Changes of axial length in primary and secondary school students in Yunnan and associated factors / 中国学校卫生

Objective@#To explore the pattern of change of axial length/curvatrue radius ratio (AL/CR) and associated factors in primary and secondary school students in Yunnan, so as to provide scientific basis and prospective guidance for early myopia intervention and control.@*Methods@#A total of 685 students from grades 2 to 3 and grade 7 in 2 cities/counties in Yunnan Province were selected by multi stage stratified random cluster sampling method in 2020. All the participants were followed up twice with questionnaire of myopia related factors, uncorrected distance visual acuity, and refractive parameter measurement from October,2021 and March,2023,respectivelty. The distribution and change of AL/CR in different classes and groups were analyzed, and the influencing factos of AL/CR cumulative progression were explored using generalized linear model.@*Results@#AL/CR ratio in primary school students was (2.95±0.09) at baseline, increased to (2.99±0.11) at the first follow up and (3.04±0.12) at the second follow up. AL/CR ratio in middle school students(3.08±0.13) at baseline, increased to (3.12±0.15) at the first follow up and (3.15±0.14) at the second follow up. The generalized linear model showed that after controlling for environmental factors, ethnicity ( β =-0.017) , cumulative progression of the SE ( β =-0.027) influenced the changes of AL/CR ratio among the primary school students, whereas the changes of AL/CR ratio were associated with baseline AL ( β =-0.005), baseline corneal curvatrue radius ( β =0.032) and cumulative progression of SE( β =-0.035) among middle school students ( P <0.05).@*Conclusions@#The AL/CR ratio of primary and secondary school students in Yunnan can be used to judge different refractive status types, but its variation is not only related to SE progression, but also affected by different ethnic groups and baseline ocular biological parameters. so the value of AL/CR application in assessing the progression of myopia needs to be further confirmed.

Evidence of validity of the Smoking Cessation Counseling scale - Brazilian version / Evidencias de validez de la escala Smoking Cessation Counseling - versión brasileña / Evidências de validade da escala Smoking Cessation Counseling - versão brasileira

Objective: to evaluate the evidence of validity of the internal structure and reliability of the Brazilian version of the Smoking Cessation Counseling instrument Method: psychometric study of confirmatory factor analysis and reliability carried out on 250 nurses in clinical practice. For the analysis of the convergent validity of the factor model, Average Variance Extracted values were calculated, and discriminant analysis was carried out using the Fornell-Larcker criterion. Reliability was examined using Cronbach's alpha coefficient and composite reliability Results: it was necessary to exclude seven items from the Advanced Counseling domain and one item from the Basic Counseling domain in order to properly obtain the Average Variance Extracted values and the Fornell-Larcker criterion. The composite reliability ranged from 0.76 to 0.86 and the overall Cronbach`s alpha coefficient was 0.86, ranging from 0.53 to 0.84 depending on the domain assessed. The final version of the instrument was made up of 16 items divided into 4 domains Conclusion: the Brazilian version of Smoking Cessation Counseling obtained adequate psychometric evidence of validity and reliability. Further studies are needed to refine the instrument.

Objetivo: evaluar las evidencias de validez de la estructura interna y de la confiabilidad de la versión brasileña del instrumento Smoking Cessation Counseling. Método: estudio psicométrico de análisis factorial confirmatorio y de confiabilidad realizado en 250 enfermeras de la práctica clínica. Para el análisis de la validez convergente del modelo factorial se calcularon valores de Average Variance Extracted, el análisis discriminante se realizó mediante el criterio de Fornell-Larcker. La confiabilidad se examinó por el coeficiente de alfa de Cronbach y por la confiabilidad compuesta. Resultados: fue necesaria la exclusión de siete ítems del dominio de Asesoramiento avanzado y un ítem del dominio Asesoramiento básico para obtener adecuadamente los valores de Average Variance Extracted y del criterio de Fornell-Larcker. La confiabilidad compuesta varió de 0,76 a 0,86 y el coeficiente de alfa de Cronbach global alcanzado fue de 0,86, variando de 0,53 a 0,84 dependiendo del dominio evaluado. Se obtuvo la versión final del instrumento compuesto de 16 ítems distribuidos en 4 dominios. Conclusión: la versión brasileña de Smoking Cessation Counseling obtuvo adecuadas evidencias psicométricas de validez y confiabilidad. Estudios posteriores serán necesarios para el refinamiento del instrumento.

Objetivo: avaliar as evidências de validade da estrutura interna e da confibialidade da versão brasileira do instrumento Smoking Cessation Counseling Método: estudo psicométrico de análise fatorial confirmatória e de confiabilidade realizado em 250 enfermeiras da prática clínica. Para a análise da validade convergente do modelo fatorial foram calculados valores de Average Variance Extracted , a análise discriminante foi realizada pelo critério de Fornell-Larcker. A confiabilidade foi examinada pelo coeficiente de alfa de Cronbach e pela confiabilidade composta Resultados: foi necessária a exclusão de sete itens do domínio de Aconselhamento avançado e um item do domínio Aconselhamento básico para obtenção adequada dos valores de Average Variance Extracted e do critério de Fornell-Larcker. A confiabilidade composta variou de 0,76 a 0,86 e o coeficiente de alfa de Cronbach global alcançado foi de 0,86, variando de 0,53 a 0,84 a depender do domínio avaliado. Obteve-se a versão final do instrumento composto de 16 itens distribuídos em quatro domínios Conclusão: a versão brasileira da Smoking Cessation Counseling obteve adequadas evidências psicométricas de validade e de confiabilidade. Estudos posteriores serão necessários para o refinamento do instrumento.

