Teaching environmental health in primary and secondary schools in Shanghai and its association with screening myopia applying multilevel models / 中国学校卫生

Objective@#To understand the status of teaching environmental health in primary and secondary schools and explore its association with myopia, so as to provide a basis for precision myopia prevention and control.@*Methods@#From September to October 2020, a stratified cluster sampling method was used in 16 districts of Shanghai. After matching the teaching environment testing classrooms with the classrooms where the students were surveyed, totally 470 classrooms and 14 624 students were monitored. Trained professional technicians used laser range finder, luxmeter to measure parameters about teaching environmental health. Students were subject vision testing and questionnaires. Multilevel models was used to analyze the association between teaching environment and screening myopia.@*Results@#The qualified rates of each indicators of teaching environmental health were as follows: window to floor area ratio (93.0%), classroom area per capita (82.1%), uniformity ratio of illuminance of blackboard ( 79.7% ), blackboard size (68.7%), daylight factor (67.0%), blackboard hanging height (66.9%), average illuminance on desk (66.4%), uniformity ratio of illuminance of desk (63.6%), reflectance of blackboard (46.8%), average illuminance on blackboard (41.4%), reflectance of wall (33.2%), desk and chair allocation compliance rate (19.8%). The results of two level Logistic model analysis showed that unqualified average illuminance on blackboard was positively associated with screening myopia ( OR =1.24, 95% CI = 1.05 -1.47, P <0.05).@*Conclusion@#Teaching environmental health of primary and secondary schools in Shanghai is not optimistic, teaching environment especially the desk and chair allocation compliance rate need to be improved. The average illumination on blackboard is positively correlated with screening myopia, suggesting that myopia prevention and control can focus on improving the illuminance on blackboard.

Association of sleep quality, depressive symptoms with non suicidal self injury among rural middle school students / 中国学校卫生

Objective@#To investigate the association of sleep quality, depressive symptoms and their interaction with non suicidal self injury (NSSI) among rural middle school students, so as to provide a reference for early prevention and control of NSSI among rural middle school students.@*Methods@#A multi stage cluster sampling method was used to randomly select four rural middle schools in Xuzhou, Jiangsu Province. A total of 1 723 middle school students were investigated according to the principle of grade stratification and class random selection. Paper questionnaires (including demographic factors, Non Suicidal Self Injury Short Scale, Pittsburgh Sleep Quality Index, Patient Health Questionnare-9) were used to conduct the questionnaire survey. Logistic regression model was used to analyze the association of sleep quality, depressive symptoms and their interaction with NSSI among rural middle school students.@*Results@#Totally 30.5% of middle school students had NSSI. Univariate results showed that girls (33.0%) had a higher incidence of NSSI than boys(27.3%), and those with sleep disorders and depressive symptoms had a higher incidence of NSSI, which was 46.8%, 43.6%. The results of multivariate Logistic regression showed that the risk of NSSI in students with sleep disorder was 1.80 times that in those without sleep disorder( OR 95%CI=1.42-2.28, P <0.01). The risk of NSSI in students with depressive symptoms was 3.32 times higher than that in those without depressive symptoms( OR 95%CI=2.60-4.24, P <0.01). The interaction results showed that there was additive interaction between sleep disturbance and depressive symptoms on the occurrence of NSSI behavior in rural middle school students, and the relative excess risk, attributable proportion and synergy index were 1.80, 0.30 and 1.57, respectively.@*Conclusion@#Sleep disorder and depressive symptoms are risk factors for NSSI among rural middle school students, and there is additive interaction between them.

Effects of environmental factors on refractive development of children and adolescents in different pubertal stages / 中国学校卫生

Objective@#To explore the effect of puberty on refractive development of children and adolescents and its interaction with outdoor activities, near work and the use of electronic products, so as to provide a reference for strategies for intervening myopia.@*Methods@#Cluster sampling method was used to select 776 students aged 7-13 from a nine year consistent school in Shanghai to participate and were followed up for 2 years. All participants underwent cycloplegic refraction and ocular axial length measurement once a year, as well as pubertal development, average daily outdoor time, near work time and time of electronic products usage. The influencing factors and interaction effects of refractive parameters in different puberty stages were analyzed by generalized estimation equation.@*Results@#At baseline, 634 children participated in cycloplegic refraction, of which 350 were myopic (55.2%). There were significant differences in axial length, average daily outdoor time, near work time and time of using electronic products at different stages of puberty ( F = 4.10 ，4.24，5.54，9.20， P <0.05). There was interaction between puberty and outdoor time on axial length development ( β =0.133, P < 0.05), and the interaction between puberty and the time of near work or using electronic products was not statistically significant ( P >0.05).@*Conclusion@#Puberty may play a regulatory role in the relationship between outdoor time and refractive development among Chinese children and adolescents.

