中国学校卫生

Improving collective health literacy in schools and comprehensively promoting the construction of healthy schools

TAO Fangbiao

2025, 46(1): 1-4. doi: 10.16835/j.cnki.1000-9817.2025026

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Chinese children and adolescents are experiencing dramatic changes in their lifestyle and the environment. Given the growing burden of myopia, obesity, and mental health problems among school-age children, school health services are presented with new challenges. It is essential to promote and implement the underlying principle of "health first" for society as a whole, while aiming to improve the collective health literacy of schools, optimizing school health management systems, and adopting a comprehensive healthy school program in order to support every school to become a foundation for healthy living.

Valuing the role of visual environment defocus characteristics in myopia prevention and control for children and adolescents

PAN Chenwei, LI Danlin

2025, 46(1): 5-8. doi: 10.16835/j.cnki.1000-9817.2025008

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Myopia is a complex disease influenced by multiple factors, and its prevention and control require a thorough identification and monitoring of its risk factors. The paper examines the defocus characteristics of the visual environment and their association with myopia among children and adolescents, and further describes their role in the prevention and control of myopia, as well as analyses the limitations of the current study and proposes directions for further research. Finally, the paper calls attention to the etiological significance of the defocus characteristics in the visual environment during the development of myopia among children and adolescents, which could provide a scientific basis for optimizing the learning environment and designing other measures to promote myopia prevention and control among children and adolescents.

Development history and challenges of sports and education integration in Chinese schools

TONG Haojie, TAO Fangbiao

2025, 46(1): 9-13. doi: 10.16835/j.cnki.1000-9817.2025002

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The physical and mental health issues of children and adolescents in China are becoming increasingly prominent. Integrating physical education deeply into the educational system and maximizing its role in fostering personal development, preventing common illnesses among students, and promoting mental health has emerged as the intersection of school health and sports. The article systematically arranges the development history and patterns of physical education in Chinese schools, summarizes the existing difficulties in the integration of physical education and educational system, and presents improvement suggestions to provide a basis for enhancing the integration system and promote the comprehensive development of children and adolescents.

Correlation of short sleep duration and screening myopia among primary and middle school students in Beijing

WANG Lu, ZHAO Hai, SUN Bingjie, XIA Zhiwei, GUO Xin

2025, 46(1): 14-17. doi: 10.16835/j.cnki.1000-9817.2025013

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Objective To study the correlation between short sleep duration and screening myopia among primary and middle school students in Beijing, so as to provide a scientific basis for the comprehensive prevention and control of myopia among students. Methods Using a stratified cluster random sampling, 25 593 primary and middle school students from 16 districts of Beijing were selected from September to November 2023. The National Common Diseases and Health Influencing Factors Monitoring Survey Questionnaire was used to conduct a questionnaire survey, and visual acuity was tested according to the Specification for the Screening of Refractive Error in Primary and Middle School Students. The reporting rates of short sleep duration and detection rates of screening myopia among primary and middle school students were compared using the Chi-square test. Binary Logistic regression was used to analyze the correlation between short sleep duration and screening myopia. Results About 68.63% of students reported short sleep duration. There was a statistically significant difference in the reporting rate of short sleep duration among students in different school stages (χ²=981.18, P < 0.01), with the lowest reporting rate of vocational high school students (47.07%) and the highest reporting rate of ordinary high school students (76.17%). The detection rates of screening myopia among primary school students (57.09%) and middle school students (76.53%) who reported short sleep duration were higher than those who reported enough sleep duration (52.65%, 71.94%), with satistically significant differences (χ²=14.83, 17.96, P < 0.01). The results of binary Logistic regression analysis showed that primary and middle school students with short sleep duration had a higher risk of developing screening myopia, compared to students with enough sleep duration (OR=1.25); after adjusting for confounding factors such as educational stage, gender, region, boarding situation, primary and secondary school students with short sleep duration still had a higher risk of screening myopia (OR=1.26) (P < 0.01). The analysis results stratified by educational stage showed that primary school students from grades 4-6 and middle school students with short sleep duration had a higher risk of screening myopia (OR=1.18, 1.20, P < 0.01). Conclusions Primary and secondary school students in Beijing with short sleep duration sleep have a higher risk of developing screening myopia. Families, schools, and society should ensure enough sleep duration to reduce the occurrence of myopia among students.

Association of outdoor activity level and myopia among children and adolescents in Shanghai

WANG Yanjiao, WANG Jingjing, NI Zihan, QI Ziyi, CHEN Jun, LIU Sichen, YANG Jinliuxing, DU Linlin, HE Xiangui

2025, 46(1): 18-23. doi: 10.16835/j.cnki.1000-9817.2025012

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Objective To analyze the status of outdoor activities on weekends among children and adolescents of different educational stages in Shanghai and their impact on myopia, so as to provide a basis for formulating more specific prevention and control protocol of myopia. Methods From September to October 2022, a stratified cluster random sampling method was employed to select 84 schools (27 kindergartens, 21 primary schools, 15 junior high schools and 21 high schools) across Shanghai, enrolling a total of 28 654 children and adolescents aged 4 to 18 for the study. Ophthalmic examinations were conducted to ascertain the prevalence of myopia among children and adolescents. Additionally, a questionnaire survey was administered to collect data on outdoor activity duration and associated factors. Multivariate Logistic regression analysis was utilized to investigate the associated factors of outdoor activity levels on weekends. Results The overall myopia detection rate among children and adolescents was 58.4%, with a higher rate observed in girls (59.2%) compared to boys (57.6%). The myopia detection rates for children and adolescents with an average daily outdoor activity duration of ≥2 h and < 2 h on weekends were 54.6% and 68.8%, and the differences were statistically significant (χ²=8.12, 460.89, P < 0.01). Multivariable Logistic regression analysis revealed that girls (OR=0.80), those with a myopic parent (OR=0.68), schools from urban districts (OR=0.72), higher education stages (primary school: OR=0.65, junior high school: OR=0.24, high school: OR=0.14) and spending≥2 h/d on homework during weekends (OR=0.57) among children and adolescents were less likely to engage in outdoor activities for ≥2 h on weekends (P < 0.01). After incorporating gender, parental myopia status, educational stage, school location, average daily duration on weekends for spending on homework, electronic product usage and outdoor activities as dependent variables in a multivariate Logistic regression analysis, the results showed that children and adolescents with an average outdoor activity duration for ≥2 h on weekends had a lower risk of myopia (OR=0.86, P < 0.01). Conclusions The level of outdoor activity among children and adolescents on weekends needs to be improved. Outdoor activities on weekends is an associated factor for myopia among children and adolescents. Particularly, girls, those with myopic parents, schools from urban districts, and spending long hours on homework during weekends among children and adolescents require increased attention.

Visual acuity and corrected visual acuity of children and adolescents in Shanghai City

ZHANG Bo, QI Ziyi, WANG Jingjing, LIU Sichen, YANG Jinliuxing, CHEN Jun, DU Linlin, HE Xiangui, GAO Wei

