Nutritional status and its related factors among primary and secondary school students in Beijing City / 中国学校卫生

Objective@#To assess the nutritional status of primary and secondary school students in Beijing City and to analyze the related factors, so as to provide a scientific basis for improving the nutritional status of primary and secondary school students in a targeted manner.@*Methods@#Based on the 2021 Beijing Student Common Diseases and Health Influencing Factors Surveillance Project, a stratified random cluster sampling method was used to conduct a physical examination and questionnaire survey on 25 487 primary and secondary school students from September to November 2021. The Chi square test was used for comparison of nutritional status detection rates, and disordered multi classification Logistic regression analysis was used to explore the factors associated with students nutritional status.@*Results@#The detection rates of malnutrition, overweight and obesity among primary and secondary school students in Beijing City were 4.7%, 18.0% and 23.8% respectively. The detection rates of malnutrition, overweight and obesity were higher among male students (5.1%, 20.4%, 29.7%) than female students (4.2%, 15.5%, 17.4%) ( χ 2= 12.23, 101.71, 526.99, P <0.01). The detection rate of obesity was higher in the suburbs than urban areas(26.6%, 19.8%), and the detection rate of malnutrition was lower in the suburbs than urban areas (4.2%,5.5%)( χ 2=157.25, 23.61, P <0.01). The results of disordered multi classification Logistic regression showed that the related factors for malnutrition, overweight and obesity were gender, residence, moderate to vigorous exercise ≥60 min per day and lack of sleep( OR =1.70, 1.88,2.48; 1.14, 0.87, 0.67; 0.85, 0.92, 0.81 ; 0.83, 1.08, 1.07); frequency of fried food intake daily was a related factor for overweight ( OR =0.70); whether eating breakfast daily or not was a related factor for overweight and obesity ( OR =0.91, 0.84); academic level (middle and high school) was a related factor for malnutrition and obesity ( OR =1.38, 1.37; 0.77, 1.40)( P <0.05).@*Conclusions@#The problem of overweight and obesity among primary and secondary school students in Beijing City continues to be serious, especially among boys and suburban areas. It is recommended that society, schools, families and individuals should work together to improve the nutritional status of primary and secondary school students by adopting a graded and classified approach.

Applied research of the impact of air pollution on absenteeism in students with respiratory issues through machine learning analysis / 中国学校卫生

Objective@#To explore the performance of machine learning prediction models in forecasting student absenteeism due to respiratory symptoms caused by air pollution in short term, aiming to provide a methodological reference for early warning systems of school diseases.@*Methods@#Utilizing data from shortterm sequences of student absenteeism due to respiratory symptoms in Jiangsu Province from September 2019 to October 2022, the study integrated average concentrations of atmospheric pollutants. A univariate distributed lag nonlinear model was employed to select optimal lag variables for the pollutants. An extreme gradient boosting(XGBoost) algorithm model was developed to predict the frequency of absenteeism due to respiratory symptoms and compared with the seasonal autoregressive integrated moving average with exogenous factors(SARIMAX) model.@*Results@#Between 2019 and 2022, an average of 9 709 students per day in Jiangsu Province were absent due to respiratory symptoms. The daily average air quality index (AQI) was 76.96,with mass concentrations of PM2.5, PM10, NO2, and O3 averaging at 35.75, 61.13, 28.89, 104.81 μg/m3, respectively. Granger causality tests indicated that AQI, PM2.5, PM10, NO2, and O3 were significant predictors of absenteeism frequency due to respirutory symptoms(F=1.46,1.79,1.67,3.41,2.18,P<0.01). The singleday lag effects of PM2.5, PM10, NO2, and O3 reached their peak relative risk (RR) values at lag4, lag0, lag0, lag4 respectively. When integrating these optimal lag variables for the pollutants, the XGBoost model demonstrated superior predictive performance to the SARIMAX model, reducing the mean absolute error (MAE) from 2.251 to 0.475, mean absolute percentage error (MAPE) from 0.429 to 0.080, and root mean square error (RMSE) from 2.582 to 0.713; at the P75 percentile alert threshold, the sensitivity improved from 0.086 to 0.694 and specificity from 0.979 to 0.988, with the Youden index increasing from 0.065 to 0.682.@*Conclusions@#The XGBoost model exhibits robust predictive performance and effective early warning capabilities for shortterm sequences of student absenteeism due to respiratory symptoms caused by air pollution. Schools could timely adopt this model to preemptively detect and control disease outbreaks, thereby enhancing school health management.

