中国学校卫生

Focus on obesity in children and adolescents and build a comprehensive public health prevention and control system

ZHANG Qian, GAN Qian

2025, 46(4): 457-459. doi: 10.16835/j.cnki.1000-9817.2025118

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In recent years, China has witnessed a trend of earlier onset and wider prevalence of overweight and obesity among children and adolescents. Obesity not only elevates the risk of chronic diseases but also adversely impacts mental health and social adaptability in the population. The study analyzes the combined effects of genetic, behavioral, social, and environmental factors on obesity in childhren and adolescents, and proposes a three-tier public health intervention framework:primary prevention targeting risk factor control, secondary prevention with early intervention for at-risk groups, and tertiary prevention employing comprehensive clinical management for severe cases. Guided by the social-ecological model, the authors emphasize a "five-in-one" collaborative approach involving individuals, families, schools, healthcare institutions, as well as communities. Multisectoral cooperation is critical to promoting healthy diets, physical activity, and ultimately curbing the rising trend of obesity in childhren and adolescents to safeguard physical and mental well-being.

A multidimensional analysis of the UK students mental health assessment system and implications

ZHAO Yang, WANG Xinxin.

2025, 46(4): 460-464. doi: 10.16835/j.cnki.1000-9817.2025122

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The mental health assessment work for students in the UK is based on mental health promotion theory, employing a multidimensional approach to evaluate emotional disorders, conduct disorders, hyperactivity disorders, and other aspects across the entire educational continuum from preschool to university. Utilizing international validated standardized scales and customized questionnaires, the system has demonstrated significant preventive efficacy against student mental health issues. China stands to gain valuable insights from the UK's experience, particularly in implementing the Special Action Plan for Comprehensively Strengthening and Improving Students Mental Health Work in the New Era (2023-2025). Strategic adaptation could involve expanding assessment populations, refining evaluation criteria, standardizing measurement tools, and strengthening implementation protocols to systematically enhance China's students mental health assessment framework.

Association between sleep status and overweight/obesity among primary school students in Bao'an District of Shenzhen

HUANG Yun, LIU Yanhong, HUANG Li, LI Yanrou, WU Mingze

2025, 46(4): 465-469. doi: 10.16835/j.cnki.1000-9817.2025108

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Objective To analyze the association between different sleep statuses and overweight/obesity among primary school students, so as to provide a basis for the development of childhood overweight and obesity prevention and control strategies. Methods In November 2023, a total of 3 391 primary school students of grade 1-6 from seven schools in Baoan District, Shenzhen, were surveyed by questionnaires and physical examinations by using multi-stage cluster sampling. The Logistic regression analysis was used to explore the association between primary school students' sleep status and overweight/obesity. Results The detection rate of overweight/obesity in primary school students was 22.59%, the detection rate of overweight/obesity in boys (27.04%) was higher than that in girls (17.44%), the only child (25.81%) had higher rates than non-only child (21.76%), and the differences were statistically significant (χ²=51.48, 5.98, P<0.05). Multivariate Logistic regression analysis showed that, after controlling for confounders, primary school students' weekend nighttime sleep duration (OR=0.83, 95%CI=0.75-0.91), weekly average nighttime sleep duration (OR=0.76, 95%CI=0.64-0.89), and weekend compensated sleep duration (OR=0.89, 95%CI=0.81-0.97) were negatively associated with the risk of developing overweight/obesity (P<0.05). Compared with to primary school students with school days nap durations<0.5 h, those whose napped for 0.5-<1 h and ≥1 h on school days had a 20% (OR=1.20, 95%CI=1.02-1.42) and 37% (OR=1.37, 95%CI=1.02-1.83) increased risk of overweight/obesity, respectively (P<0.05). Conclusions Increasing weekend nighttime sleep duration, average weekly nighttime sleep duration, and weekend compensatory sleep duration can reduce the risk of overweight and obesity in primary school students. School days nap duration is a risk factor for overweight/obesity among primary school students.

Association of health literacy with overweight and obesity among middle school students in Chongqing

