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High concentration of surface ozone (O 3 ) will cause health risks to people. In order to analyze the spatiotemporal characteristics of O 3 and assess O 3 exposure and health risks for different age groups in China, we applied multiple methods including standard deviation ellipse, spatial autocorrelation, and exposure-response functions. Results show that O 3 concentrations increased in 64.5% of areas in China from 2013 to 2018. The central plain urban agglomeration (CPU), Beijing-Tianjin-Hebei (BTH), and Yangtze River Delta (YRD) witnessed the greatest incremental rates of O 3 by 16.7%, 14.3%, and 13.1%. Spatially, the trend of O 3 shows a significant positive autocorrelation, and high trend values primarily in central and east China. The proportion of the total population exposed to high O 3 (above 160 μg/m 3 ) increased annually. Compared to 2013, the proportion of the young, adult, and old populations exposed to high O 3 increased to different extents in 2018 by 26.8%, 29.6%, and 27.2%, respectively. The extent of population exposure risk areas in China expanded in size, particularly in north and east China. The total premature respiratory mortalities attributable to long-term O 3 exposure in six urban agglomerations were about 177,000 in 2018 which has increased by 16.4% compared to that in 2013. Among different age groups, old people are more vulnerable to O 3 pollution, so we need to strengthen their relevant health protection of them., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: To report the design and baseline data of a 3-year cohort study in Beijing Pinggu District primary school students in China after COVID-19., Methods: Noncycloplegic and cycloplegic spherical equivalent refraction (SER) were measured, ocular biometry, including the axial length (AL), anterior chamber depth (ACD) and corneal power (CP), were collected before cycloplegia. Corneal radius (CR), AL-to-CR ratio, and lens power (LP) were calculated., Results: Among the 4,806 (89.1%) eligible students (51.5% male), the prevalence of emmetropia, myopia, mild hyperopia, and mild-to-high hyperopia was 12.8, 30.8, 53.0, and 3.3% after cycloplegia, respectively. Myopia increased from 2.5% in 6- to 71.6% in 12-year-old students, with 9- and 10-year-olds showing the most prominent increases. The median of cycloplegic SER was 0.50 (IQR = 1.63), and the noncycloplegic SER was -0.38 D (IQR = 1.50), which is more negative than the cycloplegic refraction. The mean AL increased with age, from 22.46 ± 0.70 mm to 24.26 ± 1.07 mm. The ACD increased from 3.38 ± 0.28 mm to 3.70 ± 0.30 mm, and the AL-to-CR ratio increased from 2.91 ± 0.08 to 3.12 ± 0.13 between 6- and 12-year-old students. AL, CR and LP explained the SER variance with R 2 of 86.4% after adjusting the age and gender., Conclusions and Relevance: The myopia prevalence since emergence of COVID-19 rapidly increased from 6- to 12-year primary school Chinese children, especially after 7 years of age. The non-cycloplegia SER overestimated the prevalence of myopia, and the cycloplegic SER is a more accurate and reliable method to assess the prevalence of refractive status., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor YZ declared a shared parent affiliation with the authors YL, YX, JM, XL, JZ, CZ, MZ, and KW at the time of review., (Copyright © 2022 Li, Xing, Jia, Ma, Li, Zhou, Zhao, Zhang, Wang, Wang, Qu, Zhao, Wang and Guo.)

Background: Diabetic kidney disease (DKD) is a major microvascular complication of diabetes mellitus and the primary cause of end-stage renal disease. Existing therapies for DKD are not sufficiently effective. We report the protocol of a pragmatic randomized controlled trial of the use of traditional Chinese herbal medicine to treat patients with DKD., Methods/design: This will be a multicenter randomized controlled trial. A total of 266 patients with DKD (106 with early stage, 80 with middle-stage, and 80 with advanced-stage disease) with an estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73m 2 will be included. Participants with DKD of each stage will be randomly allocated at a 1:1 ratio to either the experimental group, which will receive Xiaozhen formula and basic treatment, or the control group, which will receive basic treatment only. The study duration will be 24 weeks. The primary outcome will be urinary microalbumin excretion rate for early stage DKD, 24-h urinary protein for middle-stage DKD, and eGFR for advanced-stage DKD. Adverse events will also be evaluated. Data for all outcome indicators will be collected at baseline and weeks 4, 12, and 24., Discussion: This study will provide evidence of the effectiveness and safety of traditional Chinese herbal medicine in treating patients with DKD., Trial Registration: Chinese Clinical Trials Registry: ChiCTR-IOR-16010072 . Registered on 2 December 2016.