BACKGROUND:Observational studies have shown that intervertebral disc degeneration affects sedentary and physical activity levels;however,the causal relationship between sedentary and physical activity levels in the Oswestry disability index score and intervertebral disc degeneration is unclear. OBJECTIVE:To explore the causal relationship between sedentary and physical activity levels in the Oswestry disability index score and intervertebral disc degeneration using the Mendelian randomization method. METHODS:Five features associated with behavioral correlations in the Oswestry disability index score,including time spent watching TV,time spent on the computer,and light/moderate/vigorous physical activity,were selected from large-scale population-based genome-wide association studies,and instrumental variables were extracted for each of these behaviorally related features.Mendelian randomization analyses were performed in conjunction with the extraction of intervertebral disc degeneration as an outcome from the Finn Gen latest version 9 database.The results were analyzed using the inverse variance weighted,MR-Egger regression,simple mode,weighted mode,weighted median estimator,and regression model odds ratios(OR)and 95%confidence interval(CI)to assess the causal relationship between sedentary and physical activity levels in the Oswestry disability index scoring and intervertebral disc degeneration.Cochran's Q was used to test for heterogeneity,MR-Egger intercept to test for multiplicity,and leave-one-out to test the sensitivity of single nucleotide polymorphisms to the causal relationship between exposure factors and disc degeneration. RESULTS AND CONCLUSION:The results of the Mendelian randomization analysis using inverse variance weighted method showed a positive causal association between time spent watching TV/on the computer and the risk of intervertebral disc degeneration(OR=1.775,95%CI:1.418-2.221,P<0.001)/(OR=1.384,95%CI:1.041-1.839,P<0.001),an inverse causal association between light physical activity and the risk of intervertebral disc degeneration(OR=1.000,95%CI:0.999-1.000,P=0.020).MR-Egger intercept analysis indicated there was potential horizontal polytropy between light physical activity and intervertebral disc degeneration(P=0.005),while there was no horizontal pleiotropy between time spent watching TV,time spent on the computer and intervertebral disc degeneration(P=0.521,P=0.851).Cochran's Q analysis showed that heterogeneity was observed between time spent watching TV,time spent on the computer and intervertebral disc degeneration(P=3.33×10-11,P=0.001),and no significant heterogeneity was observed between light physical activity and intervertebral disc degeneration(P=0.186).Overall,there is a bidirectional causal relationship between sedentary and physical activity levels in the Oswestry disability index score and intervertebral disc degeneration,i.e.,not only does intervertebral disc degeneration affect sedentary and physical activity levels in the Oswestry disability index score,but sedentary and physical activity levels in the Oswestry disability index score also affect intervertebral disc degeneration.These findings add to the genetic evidence for a positive effect of light physical activity on intervertebral disc degeneration,indicate that moderate/vigorous physical activity shows no significant causal relationship with intervertebral disc degeneration,and expand the evidence base for sedentary behaviors such as prolonged time spent watching TV/on the computer as a risk factor for intervertebral disc degeneration.

Objective The complex evolutionary history of the origin of medicinal blue herbs might result in the presence of adulterants, affecting the accuracy and safety of clinical medication. To provide a reference basis for the identification of medicinal blue herbs with leaves as the medicinal part, based on the leaf epidermis microstructure. Methods The species belonging to medicinal blue herbs and their close relatives (10 species from 4 genera) were systematically investigated. The leaf epidermis microstructure of these species was observed and analyzed by optical microscopy and scanning electron microscopy. A species retrieval table was established based on the microstructure characteristics. Results By combining the distribution of stomata, types of subsidiary cells, stomatal index, stomatal density, characteristics of the periclinal walls of epidermal cells, and epidermal appendages, the species Clerodendrum cyrtophyllum, Polygonum tinctorium, Isatis indigotica, I. violascens, I. costata, I. minima, Strobilanthes wallichii, S. dalzielii, S. pentstemonoides, and S. cusia can be accurately distinguished. Conclusion Microscopic characteristics of leaf epidermis can provide reference data for accurately differentiating the botanical origins of medicinal blue herbs.