WANG Hong, YANG Siwei, LUO Yu, CHEN Gen, WANG Zhouyan

2025, 46(4): 470-473. doi: 10.16835/j.cnki.1000-9817.2025109

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Objective To explore the association of health literacy with overweight and obesity among middle school students in Chongqing, so as to provide evidence for obesity prevention and control strategies. Methods From November to December 2019, a stratified cluster sampling method was used to select 7 851 middle school students from 8 complete middle schools across 4 districts/counties in Chongqing. Participants completed the Adolescent Health Literacy Questionnaire and underwent nutritional status assessments. Chi-square tests and multivariate Logistic regression analyses were performed to evaluate associations. Results The prevalence of overweight and obesity among adolescents was 12.95%. The overall health literacy rate and rates for functional, interactive, and critical health literacy dimensions were 62.01%, 66.02%, 50.07%, and 72.42%, respectively. Significant differences in overweight and obesity prevalence were observed across districts/counties, urban/rural areas, sex, school stages, and only-child status (χ²=25.93, 3.86, 80.55, 8.80, 6.43, P<0.05). After adjusting for confounding factors, multivariate Logistic regression revealed that middle school students with overall health literacy (OR=0.86, 95%CI=0.75-0.99), interactive health literacy (OR=0.85, 95%CI=0.74-0.97), and critical health literacy (OR=0.84, 95%CI=0.73-0.98) had a lower risk of overweight and obesity (P<0.05). Conclusions Health literacy is inversely associated with overweight and obesity among middle school students. Strengthening health education and improving interactive and critical health literacy may create favorable conditions for adolescent overweight and obesity prevention and control.

Association of joint effect of overweight and obesity with dyslipidemia on left ventricular hypertrophy in children

AN Silian, LIU Ziqi, ZHANG Qian, ZHAO Min, XI Bo

2025, 46(4): 474-478. doi: 10.16835/j.cnki.1000-9817.2025110

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Objective To examine the association of joint effect of overweight and obesity with dyslipidemia on left ventricular hypertrophy (LVH) in children, so as to provide scientific evidence for the prevention of early cardiovascular damage in children. Methods Data were obtained from the second follow-up cross-sectional survey of Huantai Childhood Cardiovascular Health Cohort study in 2021, comprising 1 047 children aged 10-15 years with complete information. Based on overweight and obesity status and dyslipidemia status, all participants were divided into four groups: normal weight with normal lipid levels, normal weight with dyslipidemia, overweight and obesity with normal lipid levels, and overweight and obesity with dyslipidemia. Left ventricular mass index (LVMI) levels and prevalence of LVH across four groups were compared. Multivariate Logistic regression model was used to examine the association of joint effect of overweight and obesity with dyslipidemia on LVH in children. Results There were significant differences in LVMI levels [(28.66±7.10, 29.63±4.71, 31.49±5.86, 32.65±4.80)g/m^2.7] and prevalence of LVH (4.28%, 12.50%, 22.74%, 31.30%) across four groups (F/χ²=50.76, 90.92, P<0.05). After adjustment for confounding variables such as gender, age, screen time, sleep duration, fruit and vegetable intake, carbonated beverage consumption, physical activity and elevated blood pressure, compared to children with both normal weight and normal lipid levels, the risk of LVH in children with dyslipidemia alone increased (OR=3.27, 95%CI=1.57-6.82, P<0.05). Children with overweight and obesity alone also had a significantly increased risk of LVH (OR=6.33, 95%CI=3.76-10.66), and the highest risk was observed in those with both overweight and obesity with dyslipidemia (OR=9.66, 95%CI=5.35-17.43) (P<0.05). Conclusions The joint effect of overweight and obesity with dyslipidemia is positively correlated with LVH in children. To prevent LVH in children, both overweight and obesity with dyslipidemia should be paid attention to.

Development history and hotspot analysis of research on overweight and obesity in children and adolescents based on CiteSpace

TIAN Xiaoli, XIANG Minghui, ZHANG Qian

2025, 46(4): 479-484. doi: 10.16835/j.cnki.1000-9817.2025111

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Objective To explore the development history trends and research hotspots in children and adolescent overweight and obesity studies, so as to provide a basis for conducting scientific research in related fields. Methods Relevant literature were retrieved from CNKI, WanFang Data Knowledge Service Platform, VIP Chinese Journal Service Platform, China Biomedical Literature Service System, Web of Science Core Collection and PubMed database from January 1980 to September 2024, and knowledge graph was constructed by using CiteSpace visualization software to explore and analyze. Results A total of 9 108 articles were retrieved (5 197 in Chinese and 3 911 in English). From 1980 to 2024, the number of publications in the field of overweight and obesity research in children and adolescents showed an upward trend. Keyword co-occurrence analysis showed that body fat percentage (intermediary centrality: 0.69), body mass index (intermediary centrality: 0.50) and physical activity (intermediary centrality: 0.13) were the bridge keywords connecting the research field. The keyword clustering results showed that coexistence outcomes of multiple diseases such as cardiovascular metabolic diseases and psychological disorders, as well as intervention plans based on family, school and community became research hotspots. The evaluation of the effects of high-intensity interval training and emerging weight loss interventions such as electronic games gradually became a new trend in research. Conclusion Influencing factors, coexistence outcomes of multiple diseases, and the application and evaluation of intervention remain key research focuses in children and adolescent overweight/obesity studies.