2025, 46(1): 24-28. doi: 10.16835/j.cnki.1000-9817.2025001

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Objective To investigate the visual acuity and correction conditions of children and adolescents in Shanghai, so as to provide a scientific basis for developing intervention measures to prevent myopia and protect vision among children and adolescents. Methods From October to December 2022, a stratified cluster random sampling survey was conducted, involving 47 034 students from 16 municipal districts in Shanghai, covering kindergartens (≥5 years), primary schools, middle schools, general high schools and vocational high schools. According to the Guidelines for Screening Refractive Errors in Primary and Secondary School Students, the Standard Logarithmic Visual acuity Chart was used to examine naked vision and corrected vision of students, and general information was collected. The distribution and severity of visual impairment in different age groups were analyzed, and χ² tests and multivariate Logistic regression were used to explore factors associated with visual impairment. Results The detection rate of visual impairment among children and adolescents was 76.2%, with a higher rate among females (78.8%) than males (73.8%), higher among Han ethic students (76.2%) than minority students (71.2%), and higher among urban students (76.7%) than suburban students (75.8%), all with statistically significant differences (χ²=162.6, 10.4, 5.5, P < 0.05). The rate of visual impairment initially decreased and then increased with age, reaching its lowest at age 7 (53.8%) and peaking at age 17 (89.6%) (χ_trend²=3 467.0, P < 0.05). Severe visual impairment accounted for the majority, at 56.6%, and there was a positive correlation between the severity of visual impairment and age among children and adolescents (r=0.45, P < 0.05). Multivariate Logistic regression showed that age, BMI, gender, ethnicity and urban-suburban status were associated with visual impairment (OR=1.18, 1.01, 1.38, 0.79, 0.88, P < 0.05). Among those with moderate to severe visual impairment, the rate of spectacle lens usage was 62.8%, yet only 44.8% of those who used spectacle lens had fully corrected visual acuity. Females (64.9%) had higher spectacle lens usage rates than males (60.6%), and general high school students had the highest spectacle lens usage (83.9%), and there were statistically significant differences in gender and academic stages (χ²=57.7, 4 592.8, P < 0.05). Conclusions The rate of spectacle lens usage among students with moderate to severe visual impairment is relatively low, and even after using spectacle lens, some students still do not achieve adequate corrected visual acuity. Efforts should focus on enhancing public awareness of eye health and refractive correction and improving the accessibility of related health services.

Space-time analysis of poor vision among primary and secondary school students in Chengdu from 2021 to 2023

XIE Yuhuan, WANG Zitong, CHEN Xi, YUE Lin, PAN Jie

2025, 46(1): 29-33. doi: 10.16835/j.cnki.1000-9817.2025028

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Objective To analyze the space-time characteristics of poor vision among primary and secondary school students in Chengdu, in order to provide the reference for formulating myopia prevention and control policies for students. Methods The data relating to poor vision among primary and secondary school students in Chengdu from 2021 to 2023 were sourced from the Sichuan Students' Physical Health Big Data Center. The districts and counties of Chengdu were divided into three circles, including the main urban area, suburban districts and counties, and suburban districts and counties. The Chi-square test was used for inter group comparison, and the Cochran-Armitage test was used to analyze the trend of changes. Global and local Moran's I were used to analyze spatial clustering. Results The detection rates of poor vision among primary and secondary school students in Chengdu from 2021 to 2023 were 62.47%, 61.61% and 60.78%, respectively, showing a decreasing trend (Z=-32.01, P < 0.01). For each year, the higher detection rate of poor vision among students was detected in the higher level of education, and differences were statistically significant (χ²=161 549.47, 173 471.87, 233 459.09, P < 0.01). The rate of poor vision among primary and secondary school students gradually decreased from the central districts and counties of Chengdu to the surrounding districts and counties for each year, and the differences were statistically significant (χ²=299.20, 776.22, 633.16, P < 0.01). The spatial autocorrelation analysis showed that the first circle of Chengdu City was mainly characterized by high-high agglomeration (P < 0.01), with the rate of poor vision among primary school students in Wuhou District in 2023 exhibiting a low-high anomaly. The third circle was mainly characterized by low-low aggregation (P < 0.01), while the spatial clusterings of the second circle was not significant (P>0.05). Conclusions The myopia prevention and control work in Chengdu has achieved preliminary results. It should continue to consolidate existing achievements and implement targeted myopia prevention and control measures based on regional characteristics.

Effect of outdoor activities and short-distance use of eyes on myopia among primary and secondary school students in Yunnan minority areas

LI Peiqian, HUANG Dafeng, ZHANG Jinjiao, MA Zixue, LI Xixi, LUO Xiao, XIAO Jie, HUANG Ying

2025, 46(1): 34-38. doi: 10.16835/j.cnki.1000-9817.2025003

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Objective To understand the prevalence of myopia among primary and secondary school students in minority areas of Yunnan Province, and to explore the influence of outdoor activities and short-distance use of eyes, so as to provide a basis for early myopia intervention. Methods In October 2020, the survey was conducted among 1 782 primary and secondary school students in three cities of Yunnan through a multi-stage random cluster sampling method. All subjects underwent a questionnaire survey and the visual acuity examination at baseline. The first follow-up was conducted in October 2021 to obtain 1 691 valid samples, and the second follow-up was conducted in May 2023 to obtain 1 367 valid samples. Factors associated with myopia among primary and secondary school students were explored by using generalized estimating equations. Results The prevalence rates of myopia in 2020, 2021 and 2023 were 52.64%, 61.62% and 69.35%, respectively, showing an increasing trend (χ_trend²=91.77, P < 0.05). The results of multivariate regression analysis on the generalized estimation equations showed that age at baseline (OR=1.31), girls (OR=1.76), Hani ethnicity (OR=0.75), Bai ethnicity (OR=0.69), parental myopia (OR=1.97-2.29), parents often reducing children's exercise time for homework or tutoring (OR=1.35), less than 1 time or 2-3 times of ball sports per week (OR=1.27, 1.20), reading and writing in the classroom during the break (OR=1.27), reading in direct sunlight occasionally (OR=1.20), using only desk lamp for writing at home (OR=0.71), more than 1 hours of short-distance eye use for a break once (OR=1.23) were associated with myopia among primary and secondary school students (P < 0.05). Conclusions Outdoor activities and short-distance use of eye among primary and middle school students in minority areas in Yunnan province are suboptimal. Enhancing the related environmental and behavioral factors can effectively mitigate the occurrence and progression of myopia.

Evaluation of the effect of integrated interventions on comorbidity of myopia and obesity among primary and secondary school students in Tongzhou District in Beijing

YANG Gang, YANG Dongmei, SONG Yi, LI Jing, WEN Han, CHE Jingyue, DONG Yanhui

2025, 46(1): 39-44. doi: 10.16835/j.cnki.1000-9817.2025031

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Objective To evaluate the intervention effectiveness of co-occurrence and prevention for myopia and obesity among primary and secondary school students, so as to provide a scientific basis for the development of comprehensive intervention measures in myopia and obesity. Methods From September 2022 to September 2023, a cluster random sampling method was used to select 6 primary schools and 6 junior high schools from Tongzhou District, Beijing. Participants were randomly assigned to an intervention group (914 before intervention and 754 after intervention) and a control group (868 before intervention and 652 after intervention), with an expected duration of one academic year. Based on the RE-AIM framework, integrate resources from families, schools, communities, and medical institutions to develop a school-based intervention technology packagefor the co-occurrence and prevention of myopia and obesity in children. The intervention group received intervention according to the comprehensive intervention technology package, while the control group did not receive any intervention measures. Relevant health indicators during the baseline period and after intervention were measured and collected, and groups were compared by Chi-quest test, t-test and Wilcoxon rank sum test. Results After intervention, the uncorrected visual acuity of primary and secondary school students in the intervention group (4.79±0.30) and the control group (4.77±0.33) both decreased compared to those before intervention (4.80±0.30, 4.90±0.32) (t=-7.00, -5.24); the decrease in uncorrected visual acuity in the intervention group was smaller than that in the control group(t=5.33)(p < 0.01). After intervention, body mass index, waist circumference, hip circumference, and body fat percentage of primary and secondary school students in the intervention group decreased compared to those before intervention. However, the changes in these indicators were not statistically significant (t/Z=-0.03, - 0.36, - 0.30, - 0.01, P>0.05); the above indicators in the control group increased compared to those before intervention, but only hip circumference and body fat percentage showed statistically significant changes (t/Z=2.17, 2.62, p < 0.05). After intervention, both the intervention group and the control group showed increases in systolic and diastolic blood pressure compared to those before intervention(intervention group: t=2.16, 5.29; control group: t=6.84, 5.07); the intervention group had lower systolic and diastolic blood pressure than the control group(t=-5.27, -2.08)(p < 0.05). After intervention, the intervention and the control groups had statistically significant differences in cognitive accuracy(92.48%, 69.33%) in terms of "outdoor exercise can prevent myopia" and "having 5 servings of adult fist sized vegetables and fruits every day" (χ²=6.30, 7.86, p < 0.05). There was a statistically significant difference in the proportion of primary and secondary school students in the intervention group (40.98%) and the control group (35.43%) for "who did not drink sugary drinks for every day in the past 7 days" (χ²=4.32, p < 0.05). After intervention, the intervention group and the control group showed increases in "school outdoor activity duration on school days" and "outdoor activity duration on rest days" compared to those before intervention (t/Z=-13.32, -9.71;- 2.59, -2.69);the behavior rate of "visual acuity measurement frequency at least once every 3 months" in the intervention group (46.68%) and the control group (52.76%) increased compared to those before intervention (36.43%, 44.01%), and the increases in the intervention group were greater than that in the control group (χ²=17.52, 11.08) (p < 0.05). Conclusions Comprehensive intervention measures have significant intervention effects on controlling the occurrence and development of comorbidity of myopia and obesity in children. It could actively promote collaboration and cooperation among families, schools, communities and medical institutions to reduce the occurrence of myopia and obesity among primary and secondary school students.

