Objective: To explore the independent and interactive effects of school green space exposure and outdoor activity duration on screening myopia among primary and secondary school students, so as to provide theoretical support for the prevention and control of screening myopia in children and adolescents. Methods: From September to November 2023, 117 487 primary and secondary school students from 497 schools were selected using a cluster random sampling method, covering 98 counties (cities, districts) in Jiangsu Province. Data on the students screening myopia status and associated health influencing factors were collected and analyzed. School green space exposure was quantified using the normalized difference vegetation index (NDVI), which was extracted with ArcGIS Pro software; meanwhile, information on students outdoor activity duration was gathered through self reported questionnaires. Multivariate Logistic regression was applied to assess the independent and interactive effects of green space exposure and outdoor activity duration on screening myopia among primary and secondary school students. Results: Univariate analysis showed that there were statistically significant differences in screening myopia detection rates among primary and secondary school students of different genders, NDVI groups, every outdoor activity duration, monitoring points, school stages, parents educational level, and whether they lived on campus or had parents with screening myopia ( χ 2=88.91-1 950.08, all P <0.05); as the school age and sedentary time increased, the detection rate of screening myopia in primary and secondary school students also increased ( χ 2 trend =8 410.15, 2 028.91, both P <0.05). Independent effects showed that compared to the low NDVI group, the medium and high NDVI groups had lower risks of screening myopia ( OR =0.93, 0.95, both P <0.05). Compared to those with outdoor activity duration<2 h/d, students with outdoor activity duration≥2 h/d had a lower risk of screening myopia ( OR =0.96, P <0.05). When stratified by school level, compared to the low NDVI group, the medium NDVI group had lower risks of screening myopia in primary and junior high schools (primary school: OR =0.91; junior high school: OR =0.88, both P <0.05). Compared to those with outdoor activity duration<2 h/d, junior high school students with outdoor activity duration≥2 h/d had a lower risk of screening myopia ( OR = 0.90, P <0.05). When stratified by monitoring site, urban primary and secondary school students in the medium and high NDVI groups and those with outdoor activity duration≥2 h/d had lower risks of screening myopia ( OR =0.92, 0.92, 0.93, all P <0.05). Interactive effects showed that when medium or high NDVI was combined with outdoor activity duration≥2 h/d, the risks of screening myopia among primary and secondary school students were lower (medium NDVI×≥2 h/d: OR =0.89; high NDVI×≥ 2 h/d : OR =0.89, both P <0.05), and the combined effect was superior to that of a single factor. Conclusion Green space exposure and outdoor activity duration have negative correlations with screening myopia among primary and secondary students, and the combined effect is better than that of a single factor.

Objective: To investigate the association between outdoor light at night (LAN) exposure and sleep quality among primary and secondary school students, and to examine the pathways of negative affects including depressive, stress and anxiety symptoms, so as to provide a theoretical basis for optimizing the school environment and enhancing the physical and mental well being of students. Methods: In December 2024, a total of 36 885 students from 154 primary and secondary schools in Suzhou, Nantong, and Changzhou were included via a stratified cluster sampling method. Sleep quality and negative affect were assessed by using the Pittsburgh Sleep Quality Index (PSQI), Center for Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder-7 (GAD-7), and Depression, Anxiety and Stress Scale-21 (DASS-21), respectively. Outdoor LAN exposure data were obtained from the national polar orbiting partnership visible infrared imaging radiometer suite nighttime light(NPP-VIIRS NTL) dataset provided by the National Earth System Science Data Center. Multivariate Logistic regression model was employed to analyze the association between LAN exposure and sleep quality across different regions, with stratification by monitoring site. Spearman correlation analysis was used to examine the relationships between LAN, negative affect, and sleep quality. The mediating role of negative affect was tested by using Model 4 of the PROCESS macro. Results: The detection rates among students were 13.95%( n =5 147) for depressive symptom, 16.72%( n =6 166) for stress symptom, and 17.49%( n =6 451) for anxiety symptom. The median outdoor LAN exposure was 28.85(19.10, 41.44)nW/(cm 2 · ( sr). After adjusting for confounders, multivariate Logistic regression analysis showed that high LAN exposure ( Q 4) was positively associated with sleep problems (urban areas: OR =1.28, 95% CI = 1.17- 1.41; rural areas: OR =1.21, 95% CI =1.07-1.36; both P <0.05). Spearman correlation analysis revealed significant positive correlations between LAN exposure, depressive symptoms, stress symptoms, anxiety symptoms, and sleep quality ( r =0.03-0.75, all P < 0.01). The mediation analysis indicated that all dimensions of negative affect significantly mediated the relationship between high LAN exposure and poor sleep quality (all P <0.01). Specifically, the indirect effects were 0.03 (95% CI =0.02-0.05) for depressive symptom, 0.05(95% CI =0.03-0.08) for stress symptom, and 0.07(95% CI =0.05-0.09) for anxiety symptom. Overall, 31.9% of the total effect was mediated by negative affect, with anxiety (14.89%) being the strongest mediator, followed by stress (10.64%) and depression(6.38%). Conclusion Reducing high levels of outdoor LAN exposure and implementing interventions targeting negative affect may contribute to improved sleep quality among primary and secondary school students.