OBJECTIVE To investigate the effects and potential mechanisms of Xiaoqinglong decoction on airway inflammation in asthma with syndrome of cold retention accumulation in lung based on the metastasis-associated lung adenocarcinoma transcript 1 （MALAT1）. METHODS Forty Wistar rats were randomly divided into blank group， model group， dexamethasone group （positive control， 1 mg/kg）， and Xiaoqinglong decoction group （2.72 g/kg）， with 10 rats in each group. A rat model of asthma with syndrome of cold retention accumulation in lung was established， and the corresponding drugs were administered once daily starting from the second day of modeling for 21 consecutive days. Lung histopathological changes and lung function were evaluated. The levels of superoxide dismutase （SOD）， malondialdehyde （MDA）， interferron-γ （IFN-γ）， tumor necrosis factor α （TNF-α）， and interleukin-13 （IL-13） in serum were measured， and the mRNA expression levels of MALAT1， TNF- α， IL-13， IFN- γ， and transient receptor potential melastatin 2 （TRPM2） in lung tissue were determined. Twenty C57BL/6J wild-type mice and twenty C57BL/6J MALAT1（－/－）mice were randomly divided into wild-type model group， wild-type Xiaoqinglong decoction group， MALAT1 model group， and MALAT1（－/－） Xiaoqinglong decoction group， with 10 mice in each group. The same asthma model was E-mail：yan_peizheng@163.com established， and Xiaoqinglong decoction was administered once daily for 21 days starting from the second day of modeling. The serum levels of SOD， MDA， IFN-γ， TNF-α and IL-13 were measured， along with the mRNA and protein expression levels of TRPM2 in lung tissue. RESULTS The results of the rat experiment showed that， compared with model group， the airway resistance， functional residual capacity， the serum levels of IL- 13， TNF-α and MDA as well as inflammatory infiltration and collagen fiber deposition in lung tissue， and the expressions of IL- 13， TNF-α and TRPM2 in lung tissue were all significantly decreased in the treatment group （P＜0.05 or P＜0.01）. The peak expiratory flow， forced expiratory flow at 50% of forced vital capacity， the serum levels of SOD and IFN-γ， and the expression levels of IFN-γ and MALAT1 in lung tissue were significantly increased （P＜0.05 or P＜0.01）. The results of the mice experiment demonstrated that， compared with the wild-type model group， serum levels of IL-13， TNF-α and MDA in wild-type xiaoqinglong decoction group were significantly reduced （P＜0.05 or P＜0.01）， while serum IFN-γ levels and SOD activity were significantly increased （P＜0.01）. Compared with the wild-type Xiaoqinglong decoction group， the MALAT1（－/－） Xiaoqinglong decoction group showed significantly decreased serum IFN-γ levels and SOD activity （P＜0.01）， along with significantly increased levels of IL-13， TNF-α and MDA （P＜0.05 or P＜0.01）， as well as significantly elevated TRPM2 mRNA and protein expression in lung tissue （P＜0.05）. CONCLUSIONS Xiaoqinglong decoction may alleviate airway inflammation by regulating the expression of MALAT1， modulating oxidative stress， inhibiting TRPM2 activation， and reducing the release of pro-inflammatory cytokines.