Study on meal preferences of school-aged children based on discrete choice experiment

ZHOU Weiwei, WU Xiaoyu, LIU Aidong, HUANG Feifei, GUAN Fangxu, ZHANG Jiguo, WANG Huijun, ZHONG Xuefeng, LIU Shuang, DU Wenwen

2025, 46(1): 45-49. doi: 10.16835/j.cnki.1000-9817.2025020

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Objective To explore the relative importance of different food attributes and levels in food decision-making of school-aged children, and to understand their meal preferences, so as to provide the evidence for formulating precise intervention strategies for dietary behaviours of school-aged children. Methods From May to June 2024, a total of 854 children aged 11 to 15 years old were selected from 2 middle schools (each school in urban and rural areas) in both Hubei Province and Anhui Province by stratified cluster random sampling method to conduct a D-optimal discrete choice experiment. The mixed Logit model was used to analyze children's preference for meal attributes and different levels, and to calculate the relative importance (RI) of attributes and willingness-to-pay (WTP) in meal choices. Results The included five food attributes had statistical significance on meal choice of school-aged children (p < 0.05). The relative importance of food attributes affecting the meal choices of school-aged children in descending order were dining mode (RI=31.26%), food varieties (RI=30.56%), cooking method(RI=23.84%), taste(RI=8.06%) and price (RI=6.27%). Among them, school-aged children preferred home-cooked meals (β=0.74) (WTP=86.3 yuan), varied foods(grain/tubers+vegetables+fish, meat, eggs and beans) (β=0.61) (WTP=71.9 yuan), fried/roasted cooking (β=0.51) and spicy taste (β=0.33).Price was negatively correlated with meal choices(β=-0.01) (p < 0.05). Based on residential area and body mass index (BMI), the stratified analysis showed that dining mode was highest in the relative importance for rural children with overweight and obese children (RI=31.28%, 34.17%), both of whom preferred home-cooked meals (β=0.76, 0.91), and meals containing fish, meat, eggs and beans with grain/tubers or grain/tubers and vegetables in terms of food choice (area: β=0.53, 0.53; BMI: β=0.55, 0.56) (p < 0.05). Conclusions School-aged children have different preferences for different attributes of meals. The quality of school meals should be improved, the cost of buying healthy meals should be reduced, targeted family health education should be carried out, and healthy cooking methods should be advocated.

Nutritional supply status of school meals for primary and secondary students in three cities of Henan Province

LI Shan, YANG Li, HE Qidong, CAO Linlin, CHEN Xiaolong, LIU Bingrui, FENG Yinhua, FU Pengyu

2025, 46(1): 50-52. doi: 10.16835/j.cnki.1000-9817.2025016

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Objective To assess the nutritional supply status of school meals for primary and secondary school students in Henan Province, so as to provide a basis for scientific guidance of school meals. Methods During 2021-2023, 115 lunch and dinner samples were collected from 25 primary and secondary schools in Zhoukou, Anyang and Luoyang of Henan Province by a direct selection method, and 13 nutrients were determined for each sample. The nutrient supply was evaluated based on Nutrition Guidelines of School Meals and Reference Intake of Dietary Nutrients for Chinese Residents (2023 Edition). Mann-Whitney U test was used to compare the differences of nutritional supply between urban and rural schools. Results The median values for energy (709.77 kcal, 1 kcal=4.18 kJ), fat energy supply ratio (0.27) and carbohydrate energy supply ratio (0.55) in the 66 lunches and dinners from primary school were within the recommended range. The supply of protein (28.39 g) and sodium (1 464.59 mg) was excessive. The median values of zinc (2.62 mg) and dietary fiber (5.19 g) were lower than the reference values. No statistically significant differences were observed in the supply of 13 nutrients between urban and rural primary schools(U=427.00-633.00, P>0.05). Among 49 samples from secondary schools, the median value of energy supply (930.02 kcal), carbohydrate energy ratio (0.54) and fat energy supply ratio(0.25) were within the recommended range; and the median values of protein (38.82 g) and sodium (2 556.80 mg) were higher than the standard; and the median values of calcium (250.32 mg) and vitamin B1 (0.16 mg) were lower than the standard. Additionally, the differences in the level of vitamin B2 (U=372.00) and zinc (U=375.00) between the urban and rural secondary schools were statistically significant (p < 0.05). Conclusion Nutrient supply of primary and secondary school meals in three cities of Henan Province is inadequate and imbalanced, and the recipe need to be further optimized and improved.

Current status of eating behaviors and its predictive role in overweight and obese of adolescents

YAO Yisong, TANG Shiwei, SONG Jiani, FENG Jingjing, HE Jingbo, ZHANG Ziyi, SUN Mingjun, CHENG Yunxia, YONG Na

2025, 46(1): 53-57. doi: 10.16835/j.cnki.1000-9817.2025030

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Objective To explore the current status and influencing factors of eating behaviors in adolescents, so as to provide a theoretical foundation for health promotion education among adolescents. Methods Based on the database from Survey of Chinese Family Health Index (2021), by a random number table method, 1 065 teenagers were selected from the provincial capitals of 22 provinces and 5 autonomous regions in China, as well as 4 municipalities directly under the central government. A general characteristic questionnaire, Patient Health Questionnaire-9 (PHQ-9), Short Form of the Family Health Scale (FHS-SF), 10-item Short Version of the Big Five Personality(BFP-10), Content-based Media Exposure Scale (CM-E) and Sakata Eating Behavior Scale Short Form(EBS-SF) were used to collect information. Multivariate stepwise linear regression analysis was employed to identify and analyze related factors of eating behaviors among adolescents. Receiver operating characteristic was used to validate the predictive ability of the EBS-SF score for overweight and obesity among adolescents. Results The average scores of BFI-10, C-ME, FHS-SF, PHQ-9 and EBS-SF were (33.08±4.64)(19.20±4.55)(38.48±6.65)(6.09±5.63)(16.75±4.36), respectively. Multivariate linear regression showed that family type (other types), agreeableness, conscientiousness, family health and depression were the main related factors of EBS-SF scores among adolescents(B=2.61, -0.42, 0.20, -0.11, 0.23, p < 0.05).The analysis of receiver operating characteristic curve showed that the EBS-SF scores had a good ability in predicting obesity among male adolescents (AUC=0.73, p < 0.01). Conclusions Family type, big five personality, family health, depression are the related factors of eating behaviors among adolescents. EBS-SF scores are predictive of obesity in adolescents, which would provide a new perspective for promoting healthy eating habits among adolescents.