Association between sexual orientation and high risk sexual behaviors among college students in Hubei Province / 中国学校卫生

Objective@#To examine the association between sexual orientation and high risk sexual behaviors and its sex differences among college students, so as to provide a theoretical basis for intervention and controlling of high risk sexual behaviors of the college students.@*Methods@#From November 2020 to May 2021, 1 920 college students among four universities in Hubei Province were recruited by multi stage stratified random cluster sampling, and their sexual orientation and the frequency of high risk sexual behaviors were investigated by a self designed questionnaire. And then analyzed the association between sexual orientation and high risk sexual behaviors and its sex differences by using Chi square test and Logistic regression analysis method.@*Results@#The prevalence of sexual behaviors was 18.2%, the prevalence of high risk sexual behaviors was 7.2%, and the prevalence of high risk sexual behaviors was higher among non heterosexuals(13.5%) than among heterosexuals (6.7%),the prevalence of high risk sexual behaviors was higher among males (9.2%) than among females(5.3%)，and the differences were statistically significant( χ 2=9.40, 10.77, P <0.01). Logistic regression analysis showed that the association between sexual orientation and high risk sexual behaviors was not statistically significant( OR=1.52, 95%CI=0.83-2.80, P >0.05). However, stratified analysis by sex revealed that among male students, the risk of high risk sexual behaviors was 3.57 times higher among non heterosexuals than among heterosexuals( OR= 3.57 , 95%CI=1.52-8.41, P <0.01), while among female students, the association between sexual orientation and high risk sexual behaviors was not statistically significant( OR=0.48, 95%CI=0.15-1.57, P >0.05).@*Conclusion@#There are sex differences in the relationship between sexual orientation and high risk sexual behaviors among college students. Male non-heterosexuals are at higher risk for high risk sexual behaviors than male heterosexuals. Therefore, prevention and interventions for high risk sexual behaviors among college students should focus on gay and bisexual men so as to reduce the occurance rate of their high risk sexual behaviors.

Relationship between adolescent parent attachment and attempted suicide among middle school students / 中国学校卫生

Objective@#To understand the current situation of suicide attempts in middle school students and to explore its relation with adolescent parent attachment, to provide a basis for the prevention and control of middle school students suicidal behavior.@*Methods@#A total of 4 419 students from grades 7 to 12 in Ezhou City and Xiaogan City, Hubei Province were selected by stratified cluster random sampling. The Inventory of Parent and Peer Attachment, Rosenberg Self Esteem Scale, Kessler Psychological Distress Scale were used to conduct a questionnaire Survey, and evaluated the suicide attempts of middle school students.@*Results@#The detection rate of attempted suicide among middle school students was 6.8%. The detection rate of attempted suicide varies among different grades, family types, parental relation, parenting style, family income, self esteem level, and psychological distress( χ 2/ t =3.88, 10.12, 18.00, 52.54, 13.90 , 2.37, 8.99, P <0.05). The scores of paternal attachment and maternal attachment ( 14.64 ±13.45, 14.77±12.26) in the group with attempted suicide were lower than those without attempted suicide(22.05±16.08, 23.79±14.93)( t =-9.07, -12.11, P <0.05). Logistic regression analysis showed that both paternal attachment and maternal attachment were associated with lower rate of suicide attempts among middle school students(paternal attachment, OR=0.99, 95%CI = 0.98 -0.99; maternal attachment OR=0.97, 95%CI =0.96-0.98), with paternal attachment for girls only( OR=0.98, 95%CI= 0.97 -0.99)(P <0.05).@*Conclusion@#Adolescent parent attachment may be a protective factor for middle school students suicide attempts. Sex specific effects are observed in adolescent father attachment in girls. Parents should pay attention to cultivating a good attachment relationship with their children and promote the healthy growth of middle school students.

Analysis of factors influencing campus bullying among junior and senior school students and construction of a nomogram model from Jiangsu Province / 中国学校卫生

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.

A multilevel model analysis of the association between reading and writing posture with myopia in primary and secondary school students / 中国学校卫生

Objective@#To explore the association between reading and writing posture with the occurrence of myopia in Chinese children and adolescents, so as to provide a reference for reducing its prevalence among primary and secondary school students.@*Methods@#Using data from the 2020 survey on the current status of hyperopia reserve in primary and secondary school students from six provinces/cities, namely Beijing, Zhejiang, Chongqing, Shaanxi, Liaoning, and Henan selected by multi stage stratified cluster probability sampling method during November 2020 to June 2022. A total 16 782 students who completed the optometry examination of cycloplegia according to the Children and Adolescents Myopia Screening Standard and questionnaire survey were included for analyzing analyze the association between reading and writing posture with myopia.@*Results@#The overall detection rate of myopia among primary and secondary school students was 45.7%, of which 35.0% were primary school students, 84.1% junior high school students, and 90.4% senior high school students. Poor reading and writing posture was found in 73.6% of primary and secondary school students. Adjusting for confounding factors such as gender, school period, region, outdoor time every day, and whether parents were myopic, the results of the multilevel Logistic regression showed that the following factors were positively correlated with myopia:poor reading and writing posture ( OR=1.17, 95%CI =1.07-1.28), never/occasionally reading and writing with a reading distance which was more than one foot away between the eyes and book ( OR=1.28, 95%CI=1.08-1.53, OR=1.23, 95%CI = 1.08- 1.40), teachers occasionally reminding the child of their reading and writing posture ( OR=1.13, 95%CI =1.01-1.25), and often/always reading and writing while lying down or with the face on the arm ( OR=1.15, 95%CI=1.01-1.32, OR=1.46, 95% CI = 1.17-1.82), always reading and writing with the head in the hand ( OR=1.56, 95%CI =1.20-2.01). Further, a negative correlation was detected between myopia and parents occasionally reminding their children of their reading and writing posture ( OR= 0.85 , 95%CI =0.76-0.96) ( P <0.05).@*Conclusion@#Poor reading and writing posture is a risk factor for the development of myopia in primary and secondary school students, and interventions for reading and writing posture need to be strengthened to reduce the occurrence of myopia among primary and secondary school students.

