Outbreak investigation of a campus bacterial dysentery by water source pollution in Lhasa City / 中国学校卫生

Objective@#To investigate risk factors and the nature of the outbreak of bacillary dysentery in Lhasa City, so as to customize targeted prevention and control measures.@*Methods@#Using on site epidemiological investigation, the suspected, probable and confirmed cases of bacillary dysentery in one school and one kindergarten in Lhasa City from June 26 to July 1, 2022 were collected, and additional cases were identified through interview from school staffs and family members, reviewing morning examination records and tracking records of school illness related absence. A case control study was conducted to investigate suspicious meals and drinking raw water, and polymerase chain reaction (PCR) was performed to detect Shigella line nucleic acid fragment in the patients feces, anal swabs, retained food, and terminal water.@*Results@#A total of 55 cases were found in two schools, with the prevalence rate of 15.41% in total and 16.71% in students ( n =53), 7.5% in staff ( n =2). The epidemic curve was suggestive of a point source exposure. The prevalence rate among students who walk to school and students who live in the school showed no difference (16.10%，17.09%)( χ 2=0.05, P >0.05), and the prevalence rate was higher among elementary school students than kindergarten students (19.83%，6.67%)( χ 2=7.13, P <0.05). Case control comparisons showed a direct association between drinking raw water and morbidity in the case and control groups during June 24-26 ( OR=4.01, 95%CI =1.75-9.19, P < 0.05). A total of 23 fecal Shigella nucleic acid positives were detected from the two schools, two from the end water in front of the cafeteria door, and two from sludge in the sewage pipe around the wellhead.@*Conclusions@#The outbreak of bacillary dysentery is caused by the contamination of the pipe network water. Health administrative departments should improve the supervision and management of drinking water health safety, and schools should strengthen the management of water supply facilities for effectively prevent of waterborne infectious disease outbreaks.

Analysis of factors influencing elevated blood pressure and overweight/obesity and their comorbidities among Tibetan middle school students in Lhasa City / 中国学校卫生

Objective@#To explore the prevalence of elevated blood pressure and overweight/obesity and their comorbidities among Tibetan middle school students in Lhasa, and to analyze their association with lifestyle and other factors, so as to provide a basis for the intervention measures targeting elevated blood pressure, overweight and obesity among middle school students in high altitude area.@*Methods@#Using a stratified cluster random sampling method in September 2021, a total of 1 488 Tibetan junior and high students from Lhasa City were investigated with blood pressure measurement, physical examination and questionnaire survey. The influencing factors of elevated blood pressure, overweight and obesity and their comorbidities association were analyzed by multivariate Logistic regression.@*Results@#The prevalence of elevated blood pressure, overweight/obesity and their comorbidities were 17.8%, 17.4% , 5.0% respectively. Multivariate Logistic regression analysis showed that age( OR =0.81), residence, body mass inex(BMI) and gender were the influencing factors of elevated blood pressure; and the risks of elevated blood pressure in female students were higher than male students ( OR =1.89), suburban students were higher than urban students ( OR =8.06), overweight and obesity groups were higher than normal groups ( OR =2.55, 2.87) ( P <0.05). Adjusting for confounding factors such as gender, residence and school, and BMI (only for elevated blood pressure), daily screen time ≥2 h was positively correlated with elevated blood pressure, overweight/obesity and its comorbidities ( OR =1.56, 1.59 , 2.51) ( P <0.05).@*Conclusions@#The prevalence of elevated blood pressure, overweight/obesity are relatively high in Lhasa. Longer screen time is a common factor affecting with elevated blood pressure, overweight/obesity and comorbidities among Tibetan students. Measures should be taken intervene in the lifestyle of Tibetan students, in order to reduce elevated blood pressure and overweight/obesity.

Intervention effects of moderate and high intensities of classroom physical activity on cardiorespiratory fitness and executive function among junior grade one students in Tibetan / 中国学校卫生