Dietary patterns and socioeconomic, demographic, and health-related behaviors during pregnancy. A cross-sectional study

ABSTRACT BACKGROUND: The identification and understanding of dietary factors and other characteristics that influence gestational weight gain can contribute to the formulation of strategies to promote healthy eating habits before and during pregnancy. OBJECTIVE: To investigate the association between dietary patterns, sociodemographic and obstetric characteristics, and health-related behaviors in pregnant women. DESIGN AND SETTING: A cross-sectional study was conducted on women undergoing prenatal care in the Unified Health System of Colombo, Paraná, Brazil, from February 2018 to September 2019. METHOD: A weekly food frequency questionnaire was administered, and dietary patterns were identified through factor analysis. Median regression models were constructed to identify the associations between dietary pattern scores and variables. RESULTS: Complete data were obtained from 495 pregnant women. Three dietary patterns were identified: 1) "healthy," with higher factor loadings for the weekly consumption of raw vegetables, cooked vegetables, and fresh fruits; 2) "Western," including soft drinks or artificial juice, candies, milk, and dairy products, and processed cold meat; and 3) "traditional," beans and meat. Pregnant women aged 30 years or older (coefficient [Coef.] 0.86, 95% confidence interval [CI] 0.38-1.33) with moderate/intense physical activity (Coef. 0.32, 95% CI 0.02-0.62) had higher adherence to the "healthy" pattern. Adolescents and smokers adhered more to the "traditional" pattern (Coef. 0.17, 95% CI 0.01-0.33). CONCLUSION: Age, smoking status, and physical activity were associated with dietary patterns in pregnant women.

Relationship between job burnout, job stress and depression in perimenopausal women / 中国基层医药

Objective:To investigate the relationship between job burnout, job stress, and depression in perimenopausal women.Methods:A total of 1 208 postmenopausal women from Wenzhou were randomly selected from August 2020 to August 2022 as research subjects for this study. Job burnout, job stress, social support, and depression were measured using the personal general condition questionnaire, the Chinese community nurse stress scale, Maslach Burnout Inventory-General Survey, Center for Epidemiologic Studies Depression Scale. The Pearson correlation coefficient was used to analyze the correlation between job burnout, job stress, and depression.Results:The scores of the Chinese community nurse stress scale and Maslach Burnout Inventory-General Survey in married people were (47.54 ± 4.54) points and (34.69 ± 4.12) points, respectively, which were significantly lower than those in unmarried, divorced, separated, and widowed people ( F = 9.49, 51.86, all P < 0.001). The Social Support Questionnaire score in married people was (33.28 ± 8.94) points, which was significantly higher than that in unmarried, divorced, separated, or widowed people ( F = 17.55, P < 0.001). There was no significant difference in the Center for Epidemiologic Studies Depression Scale score among married, unmarried, divorced,separated, or widowed people (all P > 0.05). The scores for the Chinese community nurse stress scale, Maslach Burnout Inventory-General Survey, Center for Epidemiologic Studies Depression Scale, and Social Support Questionnaire in people who received middle school-level education were (55.41 ± 6.15) points, (44.31 ± 6.13) points, (21.24 ± 4.11) points, and (40.76 ± 10.44) points, respectively, which were significantly higher than those in people who received education of primary school and below, college and above ( F = 147.29, 106.46, 70.14, 13.08, all P < 0.001). The scores of stressors for individuals engaged in other non-service professions, the score of the Maslach Burnout Inventory-General Survey, and the score of the Center for Epidemiologic Studies Depression Scale were (44.21 ± 3.84) points, (37.78 ± 5.24) points, (17.53 ± 3.42) points, and (34.27 ± 6.97) points, respectively, which were significantly lower than that of stressors for individuals engaged in nursing, teaching, and other service professions ( F = 207.75, 102.47, 37.24, 137.35, all P < 0.001). The results of correlation analysis showed that the score of the stressor scale was positively correlated with the scores of the Maslach Burnout Inventory-General Survey, Center for Epidemiologic Studies Depression Scale, and Social Support Questionnaire ( r = 0.58, 0.62, 0.52, all P < 0.05). The score of the Maslach Burnout Inventory-General Survey was positively correlated with the scores of the Center for Epidemiologic Studies Depression Scale and Social Support Questionnaire ( r = 0.59, 0.68, both P < 0.05). The score of the depression scale was positively correlated with the score of the Social Support Questionnaire ( r = 0.65, P < 0.05). Conclusion:Job burnout and job stress are positively correlated with depression and related to perimenopausal women's marital status, social support, occupation, and education level.

Relationship between peripheral blood lipid level and hepatitis B-related liver cancer / 中国基层医药

Objective:To investigate the relationship between peripheral blood lipid levels and hepatitis B-related liver cancer, and to provide a theoretical basis for the early prevention and treatment of liver cancer.Methods:A total of 188 patients with hepatitis B-related liver cancer who received treatment in The First Hospital of Shanxi Medical University from June 2018 to June 2021 met the inclusion and exclusion criteria and had complete data, were included in this study. They were divided into three groups: chronic hepatitis B group ( n = 72), hepatitis B cirrhosis group ( n = 62), and hepatitis B-related liver cancer group ( n = 54) according to different stages of the disease. All patients' medical records were obtained from the medical data room. Fasting venous blood was collected in all patients on the second day after admission to detect peripheral blood lipid, liver function, and other relevant indicators. General data and biochemical indicators were collected. The Kruskal-Wallis test was performed to compare the measurement data among groups. The chi-squared test was performed to compare the count data among groups. Spearman's correlation (bivariate) was performed. Binary logistic regression was performed to analyze the influential factors of liver cancer. Results:There were significant differences in the levels of total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) among the three groups ( F = 32.14, 27.59, 10.88, 34.09, all P < 0.05). TC and LDL-C levels in the hepatitis B-related liver cancer group were significantly higher than those in the hepatitis B cirrhosis group ( F = -32.31, -50.19, both P < 0.05). There were no significant differences in TG and HDL-C levels between hepatitis B-related liver cancer and hepatitis B cirrhosis groups ( F = -10.69, 4.46, both P > 0.05). TC, TG, HDL-C and LDL-C levels in the hepatitis B cirrhosis group were significantly lower than those in the chronic hepatitis B group ( F = 53.30, 46.98, 24.61, 48.57, all P < 0.05). LDL-C level was positively correlated with the occurrence of liver cancer ( r = 0.20, P < 0.05). HDL-C level was negatively correlated with the occurrence of liver cancer ( r = -0.15, P < 0.05). LDL-C was an independent risk factor for liver cancer ( OR = 3.35, P < 0.05), and HDL-C was a protective factor for liver cancer ( OR = 0.12, P < 0.05). Conclusion:Compared with patients with chronic hepatitis B and hepatitis B cirrhosis, patients with hepatitis B-related liver cancer had abnormal peripheral blood lipid levels, which may be related to the abnormal lipid metabolism of tumor cells. Moreover, peripheral blood lipid levels may affect the occurrence and development of tumor cells.