Serological analysis of varicella-zoster virus IgG antibody in healthy people aged 1～30 years in Liaoning Province / 中国生物制品学杂志

@#Abstract：Objective To carry out serological analysis of varicella⁃zoster virus（VZV）IgG antibody level in healthy people aged 1 ~ 30 years in Liaoning Province. Methods In October 2020，3～5 mL venous blood samples were collected from 617 healthy people aged 1～30 years selected from six counties and districts in Shenyang，Fuxin and Dandong of Liaoning Province by stratified random sampling method，of which serum samples were collected and determined for VZV IgG antibody level by ELISA. The positive rate of serum antibody and geometric mean concentration（GMC）of antibody were calculated and compared. Results Among 617 serum samples，302 samples were positive for VZV IgG antibody，the positive rate was 48. 947%，and the GMC was 112. 772 mIU／mL. The positive rate of VZV IgG antibody was 29. 670%～75. 789% and the GMC was 45. 508～366. 559 mIU／mL in healthy people of various ages. Both of the antibody positive rate（χ2 = 67. 104， P < 0. 001）and GMC（F = 20. 685，P < 0. 001）showed significant differences. The positive rates of VZV IgG antibody in male and female were 44. 817% and 53. 633% respectively，which showed significant difference（χ2 = 4. 779，P = 0. 029）， while the GMCs were 96. 983 and 133. 829 mIU／mL respectively（t = -1. 958，P = 0. 051）with no significant difference. The positive rates of VZV IgG antibody of healthy people in Shenyang，Fuxin and Dandong of Liaoning Province were 55. 224%，40. 201% and 51. 152% respectively with significant differences（χ2 = 9. 683，P = 0. 008），of which the positive rate of FuxinwassignificantlylowerthanthoseofShenyangandDandong（χ2 =9. 046and5. 013，P =0. 003and0. 025，respectively）； While the GMCs were 133. 523，85. 953 and 123. 713 mIU／mL respectively with no significant difference（F = 0. 514， P = 0. 598）. Among 617 serum samples，54 sampleswere suspicious，which remained within the criticalrange afterre⁃examina⁃ tion，while the gap between positive rate and the total percentage of positive and suspicious results gradually decreased with the increase of age，indicating that the immunity to varicella gradually increased with the increase of age. Conclusion The VZV⁃IgG antibody level of healthy people aged 1～30 years in Liaoning Province increased gradually with age，while the overall level was low. To control the spread of varicella virus，it is recommended to increase varicella vaccine coverage in vulnerable areas and susceptible population to build VZV immune barrier.

Analysis of clinical characteristics of scrub typhus associated with hemophagocytic syndrome in 15 children / 中国热带医学

@#Abstract: Objective　To analyze the clinical features of hemophagocytic syndrome (HPS) associated with Orientia tsutsugamushi disease in children. Methods　The case data of patients with scrub typhus in Kunming Children's Hospital from January 1st 2019 to December 31st 2021 was retrospectively analyzed. The patients were divided into the HPS group and the non-HPS group according to whether associated with HPS. The clinical data of the two groups were analyzed using SPSS 25.0. Results　Eighty-five cases of scrub typhus in children were collected, 15 cases (17.6%) had HPS. The mean age of patients with HPS was (5.10±3.82) years, included 9 males and 6 female, there was no significant difference in gender and age between the HPS and the non-HPS group (P>0.05). Comparison of the two groups indicted that the incidence of cough, lung rales, edema, and hepatomegaly were significantly increased in the HPS group (P<0.05). The data showed that compared to the non-HPS group, the HPS group showed significant decreases in the levels of hemoglobin (HGB), platelet (PLT), albumin (ALB), fibrinogen (Fib) (P<0.05), and significant decreases in the levels of C-reactive protein (CRP), lactic dehydrogenase (LDH), triglyceride (TG), serum ferritin (SF) (P<0.05). The proportion of CD4+ T lymphocytes, CD4+/CD8+ were significantly decreased (P<0.05); the proportion of CD3+, CD8+ T lymphocytes were significantly increased (P<0.05). The proportion of pulmonary exudation or consolidation in the HPS group was higher than the non-HPS group, which was statistically significant (P<0.05). All the patients with scrub typhus associated with HPS were treated with oral doxycycline, and intravenous immunoglobulin was given in 13 cases (86.7%). There was one case of death and 14 cases discharged from hospital after treatment in HPS group. Conclusion　HPS in scrub typhus infected children is a nonnegligible complication. Prolonged fever, lung rales, hepatomegaly，HGB decreased, thrombocytopenia, hyperferritinemia, and abnormal lymphocyte subsets may associate with HPS. It should be alerted to scrub typhus when presenting with HPS in endemic areas. The scrub typhus associated with HPS can be successfully treated with appropriate antibiotic and immunomodulator treatment.