OBJECTIVE To investigate the effects of Ephedra-Cinnamomum couplet medicinals on respiratory function and airway inflammation in rats with asthma of cold-fluid retention in lung syndrome and its mechanism. METHODS Sixty Wistar rats were randomly divided into blank group， model group， dexamethasone group [1 mg/（kg·d）]， and Ephedra-Cinnamomum low-， medium-， high-dose groups [0.234， 0.936， 1.872 g/（kg·d）]， with 10 rats in each group. The model and treatment groups were sensitized by intraperitoneal injection of antigen solution （ovalbumin 100 mg + aluminum hydroxide 100 mg） and challenged with 1% ovalbumin nebulization， along with exposure to a cold environment and ingestion of cold water， to establish the asthma model with cold-fluid retention in lung syndrome. From day 2， rats received corresponding drugs or normal saline intragastrically， once a day， for 21 consecutive days. The general behavioral changes in each group of rats were observed during the experimental process. The lung function parameters [peak expiratory flow （PEF）， airway resistance （Raw）， functional residual capacity （FRC）， expiratory flow at 50% of forced vital capacity （EF50%）] Δ 基金项目 国家自然科学基金青年科学基金项目（No.82004233）； were measured before modeling and after the last medication as well as serum contents of interleukin-6 （IL-6）， IL-13， tumor necrosis factor- α （TNF- α） and interferon-gamma （IFN- γ） after the last medication were determined； the histopathological morphological changes in the lung tissues of rats were also observed； mRNA expressions of IL-6， IL-3， TNF-α， IFN-γ， thymic stromal lymphopoietin （TSLP）， and Toll-like receptor 4 （TLR4）， as well as protein expressions of TSLP and TLR4 were determined in lung tissue. RESULTS Compared with model group， the lung tissue damage of rats was relieved significantly； Raw， FRC， the contents and mRNA expression levels of IL-6， IL-13 and TNF-α， as well as the mRNA and protein expressions of TSLP and TLR4 were significantly decreased （P＜0.05）， while the contents and mRNA expressions of PEF， EF50 % and IFN-γ were significantly increased in the dexamethasone group and Ephedra-Cinnamomum medium- and high-dose groups （P＜0.05）. Moreover， only a few rats in the two groups exhibited typical symptoms of asthma. CONCLUSIONS Ephedra-Cinnamomum couplet medicinals improve respiratory function and ameliorate airway inflammation in asthma rats with cold-fluid retention in lung syndrome， the mechanism of which may be associated with inhibiting TSLP/TLR4 signaling pathway and modulating Th1/Th2 imbalance.

Objective: To construct a hypertension risk prediction model for residents aged 18-79 years, so as to provide an assessment tool for early screening and prevention of hypertension in high-risk groups. Methods: The permanent residents aged 18-79 years from 6 townships (streets) in Fangshan District of Beijing Municipality were selected as the study subjects using a multi-stage stratified random sampling method from March to June 2023. Demographic information, lifestyle, body mass index (BMI), blood pressure, fasting blood glucose, and blood lipid were collected through questionnaire survey, physical examination, and laboratory tests. Subjects were randomly divided into training and validation sets at a 7∶3 ratio. The logistic regression model was used to screen the risk factors of hypertension, and a hypertension risk prediction nomogram was constructed. Receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis were used to verify the discrimination, fit, and clinical application value of the model. Results: A total of 4 438 subjects were included, including 2 365 males (53.29%) and 2 073 females (46.71%), with a mean age of (44.99±14.90) years. The prevalence of hypertension was 35.29% (1 566 cases), and the standardized prevalence was 24.74%. The logistic regression model screened out 9 influencing factors of hypertension. The nomogram was established as ln[p/ (1-p)]= -2.873 + 0.935×40-<50 years + 1.463×50-<60 years + 1.908×60-<70 years + 2.346×70-79 years + 0.298×male-0.675×college degree or above + 0.384×smoking + 0.227×drinking + 0.572×overweight + 1.449×obesity + 0.557×heart rate ≥80 beats/min + 0.428×diabetes + 0.484×dyslipidemia. The area under the ROC curve of the validation set was 0.821 (95%CI: 0.798-0.843), and the calibration curve results showed that the calibration curve fitted the actual curve well. Decision curve analysis showed that the threshold probability was in the range of 0.10 to 0.70, and the model had good predictive value and clinical application value. Conclusion The nomogram based on age, gender, educational level, smoking, drinking, body mass index, heart rate, diabetes, and dyslipidemia can be used to predict the risk of hypertension among residents aged 18-79 years.