Correlation between stomach disharmony and daily diets among students of Chinese medicine colleges and universities in China / 中国基层医药

Objective:To analyze the correlation between gastric disharmony and daily eating behaviors in college students, and to provide intervention measures for improving gastric disharmony among college students.Methods:From April 10 to 30, 2021, 3 825 college students from five Chinese medicine colleges and universities in China were selected for this study using the multi-level sampling method. The information regarding college student's general situation, daily eating behavior, and stomach disharmony was collected by questionnaire.Results:A total of 3 700 valid questionnaires were collected, with an effective response rate of 96.73%. The average age was (20.0 ± 3.0) years, and 66.41% of college students included in this study were female. Students with different characteristics had different gastric disharmonies and eating behaviors, and gastric disharmony was correlated with eating behavior. Multivariate analysis results showed that snacking ( OR = 1.11, 95% CI: 1.02-1.21), partial eclipse ( OR = 1.12, 95% CI: 1.00-1.26), picky eaters ( OR = 1.23, 95% CI: 1.08-1.41), and supper ( OR = 1.19, 95% CI: 1.04-1.36) were positively correlated with gastric disharmony. Eating regular meals ( OR = 0.86, 95% CI: 0.79-0.94) and 80% fullness ( OR = 0.89, 95% CI: 0.81-0.98) were negatively correlated with gastric disharmony. Conclusion:Poor eating behaviors may be an important factor leading to gastric disharmony.

Correlation analysis between post-stroke depression and serum bilirubin and high-sensitivity C-reactive protein / 中国基层医药

Objective:To analyze the influential factors of post-stroke depression and investigate the effects of changes in serum bilirubin and high-sensitivity C-reactive protein on post-stroke depression.Methods:A total of 199 patients with stroke admitted to Qinghai Provincial People's Hospital from December 2019 to December 2020 were included in this study. These patients were divided into the Xining urban group (2 000-3 000 meters above sea level; n = 165) and the Xining prefecture and county group (over 3 000 meters above sea level; n = 34) according to their long-term residence. They were also divided into the post-stroke depression group ( n = 56, including 45 patients in the Xining urban group and 11 patients in the Xining prefecture and county group) and non-post-stroke depression group ( n = 143, including 120 patients in the Xining urban group and 23 patients in the Xining prefecture and county group). Related scales were used to evaluate neurologic deficits and the degree of depression in the two groups. Serum levels of total bilirubin, direct bilirubin, and high-sensitivity C-reactive protein were measured in each group. Neurologic deficits and the degree of depression were correlated with serum levels of total bilirubin, direct bilirubin, and high-sensitivity C-reactive protein. Results:Serum levels of total bilirubin, direct bilirubin, and high-sensitivity C-reactive protein in the post-stroke depression group were (19.95 ± 7.22) mmol/L, (3.98 ± 1.49) mmol/L, and (1.40 ± 2.29) mg/L, respectively, which were significantly higher than (16.20 ± 7.61) mmol/L, (3.19 ± 1.62) mmol/L, and (0.63 ± 1.33) mg/L in the non-post-stroke depression group ( t = 3.17, 3.18, 2.35, all P < 0.05). There was a significant difference in serum level of high-sensitivity C-reactive protein between stroke patients with mild and moderate depression and stroke patients with severe depression ( t = 2.48, P < 0.05). Conclusion:Serum levels of bilirubin and high-sensitivity C-reactive protein play an important role in the pathogenesis of post-stroke depression and there is a significant correlation between the two.

Correlation between sputum culture results and serum levels of C-reactive protein, amyloid A and procalcitonin in patients with acute exacerbations of chronic obstructive pulmonary disease / 中国基层医药

Objective:To investigate the correlation between sputum culture results and serum levels of C-reactive protein, amyloid A, and procalcitonin in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).Methods:The clinical data of 131 older adult patients with AECOPD who received treatment in the Affiliated Hospital of Shaoxing University between January 2019 and January 2021 were retrospectively analyzed. According to sputum culture results, these patients were divided into a sputum culture positive group ( n = 52) and a sputum culture negative group ( n = 79). The sputum of patients was collected aseptically for isolation and identification of pathogens. The general data [age, gender, history of smoking, underlying diseases (hypertension, diabetes mellitus, coronary heart disease), albumin level, mechanical ventilation, method of sputum suction, duration of antibiotics medication, length of hospital stay] were recorded for each group. The risk factors for positive sputum culture were analyzed using binary logistic regression techniques. The efficiency of serum levels of C-reactive protein, amyloid A, and procalcitonin for predicting positive sputum culture was analyzed using the receiver operating characteristic curve. Results:There were 67 strains of pathogens isolated from 52 older adult patients with positive sputum culture of AECOPD. The main pathogens were Gram-negative bacteria (67.16%) [Klebsiella pneumonia (31.34%)], followed by Gram-positive bacteria (25.37%) and fungi (7.47%). Logistic regression analysis showed that mechanical ventilation ( OR = 2.75, P = 0.020), usage of broad-spectrum antibiotics ( OR = 2.95, P = 0.012), serum C-reactive protein level ≥ 20.96 mg/L ( OR = 2.44, P = 0.007), serum amyloid A level ≥ 18.03 mg/L ( OR = 2.67, P = 0.016) and serum procalcitonin level ≥ 2.08 μg/L ( OR = 2.51, P = 0.013) were independent risk factors of positive sputum culture in older adult patients with AECOPD. The receiver operating characteristic curve analysis showed that the area under the receiver operating characteristic curve depicting serum levels of C-reactive protein, amyloid A, and procalcitonin in combination for predicting AECOPD was 0.896, which is of predictive efficiency for positive sputum culture ( P < 0.05). Conclusion:The sputum culture pathogens in older adult patients with AECOPD are mainly Gram-negative bacteria. Increased serum levels of C-reactive protein, amyloid A, and procalcitonin are independent risk factors for Gram-positive bacteria. Combined detection of serum levels of C-reactive protein, amyloid A, and procalcitonin is highly efficient in the diagnosis of AECOPD and can be used to evaluate the sputum culture results in older adult patients with AECOPD.