Objective@#To explore the intervention effect of different intensity of classroom physical exercise on cardiorespiratory fitness and executive function of Tibetan first grade students at high altitude, so as to provide reference for improving the level of cardiorespiratory fitness and executive function of Tibetan adolescents.@*Methods@#From September to December 2020, 184 Tibetan students from five first grade classes in a middle school in Lhasa, Tibet, were randomly assigned into a control group (81 students in two classes) and an intervention group (103 students in three classes). Both groups followed the same teaching programme, but the intervention group received 36 sessions of moderate to high intensity classroom physical activity, one session per day, Monday,Wednesday and Friday, for 12 weeks. Before and after the intervention, cardiorespiratory fitness and executive function were tested by 20m round trip running and Flanker s experimental paradigm, 2-back s experimental paradigm, and More odd shifting experimental paradigm for inhibitory control, refreshing memory, and switching flexibility, and the results were analysed by analysis of covariance (ANCOVA) to compare the results of the pre and post intervention periods.@*Results@#The maximum oxygen uptake (VO 2max ) of Tibetan first grade students in the intervention group increased by 2.25 mL/(kg〖WW）〗·〖WW(〗min) compared with the control group after the intervention ( t =-3.89, P <0.01); the response time of the inhibitory function was reduced by 4.40 ms, that of the refreshing function by 196.06 ms, and that of the switching function by 92.72 ms in the intervention group compared with the control group ( t =2.98, 4.82 ,3.21, P <0.05).@*Conclusion@#The 12 week moderate to high intensity classroom physical activity intervention has different degrees of improvement effects on cardiorespiratory fitness and executive function in Tibetan adolescents.

Association between latent classes of dietary patterns and depressive symptoms among firstgrade students from multi ethnic middle schools in Yunnan Province / 中国学校卫生

Objective@#To determine the latent class of dietary patterns and their association with depressive symptoms among first grade students from multi ethnic middle schools in Yunnan Province, so as to provide a reference basis for promoting mental health among border middle school students.@*Methods@#A cluster random sampling involving 8 500 first grade middle school students from 11 counties in Yunnan Province was conducted by a questionnaire survey between October to December 2022. The Children s Depression Inventory (CDI) was used to assess the depressive symptoms and the Food Frequency Questionnaire was used to collect eating behavior data. The latent profile analysis model was used to fit the latent class of dietary patterns among students. The association between the dietary pattern latent class and depressive symptoms was analyzed by Logistic regression.@*Results@#The depressive symptom detection rate among firstgrade middle school students was 28.3%. Prevalence of depressive symptom in girls (30.9%) was higher than boys (25.5%) with a statistically significant difference ( χ 2=29.83, P <0.01). The dietary patterns among first grade middle school students were classified into four latent classes, as follows:class 1 (low consumption of all dietary components), class 2 (high consumption of fruit, milk and dairy products), class 3 (high consumption of vegetables and meat, and low consumption of processed foods) and class 4 (low consumption of milk, dairy products and eggs, and high consumption of processed foods). After adjusting for confounding variables, the class 3 dietary pattern was negatively correlated with depressive symptoms ( OR=0.62, 95%CI =0.52-0.74) and the class 4 dietary pattern was positively correlated with depressive symptoms ( OR= 1.28 , 95%CI =1.05-1.57) ( P <0.05), compared with the class 1 dietary pattern.@*Conclusions@#Multi ethnic first grade middle school students in Yunnan Province follow various dietary patterns. Unhealthy dietary patterns increase the risk of depressive symptoms. The dietary patterns of multi ethnic middle school students in Yunnan Province should be adjusted to promote the establishment of healthy dietary patterns and reduce the risk of depression symptoms in middle school students.

Decision tree model of depressive symptoms among first grade students from multi ethnic middle schools in Yunnan Province / 中国学校卫生

Objective@#To understand the occurrence and predictive factors of depressive symptoms among multi ethnic middle school students in Yunnan Province, so as to provide a referential framework for schools to carry out targeted mental health education.@*Methods@#From October to December 2022, 8 500 first grade students from 23 middle schools were selected from 11 minority areas in Yunnan Province by cluster random sampling method. Demographic information and data relating to the students lifestyles were collected by questionnaire, and the Children s Depression Inventory (CDI) was used to evaluate depressive symptoms. Chi square test was performed to compare differences in the detection rate of depressive symptoms among first grade middle school students for univariate analysis. A decision tree model of depressive symptoms in middle school students was established by using the Chi squared automatic interaction detector (CHAID).@*Results@#The detection rate of depressive symptoms among first grade students from multi ethnic middle schools in Yunnan Province was 28.26%. The decision tree model of depressive symptoms was academic stress ( χ 2=469.08) at the first level, breakfast behaviors (low/moderate academic stress: χ 2=155.49; severe academic stress: χ 2=105.24) at the second level, and the number of close friends (low/moderate academic stress and consuming breakfast 0- 2 days weekly: χ 2=23.15; low/moderate academic stress and consuming breakfast 3-4 days weekly: χ 2=14.99; severe academic stress and consuming breakfast 0-2 days weekly: χ 2=29.26; severe academic stress and consuming breakfast 3-4 days weekly: χ 2=20.15), ethnicity ( χ 2=78.22) and drinking ( χ 2=50.36) at the third level ( P <0.01).@*Conclusions@#The study identifies academic stress, breakfast behaviors, number of close friends, drinking and ethnicity as predictive factors of depressive symptoms among multi ethnic middle school students in Yunnan Province. Schools should develop targeted strategies for preventing and managing depressive symptoms in middle school students, so as to reduce their occurrence.