ObjectiveThis paper aims to analyze the clinical characteristics and medication rationality of liver injury related to Epimedii Folium preparation （EP） and explore the possible risk factors of liver injury， so as to provide a reference for the safe clinical application of Epimedii Folium （EF）. MethodA retrospective analysis was conducted on liver injury cases related to EP from 2012 to 2016. ResultThe number of reported liver injury cases and the proportion of severe cases related to the use of EP show an increasing trend， indicating the objective existence of liver injury caused by EP. There are more cases of liver injury related to EP in women than in men， with an onset age range of 15-91 years old and a median onset age of 60 years old （median onset ages for men and women are 59 and 60 years old， respectively）. The time span from taking EP alone to the occurrence of liver injury is 1-386 days， with a median of 38 days. The time span from taking both EP and Western medicine to the occurrence of liver injury is 1-794 days， with a median of 34 days. EF-related liver injury preparations are mostly composed of traditional Chinese medicines that promote immunity and tonify the liver and kidney， indicating that immune stress in the body may be the mechanism of liver injury caused by the use of EP alone or in combination. There is no increasing trend of toxicity with time or dose in the liver injury caused by EP. By further exploring its risk factors， it is found that patients have unreasonable medication methods such as excessive dosage， repeated use， and multi-drug combination， which may also be one of the important risk factors for EF-related liver injury. ConclusionEP has a certain risk of liver injury and should be emphasized in clinical diagnosis and treatment. Immune stress may be the mechanism of liver injury caused by EP， and in clinical use， it is necessary to be vigilant about the risk of liver injury caused by unreasonable use and combined use with Western medicine.

Objective To evaluate the utilization efficiency of beds in clinical departments based on time consumption index.Methods Selecting data from the 2019 annual report of medical work statistics and data from the Beijing inpatient medical service performance evaluation platform of a tertiary grade A general hospital of Traditional Chinese Medicine,the time consumption index of departments was calculated,based on which the regional average inpatient day of each department was calculated.and the number of standard bed turnover was calculated based on the target bed utilization rate.The bed utilization model was constructed based on the actual bed utilization in the department.Results Beds are open for a certain number of days,based on the target bed occupancy rate of each department and the average inpatient days within the DRG region of each department can be calculated based on the annual standard bed turnover number of the department based on the DRG disease group,on the basis of which the bed utilisation model is constructed.59.09%of the departments were efficiency departments,and the departments of press bed type,idle type and weekly transition all accounted for 13.64%respectively.Conclusion Introducing the time consumption index into the evaluation of bed utilization efficiency is in line with the actual work situation.Shortening the time consumption index is the most important thing to improve the bed utilization efficiency.The evaluation results can be used as the basis for the allocation of hospital bed resources.

Malignant tumors in children are one of the most important diseases that threaten the health and quality of life of children and are the second most common cause of death in children.With the continuous improvement and progress of treatment technology, the long-term survival rate of children with tumor has been significantly improved, but both the disease itself and the treatment can impair the immune function of children, which makes them vulnerable to various infectious diseases and secondary serious complications, and even become a source of infection, endangering the health of others. Vaccination is the most cost-effective measure to prevent infectious diseases. For children with normal immune functions, the benefits of vaccination usually outweigh the disadvantages. However, there is a lack of detailed data on the vaccination situation, efficacy and safety of vaccine use for such immunocompromised tumor survivors, and there are no authoritative and uniform vaccination recommendations. This article reviewed and summarized the literature and consensus of some domestic and foreign scholars on current status of post-treatment vaccination status, efficacy and safety of vaccination for children with tumors after treatment, with the aim of providing a reference for the practice in this field in China.