Online learning related screen use and associated factors in school aged children in Shanghai during the COVID-19 epidemic / 中国学校卫生

Objective@#To understand the online learning related screen use duration and screen types in school aged children in Shanghai during the COVID-19 epidemic.@*Methods@#Random clustering sampling was used to select 5 591 parents of students from 8 primary and junior schools that are in the sampling pool of the national myopia survey in districts of Jiading, Pudong and Baoshan in Shanghai in April 2020. Electronic questionnaire was administered to parents regarding their child s online learning related screen use.@*Results@#On average, the median weekly duration of online learning related screen use was 13.33 hours, the curricular and extracurricular parts of which were 10(8.75，16.67) and 0(0，3.33) hours, respectively. About 29.44% of investigated school aged children only used small size screen for online learning. Children in higher grades, being myopic and parents neither being myopic were associated with reporting higher weekly duration( P <0.05); children in higher grades of primary school and parents neither being myopic were associated with a higher likelihood of using small size screen for online learning( P <0.05).@*Conclusion@#At the early stage of the COVID-19 epidemic, the burden associated with online learning related screen use was high in school aged children in Shanghai. Health education regarding online learning related screen use should be addressed in parents to guide their children to use screen appropriately.

Effects of sunlike spectrum LED illumination on retinal blood perfusion in children and adolescents: a randomized controlled trial / 中国学校卫生

Objective@#To analyze the effect of sunlike spectrum LED illumination on retinal blood flow perfusion, and to explore the the correlation between sunlike spectrum LED illumination and eye health indicators in children and adolescents.@*Methods@#A randomized control double blind trial was conducted. The ordinary LED table lamp in the control group(11) and the sunlike spectrum LED table lamp in the experimental group(12) had a fitting degree of 87% and 95% with the daylighting spectrum, respectively. Two sample independent t test and multivariable linear regression model were applied to compare the changes of retinal blood perfusion before and after the trial.@*Results@#After near reading for 1 hour, the retinal capillary density in the superficial and deep layers of the subjects in the ordinary LED illumination group decreased (superficial layer: -3.05±2.04 , P <0.01; deep layer: -4.03± 4.94, P =0.02), no significant decrease was found in the sunlike spectrum LED illumination group (superficial layer: -0.59± 1.44, P =0.18; deep layer: -0.49±4.27, P =0.70). Multivariable regression analysis found that compared with ordinary LED illumination, sunlike spectrum LED illumination could significantly alleviate the decrease in capillary density in the superficial and deep retinal layers, respectively ( β =2.83, 95% CI =1.54-4.12, P <0.01; β =4.21,95% CI =0.58-7.84, P =0.02).@*Conclusion@#Sunlike spectrum LED illumination can alleviate the decrease in retinal blood perfusion caused by near work among children and adolescents, suggesting that it may delay the onset and development of myopia. Prevention and control of myopia needs to pay attention to the spectral power distribution of artificial illumination.

Relationship between myopia and nutritional status among upper elementary students in Shanghai / 中国学校卫生

Objective@#To explore the relationship between myopia and nutritional status among upper elementary students in Shanghai.@*Methods@#A stratified cluster sampling method was used to select 5 576 fourth and fifth grade students from 16 districts in Shanghai, vision test, physical examination and questionnaire survey were administered. Two level multivariate Logistic regression and mixed linear models were used to analyze the relationship between myopia, spherical equivalent (SE) and nutritional status.@*Results@#The detection rates of overweight and obesity were 17.0%(949) and 18.7%(1 042), respectively. There was a statistical difference in the proportion of the nutritional status in boys and girls( χ 2=210.94, P <0.01), with overweight and obesity in boys higher than those of girls. The overweight boys were more likely to have myopia (univariate analysis: OR=1.23, P =0.04; multivariate analysis: OR=1.21, P =0.06) than the normal weight boy. Overweight students tended to had more negative refractive than those with normal weight in both boys and girls(multivariate analysis, boys: β =-0.19, girls: β=-0.24, P <0.05). Myopia risk and refractive power in obese students showed no statistical difference with normal weight students( P >0.05).@*Conclusion@#Overweight students have lower SE than the normal weight among upper elementary students of Shanghai, more researches are needed to confirm this finding and to provide theoretical bases for myopia prevention and control.