Focus on the dietary behaviors and mental health among multi ethnic adolescents / 中国学校卫生

Abstract@#Unhealthy eating behaviors among adolescents are common, and psychological behavior problems are prominent. The paper examines the status and associations underlying unhealthy eating behaviors and psychological behavior problems in adolescents from border multi ethnic areas, and further discusses the importance of research in border area involving multi ethnic adolescents, and highlights its significance in the context of constructing healthy schools in border areas,so as to provide a basis for promoting effectively healthy school environments in border areas of China.

Delay on detection, and diagnosis of pulmonary tuberculosis and the influencing factors in Inner Mongolia students during 2011-2022 / 中国学校卫生

Objective@#To analyze the delay on detection, care seeking, diagnosis and treatment of tuberculosis among students in Inner Mongolia Autonomous Region (Inner Mongolia) from 2011 to 2022 and its influencing factors, so as to provide support for the prevention and treatment of tuberculosis among students.@*Methods@#The general demographic indicators of students with tuberculosis in Inner Mongolia from January 1, 2011 to December 31, 2022 were collected from the infectious disease monitoring (new) module of the China Disease Prevention and Control Information System. General characteristics and trend of four types of delayed pulmonary tuberculosis patients in students were analyzed. The influencing factors were analyzed using univariate and multivariate Logistic regressions.@*Results@#From 2011 to 2022, there were 6 032 cases of pulmonary tuberculosis among students in Inner Mongolia. The rates of delayed detection, delayed care seeking, delayed diagnosis, and delayed treatment were 51.71%, 64.01%, 7.82 %, and 2.30%, respectively. The results of multivariate Logistic regression analysis showed that tracking ( OR =1.51) in the patient source,league level diagnosis ( OR =3.16) in the diagnostic institution level,and county level diagnosis ( OR =2.41) were positively associated with delayed discovery ( P <0.05). At the level of diagnostic unit, league city level diagnosis ( OR =2.69), and county level diagnosis ( OR =3.67) associated with more delayed care seeking ( P <0.05). Referral ( OR =1.58) and follow up ( OR =2.55), floating population ( OR =2.05), further consultation with a doctor ( OR =2.11), and no results in imaging manifestations ( OR =2.19) were positively associated with delayed diagnosis( P <0.05). The factors contributing to delayed treatment were referral ( OR =1.84), follow up ( OR =4.91), active screening ( OR =5.46), and floating population( OR =1.95)( P <0.05).@*Conclusions@#From 2011 to 2022, the delay on detection and care seeking for tuberculosis patients among students in Inner Mongolia is at a relatively high level, while the delay in diagnosis and treatment is at a relatively low level but shows an increasing trend. It is necessary to focus on the factors associated with delays in identification, diagnosis and treatment in tuberculosis outbreak in the context of school to prevent or reduce school tuberculosis outbreak.

Social anxiety status and its relationship with sleep duration among Tibetan adolescents at high altitude / 中国学校卫生

Objective@#To understand social anxiety of Tibetan adolescents aged 10-15 years old in high altitude areas and its correlation with sleep duration, so as to provide a reference and support for social anxiety prevention and mental health interventions for Tibetan adolescents in high altitude areas.@*Methods@#A total of 2 426 Tibetan adolescents from the Lhasa, Chamdo, and Nagchu regions of Tibet were surveyed. From April to June 2022, basic demographics, social anxiety, and sleep status were obtained and analyzed using class based, stratified whole group sampling, and the correlations detected between the two were analyzed by logistic regression analysis.@*Results@#The average social anxiety score of Tibetan adolescents aged 10-15 years in high altitude areas was (6.51±4.32), and the detection rate of social anxiety was 5.23%. The mean sleep duration was (7.42±1.18) hours/day. The differences were statistically significant when compared across gender, overweight/obesity status, level of physically activity, and sleep duration ( χ 2=19.44, 14.39, 7.83, 7.21, P <0.05). After adjusting for relevant variables, the Logistic regression analysis showed that sleep deprivation among boys ( OR =2.91, 95% CI =1.82-4.61), sleep deprivation among girls ( OR = 3.51 , 95% CI =2.01-6.04), and overall sleep deprivation among Tibetan adolescents ( OR =3.12, 95% CI =1.91-4.58) were positively associated with social anxiety( P <0.01).@*Conclusions@#A positive association was found between social anxiety and sleep deprivation, indicating that social anxiety is an issue among Tibetan adolescents living in high altitude regions. Sufficient sleep duration plays a positive protective role in reducing social anxiety among Tibetan adolescents in high altitude areas, and the findings provide a reference for future mental health interventions.

