could bring happiness (boys: OR =4.11, 2.22, girls: OR =5.32, 3.87), believing that smoking could increase attractiveness of young people (boys: OR =3.13, girls: OR =5.81), smoking cigarettes handed over by good friends (boys: OR =4.24, girls: OR =7.21), thinking smoking in the next year (boys: OR =5.77, girls: OR =7.74) had higher risks of dual use ( P <0.05).Among boys, junior middle school students ( OR =0.50), excellent academic performance ( OR =0.36), no acceptance of free tobacco products from tobacco companies ( OR =0.38), believing that smoking couldn t refresh oneself ( OR =0.37) and smoking still could pose a health hazard though not yet addictive ( OR =0.32) had lower risks of dual use ( P <0.05);and boys with a history of secondhand smoke exposure indoor outside home ( OR =2.19), believing that quitting smoking without difficulty ( OR =2.57),smoking e-cigarettes handed over by good friends ( OR =11.27) had higher risks of dual use ( P <0.05). Among girls, no acceptance of using tobacco product labeled items ( OR =0.28) had lower risks of dual use ( P <0.05); and girls whose parents both smoke ( OR =5.53), believing that quitting smoking might not be difficult ( OR =4.44) had higher risks of dual use ( P < 0.05 ). Conclusions The dual use rate of traditional cigarettes and e-cigarettes among middle school students in Beijing has decreased. It is recommended to take the construction of smoke free families as the starting point, so as to reduce indoor second hand smoke exposure and control tobacco promotions, and promote the formation of correct tobacco control culture and moral constraints among secondary school students.

Surgical treatment is one of the key approaches for non-small cell lung cancer (NSCLC). Regular postoperative follow-up is crucial for early detection and timely management of tumor recurrence, metastasis, or second primary tumors. A scientifically sound and reasonable follow-up strategy not only extends patient survival but also significantly improves quality of life, thereby enhancing overall prognosis. This consensus aims to build upon the previous version by incorporating the latest clinical research advancements and refining postoperative follow-up protocols for early-stage NSCLC patients based on different treatment modalities. It provides a scientific and practical reference for clinicians involved in the postoperative follow-up management of NSCLC. By optimizing follow-up strategies, this consensus seeks to promote the standardization and normalization of lung cancer diagnosis and treatment in China, helping more patients receive high-quality care and long-term management. Additionally, the release of this consensus is expected to provide insights for related research and clinical practice both domestically and internationally, driving continuous development and innovation in the field of postoperative management for NSCLC.

OBJECTIVE To study the improvement effects and potential mechanisms of water extract from Chrysanthemum morifolium on skeletal muscle atrophy in rats after ischemic stroke. METHODS Sprague-Dawley rats were randomly divided into sham operation group， model group， ATP group （10 mg/kg）， C. morifolium water extract high-dose and low-dose groups （1.08， 0.54 g/kg）. Except for sham operation group， ischemic stroke models were induced in rats from the other groups using middle cerebral artery occlusion. Starting from the first day after surgery， rats in each group were given corresponding drug/normal saline intragastrically， once a day， for consecutive 7 days. On the 7th day post-surgery， the rats’ body weights were measured， and their motor functions were evaluated， including Longa scores， exercise distance， grip strength； the electrophysiological signals of the skeletal muscles in rats were measured； the pathological morphology of the soleus muscle in rats was observed； the levels of tumor necrosis factor-α （TNF-α） in serum and soleus muscle were measured； the expressions of proteins related to TNF-α/c-Jun N- terminal kinase （JNK）/mitogen-activated protein kinase （MAPK） signaling pathway in the soleus muscle were determined. RESULTS Compared with sham operation group， the body weight， grip strength and exercise distance of rats were decreased/ shortened significantly （P＜0.01）； additionally， there was a notable reduction in the interpeak value of skeletal muscle electrophysiology （P＜0.05 or P＜0.01）. Longa score， as well as the levels of TNF-α in serum and soleus muscle， and the expression levels of TNF-α， phosphorylated JNK， phosphorylated MAPK， muscle ring-finger protein-1， and muscle atrophy Fbox- 1 protein in the soleus muscle， were all significantly elevated （P＜0.01）. The skeletal muscle cells of the soleus muscle in the model group showed significant atrophy， with a markedly decreased cross-sectional area （P＜0.01）. Compared with the model group， the levels of the aforementioned indicators were significantly reversed in C. morifolium water extract groups （P＜0.05 or P＜ 0.01）， and the skeletal muscle cells of the soleus muscle were markedly enlarged. CONCLUSIONS C. morifolium water extract can improve skeletal muscle atrophy in rats after ischemic stroke， the mechanism of which may be associated with suppressing the activation of the TNF- α/JNK/MAPK E-mail：19932015@cdutcm.edu.cn signaling pathway.