Expression and clinical significance of stanniocalcin-2 and cellular-mesenchymal epithelial transition factor in tumor tissues in patients with cervical cancer / 中国医师进修杂志

Objective:To investigate the expression of stanniocalcin-2 (STC-2) and cellular-mesenchymal epithelial transition factor (C-met) in tumor tissues of cervical cancer patients and their clinical significance.Methods:A total of 110 cervical cancer patients were selected in Foshan First People′s Hospital from January 2014 to December 2018. Patients′ cancer tissue samples and normal tissue samples were collected during modified radical resection to determine and compare the expression levels of STC-2 mRNA and C-met mRNA in the two tissues, and to analyze the correlation between the expression levels of STC-2, C-met and the clinicopathological characteristics of the patients as well as the multivariate analysis of tumor metastasis and recurrence in the patients. The correlation between the expression of STC-2 and C-met and the time of postoperative tumor metastasis and recurrence in cervical cancer patients were analyzed after 24 months of follow-up.Results:The expression levels of C-met mRNA and STC-2 mRNA in cancer tissues were higher than those in adjacent normal tissues: 4.51 ± 1.21 vs. 3.97 ± 1.14, 2.57 ± 0.21 vs. 2.12 ± 0.24, there were statistical differences ( t = 3.41, 14.80, P<0.05). The expression of STC-2 and C-met in cancer tissues had no significant difference with age, pathological type, federation international of gynecology and obstetrics (FIGO) stage and tumor size ( P>0.05), but had significant difference with tumor recurrence or metastasis ( P<0.05). The results of Logistic multivariate analysis showed that vascular emboli, lymph node metastasis, TNM stage, depth of tumor invasion, C-met expression and STC-2 expression were independent risk factors affecting the prognosis of cervical cancer patients ( P<0.05). The expression of STC-2 and C-met were negatively correlated with the time of tumor metastasis in patients with cervical cancer ( r = - 0.663, P<0.001; r = - 0.747, P<0.001). Conclusions:The expression levels of STC-2 and C-met in cancer tissues of cervical cancer patients are higher than those in adjacent normal tissues, and the expression levels of STC-2 and C-met are negatively correlated with the time of metastasis. The expression of C-met, the expression of STC-2, vascular emboli, lymph node metastasis, TNM stage, and the depth of tumor invasion are all independent risk factors affecting the prognosis of cervical cancer patients.

Meta-integration of the effects of continuing care services on quality / 中国实用护理杂志

Objective:To systematically evaluate the quality of continuing care services carried out by nursing staff in China, comprehensively integrate the influencing factors of continuing care services, and provide guidance for promoting the development of continuing care in China.Methods:PubMed, EMbase, Web of Science, the Cochrane Library, CMB, SinoMed, CINAHL, CNKI, Wanfang Data and VIP related qualitative studies were searched from the database establishment to March 2022. The NoteExpress software was used to screen and analyze the literature, the 2017 Australian JBI Evidence-based Health Care Center quality research quality evaluation standard was used to conduct qualitative evaluation of the literature, and the Meta-integration method was adopted to carry out pooled integration. The ConQual approach was used to evaluate the quality of the integrated results.Results:A total of 39 results were extracted from 11 studies. Eleven new categories were summarized and four integrated results were obtained, which were: nurses lack relevant cognitive, motivational and behavioral skills; patients have poor compliance and low trust in medical prescriptions; lack of team management, method guidance and system standards; lack of connection sharing, input supply and upper protection. The total evidential quality of the integration results was intermediate.Conclusions:At present, nurses should strengthen their own ability, pay attention to patient education, enhance the sense of trust between doctors and patients. Managers should pay attention to team building, standardize the service standards and systems. The state should increase input, improve social policy support and legal protection; for the orderly development of continuity of care services escort.

Cyberbullying and its effect on health risk behaviors among secondary vocational school students / 中国学校卫生

Objective@#To investigate the current situation of cyberbullying and health risk behaviors among secondary vocational school students, to explore the effects of cyberbullying on health risk behaviors, so as to provide a reference for formulating intervention strategies to promote adolescent health related behaviors.@*Methods@#From March to April 2023, a field survey was conducted on 1 184 students from one secondary vocational school each in Jilin City and Yanji City by random cluster sampling method. The data was analyzed using Chi square tests and generalized linear models.@*Results@#Among secondary vocational school students, 839 individuals (70.9%) experienced the cyberbullying, and 1 036 individuals (87.5%) had one and more health risk behavior group. There was a positive correlation between cyberbullying and health risk behaviors ( r=0.60, P <0.01). The generalized linear model analysis showed that female and no Internet addiction were negatively correlated with the health risk behaviors of secondary vocational students ( β =-2.75, -8.90), and the single parent families and peer pressure was positively correlated with the health behaviors of secondary vocational students ( β =2.56, 4.82)( P ＜0.05). Secondary vocational students experienced cyberbullying who from single parent families, peer pressure and social oriented internet usage were more likely to engage in health risk behaviors ( β= 3.41, 4.88, 2.20, P <0.05).@*Conclusions@#The incidence of cyberbullying and health risk behaviors among secondary vocational school students is relatively high, and cyberbullying can influence the occurrence of health risk behaviors. It is important to focus on and implement guidance for internet use and health behavior education for secondary vocational students from multiple perspectives, including the family, school, and society. Corresponding intervention strategies should be taken to promote the healthy development of adolescents.