Comorbidity and associated factors of overweight/obesity and dental caries among primary and secondary school students in Guangxi

LUO Yuemei, REN Yiwen, CHEN Li, DONG Yonghui, YUAN Wen, MA Jun, DONG Yanhui, LI Yan, ZHOU Weiwen

2025, 46(4): 485-488. doi: 10.16835/j.cnki.1000-9817.2025096

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Objective To explore the comorbidity and associated factors of dental caries and overweight/obesity among primary and secondary school students in Guangxi, so as to provide a scientific basis for the development of targeted prevention strategies. Methods A stratified cluster random sampling method was used to survey 178 700 students from the fourth grade of primary school to the third year of high school in Guangxi Zhuang Autonomous Region from September to November 2023, including physical examination, oral screening, and questionnaire survey. Chi-square tests and binary Logistic regression analysis were employed to investigate the related factors of the co-occurrence of dental caries and overweight/obesity among students. Results The comorbidity rate of dental caries and overweight/obesity was 9.55%, with urban areas (9.95%) higher than rural counties (9.24%), boys (10.54%) higher than girls (8.54%), primary school students (11.49%) higher than senior high school students (8.92%) and junior high school students (8.05%), and non-boarding students (11.44%) higher than boarding students (7.94%), and all differences were statistically significant (χ²=26.07, 207.91, 471.54, 629.14, P<0.01). Multivariate Logistic regression analysis showed that consuming cereal for breakfast (OR=0.91, 95%CI=0.88-0.94), drinking milk in the past week (OR=0.89, 95%CI=0.83-0.95), meeting sleep standards (OR=0.95, 95%CI=0.91-0.99), and brushing teeth at least once a day (OR=0.82, 95%CI=0.73-0.93) had a lower risk of the comorbidity of dental caries and overweight/obesity. In contrast, drinking beverages in the past week (OR=1.14, 95%CI=1.09-1.20), consuming fried foods in the past week (OR=1.11, 95%CI=1.06-1.17), eating fruit ≥1 time every day (OR=1.06, 95%CI=1.02-1.11), consuming fruit ≥1 type every day (OR=1.07, 95%CI=1.01-1.12), and having fish, poultry, meat, or egg-based breakfasts (OR=1.03, 95%CI=1.05-1.13) had a higher risk of the comorbidity of dental caries and overweight/obesity (P<0.05). Conclusions Dietary habits and lifestyle behaviors are associated with the comorbidity of dental caries and overweight/obesity among primary and secondary school students in Guangxi. Guiding students to form healthy living habits is helpful to preven dental caries and overweight/obesity.

Correlation between the health literacy of reducing salt, oil and sugar on overweight and obesity among fourth-grade elementary school students and their parents

HAO Ying, LIU Danru, CHEN Xianxian, REN Jie, XU Cong, DU Fengjun, GUO Xiaolei, DONG Jing, MA Jixiang

2025, 46(4): 489-493. doi: 10.16835/j.cnki.1000-9817.2025095

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Objective To analyze the effects of health literacy on overweight and obesity among primary school students and their parents in terms of salt, oil and sugar reduction (referred to as the "three reductions"), so as to provide a theoretical basis for the development of obesity control measures. Methods From March to April 2024, a total of 1 022 fourth-grade primary school students and 913 parents were surveyed in 24 classes in six counties in Shandong Province using multistage cluster random sampling, and physical measurements of primary school students were conducted. Pearson's correlation analysis and ordered multivariate Logistic regression were used to investigate the associations between health literacy of primary school students and their parents with overweight and obesity among children. Results The detection rates of overweight and obesity primary school students in Shandong Province were 14.87% and 24.66%, respectively, with significant sex difference in obesity rate (29.46% for boys and 19.76% for girls) (χ²=12.93, P<0.01). In addition to students' reducing oil scores, parental reducing salt, reducing oil, reducing sugar, comprehensive health literacy scores and students' reducing salt, reducing sugar and comprehensive health literacy scores showed a negative relationship with students' overweight and obesity (r=-0.10, -0.08, -0.07, -0.10, -0.04, -0.07, -0.03, P<0.05). The overweight and obesity rates among primary school students with high parental reducing salt, reducing oil, reducing sugar and composite health literacy scores were lower (OR=0.69, 0.69, 0.71, 0.63, P<0.05); and the overweight and obesity rate among students with high parental and low parental and high and low parental health literacy scores were lower (OR=0.68, 0.57, P<0.05). Conclusion Improving health literacy regarding "three reductions" for parents and children, especially parents, can effectively reduce the risk of childhood overweight and obesity.