QIN Ran, LIU Yang, LI Hongtian, LIU Jianmeng, GUO Xin

2025, 46(1): 58-62. doi: 10.16835/j.cnki.1000-9817.2025023

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Objective To analyze the factors related to dual use of traditional cigarettes and e-cigarettes among middle school students in Beijing, in order to provide a scientific basis for adapting to the new situation and carrying out tobacco control among adolescents. Methods A multi-stage cluster random sampling method was used to select 15 688 and 13 607 junior and senior middle school students from 16 districts in Beijing from April to June in 2019 and 2023, respectively. Online self-administered questionnaires among middle school students in Beijing were completed, including use of traditional cigarettes and e-cigarettes, exposure to second-hand smoke, attitudes and perceptions towards tobacco, etc. The Chi-square test was used to compare rates, and a multiple factors Logistic regression model was used to analyze related factors of traditional cigarettes and e-cigarettes dual use among middle school students. Results The dual use rate of traditional cigarettes and e-cigarettes in 2023 had decreased to 2.46% from 4.88% in 2019 among middle school students in Beijing. The results of the multiple Logistic regression model analysis showed that among middle school students, tobacco control anywhere at home (boys: OR=0.47, girls: OR=0.34), without anyone smoking on campus in the past month (boys: OR=0.43, girls: OR=0.26) had lower risks of dual use (P < 0.05); and middle school students strongly or slightly agreeing that smoking could bring happiness (boys: OR=4.11, 2.22, girls: OR=5.32, 3.87), believing that smoking could increase attractiveness of young people (boys: OR=3.13, girls: OR=5.81), smoking cigarettes handed over by good friends (boys: OR=4.24, girls: OR=7.21), thinking smoking in the next year (boys: OR=5.77, girls: OR=7.74) had higher risks of dual use (P < 0.05).Among boys, junior middle school students (OR=0.50), excellent academic performance (OR=0.36), no acceptance of free tobacco products from tobacco companies (OR=0.38), believing that smoking couldn't refresh oneself (OR=0.37) and smoking still could pose a health hazard though not yet addictive (OR=0.32) had lower risks of dual use (P < 0.05);and boys with a history of secondhand smoke exposure indoor outside home (OR=2.19), believing that quitting smoking without difficulty (OR=2.57), smoking e-cigarettes handed over by good friends (OR=11.27) had higher risks of dual use (P < 0.05). Among girls, no acceptance of using tobacco product labeled items (OR=0.28) had lower risks of dual use (P < 0.05); and girls whose parents both smoke (OR=5.53), believing that quitting smoking might not be difficult (OR=4.44) had higher risks of dual use (P < 0.05). Conclusions The dual use rate of traditional cigarettes and e-cigarettes among middle school students in Beijing has decreased. It is recommended to take the construction of smoke-free families as the starting point, so as to reduce indoor second-hand smoke exposure and control tobacco promotions, and promote the formation of correct tobacco control culture and moral constraints among secondary school students.

Physical activity level and the associated factors of after-school sports service courses for primary school students in Zhejiang Province

ZHOU Junjie, HAN Yuhang, LI Niuniu, ZHONG Yecheng, XU Wenhong

2025, 46(1): 63-67. doi: 10.16835/j.cnki.1000-9817.2025019

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Objective To understand the physical activity levels and influencing factors among primary school students during after-school sports services in Zhejiang Province, so as to provide references for PA and health promotion of after-school sports services. Methods From April to May 2024, a combined method of convenience sampling and stratified cluster sampling was used to select 314 primary school students from three primary schools in Hangzhou, Ningbo, and Wenzhou for the survey. The ActiGraph wGT3-BT accelerometer was used to measure the physical activity levels of primary school students during their after-school sports services. Family Socioeconomic Status Questionnaire, International Physical Activity Questionnaire-Short Form (IPAQ-SF), and Activity Support Scale for Children (ACTS-CN) were used to investigate family associated factors. Data were analyzed using independent samples t-test, analysis of variance, and multiple linear regression. Results During after-school sports services on average, the sedentary behavior, light-intensity physical activity, and moderate-to-vigorous-intensity physical activity durations of primary school students were (19.34±3.73) minutes, (12.43±2.39) minutes and (8.23±2.31) minutes, respectively. The results of multiple linear regression analysis showed that the associated factors of sedentary behavior during after-school sports services among primary school students included gender, grade level, family socioeconomic status and parents' daily physical activity levels (β=0.17, 0.17, -0.27, -0.17); the associated factors of light-intensity physical activity included gender and family socioeconomic status (β=-0.22, 0.15); and the associated factors of moderate-to-vigorous-intensity physical activity included grade level, family socioeconomic status and parents' daily physical activity levels (β=-0.18, 0.31, 0.18) (P < 0.01). Conclusions The moderate-to-vigorous-intensity physical activity levels of primary school students during after-school sports services in Zhejiang Province are relatively low. The adverse effects of relevant factors should be considered to enhance the physical activity levels of primary school students during after-school sports services.

Association between moderate-to-vigorous intensity physical activity and sedentary behavior among primary and secondary school students and their parents

YAO Zifeng, YE Rongrong, CHEN Jiade, XU Peng, HUANG Yanhong, LI Lixia, LI Hongjuan, GAO Yanhui

2025, 46(1): 68-72. doi: 10.16835/j.cnki.1000-9817.2025021

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Objective To explore the associations of moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior (SB) among primary and secondary school students and their parents, so as to provide a scientific basis for formulating targeted physical activity promotion strategies for children and adolescents. Methods From 2021 to 2022, basic information and 24 h movement behaviors of 2 484 pairs of students and their parents were collected from five primary and secondary schools in Haizhu District, Guangzhou City, with a convenient sampling combining with cluster sampling method. Component regression models were constructed to analyze the relationship between parental MVPA, SB and primary and secondary school students' MVPA and SB, and a component isochronous substitution model was used to explore the effects of mutual substitution between parental MVPA, residual components (time-use components other than SB during the 24 h period), and SB on the behavioral activities of MVPA and SB in primary and secondary school students. Results Parental MVPA and SB of students in grade 1 to 3 were positively correlated with both students' MVPA and SB (β=0.06, 0.12, P < 0.01). The component isochronous substitution model showed that substituting 10 and 20 minutes of MVPA for SB by parents in grade 1 to 3 was associated with an increase in MVPA of students, and substituting 10 and 20 minutes of residual ingredients for SB was associated with a decrease in SB of students, with mean changes of 0.8 (95%CI=0.4-1.2) and 1.4 (95%CI=0.7-2.2) and -1.4 (95%CI=-1.7 to -1.1) and -2.9 (95%CI=-3.4 to -2.3)(P < 0.05). No statistically significant associations were observed between parents of students in grades 4 to 6 and 7 to 9 and students' physical activity and sedentary behaviour (P>0.05). Conclusions Parents of students in grades 1 to 3 increases MVPA and decrease SB are beneficial to increase MVPA and decrease SB of students. Parents could promote physical activity among primary and secondary school students, and the intervention gateway should be advanced, with the low grades as the optimal intervention period.

Impact of childhood maltreatment and sleep quality on depressive symptoms among middle school students

LI Yitong, LIANG Yanan, CAO Jing, YANG Guang, WEI Jinsheng, ZHU Minhui, ZHANG Lina, HUANG Hai, ZHANG Junjie, WANG Jia, ZHANG Huiying

2025, 46(1): 73-77. doi: 10.16835/j.cnki.1000-9817.2025029

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Objective To explore the impact of sleep quality, experience of childhood maltreatment, and their interaction on depressive symptoms among middle school students, so as to provide the reference for early intervention of depressive symptoms among middle school students. Methods From September to December 2023, a questionnaire survey was conducted among 1 231 students from two secondary schools in Harbin, Heilongjiang Province by a convenient sampling method. The survey included general demographic information, Childhood Trauma Questionnaire Short Form, Pittsburgh Sleep Quality Index and Short Version of Center for Epidemiological Studies Depression Scale. The Chi-square test was used to analyze the differences in depressive symptom, sleep quality and childhood maltreatment among students with different demographic characteristics. Correlation analysis was conducted using Logistic regression, and interaction analysis was performed by both additive and multiplicative interaction models. Results The detection rate of depressive symptoms among middle school students was 22.7%, and the rate for high school students (35.2%) was significantly higher than that for middle school students (17.0%) (χ²=50.35, P < 0.01). The detection rates of depressive symptoms among middle school students with a history of childhood maltreatment and poor sleep quality were 45.8% and 44.0%, respectively. Multivariate Logistic regression analysis showed that compared to students without a history of childhood maltreatment, students with a history of childhood maltreatment had a higher risk of depressive symptoms (OR=4.49, 95%CI=3.31~6.09, P < 0.01);students with poor sleep quality had a higher risk of depressive symptoms than students with good sleep quality (OR=5.99, 95%CI=4.37~8.22, P < 0.01).The interaction results showed that the presence of childhood maltreatment and poor sleep quality had an additive interaction on the occurrence of depression in middle school students. Compared with students without childhood maltreatment and having good sleep quality, students with childhood maltreatment and poor sleep quality had a 22.49 times higher risk of developing depression (OR=22.49, 95%CI=14.22~35.59, P < 0.01). Conclusion Depressive symptoms among middle school students are associated with childhood maltreatment and poor sleep quality, and there is an additive interaction between childhood maltreatment and poor sleep quality on the impact of depressive symptoms.