Effectiveness and associated factors of varicella vaccination on school outbreaks / 中国学校卫生

Objective@#To evaluate the effectiveness of varicella vaccine in varicella outbreaks and to analyze the influencing factors, and to provide a reference for making the targeted prevention and controlling measures.@*Methods@#A total of 3 888 students with no history of varicella were selected from 2 schools with varicella outbreak in Guangdong Province in 2021, a retrospective cohort study was conducted by using questionnaire survey, rate ratio ( RR ) and vaccine effectiveness ( VE ) values were calculated and Logistic regression was uses to analyze the factors influencing the protective effect of varicella.@*Results@#There were 138 confirmed cases of varicella among the participants. There was no significant sex difference in the vaccination rate( χ 2=1.36, P =0.51), but there was significant difference in the vaccinattion rate of different age groups( χ 2=555.82, P <0.01). The overall protective effect of VarV was 66.94%(95% CI =56.17%-77.71%), and the protective effect of 2 doses of vaccine( VE = 90.02% , 95% CI =83.13%-96.90%) was higher than that of 1 dose( VE =49.40%, 95% CI =32.36%-66.44%)( χ 2=24.93, P < 0.01 ). The high fever rates in the vaccinated and unvaccinated groups were 7.69% and 25.81%, with significant difference( χ 2= 6.29 , P <0.05). The rates of moderate and severe skin lesions of vaccinated and unvaccinated groups was 20.00% and 50.00%, respectively, and the difference was statistically significant( χ 2=11.32, P <0.01). The protective effects of varicella vaccine against high fever and moderate to severe rash were 70.19%(95% CI =42.11%-98.27%) and 60.00%(95% CI =38.15%-81.85%). Stratified analysis showed that there were significant differences in different years of vaccination( χ 2=37.87, P <0.05), while there were no significant differences in age of vaccination and vaccine manufacturer ( P >0.05).@*Conclusion@#Varicella vaccination can prevent chickenpox infection and reduce the severity of the disease. However, the efficacy of varicella vaccine was affected by vaccination years. It is recommended to improve the vaccination coverage of varicella vaccine to prevent the outbreak of the epidemic.

Multiple correspondence analysis of the influencing factors of injury among left behind primary school students in Pingliang / 中国学校卫生

Objective@#To explore the distribution characteristics of the influencing factors of injury among left behind primary school students, so as to provide a reference for identifying high risk injury groups and carrying out accurate injury intervention.@*Methods@#From August 2021 to July 2022, a questionnaire survey was conducted among 3 769 students from grades 4 to 6 from nine primary schools in three townships in Pingliang City by using the a random cluster sampling method. Multiple correspondence analysis was used to analyze the influencing factors of injury.@*Results@#The detection rate of injuries among non left behind pupils was 21.8%(573/2 631), whereas the detection rate of injuries among left behind pupils was 40.9%(466/1 138). In addition, a statistically significant difference was observed in the detection rate of injuries between left behind pupils and non left behind pupils ( χ 2=146.21, P <0.01). Among the injuries of left behind pupils, 263 had fall related injuries, accounting for the highest proportion ( 56.4 %). Whether it was an only child，and different grades, gender, personality, psychological status, monitoring type, and maternal education level were statistically significant ( χ 2=39.05, 96.69, 143.00, 155.80, 461.39, 285.35, 17.10, P <0.01). The multiple correspondence analysis category graph showed higher rates of fall injuries, blunt injuries and sharp injuries among boys, extroverted personality types, and left behind pupils whose grandparents were their legal guardians. Animal bites, burns and other injury types were higher among left behind pupils with an introverted personality, pupils in peer/other guardianship situations, and those with a sub mental health status. Unharmed left behind students mainly included those with intermediate personality and mental health characteristics.@*Conclusion@#The injury detection rate among left behind primary school students is high. Gender, personality type, guardianship type, and mental health status are closely related to injury. Extroverted boys under grandparents guardians are identified as high risk groups for injury prevention and control. Under the guidance of the precision prevention model, precision intervention strategies for all round high risk groups should be carried out in order to effectively reduce the occurrence of injuries among left behind pupils.

Padrões alimentares e qualidade de vida de docentes universitários / Eating patterns and quality of life among university faculty

Resumo Introdução: A qualidade de vida (QDV) favorável tem sido associada a dietas de melhor qualidade nutricional. Objetivo: Identificar padrões alimentares e estimar sua associação com a QDV em docentes universitários. Método: Estudo seccional com 112 docentes de uma universidade do Rio de Janeiro. Foram obtidos dados sociodemográficos, laborais, de saúde, estilo de vida, QDV e desgaste psíquico utilizando questionário autopreenchido. Consumo alimentar foi avaliado por questionário de frequência alimentar. Os padrões alimentares foram identificados por análise fatorial com extração por componentes principais, e sua associação com a QDV foi estimada por regressão linear múltipla. Resultados: 65% eram mulheres, 45% tinham ≥45 anos de idade e 43% apresentavam excesso de peso. O escore médio de QDV geral foi 70. Foram identificados os padrões alimentares: "lanche", "fast food", "restrito" e "básico". O padrão "restrito", composto por manteiga/margarina, pão, suco de fruta, laticínios e bebidas cafeinadas, apresentou associação direta com QDV geral e domínios psicológico e relações sociais; o padrão "lanche", composto por vegetais, carnes, frutas e bebidas cafeinadas, se associou diretamente ao domínio psicológico. Conclusões: Os padrões que mais explicaram a ingestão alimentar dos docentes eram de baixa qualidade nutricional. Padrão com teor reduzido de carboidratos associou-se com melhor QVD geral.