Growth and intelligence development among a cohort of low birth weight infants / 中国学校卫生

Objective@#To explore growth and intelligence development of low birth weight infants (LBWI) at 24 and 36 months of age, so as to provide reference for early monitoring and intervention of the development of LBWI.@*Methods@#A total of 100 LBWI born and managed in Hefei Maternal and Child Health Care Institution were selected from 2012 October 1 to 2015 December 30, and 99 normal birth weight infants (NBWI) under child health management in the same sitinstitution were selected as controls. According a prospective cohort study method, and based on the establishment of a cohort and monitoring of childhood growth and development, a unified method was used to longitudinally follow up and observe the physical fitness of two groups of infants at the determined time points. The development of LBWI and NBWI at 24 and 36 months of age was surveyed using the Gesell Development Scale.@*Results@#Weight, length and head circumference of LBWI children at the age of 15-36 months were significantly lower than those of NBWI children ( P <0.05). In addition, 117 children (43.98%) completed the full assessment of intelligent development scale, including 62 LBWI and 55 NBWI. The scores of Gesell in NBWI group was higher than that in LBWI group at 24 and 36 months of age, including adaptability, gross motor, fine metor skills, language and personal social functions ( t =-4.17, -3.82, -3.21 , -3.03, -2.61; -4.23, -3.16, -3.07, -3.13, -3.99, P <0.05). Multivariate linear regression analysis found that birth weight was positively correlated with adaptability, gross motor, fine motor skills, language functions at 24 and 36 months of age and personal social function at 36 months of age ( β =0.004, 0.010; 0.003, 0.008; 0.003, 0.007; 0.004, 0.009; 0.011, P ＜0.05).@*Conclusion@#The growth and development of LBWI children are significantly delayed compared to NBWI children. The scores of LBWI children are lower than those of NBWI children in all functional areas. Weight is the main factor affecting children s intellectual development. Early monitoring and intervention of low birth weight infants should be carried out to avoid or mitigate adverse consequences.

Effectiveness of online and offline health education myopia intervention on primary school students / 中国学校卫生

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.

Efeitos da intervenção terapêutica de enfermagem em pacientes com doença cardíaca coronária / Efectos de la intervención terapéutica de enfermería en pacientes con enfermedad arterial coronaria / Effects of nursing intervention therapy on patients with coronary heart disease

Resumo Objetivo Avaliar os efeitos da intervenção terapêutica de enfermagem baseada no modelo de trajetória da doença crônica na ansiedade e na qualidade de vida de pacientes com doença cardíaca coronária (DCC). Métodos Um total de 118 pacientes com DCC admitidos entre fevereiro de 2019 e fevereiro de 2021 foram distribuídos aleatoriamente em grupos controle e observação (n = 59). O grupo controle recebeu intervenção de enfermagem de rotina, enquanto o grupo observação recebeu intervenção com base no modelo de trajetória da doença crônica. Os sintomas clínicos, a escala de autoavaliação de ansiedade (SAS), a qualidade de vida (QV) e as pontuações de autoeficácia foram comparados. As taxas de incidência de complicações foram comparadas. A análise de regressão linear multivariada foi realizada para o efeito mediador da autoeficácia na relação entre ansiedade e QV. Um modelo de equação estrutural foi construído e validado. Resultados Após a intervenção, os sintomas clínicos e a pontuação da SAS diminuíram significativamente em ambos os grupos, especialmente no grupo observação (P<0,05). As pontuações de QV e autoeficácia aumentaram significativamente em ambos os grupos, particularmente no grupo de observação (P<0,05). A pontuação de autoeficácia correlacionou-se negativamente com a pontuação SAS e positivamente com a pontuação QV. Houve correlação negativa entre a pontuação SAS e a pontuação QV (P<0,05). O modelo de autoeficácia, ansiedade e QV apresentou boa adequação, e o efeito mediador da autoeficácia na relação entre ansiedade e QV foi de 0,896. A taxa de incidência de complicações foi significativamente menor no grupo observação do que no grupo controle (P <0,05). Conclusão A intervenção de enfermagem baseada no modelo de trajetória da doença crônica alivia significativamente a ansiedade, melhora a QV e aumenta a pontuação de autoeficácia de pacientes com DCC. A autoeficácia é um mediador da relação entre ansiedade e QV.