OBJECTIVE To identify tortoiseshell glue and antler glue in Qichong zuogui granules， and determine the contents of 12 chemical components. METHODS Identification and content determination were performed by using liquid chromatography- tandem mass spectrometry （LC-MS/MS） method. The identification was performed on Hypersil GOLD column with a mobile phase consisted of acetonitrile-0.1% formic acid solution （gradient elution）； the electrospray ion source was used to scan in the positive ion multi-reaction detection mode. The mass charge ratio （m/z） 631.3→546.4， 631.3→921.4 was the detection ion pair for tortoiseshell glue， and the m/z 765.4→554.0， 765.4→733.0 was the detection ion pair for antler glue. The determination method for 12 chemical components was as follows： Accucore C18 column， methanol-0.1% formic acid as mobile phase （gradient elution）； scanning range of positive and negative ions was m/z 100→1 000 with the electric spray ion source and single ion detection scanning mode. RESULTS Average retention times of the molecular ion peaks for characteristic peptide segments of tortoiseshell glue and antler glue were 6.28 and 6.77 min， respectively； the linear relationship of 12 chemical components was good within their respective concentration ranges， such as astragaloside Ⅳ， calycosin-7-O-β-D-glucoside， calycosin， chlorogenic acid， ferulic acid， betaine， amygdalin， rutin， hydroxysafflor yellow A， hyperoside， loganin， cyasterone （r＞0.999）； RSDs for precision， stability （24 h） and reproducibility tests were all less than 5%. The average sample recovery rates ranged from 98.04% to 101.08%. The average contents of 12 components were 1.83， 25.73， 13.76，56.71， 23.80， 49.82， 807.49， 15.01， 317.02， 60.21， 202.71 and 17.70 μg/g， respectively. CONCLUSIONS In this study， tortoiseshell glue and antler glue in Qixiong zuogui granules are identified， and the contents of 12 chemical components therein are determined. This provides a reference for the quality control of this granule.

OBJECTIVE To systematically evaluate risk prediction models for chemotherapy-induced myelosuppression in breast cancer， and provide a scientific reference for clinical healthcare workers in selecting or developing effective predictive models. METHODS A systematic search was conducted for studies on predictive models of the risk of chemotherapy-induced myelosuppression in breast cancer across the CNKI， VIP， Wanfang， PubMed， Web of Science， Cochrane Library， Embase， and Scopus databases， with a time frame of the establishment of the database to May 7， 2024. Literature was independently screened by 2 investigators， data were extracted according to critical appraisal and data extraction for systematic reviews of predictive model studies， and the risk of bias evaluation tool for predictive model studies was used to analyze the risk of bias and applicability of the included studies. RESULTS There were totally 7 studies， comprising 12 models. Among them， 11 models indicated an area under the subject operating characteristic curve of 0.600-0.908； 2 models indicated calibration. The common predictor variables of the included models were age， pre-chemotherapy neutrophil count， pre-chemotherapy lymphocyte count， and pre-chemotherapy albumin. The overall risk of bias of the 7 studies was high， which was mainly attributed to the flaws in the study design， insufficient sample sizes， inappropriate treatment of variables， non-reporting of missing data， and the lack of indicators for the assessment of the models， but the applicability was good. CONCLUSIONS The predictive performance of risk predictive models for chemotherapy-induced myelosuppression in breast cancer remains to be further enhanced， and the overall risk of model bias is high. Future studies should follow the specifications of model development and reporting， then combine machine learning algorithms to develop risk predictive models with good predictive performance， high stability， and low risk of bias， so as to provide a decision-making basis for the clinic.