Abstract Background: Favorable quality of life (QOL) has been associated with diets with better nutritional quality. Objective: To identify dietary patterns and estimate their association with QOL among university faculty. Method: Cross-sectional study with faculty members (n=112) from a university in Rio de Janeiro, Brazil. Information on socioeconomic, work, health, lifestyle, QOL, and psychological distress characteristics were obtained using a self-administered questionnaire. Dietary intake was assessed by means of a food frequency questionnaire. Dietary patterns were identified by factor analysis with principal component extraction and their association with QOL scores was estimated using multiple linear regression models. Results: 65% were women, 45% were ≥45 years old, and 43% were overweight. The mean general QOL score was 70.0. Four dietary patterns were identified: "snack", "fast food", "controlled", and "basic". The "controlled" pattern, including butter/margarine, bread, fruit juice, dairy, and caffeinated beverages, was directly associated with general QOL and "social relationships" and "psychological" domains, the latter was also directly associated with the "snack" pattern, composed by vegetables, meats, fruits, caffeinated beverages, and butter/margarine. Conclusions: The eating patterns that most explained faculty food consumption presented low nutritional quality, while the pattern with limited carbohydrate content was associated with better general QOL.

Efficacy and influential factors of opening wedge high tibial osteotomy for the treatment of knee osteoarthritis / 中国基层医药

Objective:To investigate the efficacy of opening wedge high tibial osteotomy (OWHTO) in the treatment of knee osteoarthritis, and analyze the related factors that affect its clinical efficacy.Methods:The clinical data of 80 patients with knee osteoarthritis who underwent OWHTO between December 2016 and May 2020 in Hospital of the Marine Police Corps of the Chinese People's Armed Police Force were retrospectively analyzed. These patients were divided into effective group ( n = 76) and ineffective group ( n = 4) according to clinical efficacy. The Visual Analogue Scale (VAS), the Hospital for Special Surgery Knee Score (HSS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were used to assess the severity of knee osteoarthritis before and 3 months after surgery. The influential factors of clinical efficacy were analyzed. Results:VAS score, WOMAC score, HSS score, joint pain, joint function, joint range of motion, muscle strength, and flexion deformity of 80 patients post-surgery were improved compared with those pre-surgery ( t = 24.92, 21.45, 52.62, 15.87, 10.88, 15.28, 42.54, 11.07, all P < 0.05). After surgery, excellent outcomes were observed in 29 (36.25%) patients, good outcomes in 34 (42.50%) patients, fair outcomes in 13 (16.25%) patients, and poor outcomes in 4 (5.00%) patients. Body mass index, preoperative VAS score, and preoperative WOMAC score in the effective group were (24.10 ± 3.06) kg/m 2, (5.55 ± 1.57) points, and (36.96 ± 9.62) points, respectively, which were significantly lower than those in the ineffective group [(27.64 ± 3.62) kg/m 2, (7.87 ± 1.39) points, (47.95 ± 9.63) points, t = 2.23, 2.89, 2.22]. HSS score in the effective group was significantly higher than that in the ineffective group [(52.81 ± 3.71) points vs. (46.83 ± 3.69) points, t = 3.14, P < 0.05)]. Body mass index, preoperative VAS score, and preoperative WOMAC score were positively correlated with clinical efficacy ( r = 0.24, 0.31, 0.24, P < 0.05), and preoperative HSS score was negatively correlated with clinical efficacy ( r = -0.33, P < 0.05). Logistic regression analysis was performed to analyze the above markedly related factors. Preoperative HSS score was an independent protective factor of clinical efficacy of OWHTO, and body mass index and preoperative VAS score were risk factors of clinical efficacy of OWHTO. Conclusion:OWHTO can greatly improve knee function of patients with knee osteoarthritis and reduce postoperative pain. It should be noted that excessive obesity may affect the clinical efficacy of OWHTO, and preoperative VAS score and WOMAC score should be controlled in patients with excessive obesity.

Correlation between serum epidermal growth factor level change and cognitive impairment in patients with Parkinson's disease / 中国基层医药

Objective:To investigate the change in serum epidermal growth factor (EGF) level in patients with Parkinson's disease (PD) and correlate it with cognitive impairment.Methods:A total of 154 patients with early PD who received treatment in Hangzhou Third People's Hospital between July 2017 and June 2018 were included in this study. They were randomly divided into mild cognitive impairment (observation group) and no cognitive impairment (control group) according to the severity of cognitive impairment. Cognitive impairment was graded using Montreal cognitive assessment scale. Motor function was assessed using Unified Parkinson's Disease Rating Scale Part III formulated by International Parkinson and Movement Disorder Society. All these assessments were performed at enrollment and at the end of 2-year follow-up. Serum EGF level was measured by double antibody sandwich enzyme-linked immunosorbent assays. Patients without cognitive impairment were divided into four groups according to quartiles of serum EGF levels. The conversion rate of PD-MCI was calculated at 2 years of follow-up and compared between groups.Results:Among 154 patients, 68 (44.16%) patients developed PD-MCI, and 86 (55.84%) patients had no cognitive impairment. Montreal cognitive assessment scale score and serum EGF level in the observation group were (20.01 ± 3.15) points and (267.79 ± 63.18) ng/L, respectively, which were significantly lower than those in the control group [(28.21 ± 2.84) points, (491.53 ± 67.38) ng/L, t = 8.11, 9.03, both P < 0.001]. Unified Parkinson's Disease Rating Scale Part III score in the observation group was significantly higher than that in the control group [(23.47 ± 5.33) points vs. (18.69 ± 4.37) points, t = 5.18, P < 0.001]. Among the first quartile group, 14 (63.64%) patients converted to PD-MCI; while among the fourth quartile group, 2 (9.52%) patients converted to PD-MCI. The conversion rate of PD-MCI in the second, third and fourth quartile groups was significantly lower than that in the first quartile group (χ 2 = 9.73, 14.48, 33.47, all P < 0.05). Conclusion:Cognitive impairment in patients with PD is closely related to serum EGF level. Serum EGF level is a hematological index to predict cognitive impairment in patients with PD. This study is innovative and scientific.