Resumen Objetivo Evaluar los efectos de la intervención terapéutica de enfermería con base en el modelo de trayectoria de la enfermedad crónica en la ansiedad y en la calidad de vida de pacientes con enfermedad arterial coronaria (EAC). Métodos Un total de 118 pacientes con EAC admitidos entre febrero de 2019 y febrero de 2021 fueron distribuidos aleatoriamente en grupos control y observación (n = 59). El grupo control recibió intervención de enfermería de rutina, mientras el grupo observación recibió intervención con base en el modelo de trayectoria de la enfermedad crónica. Se compararon los síntomas clínicos, la escala de autoevaluación de ansiedad (EAA), la calidad de vida (CV) y el puntaje de autoeficacia. Se compararon las tasas de incidencia de complicaciones. El análisis de regresión lineal multivariado se realizó para el efecto mediador de la autoeficacia en la relación entre ansiedad y CV. Se elaboró y validó un modelo de ecuación estructural. Resultados Después de la intervención, los síntomas clínicos y el puntuaje de la EAA disminuyeron de forma considerable en ambos grupos, especialmente en el grupo observación (P<0,05). Los puntajes de CV y de autoeficacia aumentaron considerablemente en ambos grupos, particularmente en el grupo de observación (P<0,05). El puntaje de autoeficacia se correlacionó negativamente con el puntaje EAA y positivamente con el puntaje CV. Hubo una correlación negativa entre el puntaje EAA y el puntaje CV (P<0,05). El modelo de autoeficacia, ansiedad y CV presentó una buena adecuación y el efecto mediador de la autoeficacia en la relación entre ansiedad y CV fue de 0,896. La tasa de incidencia de complicaciones fue considerablemente inferior en el grupo observación que en el grupo control (P <0,05). Conclusión La intervención de enfermería con base en el modelo de trayectoria de la enfermedad crónica alivia de forma considerable la ansiedad, mejora la CV y aumenta el puntaje de autoeficacia de pacientes con EAC. La autoeficacia es un mediador de la relación entre ansiedad y CV.

Abstract Objective We aimed to assess the effects of nursing intervention therapy based on chronic disease trajectory model on anxiety and quality of life (QOL) of patients with coronary heart disease (CHD). Methods A total of 118 CHD patients admitted from February 2019 to February 2021 were randomly assigned into control and observation groups (n=59). Control group was given routine nursing intervention, while observation group was given intervention based on chronic disease trajectory model. Clinical symptom, self-rating anxiety scale (SAS), QOL and self-efficacy scores were compared. Incidence rates of complications were compared. Multivariate linear regression analysis was performed for the mediating effect of self-efficacy on relationship between anxiety and QOL. A structural equation model was constructed and verified. Results After intervention, clinical symptom and SAS scores significantly declined in both groups, especially in observation group (P<0.05). QOL and self-efficacy scores rose significantly in both groups, particularly in observation group (P<0.05). Self-efficacy score was negatively correlated with SAS score and positively correlated with QOL score, and there was a negative correlation between SAS score and QOL score (P<0.05). The model of self-efficacy, anxiety and QOL had good fitness, and the mediating effect of self-efficacy on relationship between anxiety and QOL was 0.896. The incidence rate of complications was significantly lower in observation group than in control group (P<0.05). Conclusion Nursing intervention based on chronic disease trajectory model significantly relieves the anxiety, improves QOL, and increases the self-efficacy score of CHD patients. Self-efficacy is a mediator for the relationship between anxiety and QOL.

Enrichment of miR-17-5p enhances the protective effects of EPC-EXs on vascular and skeletal muscle injury in a diabetic hind limb ischemia model