AIM: To analyze the corneal morphological characteristics of school-age children, and provide reference for the examination of refractive errors, corneal lesions, and treatment in school-age children.METHODS: Children aged 6-12 years in our hospital from March 2020 to June 2023 were included as the research objects, and they are divided into emmetropia group(-0.25 D≤SE≤+0.25 D)and myopia group(-6.00 D≤SE<-0.25 D)according to spherical equivalent(SE). The flat curvature(K1), steep curvature(K2), mean curvature(Km), radius of curvature(Rm), white-to-white(WTW)and corneal central thickness(CCT)were measured by Pentacam anterior segment analyzer. The corneal morphological differences between the emmetropia group and myopia group, boys and girls and children of different ages were analyzed.RESULTS: In the emmetropia group, the anterior corneal surface Km was 42.84±0.61 D, Rm was 7.85±0.15 mm, the posterior corneal surface Km was -6.23±0.04 D, Rm was 6.77±0.15 mm, WTW was 11.89±0.28 mm, CCT was 557.77±22.44 μm; in the myopia group, Km was 43.68±0.62 D, Rm was 7.72±0.16 mm, Km was -6.49±0.03 D, Rm was 6.64±0.17 mm, WTW was 12.17±0.27 mm, CCT was 553.24±22.23 μm. There was significant difference in corneal morphology between the emmetropia group and the myopia group(both P<0.01). Correlation analysis showed that corneal morphology was significantly correlated with age and gender.CONCLUSION: The corneal morphology of school-age children is not fixed, and the occurrence of myopia is not only related to the growth of axial length, but also significantly related to the changes of corneal morphology.

Objective: To investigate the prevalence, awareness, treatment and control rates of diabetes among residents in Fangshan District, Bejing Municipality, so as to provide reference for strengthening the prevention and control of diabetes. Methods: The residents aged 18 to 79 years were selected in Fangshan District using multistage stratified cluster sampling method from March to June 2023. Demographic information, lifestyle, body mass index, fasting blood glucose, and blood lipid were collected through questionnaire surveys, physical examinations and laboratory tests. The prevalence, awareness, treatment and control rates of diabetes among residents were analyzed and their influencing factors were identified using a multivariable logistic regression model. Results: A total of 4 438 residents were enrolled, including 2 367 males (53.33%) and 2 071 females (46.67%), and had a mean age of (44.99±14.90) years. The prevalence, awareness, treatment and control rates of diabetes were 15.75%, 57.37%, 56.22% and 22.90%, respectively. Multivariable logistic regression analysis showed that age (aged 30 to 39 years, OR=1.624, 95%CI: 1.011-2.609; aged 40 to 49 years, OR=3.469, 95%CI: 2.163-5.561; aged 50 to 59 years, OR=4.202, 95%CI: 2.595-6.803; aged 60 to 69 years, OR=7.229, 95%CI: 4.406-11.862; aged 70 to 79 years, OR=7.929, 95%CI: 4.665-13.479), obesity (OR=1.368, 95%CI: 1.071-1.748), hypertension (OR=1.943, 95%CI: 1.601-2.359) and dyslipidemia (OR=2.754, 95%CI: 2.287-3.317) were the factors affecting the prevalence of diabetes. Sex (women, OR=1.529, 95%CI: 1.019-2.293), age (aged 40 to 49 years, OR=4.971, 95%CI: 1.681-14.698; aged 50 to 59 years, OR=6.070, 95%CI: 2.045-18.020; aged 60 to 69 years, OR=6.902, 95%CI: 2.287-20.832; aged 70 to 79 years, OR=6.954, 95%CI: 2.191-22.070) and hypertension (OR=1.906, 95%CI: 1.337-2.718) were the factors affecting the awareness of diabetes. Age (aged 40 to 49 years, OR=4.699, 95%CI: 1.594-13.855; aged 50 to 59 years, OR=5.990, 95%CI: 2.023-17.732; aged 60 to 69 years, OR=7.134, 95%CI: 2.370-21.470; aged 70 to 79 years, OR=6.639, 95%CI: 2.102-20.964) and hypertension (OR=1.857, 95%CI: 1.304-2.645) were the factors affecting the treatment of diabetes. Age (aged 40 to 49 years, OR=2.948, 95%CI: 1.349-6.438; aged 60 to 69 years, OR=2.344, 95%CI: 1.049-5.234) was the factor affecting the control of diabetes. Conclusions The prevalence rate of diabetes among residents in Fangshan District was high, and the improvements of awareness rate, treatment rate and control rate were not obvious. Health education and management of diabetes should be strengthened for elderly, hypertensive and dyslipidemic residents.