Establishment of swimming posture teaching model based on integrated algorithm / Estabelecimento do modelo de ensino de postura na natação baseado no algoritmo integrado / Establecimiento de un modelo de enseñanza de la postura de natación basado en algoritmos integrados

ABSTRACT As people's lives become better and better, more and more citizens are no longer satisfied with simple food-and-clothing problems, but gradually move towards the spiritual life they are yearning for. Among this, physical health is also an important part of it. So, at this stage, a lot of people will go swimming to exercise their body and mind. In this paper, the integration algorithm was used, and the self-learning ability of the integration algorithm was used. This algorithm was used to study the swimming posture model. This model can play an important role in the teaching of traditional swimming posture.

RESUMO À medida que a vida das pessoas se torna melhor, cada vez mais cidadãos já não se contentam com problemas simples como comida e vestuário, mas, gradualmente, passam a cuidar da vida espiritual que anseiam. Nesse contexto, a saúde física é também um fator importante. Então, nesse estágio, muita gente passa a fazer natação para exercitar o corpo e a mente. Neste artigo, utilizou-se o algoritmo de integração, além da capacidade de autoaprendizagem do algoritmo. Utilizou-se o algoritmo para estudar o modelo de postura na natação, que pode desempenhar um papel importante no ensino da tradicional postura de natação.

RESUMEN A medida que la vida de las personas se vuelve mejor, cada vez más ciudadanos no se contentan con problemas simples como la comida y la vestimenta, sino que gradualmente, empiezan a cuidar la vida espiritual que anhelan. En ese contexto, la salud física es también un fator importante. Entonces, en ese nivel, mucha gente comienza a hacer natación para ejercitar el cuerpo y la mente. En este artículo, se utilizó el algoritmo de integración, además de la capacidad de autoaprendizaje del algoritmo. Se utilizó el algoritmo para estudiar el modelo de postura en la natación, que puede desempeñar un papel importante en la enseñanza de la tradicional postura de natación.

Influence of physical activity patterns on academic performance in children and adolescents / 中国学校卫生

Abstract@#Physical activity promotes the physical and mental health of children and adolescents, and a growing body of research has demonstrated the positive effects of physical exercise, including better academic performance. This review presents a retrospective analysis of the existing literature in order to explore the relationship between physical activity patterns and academic performance in children and adolescents. This study analyzes the impact of differences in the duration, frequency, intensity, and type of physical activity on the academic performance of children and adolescents, which provides a basis for improving the quality and effect of such physical activities. High-quality evidence supports the view that long-term, high-frequency, aerobic physical activities of moderate-to-vigorous intensity have a positive impact on children and adolescents’ academic performance. This study provides a reference to help families, schools, and society to scientifically and rationally promote physical activity among children and adolescents.

Analysis of myopia related factors among primary and secondary school students in Shanghai / 中国学校卫生

Objective@#To analyze myopia related factors among students in Shanghai, to explore associated risky behaviors associated with mild, moderate, high myopia,so as to provide the evidence for the implementation of home and school combination intervention measures.@*Methods@#Six primary and secondary schools (2 primary schools, 2 middle schools and 2 high schools) were selected from each district of Shanghai. The primary schools began to investigate from the fourth grade. All the students in the selected classes participated in the vision test and questionnaire survey. Chi square test was used for categorical data analysis. The relationship between myopia and related behaviors was analyzed by multivariate Logistic analysis.@*Results@#The prevalence of visual-related risky behaviors such as short outdoor time during the day, lack of sleep, long after-school reading and writing time, poor reading and writing posture, and longtime-using mobile electronic screen was higher in girls than in boys (P<0.05), boys were more likely than girls to use computer for long time and read books/electronic screen in sunlight (P<0.05). The group with 3 hours or more than of reading and writing compared with the less than 2 hours, the OR value of mild myopia model was 1.31(1.20-1.44), moderate myopia model was 1.78(1.62-1.96), severe myopia model was 2.37(2.07-2.71). In the model of moderate and high myopia, reading and writing posture, frequency of eye relax, outdoor activity time and watching TV time were also included.@*Conclusion@#The prevalence of myopia related behaviors among primary and secondary school students is high, and there are significant gender differences among different behaviors. Students reading and writing time should be strictly controlled after school. Intervention strategies and measures should be carried out according to the characteristics of different ages and genders.