Physical health status and influencing factors of preschool children in Tibet / 中国学校卫生

Objective@#To explore physical health status and influencing factors of preschool children in Tibet, so as to provide a scientific reference and theoretical basis for the healthy development of physical fitness.@*Methods@#Data were collected from children (3-6 years old) of Xizang national physical fitness monitoring, and a total of 1 521 preschool children were recruited who received questionnaire survey and physical fitness test. Independent sample t-test and one-way ANOVA were used to compare the differences in physical fitness indexes of preschool children in different groups. Chi square test and binary Logistic regression model were used to analyze the factors affecting physical health of preschool children.@*Results@#The total qualified rate of physical fitness was 79.75%, among which the excellent rate was 3.16%, the good rate was 15.12%, the qualified rate was 61.47% and the unqualified was 20.25%. From the perspective of BMI, the excellent physical fitness rate (3.74%) and good physical fitness rate ( 17.47% ) were highest in healthy weight preschool children, and the qualified physical fitness rate of overweight preschool children (69.03%) was higher than that of obese (55.88%) and healthy weight preschool children (60.68%)( χ 2=53.56, P <0.01). From the perspective of ethnic, Tibetan children s physique proficiency (3.69%), good rate ( 17.13% ) than with the elevation of the Han nationality (0.74%, 5.88%), fraction defective (16.97%), lower than that of Han nationality (35.29%) ( χ 2=53.71, P <0.01); The results of chest circumference, skinfold thickness, body fat percentage, tennis throw distance, continuous jump of both feet, sitting forward bend and balance beam walking of Tibetan children were higher than those of Han children, and the results of quiet heart rate and standing long jump were lower than those of Han children ( t = 2.72 , 10.95, 9.66, 3.68, 3.88, 8.04, 3.56, 8.70, -4.39 , -4.40, P <0.01). Binary Logistic regression analysis showed that Tibetans ( OR =2.29), breastfeeding ( OR =1.51), body dynamics outdoor daily exercise duration 30-90 min (30-<60 min ;OR = 2.03 ; 60-90 min: OR =2.22) were positively correlated with physical health of preschool children ( P <0.05).@*Conclusions@#The total physical qualification rate of preschool children aged 3-6 years old in Tibet is lower than the national average. Ethnic group, feeding pattern during infancy, and physical activity are all factors that affected the physical fitness of preschool children in Tibet. It is of great significance to improve the physique of preschool children in Tibet to promote their sustainable and healthy development.

Campus bullying and associated factors among college and middle school students in Tibet / 中国学校卫生

Objective@#To understand campus bullying in colleges and middle schools in Tibet, and to analyze related influencing factors, so as to provide reliable basis and reference for formulating targeted intervention measures.@*Methods@#A stratified cluster sampling method was used to investigate the status and influencing factors of being bullied by questionnaire among 3 875 college and middle school students in Ngari, Qamdo, Lhasa, Nagqu and Xigaze of Tibet, from September to November 2019. Chi-square test and Logistic regression method were used for data analysis.@*Results@#The report rate of campus bullying among college and middle school students in Tibet was 5.50%; 4.35% for girls and 6.76% for boys；8.81% for college students, 1.64% for senior high school students and 5.94% for junior high school students. The results of multivariate Logistic regression analysis showed that smoking ( OR =1.71), Internet addiction ( OR =3.82), depression ( OR =3.84), obesity ( OR =2.02), single parent family ( OR = 1.67 ) and reorganized family ( OR =3.74) were positively correlated with campus bullying ( P <0.05). Girls ( OR =0.66) and senior high school ( OR =0.28) were negatively correlated with campus bullying ( P <0.05).@*Conclusion@#Campus bullying is related to campus environment, family type, behaviors and life styles, etc. Efforts should be committed to build a caring campus culture and a good family moral education environment, in order to reduce the incidence of campus bullying and associated adverse effects.

