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Objective@#To develop an assessment questionnaire for screen based behaviors among primary and secondary school students, so as to provide a basis for comprehensive assessment among the population.@*Methods@#Nineteen experts were invited to take part in this study from August to September 2022. The initial framework and item pool of the assessment questionnaire were developed based on literature review and a series of guidelines and standards issued by the national education and health authorities, as well as relevant domestic and foreign guidelines, and were combined with existing assessment tools that were used to evaluate screen based behavior among these age groups. Experts in related fields were selected for two rounds of Delphi consultation to determine the dimensions, items and corresponding weights of the assessment questionnaire.@*Results@#The response rates from two rounds of consultation were 95.0% and 100.0% respectively, the opinion submission rates were 89.5% and 63.2% respectively, and the authority coefficient ( Cr ) was 0.87. An assessment questionnaire was finally designed, consisting in 44 items and four dimensions, namely screen use type and time, screen use related health behaviors, safety and civilization in screen use, and reasonable arrangement of screen and non screen activities. The coefficient of variation( CV ) of each item ranged from 0.00 to 0.19, and the Kendall s W increased from 0.22 to 0.34( P <0.01). Expert opinions were in agreement and credible.@*Conclusion@#The designed assessment questionnaire can be used to comprehensively evaluate screen based behavior among primary and middle school students, and provides a basis for subsequent intervention measures to improve screen based behavior among this population.
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Objective@#To investigate the distribution of various types of screen time and examine the association of screen time with psychological and behavioral development problems in children aged 3-6 years, so as to provide scientific basis for children s screen use and mental health promotion.@*Methods@#A total of 3 875 mother child dyads who completed the follow up in Shanghai Maternal-Child Pairs Cohort were included. The daily usage time of children s tablet, mobile phone, TV, projectors, and other types of screens were obtained in questionnaire survey. Children s psychological and behavioral development problems were evaluated by Age-Stage Questionnaire, Third Edition (ASQ-3) and Strengths and Difficulties Questionnaire (Parent version) (SDQ). The Chi-square test, Mann Whitney U and Kruskal Wallis rank sum test were used to compare the detection rate of psychological and behavioral development problems and screen time in children with different characteristics. Multivariate binary Logistic regression was used to analyze the association of screen time with psychological and behavioral development problems.@*Results@#There were 49.91% of children having screen time more than 1 h/d. Children s TV, tablet and mobile phone screen time were 0.39(0.25, 0.96 ), 0.25(0,0.61) and 0.18(0,0.25) h/d. The detection rates of suspected developmental delay in fine motor, problem solving and personal-social domains and pro social behavior deficiency and externalizing behaviors in boys (8.54%, 6.77%, 5.46%, 30.07 %, 27.39%) were higher than that in girls (4.64%, 4.85%, 2.48%, 22.10%, 22.36%) ( χ 2=23.76, 6.49, 22.37, 31.81, 13.06, P <0.05). There were statistically significant differences in the detection rates of suspected developmental delay in communication, fine motor and problem solving, as well as internalizing behavior and externalizing behavior of children with different parents educational levels ( χ 2=14.37, 15.18, 21.10, 11.66, 9.27; 16.34, 26.75, 32.89, 16.97, 6.37, P <0.05). There were significant differences in the detection rates of suspected developmental delay in problem solving, prosocial behavior deficiency, internalizing behavior and externalizing behavior of children whose mothers had anxiety/depression symptoms during pregnancy ( χ 2= 5.61 , 9.05, 21.90, 7.17; 8.75, 6.06, 12.76 , 5.55, P <0.05). The average total screen time of boys was longer than that of girls (1.07, 1.00 h/d, Z=-2.08, P =0.04). Compared with children with other educational levels of their parents, the total screen time, mobile phone and TV screen time of children whose parents had college education or above were short (father: H =42.01, 44.49 , 21.24, mother: H =42.31, 39.21 , 26.47, P <0.01). Among all types of screen time, mobile phone screen time had the most impact on psychological and behavioral development. More mobile phone screen time increased the risk of suspected developmental delay and abnormal emotional behavior ( P < 0.05). Screen time of tablet, mobile phone and TV were positively correlated with externalizing behavior ( OR=1.36, 1.57, 1.27 , P <0.05).@*Conclusions@#Screen time is related to children s psychological and behavioral development problems and mobile phones affect the most. Parents should limit their children s screen time to avoid excessive screen time affecting their psychological and behavioral development.