Correlation between cognitive function and living ability of older adult patients living in a mining community / 中国基层医药

Objective:To investigate the correlation between cognitive function and living ability of older adult patients living in a mining community.Methods:A total of 180 older adult patients living in a mining community who received treatment during July-October 2019 were included in this study. They were randomly divided into the low-age group (< 68 years old, n = 94) and the high-age group (≥ 68 years old, n = 86). Cognitive function and living ability were evaluated using the Mini-Mental State Examination (MMSE), The Montreal Cognitive Assessment (MoCA), and the Activity of Daily Living Scale (ADL). The relationship between cognitive function and living ability was investigated using hierarchical analysis and Pearson correlation analysis. Results:The proportions of older adult patients with abnormal cognitive function identified by the MMSE and MoCA were 39.4% and 66.0%, respectively in the low-age group, and they were 32.6% and 61.6%, respectively in the high-age group. The MoCA had a greater performance in identifying abnormal cognitive function in each group than the MMSE ( χ2 = 26.69, 10.18, both P < 0.001). There were no significant differences in proportions of older adult patients with abnormal cognitive function identified by the MMSE and MoCA between low-age and high-age groups ( χ2 = 0.90, 0.36, both P > 0.05). The proportion of older adult patients with abnormal living ability was not significantly different between low-age and high-age groups (4.3% vs. 10.5%, χ2 = 2.58, P > 0.05). Compared with patients negative for MMSE items, living ability and instrumental activity of daily living increased by 7.0% and 9.4% in low-age patients positive for MMSE items (both P < 0.05). Compared with patients negative for MoCA items, living ability increased by 3.5% in low-age patients positive for MoCA items ( P < 0.05). Correlation analysis revealed that total scores of MMSE and MoCA were significantly negatively correlated with ADL score ( r = -0.26, -0.27, both P < 0.001) and instrumental activity of daily living score ( r = -0.27, -0.27, P < 0.001). Conclusion:Cognitive function and living ability are correlated in older adult patients living in a mining community. We should pay attention to the screening results of cognitive disorder in older adult patients and improve their living ability by improving their cognitive function.

Relationship between serum 25(OH)D and SIRT4 levels and glycolipid metabolism in children with different levels of obesity / 中国基层医药

Objective:To investigate the relationship between serum 25(OH)D and SIRT4 levels and glycolipid metabolism in children with different levels of obesity.Methods:A total of 124 children with different levels of obesity who received treatment in Shaoxing Women's and Children's Health Care Hospital from February 2016 to February 2021 were included in this study. These children were divided into mild/moderate obesity group ( n = 76) and severe obesity group ( n = 48) according to body mass index. An additional 62 healthy children who concurrently received a physical examination were selected for controls. The general data of all children were collected. The relationship between the factors that affect obesity in children and serum 25(OH)D and SIRT4 levels and glycolipid metabolism was analyzed. Results:In the control, mild/moderate obesity, and severe obesity groups, body mass was (26.68 ± 4.98) kg, (33.24 ± 5.48) kg, (37.18 ± 5.88) kg, respectively; waist circumference was (56.12 ± 4.62) cm, (68.45 ± 5.20) cm, (79.34 ± 5.65) cm, respectively; hip circumference was (68.42 ± 5.08) cm, (72.45 ± 6.45) cm, (80.56 ± 6.95) cm, respectively; body mass index (BMI) was (15.90 ± 2.04) kg/m 2, (23.58 ± 2.45) kg/m 2, (25.89 ± 2.35) kg/m 2], respectively; fasting insulin (FINS) level was (26.65 ± 3.68) pmol/L, (34.82 ± 4.15) pmol/L, (48.56 ± 5.49) pmol/l, respectively; homeostasis model assessment of insulin resistance (HOMA-IR) was (1.06 ± 0.24), (2.12 ± 0.35), (3.84 ± 0.52), respectively; total cholesterol (TC) level was (2.21 ± 0.45) mmol/L, (4.14 ± 0.58) mmol/L, (5.96 ± 0.64) mmol/L, respectively; triacylglycerol (TG) level was (0.68 ± 0.16) mmol/L, (1.12 ± 0.24) mmol/L, (1.56 ± 0.35) mmol/L, respectively; low density lipoprotein cholesterol (LDL-C) was (2.68 ± 0.42) mmol/L, (2.10 ± 0.32) mmol/L, (1.41 ± 0.25) mmol/L, respectively; high density lipoprotein cholesterol (HDL-C) was (1.98 ± 0.42) mmol/L, (3.12 ± 0.51) mmol/L, (4.10 ± 0.56) mmol/L, respectively. There were significant differences in body mass, waist circumference, hip circumference, BMI, FINS, HOMA-IR, TC, TG, HDL-C, and LDL-C among the three groups ( F = 53.62, 280.42, 53.33, 303.44, 338.48, 755.71, 618.75, 165.81, 186.89, 251.42, all P < 0.001). Body mass, waist circumference, hip circumference, BMI, FINS, HOMA-IR, TC level, TG level, HDL-C level, and LDL-C level were lower in the control group than in the mild/moderate obesity group ( t = -7.28, -14.56, -4.00, -19.72, -6.49, -21.45, -12.36, 9.20, -14.12, all P < 0.05). Body mass, waist circumference, hip circumference, BMI, FINS, HOMA-IR, TC, TG, HDL-C and LDL-C were lower in the mild/moderate obesity group than in the severe obesity group ( t = -3.79, -10.98, -6.61, -5.19, -15.81, -22.02, -16.34, -8.30, 12.68, -10.03, all P < 0.05). Serum 25(OH)D [(60.52 ± 8.95) nmol/L vs. (49.88 ± 8.12) nmol /L, t = 7.31, P < 0.05] and SIRT4 [(1.98 ± 0.38) mmol/L vs. (1.06 ± 0.30) mmol/L, t = 15.89, P < 0.05] levels were significantly greater in the control group than in the mild/moderate obesity group. Serum 25(OH)D [(49.88 ± 8.12) nmol/L vs. (41.62 ± 7.50) nmol /L, t = 5.68, P < 0.05] and SIRT4 [(1.06 ± 0.30) mmol/L vs. (0.52 ± 0.15) mmol/L, t = 11.57, P < 0.05] levels were significantly greater in the mild/moderate obesity group than in the severe obesity group. Multiple linear regression analysis showed that body mass, waist circumference, hip circumference, FINS, HOMA-IR, TC, TG, and LDL were the positive influential factors of childhood obesity ( B = 0.170, 0.310, 0.403, 1.000, 3.464, 2.080, 2.656, 4.324); HDL, serum 25(OH)D and SIRT4 were the negative influential factors of childhood obesity ( B = -2.096, -0.156, -6.615). Pearson correlation analysis showed that serum 25(OH)D was significantly negatively correlated with FINS, HOMA-IR, TC, TG and LDL ( r = -0.20, -0.46, -0.30, -0.36, all P < 0.01), and significantly positively correlated with FPG and HDL ( r = 0.43, 0.77, both P < 0.01). Serum SIRT4 was negatively correlated with FINS, TC, TG, and LDL ( r = -0.48, -0.74, -0.61, -0.64, all P < 0.01), and positively correlated with FPG and HDL ( r = 0.21, 0.84, both P < 0.01). Conclusion:Serum 25(OH)D and SIRT4 levels decrease with the aggravation of obesity in children and are closely related to glycolipid metabolism. Therefore, early detection of obesity can reflect the degree of obesity and glycolipid metabolism in children.