Idiopathic oligoasthenospermia （IO） has been increasingly emphasized in the diagnosis and treatment of male infertility. Oxidative stress damage directly affects sperm quality and spermatogenesis， constituting a major causative factor of IO. Firstly， due to its high content of polyunsaturated fatty acids， the sperm plasma membrane is highly sensitive to reactive oxygen species （ROS）， leading to lipid peroxidation accumulation and even inducing ferroptosis. Secondly， deficient downstream key proteins in the base excision repair pathway render sperm unable to repair extensive DNA oxidative damage under oxidative stress. Simultaneously， under oxidative stress， the apoptotic pathway of sperm is cascade-activated， causing rapid loss of motility. ROS further disrupts the hypothalamic-pituitary-gonadal axis， inhibiting testosterone production and ultimately affecting spermatogenesis. Wuzi Yanzongwan，in line with traditional Chinese medicine theory of treating IO through "nourishing kidney essence and harmonizing Yin and Yang"， clinically demonstrates its ability to improve sperm morphology， count， and motility， thereby enhancing male fertility. The research on the pharmacological constituents of Wuzi Yanzongwan primarily involves establishing a characteristic spectrum of Chinese medicine to achieve quality control and exploring the pharmacology of effective components. Studies have found that its main active ingredients consist of flavonoids and phenylpropanoids. Specifically， compounds such as hyperin， acteoside， kaempferol， and schisandrin A are identified as the primary active substances and quality control components. These compounds exhibit strong antioxidant activity and have been partly applied in research related to reproductive endocrine disorders. Tripterygium glycoside is primarily used for modeling of oxidative stress-induced IO. It leads to the accumulation of various lipid peroxides in testicular tissues and concurrently compromises the body's antioxidant capacity. Mechanistic studies have found that Wuzi Yanzongwan can inhibit elevated ROS levels in IO models and enhance the body's antioxidant capacity， thereby ameliorating inflammation， suppressing cell apoptosis， promoting testosterone production， and ultimately alleviating the decline in sperm quality and spermatogenesis caused by oxidative stress.

Objective: To assess the effectiveness of online and offline myopia prevention and control health education interventions using wearable behavior monitoring tools for non myopic elementary school students,so as to provide evidence based medical support for public health practices. Methods: From May to June in 2021, two schools were selected within the same county in Jiangsu Province. School 1 conducted online and offline parental health education ( n =111), while school 2 exclusively conducted offline health education activities, representing the traditional intervention group ( n =122). Students from both schools underwent monitoring through wearable behavior tracking tools, with feedback reports provided (eye distance, eye duration, ambient light, and outdoor exposure time). Both schools relied on activities to carry out health education interventions, and organized the distribution of promotional materials and display boards. The intervention group also established WeChat groups to conduct online "Healthy Parents Action" (answering and providing feedback on health knowledge related to myopia prevention and control, myopia prevention and control, science popularization, etc. raised by parents). Evaluation criteria included myopia rates, post dilation refractive error, and axial length, with a tracking period of two years (from 2021 to 2023). Additionally, the study collected refractive parameters from non myopic students who did not participate in wearable tool monitoring in the 12 classes across the two schools. Results: The baseline results indicated that there were no significant differences between the two groups in terms of refractive parameters and wearable tool monitoring results (including screen time, viewing distance, outdoor exposure time, and homework light exposure)( t/Z/χ 2=1.94,1.17,0.58,0.40,0.80,0.69,0.32, P >0.05). After a two-year follow up, in the first and second year, the myopia rate of the online Healthy Parents Action group (11.4%, 29.7%) were lower than that of the traditional group (26.2%, 50.9%), and the degree of refractive change in the intervention group [0.63(0.38,1.19)D] was lower than that of the traditional group [0.91(0.40,1.50)D], and all the differences were statistically significant( χ 2/ Z =4.93，10.37，2.29， P <0.05). However, there were no significant differences ( P >0.05) in axial length changes between the two groups over the twoyear intervention period. Nevertheless, in the second year, the axial length change in the traditional group [0.35(0.20,0.65)mm] was lower than that in the natural observation group [0.55(0.30,0.75)mm], and this difference was statistically significant ( Z =1.92, P <0.05). Conclusions Online and offline myopia prevention and control health education can effectively reduce myopia rates. The intervention mode combining wearable behavior monitoring tools with online health education may have better effects, but further large sample and multi center studies are needed to provide additional evidence and confirmation.