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Objective:To compare the diagnostic value of Copenhagen index (CPH-I), serum carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4), and risk of ovarian malignancy algorithm (ROMA) for diagnosis of ovarian cancer in premenopausal and postmenopausal women.Methods:The clinical data of 239 patients with ovarian tumor treated in People's Hospital of Rizhao in Shandong Province from January 2017 to January 2020 were retrospectively analyzed. The patients were divided into ovarian benign disease group (152 cases) and ovarian cancer group (87 cases) according to postoperative pathology. The receiver-operating characteristic curve (ROC) was drawn with surgical pathology as the gold standard; the area under the curve (AUC) and the sensitivity and specificity of CPH-I, CA125, HE4, ROMA were calculated. The diagnostic performance of CA125, HE4, ROMA and CPH-I for diagnosis of ovarian cancer was compared in overall, premenopausal and postmenopausal patients.Results:The CA125 level, HE4 level, ROMA index, and CPH-I predicted probability (PP) values of ovarian cancer group were higher than those of ovarian benign disease group, and the differences were statistically significant (all P < 0.01). The AUC of CA125, HE4, ROMA, and CPH-I in the overall patients was 0.935 (95% CI 0.896-0.963), 0.940 (95% CI 0.901-0.966), 0.964 (95% CI0.932-0.984), 0.964 (95% CI 0.932-0.984); the AUC differences of CA125 and ROMA, CA125 and CPH-I (PP values), HE4 and ROMA, HE4 and CPH-I PP values were statistically significant (P values were 0.036, 0.009, 0.018, 0.019). The AUC of HE4, ROMA, and CPH-I in the premenopausal patients was 0.947 (95% CI 0.896-0.978), 0.949 (95% CI 0.898-0.979), 0.944 (95% CI 0.893-0.976), which were all larger than AUC of CA125 (0.921) (95% CI 0.863-0.960), the differences were statistically significant (P values were 0.036, 0.036, 0.026); AUC of CA125, ROMA, CPH-I PP values in postmenopausal patients was 0.953 (95% CI 0.891-0.986), 0.947 (95% CI 0.882-0.982), 0.943 (95% CI 0.877-0.980), all of which were larger than AUC of HE4 (0.889) (95% CI 0.810-0.944), and the differences were statistically significant (P values were 0.029, 0.014, 0.015). Conclusions:The diagnostic efficacy of CPH-I and ROMA for ovarian cancer is comparable, and regardless of menopause or not, the diagnostic efficacy of CPH-I and ROMA is higher. The diagnostic efficacy of CPH-I and ROMA for ovarian cancer is better than that of CA125 and HE4 in overall patients, the diagnostic efficacy of CA125 is the lowest in premenopausal patients, and the diagnostic efficacy of HE4 is the lowest in postmenopausal patients.
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OBJECTIVE：To optimize the primary processing technology of Gentiana rigesce ns. METHODS ：HPLC method was adopted for content determination of loganic acid ，swertiamarin and gentiopicroside in G. rigescens ，and overall desirability value （OD value ） of the contents of above 3 components was taken as index to carry out single factor test on blanching temperature，blanching time and drying temperature. Based on that ，Box-Behnken design-response surface methodology was used to optimize primary processing technology of G. rigescens . Validation test was also performed. The samples prepared by optimized technology were compared with those dried in the shade. RESULTS ：The optimal primary processing technology of G. rigescens included blanching time of 5 min，blanching temperature of 40 ℃ and drying temperature of 60 ℃. Validation test showed that the average OD value of the 3 components was 0.565 2，with a deviation of 0.94％ from the predicted value （0.570 6）. Compared with samples dried in the shade ，OD value of 3 components in samples prepared by optimized technology were increased significantly ， indicating the quality of the samples prepared by the optimized technology was better. CONCLUSIONS ：The optimal technology is stable and feasible ，and can be used for the primary processing of G. rigescens .