Cognitive function changes and their influential factors in patients with ischemic stroke and leukoaraiosis / 中国基层医药

Objective:To investigate cognitive function changes and their influential factors in patients with ischemic stroke and leukoaraiosis.Methods:A total of 500 patients with ischemic stroke who received treatment in Yiwu Central Hospital from January 2018 to October 2019 were included in this study. They were divided into simple ischemic stroke group ( n = 200) and ischemic stroke complicated by leukoaraiosis group (combination group, n = 300). The infarct location and the degree of leukoaraiosis in the combination group were analyzed. An additional 150 volunteers who concurrently underwent the Cognitive Function Test in the same hospital were selected as controls. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Patients in the combination group were divided into cognitive impairment group (MoCA score ≥ 26 points) and non-cognitive impairment group (MoCA score < 26 points) according to MoCA score. The risk factors of cognitive impairment in patients with ischemic stroke and leukoaraiosis were analyzed. Results:The scores of the MMSE, MoCA, Clock Drawing Test (CDT), Verbal Fluency Test (VFT), and Digit Span Test (DST) in the control group were (28.93 ± 2.70) points, (28.35 ± 2.74) points, (4.69 ± 1.14) points, (4.94 ± 0.42) points, and (14.33 ± 1.66) points respectively. They were (26.92 ± 2.18) points, (25.02 ± 3.52) points, (3.61 ± 1.60) points, (4.77 ± 0.46) points, and (11.73 ± 1.16) points, respectively in the simple ischemic stroke group and (24.91 ± 2.79) points, (20.70 ± 3.06) points, (2.87 ± 1.23) points, (4.07 ± 0.85) points, and (10.82 ± 0.93) points respectively in the combination group. There were significant differences in the scores of the MMSE, MoCA, CDT, VFT, and DST among the three groups ( F = 124.50, 318.50, 93.43, 112.60, 428.60, all P < 0.001). Significant differences in the scores of the MMSE, MoCA, CDT, VFT, and DST were observed between patients with different degrees of leukoaraiosis ( F = 69.09, 102.40, 20.98, 60.90, 57.00, all P < 0.001). Spearman correlation analysis results showed that the scores of the MMSE, MoCA, CDT, VFT, and DST were negatively correlated with the degree of leukoaraiosis ( r = -0.61, -0.69, -0.43, -0.56, -0.44, all P < 0.05). Logistic regression analysis results showed that age, history of smoking and drinking, history of diabetes, history of stroke, and infarct location were the independent risk factors for cognitive impairment in patients with ischemic stroke and leukoaraiosis. Education level was a protective factor against ischemic stroke and leukoaraiosis. Conclusion:The degree of cognitive impairment in patients with ischemic stroke and leukoaraiosis is related to the degree of leukoaraiosis. Age, history of smoking and drinking, history of diabetes, history of stroke, infarction location, and education level are the influential factors of cognitive impairment.

Correlation between climate change and epistaxis in Yueqing of Zhejiang province / 中国基层医药

Objective:To correlate climate change with epistaxis in Yueqing of Zhejiang province and to provide evidence for the diagnosis and treatment of epistaxis.Methods:A total of 1 800 patients with epistaxis, who received treatment in Yueqing People's Hospital between October 2018 and October 2019, were included in this study. The data of these patients were input into the Microsoft Excel software. They were summarized and sorted as per admission time. Climate change was correlated with epistaxis.Results:Daily average temperatures were negatively correlated with epistaxis ( r = -0.65, P = 0.003). A non-linear, inverted-U-shaped relationship was observed between daily relative humidity and epistaxis. When the daily relative humidity was < 65%, daily relative humidity was positively correlated with epistaxis ( r = -0.54, P = 0.007).When the daily relative humidity was > 65%, daily relative humidity was negatively correlated with epistaxis ( r = -0.68, P = 0.002). There was a nearly linear positive correlation between diurnal temperature range and epistaxis ( r = 0.52, P = 0.009). There was a linear and positive correlation between daily average atmospheric pressure and epistaxis ( r = 0.60, P = 0.004). The risk of epistaxis increased by 1.48% (95% CI: -2.15 to -0.81) when the temperature decreased by 1 ℃. When daily relative humidity was < 65%, the effects of humidity change on the risk of epistaxis were not statistically significant ( P > 0.05). When the relative humidity of the day was > 65%, the risk of epistaxis decreased by 1.82% (95% CI: -2.71 to -0.93) for every unit of humidity rise. The risk of epistaxis increased by 2.86% (95% CI: 0.54 - 5.18) for every 1 ℃ increase in temperature. The risk of epistaxis increased by 1.18% (95% CI: 0.50 - 1.87) for every 1 Pa increase in air pressure. Conclusion:Temperature change is negatively correlated with epistaxis. Atmospheric pressure and diurnal temperature range are positively correlated with epistaxis. Temperature change, atmospheric pressure, and diurnal temperature have temporary effects on epistaxis. High humidity has an obvious long-term protective effect against epistaxis.