Effect of the family function intervention on mental health status of middle school students

YANG Jing, LIU Mingxin, ZHAGN Xingli

2025, 46(1): 78-81. doi: 10.16835/j.cnki.1000-9817.2025018

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Objective To explore the impact of family function intervention on mental health status of middle school students, so as to provide the reference for promoting adolescent mental health. Methods From October 2023 to January 2024, 44 families from grade 2 of one junior high school were recruited. They were randomly divided into an intervention group (n=21) and a control group (n=23) using a simple random sampling method. Both groups of families participated in various daily school activities and learning, but the intervention group of families also participated in 10 online family function intervention courses. Family Assessment Device (FAD) and the Middle School Student Mental Health Scale (MSSMHS) were used as evaluation tools. Pearson correlation analysis was used to test the correlation between FAD total scores of middle school students and the total mean scores of MSSMHS, and repeated-measures ANOVA was used to analyze FAD scores changes in various dimensions before and after intervention. Results The total score of FAD in middle school students was positively correlated with the total average score of MSSMHS (r=0.44, P < 0.01). Before intervention, there was no statistically significant difference in the FAD scores (intervention group: 143.19±16.05, control group: 144.87±22.40) and MSSMHS total average scores (intervention group: 1.69±0.46, control group: 1.77±0.59) between the two groups (t=0.28, 0.53, P>0.05). After intervention, the main effect of time, group, and time-group interaction of the interventions on the FAD total scores between the intervention group and the control group were statistically significant (F=11.87, 7.26, 11.04, P < 0.05). Further simple effects analysis revealed that the post-test FAD total score of the intervention group (121.71±16.01) decreased by 21.48 points compared to the pre-test and was lower than the post-test total score of the control group (144.47±17.71), with statistically significant differences (t=4.68, 4.11, P < 0.05). The main effect of the group on the total mean MSSMHS score between the intervention and control groups was statistically significant (F=8.45, P < 0.05), while the main effect of time was not statistically significant (F=1.68, P>0.05). Further comparative analysis revealed that the post-test total mean score of MSSMHS in the intervention group (1.34±0.23) was lower than that in the control group (1.85±0.52) (t=3.48, P < 0.01). Conclusion Family function intervention can improve the mental health status of middle school students, and relevant measures should be actively taken to promote adolescent mental health.

Effects of dietary rhythm and digital media use rhythm disorders and their interaction on psychological health among middle school students

ZHANG Yadi, XIE Yang, LIU Xiaoling, ZHANG Mengqian, WAN Yuhui, TAO Fangbiao

2025, 46(1): 82-85. doi: 10.16835/j.cnki.1000-9817.2025006

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Objective To explore the effects of dietary rhythm and digital media use rhythm disorders, as well as their interactions on the psychological health of middle school students, so as to provide a reference basis for promoting the psychological health of middle school students with rhythm disorder. Methods From November to December 2023, a total of 12 847 middle school students were selected from seven middle schools and six high schools in three cities (Shenzhen, Taiyuan and Zhengzhou) by a multi-stage cluster random sampling method. A self-administered questionnaire was used to assess dietary rhythm and digital media use rhythm disorders of middle school students. The Brief Instrument on Psychological Health of Youths was used to assess psychological sub-health of middle school students. A Logistic regression model was constructed to analyze the associations of dietary rhythm and digital media use rhythm disorders with psychological sub-health among middle school students, as well as their interaction effects on psychological sub-health. Results The detection rate of psychological sub-health among middle school students was 20.58%. The analysis results of Logistic regression model showed that taking the low disorder groups of dietary rhythm and digital media use rhythm as the references, middle school students in the moderate and high disorder groups of dietary rhythm (OR=2.85, 95%CI=2.51-3.23) and digital media use rhythm (OR=2.33, 95%CI=2.07-2.63) had higher risks of psychological sub-health (P < 0.01). In addition, the results revealed that disorders of dietary rhythm and digital media use rhythm had multiplicative interactions (OR=2.48, 95%CI=2.33-2.76) and additive interactions [RERI(95%CI)=0.84(0.32-1.36), AP(95%CI)=0.20(0.08-0.33), SI(95%CI)=1.36(1.08-1.72)](P < 0.01), that contributed to psychological sub-health. Conclusion The prevention and management of psychological sub-health among middle school students should focus on disorders of dietary rhythm and digital media use rhythm, in order to improve irregular dietary patterns and reduce irrational use of digital media, which may contribute to promoting psychological health among middle school students.

Assocation of family environment and depressive symptoms among primary and secondary school students in Shanxi province

YANG Yang, YANG Le, QU Hongfei, YAO Dianrui, LI Zhenhao, GUO Dan

2025, 46(1): 86-91. doi: 10.16835/j.cnki.1000-9817.2025010

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Objective To explore the assocation of the family environment and depressive symptoms among primary and middle school students, so as to provide suggestions for further maximizing the utility of family environment in the growth of primary and secondary school students, as well as prevention and intervention of depressive symptoms among children and adolescents. Methods From June to July 2024, through a multistage cluster random sampling method, 8 800 primary and middle school students aged 10 to 18 from 36 schools in 3 cities (Datong, Lvliang, Linfen) in Shanxi Province. A self-designed questionnaire was used to conduct a family environment survey, including family socioeconomic conditions, family structure, family parenting behavior, family member health behavior, etc; and the depression symptoms of primary and secondary school students were investigated by Patient Health Questionnaire-9. The χ² test and binary Logistic regression to method were used to analyze the association of the family environment with depressive symptoms among primary and secondary school students, and to analyze gender and urban-rural heterogeneity in this association. Results The detection rate of depressive symptoms among primary and middle school students was 46.7% (n=4 111). Among them, the detection rates of depressive symptoms for male and female students were 45.7% and 47.7% respectively, and the detection rates for rural and urban students were 48.0% and 44.9% respectively. The results of binary Logistic regression model showed that in the family environment, factors such as the father's education level (junior high school: OR=0.84), self-assessed family socio-economic status (average: OR=0.78, good: OR=0.80), parental support and understanding (yes: OR=0.55), family atmosphere (harmonious: OR=0.66), living arrangement (living only with father or mother: OR=1.31, living with parents and grandparents: OR=1.19), and family rearing style (combining punishment and reward: OR=1.42, punishment only: OR=1.25) were related to depressive symptoms in primary and middle school students in Shanxi Province (P < 0.05). From the perspective of gender heterogeneity, the living arrangement (living only with father or mother: OR=1.67, others: OR=1.67) had a statistically significant association with depressive symptoms in male students (P < 0.05). From the perspective of urban-rural heterogeneity, the living arrangement (living only with father or mother: OR=1.38) had a statistically significant association with depressive symptoms in rural primary and middle school students (P < 0.05). Conclusions The family environment has an important impact on depressive symptoms in primary and middle school students. Family functioning should be fully exerted to prevent depressive symptoms in primary and middle school students.

