ABSTRACT
Objective@#To explore the association of health literacy with smoking attempt behavior among middle school students in China，and to provide ideas for health education for middle school students.@*Methods@#Using stratified cluster sampling method, 1 066 students were selected from Zhejiang, Guangdong, Jiangxi, Sichuan and Guizhou provinces in China during June to November 2017, a questionnaire survey was conducted to collect health literacy and smoking attempt behavior.@*Results@#The score of health literacy among middle school students was (13.49±1.87). Students who lived in eastern and rural areas, girls, guardians who were jointly supervised by their parents and grandparents, the only child, non smokers, and small amount of weekly pocket money had higher scores in health literacy（ t/F =9.81,3.10,11.12,2.65,3.50,4.47,2.64， P ＜0.05）. The prevalence of smoking attempt behavior was 5.5%. Multiple Logistic regression analyses showed that central and western China, drinking and low healthy literacy were positively correlated with smoking attempt behavior ( OR =2.75, 3.54, 21.62, 2.50, P <0.05).@*Conclusion@#Low healthy literacy can be used as a predictor of smoking attempt among middle school students, the health education should be conducted to control the smoking attempt behavior.
ABSTRACT
OBJECTIVE To evaluate the efficacy and safety of different drug regimens in the treatment of children with Kawasaki disease， and to provide evidence-based reference for clinical treatment. METHODS Retrieved from the Cochrane Library， Medline， Embase， CINAHL， Web of Science， ProQuest， Google Scholar， CNKI， Wanfang Data， Baidu academic database， World Health Organization International Clinical Trials Registration Platform and ClinicalTrials. gov， randomized controlled trials （RCTs） about intravenous immunoglobulin （IVIG）+glucocorticoid or cyclosporine or tumor necrosis factor-alpha （TNF-α） blocker （trial group） versus standard IVIG therapy （control group） were collected from the establishment of the database to Feb. 28th， 2023. After screening the literature， extracting data， and evaluating the quality of the literature， Stata 14.2 software was used for network meta-analysis. RESULTS Ten RCTs with a total of 1 323 participants involving six measures were included： standard IVIG therapy， glucocorticoid therapy，cyclosporine therapy， TNF- α blocker therapy， remedial glucocorticoid therapy and remedial TNF- α blocker therapy. Results of network meta-analysis showed that the incidence of coronary artery aneurysms （CAA） at 4-8 weeks was significantly lower in patients receiving glucocorticoid therapy than receiving standard IVIG therapy and TNF-α blocker therapy. The incidences of CAA at 4-8 weeks in children treated with remedial glucocorticoid therapy and remedial TNF- α blocker therapy were significantly higher than those treated with glucocorticoid therapy； there was no significant difference in the incidence of CAA at 4-8 weeks among other interventions （P＞ 0.05）； network meta-order of the incidence was glucocorticoid therapy＜cyclosporine therapy＜standard IVIG therapy＜remedial TNF-α blocker therapy＜remedial glucocorticoid therapy＜TNF-α blocker therapy. The incidence of initial IVIG resistance in children receiving cyclosporine therapy was significantly lower than those receiving standard IVIG therapy； there was no significant difference in the incidence of initial IVIG resistance among other interventions （P＞0.05）； network meta-order of the incidence was cyclosporine therapy＜glucocorticoid therapy＜TNF-α blocker therapy＜standard IVIG therapy. There was no significant difference in the incidence of ADR among different interventions （P＞0.05）； network meta-order of the incidence was remedial TNF-α blocker therapy＜TNF-α blocker therapy＜standard IVIG therapy＜glucocorticoid therapy＜cyclosporine therapy. CONCLUSIONS Glucocorticoid therapy at the initial treatment can significantly reduce the risk of CAA at 4-8 weeks in children with Kawasaki disease； cyclosporine has a significant effect on improving initial IVIG resistance， and the use of TNF-α blocker in the remedial stage may have the lowest incidence of adverse reactions.