Objective: To explore the influencing factors of exposure to campus bullying among junior and senior school students, and to establish a column line diagram model for risk prediction, while providing a theoretical basis for campus bullying prevention and control in secondary schools. Methods: A total of 22 034 junior and senior school students were selected via direct sampling technique from September to November 2021 in 13 cities in Jiangsu Province, China, and questionnaires were administered using the Student Health Behavior Questionnaire. The Chi squared test and multifactor Logistic regression analysis were used to derive the influencing factors of exposure to campus bullying, and a column line graph prediction model was drawn. Results: A total of 540 students reported that they had experienced campus bullying, with a prevalence rate of 2.45%. Being in a non conventional family ( OR =1.30,95% CI =1.02-1.65), overweight/obesity ( OR =1.35,95% CI =1.09-1.67), scolding by parents in the past 30 days ( OR =2.27,95% CI =1.82-2.84), cigarette smoking in the past 30 days ( OR =1.54,95% CI =1.11-2.15), Internet addiction ( OR =2.03，95% CI =1.34-3.08), and depressive symptoms( OR =5.24，95% CI =4.16-6.61), all of which were positively correlated with exposure to campus bullying among junior and senior school students ( P <0.05). Furthermore, the following factors were negatively associated with junior and senior school students protection from campus bullying in female students ( OR = 0.58 , 95% CI =0.46-0.72)，senior school students ( OR =0.68，95% CI =0.54-0.83), eating breakfast sometimes ( OR =0.37，95% CI = 0.22 -0.62), and eating breakfast everyday ( OR =0.28，95% CI =0.17-0.49) ( P <0.05). The column line graph established based on the above influencing factors had an area under the curve of 0.792 (95% CI =0.769-0.815), and the calibration curve showed that the predicted value was basically the same as the measured value. Conclusions Non conventional families, overweight/obesity, male students, junior school students, scolding by parents, cigarette smoking, Internet addiction, and depressive symptoms are correlated with school bullying among middle school students. The predictive model constructed in the study can provide an effective basis to predict the risk of school bullying and facilitate the implementation of proactive interventions for junior and senior school students.

OBJECTIVE： To optimize the integrated processing technology for “precise decoction pieces” of Helianthus annuus. METHODS： The contents of total flavonoids and total protein in H. annuus were determined by UV spectrophotometry with rutin and bovine serum albumin as control. Refering to Chinese Pharmacopoeia， the contents of water soluble extract， dilute ethanol extracts and ethyl acetate extract were determined. Based on the different needs such as maintaining quality consistency with the original medicinal materials， preference for anti-gout treatment， preference for liver calming and pain relief， using the contents of total flavonoids， total protein and 3 kinds of polar extract as indexes， gray correlation method was used to optimize the integrated processing technology of 3 kinds of “precise decoction pieces” of H. annuus. RESULTS： Gray correlation analysis showed that the ideal sample sequence of decoction pieces in massive shape dried at 60 ℃ with the original medicinal materials and decoction pieces with preference use of liver calming and pain relief was the most relevant； the ideal sample sequence of ideal sample sequence of decoction pieces in massive shape dried in the shade with decoction pieces with clinical application preference of anti-gout therapy was the most relevant. CONCLUSIONS： Different integrated processing technology for “precise decoction pieces” of H. annuus can be adopted for different needs. If it is necessary to keep the quality consistent with the original medicinal materials or to prepare H. annuus decoction pieces for liver calming and pain relieving， medicinal material can be cut into massive shape and dried at 60 ℃； if it is necessary to prepare H. annuus decoction pieces for anti-gout treatment， cutting into massive shape and drying in the shade can be adopted.