Network analysis of factors related to non-suicidal self-injury among middle school students in Guizhou Province

ZHAO Wenxin, TIAN Meng, CHEN Siyuan, WU Jinyi, GAO Ying, DENG Xiwen, ZHANG Wanzhu

2025, 46(1): 92-95. doi: 10.16835/j.cnki.1000-9817.2025022

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Objective To explore the relationship between related factors of non-suicidal self-injury behavior (NSSI) among middle school students in Guizhou Province, so as to provide the evidence for preventing high-risk behaviors in adolescents. Methods A stratified cluster random sampling method was used to select 1 034 junior and senior middle school students from Zunyi City, Qiannan Prefecture and Tongren City in Guizhou Province from April to October in 2023. Questionnaire survey was conducted to collect information including Adolescent Self-injury Scale and Family Assessment Device. The R 4.4.1 software was employed for network analysis visualization, centrality indicators, and result stability assessment. Results The detection rate of NSSI behavior among middle school students in Guizhou province was 29.6%, with a detection rate of 25.5% for boys and 33.1% for girls, showing a statistically significant difference (χ²=7.07, P < 0.05). There were statistically significant differences in scores of emotional communication, egoism, family rules, positive communication, problem-solving, expression of positive emotions and management of negative emotions self-efficacy, and bullying victimization in various dimensions between middle school students with and without NSSI (Z=-13.66 to -7.05, P < 0.01). NSSI among middle school students was positively correlated with social/relational bullying, depression and anxiety, and there were relatively close connections in the network (r=0.35, 0.43, 0.42, P < 0.01). Centrality indicators showed that the highest in strength and closeness centrality were stress (Z=1.29, 1.58), the highest in betweenness centrality was for emotional communication (Z=1.91), and the highest in expected influence index was for physical bullying (Z=1.44)(P < 0.05). Conclusions Stress, emotional communication and physical bullying have significant impacts in the network of factors related to NSSI. Social/relational bullying, depression and anxiety have strong direct correlations with NSSI behavior among middle school students.

Depressive symptoms and associated factors among middle school and college students from 2021 to 2023 in Hunan Province

LIAN Xinyao, WANG Fei, WANG Yaqi, WANG Huan, GUO Jianhui, SHI Di, WANG Shaoguan, ZOU Zhiyong, CHEN Yanhua, LI Jing

2025, 46(1): 96-101. doi: 10.16835/j.cnki.1000-9817.2025027

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Objective To investigate the current status and trends of depressive symptoms among middle school and college students in Hunan Province, and to explore the primary related factors of depressive symptoms, so as to provide a scientific basis for strengthening mental health among students. Methods A total of 279 382 students in Hunan Province were selected through a stratified cluster random sampling method from 2021 to 2023. National Survey Questionnaire on Common Diseases and Health Influencing Factors among Students was adopted for the survey, and the Center for Epidemiological Studies Depression Scale was used to assess their depressive symptoms. The χ² test and trend χ² test were used to analyze depressive symptoms prevalence and trends, and multivariable Logistic regression was used to analyze the related factors of depressive symptoms. Results The prevalence of depressive symptoms among students in Hunan Province from 2021 to 2023 were 19.66%, 20.17% and 21.47%, respectively, showing an upward trend (χ_trend²=9.07, P < 0.01). In addition, the results of the multivariable Logistic regression analysis showed that students with healthy diet (OR=0.43, 95%CI=0.40-0.45), adequate sleep (OR=0.88, 95%CI=0.86-0.90), and acceptable screen time (OR=0.61, 95%CI=0.60-0.62) had lower risks in depressive symptoms detection, while students with smoking (OR=1.95, 95%CI=1.88-2.02), secondhand smoke exposure (OR=1.33, 95%CI=1.30-1.36) and Internet addiction (OR=4.19, 95%CI=4.05-4.34) had higher risks in depressive symptoms detection, with differences in the degree of association among different genders, educational stages and urban-rural groups (OR=0.40-6.04, Z=-12.69-11.98) (P < 0.05). Conclusions There is an increasing trend of depressive symptoms among middle school and college students in Hunan Province from 2021 to 2023.Targeted depression prevention measures should be taken for students with different demographic characteristics to promote their mental health.

Association of physical activity and sugar-sweetened beverage consumption with psychological sub-health among middle school students in Bao'an District, Shenzhen

WANG Xi, GAO Yue, WEI Ruihong, WANG Yanan, ZHOU Ruyi, LIU Yanhong, LI Yunfeng, REN Liuyingying, WAN Yuhui

2025, 46(1): 102-105. doi: 10.16835/j.cnki.1000-9817.2025004

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Objective To explore the association of physical activity and sugar-sweetened beverage consumption with psychological sub-health among middle school students in Bao'an District, Shenzhen, so as to provide a reference for adolescent mental health promotion. Methods A questionnaire survey was conducted in November 2024 by a stratified cluster random sampling method to select 6 926 junior and senior middle school students from 5 middle schools in Shenzhen. The questionnaire from Youth Risk Behavior Surveillance System was used to assess the consumption of sugar-sweetened beverages, and physical activity Rating Scale was used to assess the level of physical activity, and Brief Instrument on Psychological Health of Youths was used to evaluate the psychological sub-health status. The Chi-square test was used to analyze the differences in the detection rates of psychological sub-health among different groups of middle school students, and a multivariate Logistic regression model was established to analyze the effects of physical activity and sugar-sweetened beverage consumption and their combined effects on the psychological sub-health of middle school students. Results The detection rate of psychological sub-health among middle school students in Bao'an District, Shenzhen was 18.93%. Multivariate Logistic regression analysis showed that, after controlling for confounding factors such as gender, school stage, family residence, family economic status, parental literacy, academic stress and number of friends, lack of physical activity or excessive sugar-sweetened beverage consumption were associated with increased risks of psychological sub-health among middle school students (OR=1.36, 1.45); and the highest risk of psychological sub-health was found in middle school students who were lack of physical activity and excessive sugar-sweetened beverage consumption (OR=2.59) (P < 0.01). Further analysis by school stages showed that junior high school students with sufficient physical activity and excessive intake of sugary drinks (ROR=2.10), lack of physical activity and excessive intake of sugary drinks (ROR=2.31) were at higher risks of psychological sub-health than senior high school students(P < 0.05). Conclusions Insufficient physical activity and excessive sugar-sweetened beverage consumption are closely associated with an increased risk of psychological sub-health among middle school students. Effective interventions should be targeted to reduce the risk of psychological sub-health problems among middle school students.

Relationship of family function with sleep quality and externalizing problem behaviors among preschool children

LU Yanping, GUO Shi, ZHOU Mingyue, ZHU Dongmei, YU Yizhen

2025, 46(1): 106-110. doi: 10.16835/j.cnki.1000-9817.2025011

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Objective To explore the relationship of family function with sleep and externalizing problem behaviors of preschool children, so as to provide a guidance for externalizing problem prevention and intervention among preschool children. Methods From October 2023 to January 2024, a convenience sampling method was used to select 5 138 preschool children from kindergartens in 8 districts of Wuhan City, Hubei Province. Parents completed the survey for Family Adaptability and Cohesion Scale, children's sleep habits and Child Behavior Checklist (CBCL). Spearman correlation analysis was used to examine the correlation of family function with scores of sleep quality and externalizing problem behaviors among preschool children. A mediation model analysis and bootstrap test were conducted to further investigate the mediating role of sleep quality between family function and externalizing problem behaviors. Mplus 8.7 software was used for latent profile analysis of family function. Results The reported rates of poor sleep quality and externalizing problem behaviors among preschool children were 11.8% (n=607), 20.0% (n=1 026). The relevant analysis results showed that family function was negatively correlated with sleep quality and externalizing problem behaviors (r=-0.20, -0.23), and sleep quality was positively correlated with externalizing problem behaviors (r=0.27) (P < 0.01). The mediation effect test showed that family function negatively predicted externalizing problem behaviors (β=-0.079) and sleep quality (β=-0.075), while sleep quality positively predicted externalizing problem behaviors (β=0.215) (P < 0.01). The latent profile analysis results showed that family function could be classified into 4 categories: high family function group (23.01%), upper middle family function group (44.65%), moderate family function group (26.24%) and low family function group (6.11%). Compared to high family function, the other three categories significantly positively predicted externalizing problem behaviors, and the mediating effects of sleep quality on different categories of family function were statistically significant [upper middle family function: mediation effect value was 0.022 (95%CI=0.004-0.041) and direct effect value was 0.329 (95%CI=0.263-0.396); middle family function: mediation effect value was 0.087 (95%CI=0.063-0.115) and direct effect value was 0.491 (95%CI=0.416-0.565); low family function: mediation effect value was 0.144 (95%CI=0.107-0.185) and direct effect 0.621 (95%CI=0.503-0.740)] (P < 0.05). Conclusion Family function negatively predicts the externalizing problem behaviors of preschool children, and sleep quality plays a partial mediating role.