BACKGROUND/AIMS: Diabetes mellitus (DM) is highly susceptible to diabetic hind limb ischemia (DHI). MicroRNA (MiR)-17-5p is downregulated in DM and plays a key role in vascular protection. Endothelial progenitor cell (EPC)-released exosomes (EPC-EXs) contribute to vascular protection and ischemic tissue repair by transferring their contained miRs to target cells. Here, we investigated whether miR-17-5p-enriched EPC-EXs (EPC-EXsmiR-17-5p) had conspicuous effects on protecting vascular and skeletal muscle in DHI in vitro and in vivo. METHODS: EPCs transfected with scrambled control or miR-17-5p mimics were used to generate EPC-EXs and EPC-EXsmiR-17-5p. Db/db mice were subjected to hind limb ischemia. After the surgery, EPC-EXs and EPC-EXsmiR-17-5p were injected into the gastrocnemius muscle of the hind limb once every 7 days for 3 weeks. Blood flow, microvessel density, capillary angiogenesis, gastrocnemius muscle weight, structure integrity, and apoptosis in the hind limb were assessed. Vascular endothelial cells (ECs) and myoblast cells (C2C12 cells) were subjected to hypoxia plus high glucose (HG) and cocultured with EPC-EXs and EPC-EXsmiR-17-5p. A bioinformatics assay was used to analyze the potential target gene of miR-17-5p, the levels of SPRED1, PI3K, phosphorylated Akt, cleaved caspase-9 and cleaved caspase-3 were measured, and a PI3K inhibitor (LY294002) was used for pathway analysis. RESULTS: In the DHI mouse model, miR-17-5p was markedly decreased in hind limb vessels and muscle tissues, and infusion of EPC-EXsmiR-17-5p was more effective than EPC-EXs in increasing miR-17-5p levels, blood flow, microvessel density, and capillary angiogenesis, as well as in promoting muscle weight, force production and structural integrity while reducing apoptosis in gastrocnemius muscle. In Hypoxia plus HG-injured ECs and C2C12 cells, we found that EPC-EXsmiR-17-5p could deliver their carried miR-17-5p into target ECs and C2C12 cells and subsequently downregulate the target protein SPRED1 while increasing the levels of PI3K and phosphorylated Akt. EPC-EXsmiR-17-5p were more effective than EPC-EXs in decreasing apoptosis and necrosis while increasing viability, migration, and tube formation in Hypoxia plus HG-injured ECs and in decreasing apoptosis while increasing viability and myotube formation in C2C12 cells. These effects of EPC-EXsmiR-17-5p could be abolished by a PI3K inhibitor (LY294002). CONCLUSION: Our results suggest that miR-17-5p promotes the beneficial effects of EPC-EXs on DHI by protecting vascular ECs and muscle cell functions.

AIM2 inflammasome activation may mediate high mobility group box 1 release in murine allergic rhinitis / Ativação do inflamassoma AIM2 pode mediar a liberação da proteína do grupo Box-1 de alta mobilidade no modelo murino de rinite alérgica

Abstract Introduction: High mobility group box 1 protein participates in the pathogenesis of allergic rhinitis. Activation of the inflammasome can mediate the release of high mobility group box 1. The role of the absent in melanoma 2 inflammasome in allergic rhinitis remains unclear. Objective: This study aimed to investigate the function of absent in melanoma 2 inflammasome in murine allergic rhinitis and the interaction between high mobility group box 1 and the absent in melanoma 2 inflammasome. Methods: A murine allergic rhinitis model was established using twenty Balb/c mice. Expression of the components of the absent in melanoma 2 inflammasome: absent in melanoma 2, apoptosis-associated speck-like protein containing a CARD (Asc), caspase-1 p20, and additional nod-like receptor family pyrin domain containing 3 (Nlrp3) were detected by western blotting during allergic rhinitis. Alterations of absent in melanoma 2, caspase-1, and high mobility group box 1 after ovalbumin challenge were demonstrated by immunohistochemistry. TdT-mediated dUTP Nick end labeling, TUNEL assay, and cleavage of caspase-3 and PARP-1 were used for the observation of pyroptosis. Results: Eosinophilia and goblet cell infiltration were observed in the nasal mucosa of mice in the allergic rhinitis group. Absent in melanoma 2, Asc, and caspase-1 p20 increased after ovalbumin exposure while Nlrp3 did not. High mobility group box 1 was released in the nasal mucosa of allergic rhinitis mice. TUNEL-positive cells increased in the epithelium and laminae propria, whereas cleavage of caspase-3 and PARP-1 was not observed. Conclusions: The absent in melanoma 2 inflammasome was activated and pyroptosis may occur in the nasal mucosa after ovalbumin treatment. These may contribute to the translocation of high mobility group box 1 and the development of allergic rhinitis.

Resumo Introdução: A proteína do grupo Box-1 de alta mobilidade participa da patogênese da rinite alérgica. A ativação do inflamassoma pode mediar a liberação de proteína do grupo Box-1 de alta mobilidade. O papel do inflamassoma ausente no melanoma 2 na rinite alérgica permanece incerto. Objetivo: Investigar a função do inflamassoma ausente no melanoma 2 em um modelo murino de rinite alérgica e a interação entre a proteína do grupo Box-1 de alta mobilidade e o inflamassoma ausente no melanoma 2. Método: Um modelo murino de rinite alérgica foi estabelecido com 20 camundongos Balb/c. A expressão dos componentes do inflamassoma ausente no melanoma 2, da proteína speck-like associada à apoptose com CARD (Asc), da caspase-1 p20 e do domínio de pirina da família NLR adicional com 3 (Nlrp3) foi detectada por western blotting durante a rinite alérgica. Alterações de inflamassoma ausente no melanoma 2, na caspase-1 e na proteína do grupo Box-1 de alta mobilidade após o teste de provocação com ovalbumina foram demonstradas por imuno-histoquímica. O ensaio dUTP Nick-End Labeling mediado por TdT, TUNEL e clivagem de caspase-3 e PARP-1 foram usados para a observação de piroptose. Resultados: Eosinofilia e infiltração de células caliciformes foram observadas na mucosa nasal de camundongos do grupo rinite alérgica. Inflamassoma ausente no melanoma 2, Asc e caspase-1 p20 aumentou após a exposição à ovalbumina, enquanto Nlrp3 não aumentou. A proteína do grupo Box-1 de alta mobilidade foi liberada na mucosa nasal de camundongos com rinite alérgica. As células TUNEL-positivas aumentaram no epitélio e na lâmina própria, enquanto a clivagem da caspase-3 e a PARP-1 não foram observadas. Conclusão: O inflamassoma ausente no melanoma 2 foi ativado e pode ocorrer piroptose na mucosa nasal após o tratamento com ovalbumina. Esses fatores podem contribuir para a translocação de proteína do grupo Box-1 de alta mobilidade e o desenvolvimento de rinite alérgica.