Status of scoliosis and the related factors among 12yearold school students from Inner Mongolia Autonomous Region in 2021 / 中国学校卫生

Objective@#To understand the current situation and influencing factors of scoliosis in 12-year-old students from Inner Mongolia Autonomous Region, so as to provide scientific basis for accurate prevention and control of abnormal spinal curvature.@*Methods@#From October to November 2021, a total of 18 399 students aged 12 were selected by region and school level by stratified random cluster sampling method, and spinal curvature screening and questionnaire survey of common diseases and health influencing factors among students were carried out. Chi squared test was used for single factor analysis, and binary Logistic regression model was used for multi factor analysis.@*Results@#A total of 397 students (2.2%) were detected with abnormal curvature of the spine, including 368 students (2.0%) with scoliosis. Among them, 205 cases were in the lumbar thoracic segment with a detection rate of 1.1%, 173 cases were in the thoracic segment with a detection rate of 0.9%, and 141 cases were in lumbar thoracic segment with a detection rate of 0.8%. Binary Logistic regression analysis showed that urban area, economic area(moderate), attending tutorial classes before primary school and class seats never changed regularly were positively correlated with the occurrence of scoliosis among 12 year old students ( OR =1.95,1.67,1.76,1.71, P <0.05). Obesity, attending an average of 3 or 4 physical education classes per week, attending physical fitness and beauty classes before primary school were negatively correlated with the occurrence of scoliosis among 12 year old students ( OR =0.69,0.31,0.36,0.71, P <0.05).@*Conclusion@#The prevalence of scoliosis among 12-year-old students in Inner Mongolia Autonomous Region is not optimistic. It should pay attention to the prevention and control of scoliosis in students before the age of 12, actively prevent the occurrence and progress of scoliosis.

A survey on self-management level and physical activity in patients with type 2 diabetes mellitus of Zang and Han nationalities in Tibetan of China / 中国基层医药

Objective:To investigate the level of self-management and daily physical activity in patients with type 2 diabetes mellitus (T2DM) of Zang and Han nationalities in Tibetan, China, and to compare the difference in daily management between T2DM patients of Zang and Han nationalities, to develop reasonable and effective chronic disease management strategies for long-term out-of-hospital management of T2DM patients of Zang nationalities.Methods:A total of 265 T2DM patients with glycosylated hemoglobin (HbA1c) ≥ 7% who were admitted to the Endocrinology Ward of the Hospital of Chengdu Office of People's Government of Tibet Autonomous Region from November 2020 to April 2021 and who were from different regions of Tibet were included in this study according to inclusion and exclusion criteria. The general data of all included patients were collected. Glucose and lipid metabolism-related indicators were determined. The Generalized Diabetes Self-Management Efficacy Scale and International Physical Activity Questionnaires (IPAQ) were used to evaluate patients' levels of self-management and daily physical activity.Results:The hemoglobin level in T2DM patients of Zang nationality was (154.09 ± 24.11) g/L, which was significantly higher than that in T2DM patients of Han nationality ( P < 0.05). The total cholesterol, fasting blood glucose, and low-density lipoprotein in T2DM patients of Zang nationality were (4.63 ± 1.41) mmol/L, (7.94 ± 2.19) mmol/L, and (2.75 ± 1.11) mmol/L, respectively, which significantly higher compared with T2DM patients of Han nationality (all P < 0.05). Compared with T2DM patients of Han nationality, T2DM patients of Zang nationality had lower self-management scores (81.40 ± 15.44) points, diet control scores (17.26 ± 4.97) points, physical exercise scores (11.67 ± 4.42) points, prevention and treatment of high and low blood sugar score (12.21 ± 5.72) points. The differences were statistically significant (all P < 0.05). Moderate-intensity physical activity was a significant difference between T2DM patients of Zang and Han nationalities ( P < 0.05). Conclusion:Compared with T2DM patients of Han nationality, T2DM patients of Zang nationality have lower overall self-management levels, including diet control, physical exercise, prevention and management of high and low blood glucose, and moderate-intensity physical activity. Targeted individualized education should be carried out according to the Tibetan cultural characteristics, to further develop an intervention method and an out-of-hospital management strategy for chronic disease, which are suitable for T2DM patients of Zang nationality.