Analysis of correlation between eye strain and eye health behavior in college students during the period of COVID-19 epidemic / 中国学校卫生

Objective@#To understand the relationship between eye strain and eye health behavior in college students learning at home during the period of COVID-19 epidemic, and to provide a scientific reference for improving the hygiene of using eyes among the college students.@*Methods@#A cross sectional study and stratified cluster sampling was used to select 2 671 college students from 8 colleges in Anhui Province during the March 1st to July 1st in 2020, and an online questionnaire was survey included general information,eye strain,and daily eye health behavior.@*Results@#The prevalence of eye strain in college students was 69.64%. Multivariable Logistic regression analysis showed that eye strain was correlated with gender, myopia, siesta habit, staying up until 2:00 am, and the use of eye liquid, with OR values(95% CI ) were 0.64(0.53-0.76), 1.77(1.42- 2.20 ),0.71(0.59-0.86), 1.39(1.17-1.65), and 2.18(1.71-2.79), respectively. There was no correlation among daily outdoor activity time, daytime reading time and the occurrence of eye strain( P >0.05).@*Conclusion@#During the period of COVID-19 epidemic, eye strain among college students is common. The daily eye health behavior is related to the occurrence of eye strain. Under the special learning context, eye care measures should be encouraged specifically.

Study on the growth curve of uncorrected visual acuity of children and adolescents with relative safe refractive range / 中国学校卫生

Objective@#To analyze the distribution of uncorrected visual acuity in children and adolescents aged 3-18 years with relative safe refractive range, and to develop the growth curve and reference range of uncorrected visual acuity in children and adolescents of different ages, so as to provide reference for formulating the referral threshold for myopia screening practice.@*Methods@#Using cluster sampling method, 9 146 children and adolescents aged 3-18 years old in Shanghai were selected for uncorrected visual acuity, cycloplegic refraction, slit lamp and other ophthalmic examinations, and the percentiles and growth curve of uncorrected visual acuity of children and adolescents in the relative safe refractive range were fitted by LMS method. Besides, the area under the ROC curve and the sensitivity and specificity of different cut-off values were analyzed.@*Results@#The uncorrected visual acuity was skewed, with a median of 4.8. There were 4 675 individuals with safe refraction, the median of uncorrected visual acuity in which was 4.9. The LMS curve showed that the uncorrected visual acuity increased with age in the lower age group, and gradually stabilized to the best level at the age of 6-10. P 50 was 4.8 in 3-4 years old, 4.9 in 5-8 years old, 5.0 in 9 years old and above. The area under ROC curve of uncorrected visual acuity predicting refractive abnormality increased with age, with the lowest value of 0.55(95%CI=0.50-0.61) at 3 years old and the highest value of 0.95 (95%CI=0.94-0.96) at 12-18 years old. The Youden index was the highest for P25 at 3-6 years old, and the highest for P 10 at 7 years old and above. With the increase of the cut off value, the sensitivity increased and the specificity decreased.@*Conclusion@#The uncorrected visual acuity increases gradually with age, and reaches the best level after 6-10 years old. The screening effect of uncorrected visual acuity predicting refractive abnormality increased with age. It is suggested that the referral threshold of children and adolescents with abnormal uncorrected visual acuity should be set according to their ages, and P 25-P 75 can be selected according to the screening purposes.