Clinical assessment of occlusion and temporomandibular joint after placement of preformed metal crowns for primary molars / 口腔疾病防治

Objective @#To explore the effect on children's occlusion and temporomandibular joint (TMJ) after placement of preformed metal crowns and provide a reference for the restoration of defective primary molars. @*Methods @#A total of 39 children who underwent all primary molar metal crown restorations under general anesthesia were enrolled. The participants underwent occlusal contact area, percentage of total occlusal force, asymmetric ratio of occlusal force and occlusal contact time examinations with the T-scan computerized occlusal analysis system. Vertical dimension of occlusion (VDO) was measured using a dental vertical dimension gauge. TMJ dysfunction signs were recorded using the modified clinical dysfunction index (Di), and TMJ dysfunction symptoms were recorded using questionnaires. All data were collected at pretreatment, 1-week, 1-month, 3-month, and 6-month follow-up visits. @*Results@#The occlusal contact area at the 3-month and 6-month follow-up visits returned to the occlusal contact area of pretreatment, and the difference was statistically significant (P>0.05). Compared with pretreatment, the percentage of total occlusal force at the 3-month and 6-month follow-up visits increased significantly, and the difference was statistically significant (P<0.05). The asymmetric ratio of occlusal force and the occlusal contact time were significantly decreased at the 6-month follow-up visit (P<0.05). The vertical dimension of occlusion recovered after one month of treatment (P>0.05). The final statistical analysis of the TMJ assessment showed that there was no significant difference in the clinical disorder index and TMJ dysfunction symptoms before and after treatment (P>0.05). @*Conclusions @# After undergoing all primary molar metal crown restorations, occlusal re-equilibrations were attained after approximately one month. The percentage of total occlusal force and occlusal stability were significantly increased after six months of treatment, without significant temporomandibular joint dysfunction.

Relationship between different roles of school bullying and self consciousness among adolescents / 中国学校卫生

Objective@#To explore the relationship between different roles of school bullying and self consciousness among adolescents, and to provide a reference for school bullying prevention and control.@*Methods@#In Ezhou and Xiaogan, two cities selected randomly from Hubei Province, 4 336 middle school students randomly selected from Ezhou and Xiaogan City in Hubei Province by stratified cluster sampling method during March to October in 2017, were investigated for an anonymous questionnaire survey. The Chinese version of adolescent school violence questionnaire was used to evaluate the different roles in school bullying, and the Self Consciousness Scale(SCS) was used to assess the level of self awareness.@*Results@#About 18.9% of the respondents (819) were involved in bullying, among 86(2.0%) were pure perpetrators, 369 (8.5%) were pure victims, 364 (8.4%) were perpetrator victims. There were significant differences in public and private self awareness among different roles of campus bullying ( F=4.05, 2.90, P <0.05). The public self awareness score of perpetrator victims was higher than that of the uninvolved. The private self consciousness score of perpetrator victims was lower than that of the uninvolved ( P <0.05). Multivariate Logistic regression showed a negative correlation between private self awareness and perpetrator victims. Private self awareness might reduce the risk of teenagers becoming perpetrator victims ( OR=0.93, 95%CI =0.91-0.96). A positive correlation between public self awareness and perpetrator victims and public self awareness might increase the risk of adolescents becoming perpetrator victims ( OR=1.08, 95%CI = 1.06- 1.11).@*Conclusion@#Self awareness is related to different roles of school bullying, and higher public self awareness and lower private self awareness are important predictors of perpetrator victims of school bullying.