Abnormal spinal curvature and its influencing factors among middle and high school students in Inner Mongolia Autonomous Region / 中国学校卫生

Objective@#To investigate the incidence of abnormal spinal curvature and related factors among middle school students in the Inner Mongolia Autonomous Region, so as to provide evidence for abnormal spinal curvature prevention and treatment.@*Methods@#By using a random stratified cluster sampling method, 87 908 students of middle and high school students from all 12 counties(districts) were investigated via questionnaires for abnormal spinal curvature and health influencing factors in Inner Mongolia Autonomous Region. Chi square test was used to perform demographic characteristics and univariate analysis, and binary multivariate Logistic regression model was used to screen the risk factors for spinal curvature abnormalities in middle school students.@*Results@#A total of 3 131(3.56%) students with spinal curvature abnormalities were detected, with boys (3.69%) higher than that of girls(3.44%), urban areas (6.15%) higher than that of the suburban counties (2.50%), and high school students ( 4.97 %) higher than that of junior high school(2.73%) students( χ 2=4.01, 702.19, 299.36, P <0.05). The detectable rate of spinal curvature abnormalities increased with grade ( χ 2 trend =309.29, P <0.05). Logistic regression analysis showed that factors influencing abnormal spinal curvature included myopia, overweight, obesity, the frequency of classroom seating arrangements, time spent on homework/reading after school every day, time spent in daytime outdoor activities, self imposed requirements for posture of sitting and standing, phase of studying, gender, and area ( OR =0.53-2.55, P <0.05).@*Conclusion@#Abnormal spinal curvature is strongly correlated to nutritional status, myopia, sitting posture when reading and writing, sedentary time, and time spent in outdoor activities. The collaboration of multiple departments is required to establish anenvironment to protect the spine, early detection and early intervention.

Physical fitness evaluation results among students in Yunnan Province in 2019 / 中国学校卫生

Objective@#To analyze physical fitness of students aged 6-22 years old from seven ethnic groups in Yunnan Province, and to provide reference for physical fitness intervention measures.@*Methods@#The nationality, gender, grade, body shape, vital capacity, exercise quality of students were derived from the 2019 Yunnan Student Physical Health Survey Database. Comprehensive physical fitness score was calculated according to the National Student Physical Fitness Standards(revised in 2014). t test, ANOVA, and χ 2 test were used to analyze physical fitness score and level among students with different ethnic groups, gender, and school stages.@*Results@#The average comprehensive score of physical fitness among students from 7 ethnic groups in Yunnan Province was (70.02±9.69）, with the pass rate being 88.91%. The proportion of excellent was 0.93%, good was 17.90%, pass 70.09 %, and failed was 11.09%. Physical fitness score was highest in BMI (94.99 points), followed by 50 meter running (74.13 points), sitting forward bend (72.63 points), endurance running (70.43 points), standing long jump (67.77 points), sit ups ( 65.71 points) , 1 minute skipping rope (65.25 points), vital capacity (62.97 points), pull up (29.04 points). Physical fitness score and pass rate and evaluation level varied significantly by ethnicity and school stage( F =293.53，452.85， χ 2/ χ 2 trend =466.65， 412.57 ； 1 553.22 ，1 045.36， P <0.01).@*Conclusion@#The excellent rate of physical fitness among students in Yunnan Province is relatively low. Physical fitness promotion requires specific guidance and training based on ethnicity and school stage.

Correlation between waist circumference and psychological sub health of middle school students in Xinjiang / 中国学校卫生

Objective@#To understand the association between waist circumference with psychological sub health among middle school students in Xinjiang, and to provide evidence for the management of waist circumference and effective prevention of mental health problems.@*Methods@#By using the stratified cluster sampling, 6 191 middle school students aged 13-15 in Urumqi, Karamay, Yining, and Kashgar of Xinjiang were surveyed on demographic information, lifestyle, waist circumference, and psychological sub health symptoms. Chi square test, one way ANOVA, and Logistic regression analysis were used to analyze the association between waist circumference and mental sub health.@*Results@#The detection rate of psychological subhealth among secondary school students in Xinjiang was 21.4%. The detection rates of emotional problems, behavioral problems, and social adjustment difficulties were 28.4 %, 28.1%, and 17.7%, respectively. Significant differences in the detection rate of emotional problems, social adjustment difficulties, and psychological sub health scores were observed among students with different waist circumference levels ( F= 4.03 , 10.90 , 5.81, P <0.05). Logistic regression analysis showed that secondary school students with high waist circumference had a higher risk of social adjustment difficulties ( OR=1.45, 95%CI =1.20-1.75) and psychological sub health problems ( OR=1.46, 95%CI =1.22-1.74) compared to those with normal waist circumference ( P <0.01).@*Conclusion@#Psychological sub health problems of middle school students in Xinjiang are prominent, and the waist circumference is positively related to the psychological sub health problems. Schools should pay attention to the mental health education of middle school students, ensure reasonable diet, sleep and living habits, and promote their physical and mental health development.