Clinical significance and correlation of microRNA-21 expression and the neutrophil-lymphocyte ratio in patients with acute myocardial infarction

OBJECTIVES: To explore the clinical significance and correlation of microRNA-21 (miR-21) and the neutrophil-lymphocyte ratio (NLR) in patients with acute myocardial infarction (AMI). METHODS: The observation group contained 184 patients, while the control group contained 150 patients. The expression of miR-21 in the serum of each group was detected by qRT-PCR. RESULTS: A total of 184 patients and their family members were followed-up for 30 days, among which 35 patients died and 149 patients survived, resulting in a survival rate of 80.97%. According to univariate analysis, there were significant differences in age, cardiac troponin (cTn), heart rate, Killip grade, percutaneous coronary intervention (PCI) operation rate, miR-21 and NLR. In the receiver operating characteristic (ROC) analysis, the area under the curve (AUC) values of miR-21 and NLR for the diagnosis of AMI were 0.909 and 0.868, respectively, and the area under the combined detection curve was 0.960. In the Kaplan-Meier survival analysis, the survival of patients with high miR-21 expression and NLR was significantly higher than that of patients with low miR-21 expression and NLR (p=0.027; p=0.001). The correlation showed that miR-21 expression in serum was positively correlated with the NLR in the observation group (r=0.528, p<0.05). cTn, heart rate, Killip classification, PCI operation rate, miR-21, NLR are independent risk factors for AMI. CONCLUSION: miR-21 and NLR play a role in the diagnosis of AMI and can be used as predictors for the survival of AMI.

Sertoli cells promote proliferation of bone marrow-derived mesenchymal stem cells in co-culture.

Bone marrow-derived mesenchymal stem cells (BMSCs) are a major source for cell transplantation. The proliferative ability of BMSCs is an important determinant of the efficiency of transplant therapy. Sertoli cells are ‘‘nurse’’ cells for development of sperm cells. Our recent study showed that Sertoli cells promoted proliferation of human umbilical cord mesenchymal stem cells (hUCMSCs) in co-culture. Studies by other groups also showed that Sertoli cells promoted growth of endothelial cells and neural stem cells. In this study, we investigated the effect of Sertoli cells on proliferation of BMSCs. Our results showed that Sertoli cells in co-culture significantly enhanced proliferation of BMSCs (P <0.01). Moreover, co-culture with Sertoli cells also markedly increased mRNA and/or protein expressions of Mdm2, p-Akt and Cyclin D1, and decreased p53 expression in BMSCs (P <0.01 or <0.05). These findings indicate that Sertoli cells have the potential to enhance proliferation of BMSCs.

Rhamnolipid but not motility is associated with the initiation of biofilm seeding dispersal of Pseudomonas aeruginosa strain PA17.

Seeding dispersal is an active detachment exhibit in aging Pseudomonas aeruginosa biofilm. Yet, effect factors of this process in the biofilm of clinical isolated mucoid P. aeruginosa strain remain to be better characterized. In our previous work, one mucoid P. earuginosa strain PA17 was isolated from a patient with recurrent pulmonary infection. In this study, confocal scanning laser microscope combined with LIVE/DEAD viability staining revealed that PA17 biofilm exhibited earlier seeding dispersal than non-mucoid PAO1. We further compared the motility and the expression of motility-associated gene during biofilm development between PA17 and PAO1. PA17 was found to be impaired in all three kinds of motility compared to PAO1. Moreover, we investigated the expression of rhamnolipid-associated genes in PA17 and PAO1 biofilm. The expression of these genes was in accordance with the process of seeding dispersal. Our results indicated that rhamnolipid but not motility is associated with the initiation of seeding dispersal of PA17 biofilm.

Efficiency of phosphorus utilization in phyA-expressing cotton lines.

To evaluate and characterize the stability of traits conferred by phyA from Aspergillus ficuum, we examined expression of phyA in sexually-derived transgenic cotton progeny and assessed the capacity for phytate-utilization in T4 progeny. The gene (phyA) was expressed only in the roots, but not in the stem and leaf tissues. Phytase activity was 2.38-fold higher in transgenic line L2 than in wild-type (WT) plants. The amount of phosphorus in the leaves was also significantly higher in transgenic lines L2, L6 and L9. Among those lines, L2 performed best, showing increase in phosphorus contents of 10.67% (seedling stage), 8.78% (squaring), 11.77% (flowering) and 11.59% (boll-opening). The level of available phosphorus in the rhizosphere was 19% higher in soil containing transgenic plants compared with the WT. When both transgenic and WT were grown in the same type of soil, the number of bacteria, fungi and actinomycetes was not obviously different. These results indicated that although the T4 generation enhanced the utilization of phytate phosphorus, it had no influence on the number of soil microorganisms. Our findings also demonstrated that phytase-expression lines could be used for developing new varieties of cotton having improved phosphorus uptake from the soil.