Carbon dioxide laser treatment of facial papilloma in children: case report and literature review / 口腔疾病防治

Objective@#To investigate the feasibility of using a carbon dioxide(CO2) laser in the treatment of facial papilloma in children and to evaluate its curative effect and prognosis.@*Methods @#A case of pediatric facial papilloma treated with a CO2 laser was reported, and the effects of this disease and CO2 laser treatment were reviewed and analyzed in combination with the literature. @* Results@#Under general anesthesia, the lesion tissue of the left lip was excised for pathological biopsy, and the diagnosis was maxillofacial papilloma. The lesions were surgically ablated in stages with a CO2 laser, and erythromycin ointment was applied to the surgical incision after surgery. A total of three rounds of CO2 laser treatment were performed for 3 treatment courses. The child had no complications during or after the operation, the facial appearance was significantly improved, and there was no sign of recurrence during the 6-month follow-up. A literature review showed that CO2 lasers have been widely used in the excision of various surface lesions. In clinical practice, continuous CO2 laser with power of 10-50 W and wavelength of 10.6 μm is used to treat superficial tissue lesions, which can achieve accurate vaporization resection of diseased tissue, less bleeding and a good prognosis.@* Conclusion@#CO2 laser was accurate and minimally invasive for the removal of facial papilloma in children.

Progress on identification and management of Parkinson′s disease-related fatigue / 中华神经科杂志

Fatigue is one of the most common and disabling symptoms of Parkinson′s disease (PD), which has an important impact on the quality of life. Due to the lack of a strict and unified definition and classification of PD-related fatigue, as well as a clear quantitative standard, clinical studies on fatigue in PD have drawn different conclusions, making fatigue research challenging. Normative studies in this area have been complemented by the publication of the 2016 expert consensus on diagnostic criteria for PD associated fatigue. In this paper, the incidence, influencing factors, clinical evaluation measures and treatment of PD-related fatigue were reviewed to provide the latest information for clinical identification and management of PD-related fatigue patients.

Study on map analysis and trend prospect of campus thermal environment based on CiteSpace / 中国学校卫生

Objective@#To grasp the research dynamics and development trend of the thermal environment of campus buildings in China, so as to lay the foundation for in depth research and provide a reference basis.@*Methods@#Based on 479 documents in CNKI from 2000 to 2020, the documents were visualized and analyzed by keywords, including co occurrence, clustering, outbreak and author cooperation network in CiteSpace.@*Results@#In the past 20 years, the research on thermal environment of campus buildings in China had gone through a period of formation development growth, and was at a high growth stage now. The word frequency of "thermal comfort, thermal environment, indoor thermal environment, natural ventilation" was greater than 50, which was a high frequency keyword. The highest outbreak rate of "green campus" was 3.75, and "university library, university building, microclimate and green building" was in the outbreak period. And LIU Jiaping, LIU Zehua, WANG Hongguang and others were highly productive authors and have formed cooperative network groups with their own cores, but the cooperation among the network groups was less to be strengthened.@*Conclusion@#The research dynamics of the thermal environment of campus buildings is closely related to the policy development in China, and the research on "green campus, campus energy saving optimization, and university buildings" based on human thermal comfort theory is a hot topic of continuous attention.

Effects of Alzheimer's disease of varying severity on cardiac and autonomic function

Alzheimer's disease (AD) is one of the most common neurodegenerative diseases in the elderly. The aim of this study was to explore the effects of AD on cardiac function and autonomic nervous function, and the feasibility of electrocardiogram (ECG) in monitoring the development of AD. APP/PS1 double transgenic mice were used in the Morris water maze (MWM) experiment to evaluate the changes of cognitive ability of AD mice, then the non-invasive ECG acquisition system was used and the changes of ECG intervals and heart rate variability (HRV) were analyzed. AD mice already had cognitive dysfunction at the age of 5 months, reaching the level of mild dementia, and the degree of dementia increased with the course of disease. There were no significant changes in ECG intervals in the AD group at each month. The mean square of successive RR interval differences, percentage of intervals >6 ms different from preceding interval, and normalized high frequency power component in the AD group were decreased and low-to-high frequency power ratio and normalized low frequency power component were increased. Combined with the results of the MWM, it was shown that the regulation mechanism of sympathetic and parasympathetic nerves in mice was already imbalanced in early stage AD, which was manifested as the increase of excessive activity of sympathetic nerves and the inhibition of parasympathetic activities. Therefore, ECG-based analysis of HRV may become a means of daily monitoring of AD and provide an auxiliary basis for clinical diagnosis.

Co-occurrence of myeloid neoplasm and plasma cell neoplasm

ABSTRACT Co-occurrence of myelodysplastic syndrome (MDS) and plasma cell neoplasm in patients with no history of chemo and/or radiotherapy is rarely reported. Herein, we report a case of a female in her seventieth decade of life who was referred to the hospital for pancytopenia. The patient was asymptomatic and was doing well overall. Serum protein electrophoresis was remarkable for a lambda-restricted monoclonal protein (IgG) estimated at 1.8g/dL. Immunoglobulin G serum level was also elevated, and serum Kappa/Lambda free light chain ratio was decreased. At that time, a bone marrow biopsy showed myelodysplastic syndrome with excess blasts-2 (MDS-EB2) and a monoclonal plasma cell proliferation. Some studies have shown that patients with plasma cell neoplasm could be associated with an increased risk of developing MDS compared to the general population. Based on reviewing the literature, to our knowledge, the pathological mechanism of the co-occurrence of both diseases is not yet clear.