Analysis of ROC curves for the effect of predicting hand grip strength based on morphological indicators in high school girls

WANG Kai, ZHAO Guanxiang

2025, 46(1): 111-114. doi: 10.16835/j.cnki.1000-9817.2025024

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Objective To evaluate and compare the accuracy of body mass index (BMI), waist circumference (WC), waistcorrected BMI (wBMI), and waist-to-height ratio (WHtR) in predicting hand grip strength (HGS) in high school girls, so as to provide the reference for evaluating their overall physical fitness and health status. Methods From May to December in 2022, a total of 1 600 girls aged 15 to 18 years old were selected by cluster random sampling from 12 high schools in Xuzhou, Jiangsu Province. Measures of HGS, waist circumference, height and weight among high school girls were taken, and their BMI, wBMI and WHtR were calculated. Pearson correlation analysis and Logistic regression were used to analyze the association between BMI, wBMI, WC, WHtR and HGS Receiver operating characteristic (ROC) curves were constructed to evaluate the accuracy of different indicators in predicting HGS Results Pearson correlation analysis showed that the BMI, wBMI, WHtR and HGS expression of high school girls were positively correlated (r=0.31, 0.27, 0.32, 0.14, P < 0.01). Logistic regression analysis showed that BMI, WC and wBMI were correlated with HGS expression (OR=2.00, 0.47, 1.22, P < 0.05), while the association of WHtR and HGS expression had no statistical significance (OR=0.51, P>0.05). The area under the curve (AUC) of BMI for predicting HGS expression in high school girls was the largest (AUC=0.65, 95%CI=0.61-0.69), followed by the AUC of wBMI for predicting HGS expression (AUC=0.65, 95%CI=0.57-0.66)(P < 0.05). The most sensitivity was wBMI (71.5%), followed by BMI (69.4%), and the least sensitivity was WHtR (52.3%); and WC had the best specificity (61.1%), whereas wBMI had a relatively low specificity (52.5%). Conclusion For high school girls, BMI, WC and wBMI could predict the strenth of HGS expression, but BMI and wBMI have the highest accuracy and sensitivity, while wBMI has the lowest specificity in predicting the strenth of HGS.

Effect of fine particulate matter exposure in the air on dyslipidemia among primary school students in two provinces and cities of China

ZHU Yuanduo, HAN Yingying, LI Dandan, ZHANG Jingwei, XU Yanlong

2025, 46(1): 115-118. doi: 10.16835/j.cnki.1000-9817.2025032

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Objective To analyze the association between fine particulate matter (PM_2.5) exposure in the air and dyslipidemia among primary school students, in order to provide the evidence-based support for the prevention and control of chronic diseases in children. Methods The random sampling method was used to select 625 students from two primary schools in Anhui Province and Tianjin City from May to June 2024. Based on the home address, the annual average exposure levels of PM_2.5 were obtained in 3 years before investigation, 2 years before investigation, and the past year before investigation. Fasting blood samples were collected for the detection of total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. Linear regression modeling was used to analyze the association between PM_2.5 exposure and dyslipidemia among primary school students. Results The rate of dyslipidemia among primary school students was 14.72% in the present study. The results of linear regression analysis showed that the TG increased by 0.019(95%CI=0.012-0.025), 0.023(95%CI=0.016-0.030) and 0.021(95%CI=0.014-0.027) mmol/L for every 1 μg/m³ increase of PM_2.5 in the past year before investigation, 2 years before investigation and 3 years before investigation respectively (P < 0.05). The results of binary Logisitic analysis showed that the risks of dyslipidemia in primary school students were positively correlated with PM_2.5 mass concentration in the past year before investigation, 2 years before investigation, and 3 years before investigation [OR(95%CI)=1.06(1.02-1.11), 1.06(1.01-1.12), 1.06(1.01-1.11), P < 0.05]. Conclusions PM_2.5 exposure is associated with increased risk of dyslipidemia among primary school students. To protect the health of primary school students, effective measures should be taken to improve air quality.

Association between dietary inflammation index and obesity risk in first-grade primary school students

SUN Qian, ZHANG Liurong, ZHAI Guangfu, ZHU Yudian, LU Fen, QU Guangbo

2025, 46(1): 119-123. doi: 10.16835/j.cnki.1000-9817.2025017

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Objective To explore the association between the dietary inflammation index (DII) and the risk of obesity in the first-grade primary school students, so as to provide a scientific evidence for the prevention and intervention of childhood obesity. Methods From April to June 2024, a method combining multi-stage cluster sampling and convenience sampling was used to select 4 059 first-grade students from the Ma'anshan Children and Adolescents Health Growth Cohort as study participants. Dietary information was collected through Semi-quantitative Food Frequency Questionnaire, and each student's DII score was calculated. The students were categorized into four groups (Q1, Q2, Q3, Q4) by their DII quartiles. Height and weight were measured using unified electronic height-weight machines, and obesity was diagnosed according to the Screening for Overweight and Obesity in School-age Children and Adolescents (WS/T 586-2018). Logistic regression was employed to investigate the relationship between DII scores and the risk of obesity among students, with gender stratification. Results A total of 895 obese children were identified, with an obesity rate of 22.0%. After adjusting for covariates, compared to students in the DII Q1 group, students in the Q3 and Q4 groups had increased risks of obesity (Q3: OR=1.43, 95%CI=1.12-1.82; Q4: OR=4.14, 95%CI=3.32-5.16, P < 0.05). Gender stratified analysis revealed that, after adjusting for covariates, boys in the DII Q4 group (OR=4.83, 95%CI=3.61-6.46, P < 0.01) had a higher obesity risk than girls in the same group (OR=3.46, 95%CI=2.45-4.90, P < 0.01). Restricted cubic spline analysis showed a "J-shaped" dose-response relationship between DII scores and obesity risk among students (P < 0.01). Conclusion Higher DII scores may be associated with an increased risk of obesity in the first-grade primary school students. It is recommended to promote anti-inflammatory diets in children to prevent and reduce the incidence of obesity.

Association between sleep and blood pressure among primary and secondary school students with different nutritional status

YANG Fan, ZHU Weiwei, YAO Qingbing, LU Shenghua

2025, 46(1): 124-128. doi: 10.16835/j.cnki.1000-9817.2025033

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Objective To explore the association between sleep quality, sleep duration with blood pressure in primary and secondary school students with different nutritional status, so as to provide a reference for targeted intervention measures. Methods By using stratified cluster random sampling method, a total of 10 871 students aged 7 to 18 years were selected from 36 primary and secondary schools in 6 counties of Yangzhou from October to November 2023. Physical examination and questionnaire survey were conducted respectively. Student Health Status and Influencing Factors Questionnaire was used to collected basic information. The overweight/obesity and sleep quality of primary and secondary school students were determined according to the Screening for Overweight and Obesity among School-age Children and Adolescents and the Pittsburgh Sleep Quality Index scale. The χ² test was used to compare the prevalence of elevated blood pressure in different groups of primary and secondary school students. Multivariate Logistic regression model was used to explore the association between sleep and blood pressure in primary and secondary school students. Results The prevalence of elevated blood pressure among primary and secondary school students in Yangzhou was 13.86%, higher among boys (15.13%) than girls (12.62%) (χ²=14.30, P < 0.01). The elevated blood pressure rate of obese and overweight primary and secondary school students were 26.98% and 14.90%, respectively, higher than 8.71% of non-overweight and obese children (χ²=482.58, P < 0.01). There were statistically significant differences in elevated blood pressure rate among primary and secondary school students in different sleep quality and sleep duration (χ²=8.45, 71.58, P < 0.05). After controlling for gender, residence, educational stage, parental education, sedentary time, the results of multiple Logistic regression analysis showed that no correlation between sleep quality and elevated blood pressure under different nutritional status was found among primary and secondary school students. In primary and secondary school students with obesity, prevalence of elevated blood pressure was higher among those with sleep duration < 8 and 8 to < 9 h/d (OR=1.54, 1.72, P < 0.05). However, there was no significant association found in the other groups (OR=1.04-1.28, P>0.05). In gender stratification, sleep duration < 8, 8 to < 9 and 9 to < 10 h/d of obese boys were positively correlated with elevated blood pressure (OR=1.97, 2.09, 1.86, P < 0.05). Conclusion Among obese primary and secondary school students, sleep duration < 9 h/d is associated with an increased risk of elevated blood pressure, especially among obese boys.