OBJECTIVE To compare the long-term cost-effectiveness of gonadotrophin-releasing hormone analogue （GnRHa） combined with recombinant human growth hormone （rhGH） （combination therapy regimen） versus GnRHa monotherapy （monotherapy regimen） in the treatment of central precocious puberty （CPP）. METHODS From the societal perspective and based on a real-world study conducted at West China Second Hospital of Sichuan University， the cost-effectiveness analysis was performed to compare the long-term cost-effectiveness of two pharmacotherapy regimens for CPP girls， with final height as outcome indexes， using per capita disposable income of rural residents and urban residents （20 133-49 283 yuan） in 2022 as the social willing-to-pay （WTP） threshold. The robustness of the basic analysis result was verified by using one-way sensitivity analysis and probability sensitivity analysis， and the cost-effectiveness of different combinations of long-acting preparations was compared using scenario analysis. RESULTS The basic analysis result showed that the combination therapy regimen required an additional cost of 25 193.49 yuan for every one-centimeter improvement in the final height of girls with CPP compared with the monotherapy regimen， which was not cost-effective for residents in rural areas， but it was cost-effective for residents in urban areas. One-way sensitivity analysis showed that the uncertain factors with potential impacts on the results were， in order， the price of rhGH， the final height of pediatric patients in the combination therapy regimen group， the course of rhGH in the combination therapy regimen group， and the final height of pediatric patients in the monotherapy regimen group. Probabilistic sensitivity analysis indicated that the probability of the combination therapy regimen being cost-effective was higher than that of the monotherapy regimen when WTP was more than 26 010 yuan/cm. When GnRHa long-acting preparation was used for intramuscular injection every 3 months， the combination therapy regimen was not cost-effective for rural residents， but was cost-effective for urban residents； when rhGH long-acting preparation was injected subcutaneously once a week， the combination therapy regimen was not cost-effective for residents in both rural areas and urban areas. CONCLUSIONS The combination of GnRHa and rhGH is only recommended for CPP children with better affordability to improve final height. The benefits， risks， and affordability of treatment should be comprehensively considered before the decisions on pharmacotherapy， to avoid abuse of rhGH due to the blind pursuit of height growth.

To summarize Prof. ZHANG Zhiyuan's clinical experience in using large doses of Fuzi （Aconiti Lateralis Radix Praeparata）. The effect of Fuzi is based on its acrid and hot propoerties， warming and invigorating yang qi and running without guard. The application of large doses of Fuzi can be categorized into raw and processed， with common dosage ranging from 30 g to 60 g of raw Fuzi， and 15 g to 30 g， 30 g to 60 g of processed Fuzi. The quantity-effect relationship of the large dose of Fuzi is summarized as 15 g to 30 g of processed Fuzi could warm water， warm yang and eliminate timidity， as the treatment of asthma with deficiency cold phlegm， edema of yang deficiency， and panic and timidity of yang deficiency； 30 g to 60 g of processed Fuzi could tonify fire， warm the meridians and collaterals， assist yang to dispel cold and relieve pain， as the treatment of coldness in the limbs， abdominal pain， pain in the joints of the limbs， and loose stools due to deficient yang qi and exuberant internal yin cold； 30 g to 60 g raw Fuzi could restore yang to save from collapse， as the treatment of yang depletion after profuse sweating and vomiting. At the same time， different dosages of Fuzi were flexibly paired with other medicines， i.e.， 15 g to 30 g of processed Fuzi was paired with Mahuang （Ephedrae Herba） and Xixin （Asari Radix et Rhizoma） to assist yang to dispel coldness， 30 g to 60 g of processed Fuzi was paired with Baizhu （Atractylodis macrocephalae rhizoma） or Wuzhuyu （Euodiae Fructus） to warm yang and dispel dampness， and 30 g to 60 g of raw Fuzi was paired with Shanzhuyu （Corni Fructus） to tonify both yin and yang.