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Objective To compare the muscular relaxation effect and side effects of Cisatracuri-um and Succinylcholine for children on tracheal foreign body removal.Methods Forty ASA Ⅰ pediat-ric patients,undergoing electivetracheal foreign body removal,were randomly divided into two groups:group C,received cisatracurium 0.2 mg/kg for induction,0.05 mg/kg for maintenance,n=20;group S,received succinycholine 2 mg/kg for induction,0.4 mg/kg for maintenance,n=20.All patients were performed with controlled ventilation assisted by high-frequency jet ventilation (HFJV).We recorded bronchoscope condition,muscle relaxant supplements,extubation time and the incidence of muscle soreness in postoperative 24 h.Results There was no significant difference in bronchoscope condition between these two groups.The extubation time were significantly longer in group C than in group S (P<0.05).The incidence of muscle soreness in postoperative 24 h were sig-nificantly higher after the operation in group S than that in group C (P<0.01).All patients in group S needed muscle relaxant supplements,but none in group C (P <0.01).Conclusion Both Cisatra-curium and succinylcholine can provide good muscle relaxation effect on tracheal foreign body remov-al,but cisatracurium prolong the extubation time,and succinylcholine increase the incidence of muscle soreness.
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Objective To evaluate the effectiveness and safety of fire needle therapy for knee osteoarthritis (KOA), and provide reference for clinic and research. Methods Systematic searches were conducted in PubMed, EMBASE, the Cochrane Library, Web of science, CNKI, VIP, CBM and WanFang Data to collect randomized controlled trials (RCTs) on fire needle therapy treating KOA from inception to August 2013. Two reviewers independently screened articles according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. Then meta-analysis was performed using RevMan5.2. Results A total of 8 RCTs involving 820 patients were included. According to the different measures of control groups, subgroup analyses was performed and meta-analysis results showed that compared with the routine acupuncture group, the fire needle therapy group in clinical cured rate [OR=2.12, 95% CI (1.48, 3.02), P=0.000 1] and markedly effective rate (OR=3.92, 95%CI (2.65, 5.81), P<0.000 01] aspects all have statistical difference. Compared with the warm acupuncture group, the fire needle therapy group in the markedly effective rate [OR=4.12, 95% CI (1.92, 8.87), P=0.000 3] is statistically significant, but there is no statistical difference between the two groups in clinical cured rate [OR=3.09, 95% CI (0.95, 10.05), P =0.06]. Compared with the acupuncture needle (routine acupuncture and warm acupuncture) group, the fire needle therapy group in the visual analogue scale of knee pain [OR=-0.54, 95%CI (-0.85, -0.24), Z=3.46, P=0.000 5] after treatment is statistically difference. The adverse reactions to fire needle treatment of KOA patients have not been reported. Conclusion Current clinical evidence indicates that fire needle therapy is efficient for relieving clinical symptoms of patients with KOA, and improving their quality of life. However, due to lack of enough high-quality studies, fire needle therapy has to be further studied by conducting more strictly-designed, multicenter and large-scale RCTs.
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Objective: To investigate the inlfuence of different blood pressure (BP) circadian rhythm on cardiac function in hypertensive patients. Methods: A total of 180 hypertensive patients with well controlled day-time blood pressure were divided into 3 groups. Dipper group, n=30, Non-dipper group, n=99 and Reverse dipper group, n=51. The relationship between cardiac function, relevant clinical index and blood pressure circadian rhythm were analyzed. Results: The mean systolic and diastolic BP, BP classiifcation and the antihypertensive medication were similar among 3 groups.①The ratio of peak mitral E wave to peak mitral annulus E' wave (E/E') increased accordingly from Dipper group, Non-dipper group and Reverse-dipper group as (8.1 ± 2.4), (8.6 ± 2.5) and (9.6 ± 3.2), P Conclusion: Abnormal blood pressure circadian rhythm was associated with the cardiac injury in hypertensive patients. The cardiac injury increased accordingly from Non-dipper group to Reverse-dipper group and the main damage was in diastolic function.