Spinal curvature disorders among primary and middle school students in Hohhot / 中国学校卫生

Objective@#To investigate the incidence and associated factors of spinal curvature disorders among primary and middle school students in Hohhot, so as to provide reference for relevant prevention strategies.@*Methods@#According to the monitoring and intervention work of students common diseases in Inner Mongolia Autonomous, 13 586 primary and middle school students in Hohhot were selected by random sampling method to carry out scoliosis examination in September 2021.@*Results@#A total of 538( 4.0% ) students were found to have spinal curvature disorder. Multivariate Logistic regression analysis showed that monitoring site, phases of studying, and persistent back pain in the past 1 month were associated of spinal curvature disorder in primary and middle school students ( OR =0.33, 1.74, 1.28, 1.51, P <0.05).@*Conclusion@#Spinal curvature disorder is relatively common in primary and middle school students in Hohhot. Effective measures should be taken to reduce the burden of spinal curvature disorders in primary and middle school students.

Physical fitness and health status and gender differences of middle school students among five Chinese minorities during 2010 to 2019 / 中国学校卫生

Objective@#To analyze physical fitness and health status and gender differences of middle school students among 5 minorities (Mongolian, Hui, Uyghur, Zhuang and Korean), and to provide the theoretical basis for the strategy formulation.@*Methods@#The present data came from 3 waves of Chinese National Survey on Students Constitution and Health (2010, 2014, and 2019). According to National Standards for Students Physical Health (2014 Revision), excellent, and excellent good physical fitness and health status were defined. Cochran Armitage test was used to examine the trends of physical fitness and health status. Chi square test and Logistic regression were used to analyze the difference of physical fitness and health status by sex and survey year.@*Results@#From 2010 to 2019, the excellent physical fitness and health status rate of Mongolian, Hui, Uyghur, Zhuang and Korean students increased from 1.8%, 0.7%, 0.3%, 0.5% and 1.3% to 4.3%, 2.8%, 1.2%, 1.3% and 3.5%, respectively. The excellent good physical fitness and health status rate of Mongolian, Hui, Uyghur and Zhuang students increased from 12.9%, 8.0%, 7.2 % and 8.4% to 24.7%, 20.1%, 12.6% and 19.8%( Z =6.15，6.71，4.12，3.06，5.26；11.88，13.42，6.70，11.08， P <0.05), respectively. In 2019, students aged 13 to 15 years showed higher proportion of excellent/excellent good physical fitness and health status than that of students aged 16 to 18. Boys were more likely to be in excellent/excellent good physical fitness and health status than girls from 2010 to 2019. The sex difference in excellent/excellent good physical fitness and health status narrowed during 2010 and 2019.@*Conclusion@#Physical fitness and health status of minority students improved while sex difference narrowed during last decade, but there is still a long way to reach the goal proposed by China. Targeted intervention should be proposed to promote physical fitness and health status in accordance with the developmental characteristics, especially for girls and students aged 16 to 18 years.

Correlation between serum vitamin D level and glucose and lipid metabolism among primary and middle school students in Inner Mongolia / 中国学校卫生

Objective@#To explore the correlation between serum vitamin D level and glucose and lipid metabolism among primary and middle school students in Inner Mongolia, so as to providing a scientific basis for guiding rational vitamin D supplementation among primary and middle school students in Inner Mongolia Region.@*Methods@#A total of 2 206 students of primary and middle school students from 8 counties (districts) in Inner Mongolia were enrolled for a questionnaire survey, physical examination, and laboratory test by a multi stage stratified random sampling approach.The levels of fasting blood glucose, blood lipid and other related indexes with different vitamin D levels were analyzed, and their correlation was further discussed.@*Results@#The deficiency and insufficiency rates of vitamin D among primary and middle school students were 33.2% and 42.8%, respectively, and the suitable rate was 24.0%. The body mass index (BMI) and waist height ratio (WHtR) of the vitamin D deficiency group [(22.87±7.41) kg/m 2 , 0.46±0.08)]were higher than the insufficiency [(20.59±8.00)kg/m 2, 0.44±0.09)] and suitable group [(18.01±7.38)kg/m 2, 0.43 ±0.08)] ( P <0.05). Compared with the vitamin D suitable group [(3.87±0.85) mmol/L], the total cholesterol (TC) level in the deficiency group [(3.73±0.67)mmol/L] decreased, with a statistically significant difference ( P <0.05). The levels of high density lipoproteins (HDL) in the vitamin D insufficiency[(1.40±0.33)mmol/L] and deficiency groups [(1.34±0.31)mmol/L] were lower than the suitable group [(1.48±0.34)mmol/L], with a statistically significant difference ( P <0.05). The detection rate of hyperuricemia (HUA) in the vitamin D deficiency group (22.95%) was higher than the suitable group (17.20%), with a statistically significant difference ( P <0.016 7). Pearson correlation analysis showed that vitamin D was negatively correlated with BMI and WHtR ( r =-0.23, -0.11), and positively correlated with TC and HDL level ( r =0.06, 0.16) ( P <0.05).@*Conclusions@#The deficiency and insufficiency rates of serum vitamin D among primary and middle school students in Inner Mongolia are high which are associated with several indicators of blood lipids. Therefore, it is recommended to supplement vitamin D preparations in moderation in daily life.