OBJECTIVETo explore the technique of temperature control on the abdomen in penetrating moxibustion through observing moxibustion time on the abdomen, abdominal skin temperature and effect after moxibustion so as to provide the safe, effective and easily applicable method for penetrating moxibustion.

METHODSThirty-two patients were selected in an observation group, 32 healthy persons in a control group. In the observation group, the penetrating moxibustion was applied to the corresponding acupoint locations according to different symptoms. In the control group, moxibustion was used on the abdomen around the umbilicus. The skin temperature was recorded once every minute. The skin temperature of known heat sensation, the time of known heat sensation, the known reduced temperature, the time of temperature reducing, the skin temperature difference, the duration of penetrating moxibustion and the reaction of moxibustion from participants were recorded.

RESULTSThe differences in the skin temperature of known heat sensation, the time of known heat sensation and the duration of penetrating moxibustion were significant statistically in comparison between the observation group and the control group (all P<0.01). The differences in the known reduced temperature, the time of temperature reducing and the skin tem- perature difference were not significant (all P>0.05). The differences were significant statistically in skin rashes and moxibustion reaction (gastrointestinal peristalsis, chills, ant climbing feeling and hunger, etc.) between the two groups (P<0.01). The differences were not significant statistically in flushing, sweating and blisters (all P>0.05).

CONCLUSION(1) The level of temperature sensitivity in the observation group is lower than that in the control group. During penetrating moxibustion, the sensations such as gastrointestinal peristalsis, chills, ant climbing feeling and hunger appear easily, suggesting the positive self-adjustment in the body. (2) During penetrating moxibustion, the warm feeling is penetrated not just from the epidermis to the abdominal cavity and lumbar region, but also up to thehead and down to the knee. (3) The flushing, sweating and skin rashes are the important indices for the effectiveness of penetrating moxibustion. (4) The temperature control is the core technique of penetrating moxibustion. The penetrating moxibustion in 28 min to 32 min and the temperature controlled in 43 degrees C to 45 degrees C can solve the moxibustion smoky impact to the environment, but also relieve pains of the patients.

Abdomen ; physiology ; Acupuncture Points ; Adult ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Skin Temperature ; Thermosensing ; Young Adult

Objective: To explore the ralationship between common used TCM prescriptions and syndrome elements in acute ischemic stroke and to lay a foundation for further study of the correspondence of the prescription and the syndrome. Methods: We extracted the clinical information of 359 patients (451cases) who were in accordance with the inclusive criteria and were given Wendan Decoction, Xinglou Chengqi Decoction, Zhengan Xifeng Decoction and Tianma Gouteng Decoction, Buyang Hanwu Decoction and Banxia Baizhu Tianma Decoction. We investigated the correlation between six prescriptions and six syndrome elements through comparing the mean value of score of each syndrome element which was corresponding to each prescription. Then we obtained their odds ratio by using the multiple logistic regression. Results: The mean value of wind syndrome, fire syndrome and phlegm syndrome were the top three in the cases who drank Wendan Decoction, Xinglou Chengqi Decoction, Zhengan Xifeng Decoction. The mean values of wind syndrome, phlegm syndrome, syndrome of blood stasis were in the top three in the cases who drank Buyang Huanwu Decoction. By analyzing logistic regression, Wendan Decoction had close correlation with phlegm syndrome, Xinglou Chengqi Decoction had close correlation with phlegm syndrome or fire syndrome, Tianma Gouteng Drink had close correlation with syndrome of hyperactivity of yang due to yin deficiency, Buyang Huanwu Decoction had close correlation with syndrome of qi deficiency or syndrome of blood stasis, Banxia Baizhu Tianma Decoction had close correlation with wind syndrom or phlegm syndrome, and the correlations above were all positive, Zhengan Xifeng Decoction had close correlation with phlegm syndrome or syndrome of qi deficiency, and their correlation was negative. Conclusion: The prescription corresponded with the syndrome element, and it was the key points in clinical practice.