Prevalence of latent tuberculosis infection among freshmen in middle schools and their willingness of preventive treatment in Yunyan District of Guiyang

PENG Xiaowei, ZHANG Jiangping, LUO Peng, CHEN Siyin, XU Mengqun, WANG Qun

2025, 46(1): 129-133. doi: 10.16835/j.cnki.1000-9817.2025007

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Abstract:
Objective To investigate the status of latent tuberculosis infection(LTBI)among freshmen in middle schools and their willingness of preventive treatment in Yunyan District of Guiyang, so as to provide a reference for the prevention and control of tuberculosis in schools. Methods The tuberculin skin test (TST) and X-ray scans were used to screen the TB infection of 13 915 freshmen in middle schools in Yunyan District of Guiyang in 2023, and a questionnaire survey on the willingness of accepting tuberculosis preventive treatment was conducted to LTBI patients. The χ² test and Fisher exact probability was conducted for the comparison of the rates among the groups. Results Among the freshmen screened, the detection rate of LTBI was 3.29%. There were statistically significant difference in LTBI rates among freshmen of different genders (boys: 2.87%, girls: 3.81%), age groups (12-15 years old: 3.31%, 16-17 years old: 3.92%, 18-20 years old: 1.91%), and school stages (junior high school: 3.52%, ordinary high school: 5.96%, vocational high school: 2.29%)(χ²=9.59, 13.08, 54.30, P < 0.01). A total of 356 LTBI freshmen completed questionnaire survey, and 299(83.99%) were willing to accept tuberculosis preventive treatment, but the actual number of LIBI freshman who underwent preventive treatment was zero. Those LTBI who had received Bacille Calmette-Guérin(BCG) vaccine(86.97%) was higher in the reporting rates of being willing to accept preventive treatment than that of LTBI who had not received BCG vaccine(75.79%), the differences were statistically significant(χ²=6.48, P < 0.05). The main reasons for refusing preventive treatment was worry about adverse drug reactions(80.70%), social acceptance and the support of social institutions were needed most(85.96%). Conclusion The LTBI rate among freshmen in Yunyan District of GuiYang is higher. Although the freshmen with LTBI have a higher willingness to accept preventive treatment, however, no one has undergone preventive treatment. Corresponding measures need to be taken for improving the preventive treatment rate of LIBI freshmen.

Health risk assessment of fluoride and trichloromethane in drinking water in rural schools in Guizhou Province

JIAN Zihai, ZHANG Jianhua, SU Minmin, CHEN Xuanhao, YUAN Minlan, YANG Dan, CHEN Gang

2025, 46(1): 134-137. doi: 10.16835/j.cnki.1000-9817.2025025

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Abstract:
Objective To analyze the distribution characteristics of fluoride and trichloromethane in drinking water in rural schools in Guizhou Province and assess their health risks, so as to provide a scientific basis for ensuring the safety of drinking water in rural schools. Methods During the dry season (March to May) and wet season (July to September) of 2020 to 2022, 788 rural primary and secondary schools in agricultural counties (districts) in Guizhou Province were selected for investigation by using a direct sampling method. A total of 1 566 drinking water samples were collected from these schools, and the mass concentrations of fluoride and trichloromethane in the water samples were detected. The Mann-Whitney U test was used for intergroup comparison, and a health risk assessment model was employed to evaluate the health risks of students' oral intake of fluoride and trichloromethane. Results From 2020 to 2022, the mass concentrations of fluoride and trichloromethane in the drinking water of rural schools in Guizhou Province all met the standards, and the ranges were no detection to 0.99 mg/L and (no detection to 0.06)×10^-3 mg/L, respectively. The mass concentrations of fluoride in dry and wet seasons were 0.05(0.05, 0.10), 0.05(0.05, 0.10) mg/L, the mass concentrations of trichloromethane were [0.02(0.02, 1.00)]×10^-3, [0.02(0.02, 1.00)]×10^-3 mg/L, the mass concentrations of fluoride in factory water and terminal water were 0.05(0.05, 0.05), 0.05(0.05, 0.10) mg/L, and the differences were not statistically significant (Z=-0.04, -0.88, -0.98, P>0.05). There was a statistically significant difference in the mass concentration of trichloromethane between factory water and peripheral water [0.02(0.02, 0.02)×10^-3, 0.02(0.02, 1.05)×10^-3 mg/L](Z=-2.16, P < 0.05). The non-carcinogenic risk assessment values for students' oral exposure to fluoride and trichloromethane were in the range of 0.01(0.01, 0.03)-0.03(0.03, 0.06) and [0.26(0.26, 14.54)]×10^-4-[0.52(0.52, 48.62)]×10^-4, respectively, all of which were at acceptable levels; the carcinogenic risk assessment values for oral exposure to trichloromethane were in the range of [0.08(0.08, 4.51)]×10^-7-[0.16(0.16, 15.07)]×10^-7, indicating a low risk. Conclusions The health risks of students' expore to fluoride and trichloromethane in drinking water in rural schools of Guizhou Province are low. It is necessary to strengthen the standardized management of disinfection in some rural drinking water projects and the monitoring of fluoride in water sources to reduce the exposure risk to children.

New trends of the effects of aerobic exercise on adolescents' emotional health

LIU Yan

2025, 46(1): 138-143. doi: 10.16835/j.cnki.1000-9817.2025014

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Abstract:
In order to explore the positive effects of aerobic exercise on adolescents' emotional health, based on analyzing domestic and international literature, the article provides a detailed elucidation of the specific benefits of aerobic exercise in enhancing adolescents' positive emotions, reducing negative emotions and preventing and treating emotional disorders, while it further explores the neurophysiological mechanisms underlying these benefits. Finally, the article offers future research directions in terms of research content, methodologies and practical applications, aiming to advance the practical implementation of aerobic exercise in promoting adolescents' emotional health.

Research progress on pathogenesis and exercise intervention of adolescent with upper cross syndrome

YIN Ding, WANG Hui, ZHAI Suo, CHEN Miao

2025, 46(1): 144-147. doi: 10.16835/j.cnki.1000-9817.2025009

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Abstract:
Upper cross syndrome (UCS) is an abnormal body posture phenomenon. The detection rate of UCS in adolescents is high in China, which has become a serious public health problem threatening the health of adolescents. Exercise therapy has a positive effect on the prevention and treatment of UCS.The article reviews the pathological mechanisms of muscle imbalance, muscle interaction inhibition, and neural control related to the occurrence and development of UCS both domestically and internationally in recent years.And it elucidates the effects and corresponding mechanisms of exercise interventions such as gentle exercise, stretching exercise and physical function training on UCS, so as to provide help for the correction of UCS.

Research progress on the relationship between adverse childhood experiences and cardiovascular diseases

LEI Wenqi, SUN Wenjie, SUN Jingyuan, WANG Yiru, SUN Xianghui, SHAO Jinang, MA Yanan

2025, 46(1): 148-152. doi: 10.16835/j.cnki.1000-9817.2025005

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Abstract:
To understand the relationship between cardiovascular disease (CVD) and adverse childhood experiences (ACEs), the present review aims to describe the burden and influencing factors of CVD, epidemiological characteristics and burden of ACEs, current research on the relationship between ACEs and CVD, and the mechanism of ACEs leading to CVD. It is proposed that further assessment of the relationship is warranted through identifying blood biomarkers, conducting prospective cohort studies and intervention studies. Such efforts would provide valuable scientific insights for primary prevention strategies for cardiovascular disease.

2025 Vol. 46, No. 1