Correlation between 24-hour time allocation patterns and physical fitness of Mongolian junior school students / 中国学校卫生

Objective@#To identify the 24-hour time allocation patterns of Mongolian junior school students, and to clarify the nature and degree of the influence of the time allocation patterns on the physical fitness of junior school students, so as to provide reference for optimizing and improving the scientific allocation of activity time of young students.@*Methods@#In October 2022, 1 389 Mongolian junior school students aged 13-15 from four schools in Xing an League of Inner Mongolia Autonomous Region were selected with stratified cluster sampling method. The 24-hour time utilization of students were collected by using the questionnaire of "China Time Utilization Survey (CTUS) Time Log in 2017" from October 21 to 22, 2022, and physical fitness was evaluated by using the test data of the National Student Physical Health Standard from September to November 2022. Students time allocation patterns were determined by Latent Profile Analysis with Mplus software, and the correlation between the time allocation patterns and the physical fitness was analyzed by multiple linear regression.@*Results@#The time allocation patterns of Mongolian junior school students could be classified into four types:learning type, screen type, diversity type, and sports type, and the population distribution were 24.7%, 18.3%, 9.9% and 47.1%, respectively. Among all gender and age groups, the sports type received highest total score physical fitness, followed by diversified type, learning type, and screen type ( F =72.25-154.94, P <0.01). The results of multiple regression analysis showed that gender, age, and time allocation patterns were significantly related to the total score of physical fitness ( P < 0.05 ). The total score of physical fitness in learning type, diversity type and sports type groups were all higher than that of screen type ( β =5.63, 12.86, 18.03, P <0.05). Moreover, the sports type showed highest effects on the total score of physical fitness, followed by the diversity type and learning type ( B =0.72, 0.31, 0.19, P <0.05).@*Conclusions@#There is a significant correlation between time allocation patterns and physical fitness of Mongolian junior school students, and those in sports type and diversity type of time allocation achieve better physical fitness, while those in learning type and screen type of time allocation shows relatively poorer physical fitness.In order to promote students physical fitness and healthy development, it is suggested to scientifically arrange students time allocation, increase physical activity time, and reduce sedentary activities that are detrimental to health.

The correlation between physical activity and fitness of the Tibetan children and adolescents living on the plateau in China / 中国学校卫生

Objective@#To learn about the characteristics of physical activity(PA) and physical fitness, and to provide basis for the health and development of the Tibetan students.@*Methods@#The cluster stratified random sampling was used, and 8 945 Tibetan students in Tibet were selected in May to June, 2019, and were administrated with questionnaire. Independent samples t test, one way ANOVA and Pearson correlation analysis were used.@*Results@#There were significant differences of PA, and physical fitness by gender, grade and living area among Tibetan adolescents ( P <0.05). The PA score of boys(2.79±0.58) was higher than that of girls( 2.51 ±0.56), while the physical fitness level of girls(62.40±25.55) was higher than that of boys(59.26±26.55). The PA score( 2.59 ±0.55) of rural Tibetan children and youth was lower than those of urban areas, while the physical fitness level(61.53±26.53) was only lower than that of county area; the PA score(2.60±0.58) of Tibetan children and youth was the lowest for grade 7 and 9, while physical fitness level(57.62±24.33) was the lowest for grade 5 and 6. PA was not significantly correlated with physical fitness of Tibetan adolescents( r =-0.01， P >0.05).@*Conclusion@#Lack of physical activity and poor physical fitness are observed in Tibetan adolescents. It is suggested that schools, families and society should cooperate in various aspects and actively take measures to improve the physical health level of Tibetan children and adolescents.