Analysis of major food consumption frequencies among children aged 6-17 years in China

CAO Wei, REN Zhibin, XU Juan, YANG Titi, GAN Qian, WANG Hongliang, LUO Ruihe, PAN Hui, ZHAO Wenhua, YANG Zhenyu, ZHANG Qian

2025, 46(4): 494-499. doi: 10.16835/j.cnki.1000-9817.2025119

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Objective To analyze the consumption frequency of major foods among Chinese children aged 6-17 years old, and to provide a basis for optimizing the dietary structure of children in China. Methods Using data from the China Nutrition and Health System Survey and Application Program for Children 0-18 years old, 56 734 children aged 6-17 years old from North, Norththeast East, Central, South, Southwest and Northwest seven regions in China were selected for the study using stratified cluster random sampling from 2019 to 2021. A food frequency questionnaire was used to investigate the intake frequency of eight food groups in a month, including fresh vegetables, fresh fruits, livestock and poultry meats, aquatic products, eggs, dairy products, legumes, and cereals and potatoes. The foods were grouped according to whether they met the recommended intake criteria outlined in the Dietary Guidelines for Chinese Residents 2022. The χ² test was used to compare the differences in the proportion of children's intake frequency of each food group meeting the standard in different regions and age groups. Results The proportions of Chinese children aged 6-17 years who consumed fresh vegetables and cereals and potatoes ≥3 times/d were 12.1% and 67.2%, respectively. The proportions of children who consumed fresh fruits, livestock and poultry meats, eggs and dairy products ≥1 time/d were 50.8%, 58.8%, 36.0% and 54.3%, respectively. The proportion of legumes consumed ≥4 times/week was 37.4%, and the proportion of aquatic products consumed ≥2 times/week was 39.7%. Fresh vegetables (5.5%), fresh fruits (33.1%), and dairy products (36.4%) had the lowest frequency of meeting the recommended standards in South China, and aquatic products (27.4%) and eggs (21.1%) had the lowest frequency of meeting the recommended standards in Northwest (P < 0.008 3). Conclusion The overall intake frequency of fresh vegetables, fresh fruits, legumes, and dairy products are insufficient among Chinese children, with significant regional variations.

Relationship of the cumulative ecological risk and physical activity behaviors among junior high school students

DU Wenzhe*, HUANG Kai, WU Cuiping

2025, 46(4): 500-503. doi: 10.16835/j.cnki.1000-9817.2025107

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Objective To analyze the relationship between cumulative ecological risks and physical activity behaviors of junior high school students, so as to provide theoretical support for promoting the physical and mental health development of junior high school students. Methods From March to April 2023, a multi-stage random cluster sampling method was used to conduct an online survey of 3 502 middle school students in Henan Province. Physical activity levels and cumulative ecological risk were measured using the Physical Activity Rating Scale-3 and the Cumulative Ecological Risk Scale. Chi-square test and multiple Logistic regression were employed to examine the distribution and influencing factors of physical exercise behaviors among different student groups. Results light physical exercise had the highest proportion of physical activity in tensity among junior high school students (48.5%), with 80.4% engaging in low levels of physical activity. Only 16.8% of students exercised ≥1 time daily, and the most common frequency was 1-2 times per week (44.1%). Gender, residential area, parental education, and peer support were all significantly associated with physical activity levels among junior high school students (χ²=122.53, 6.49, 7.49, 10.17, P<0.05). Logistic regression analysis showed that higher cumulative ecological risk scores were associated with a greater likelihood of engaging in low levels of physical activity compared to high levels (OR=1.12, 95%CI=1.02-1.23, P < 0.05), but no significant association was found for moderate physical activity (OR=1.08, 95%CI=0.97-1.21, P>0.05). Conclusions Junior high school students in Henan Province generally engage in insufficient physical exercise. Cumulative ecological risk negatively predicts their physical activity behaviors.

Effect of zero-time exercise intervention on physical activity levels and sedentary behavior among college students

WANG Jingsong, FU Rao, WANG Shen, LI Chuangtao

2025, 46(4): 504-508. doi: 10.16835/j.cnki.1000-9817.2025127

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Objective To explore the effects of a zero-time exercise (ZTEx) intervention on physical activity levels and sedentary behavior among college students, providing evidence for improving physical activity and reducing sedentary habits. Methods In September 2023, 45 sedentary college students from a university in Fuzhou were recruited and randomly assigned to either the ZTEx group (23 students) or the control group (22 students) according to a random number table method. ZTEx group received two ZTEx focus group meetings for 3 months, while the control group received safety and health education. The International Physical Activity Questionnaire and a three-axis accelerometer were used to evaluate the sedentary and physical activity levels of college students. At the same time, evaluations related to physical health and psychological questionnaires were completed. Mixed effects analysis of variance and non-parametric tests were used to statistically analyze the physical health, psychological questionnaire, and sedentary and physical activity data of the college students. Results Post-intervention, the ZTEx group showed significant improvements in the duration of low-intensity physical activity [pre-test(1 492.78±369.50)min; post-test(1 918.93±354.63)min] and the number of sedentary interruptions [pre-test(45.26±13.69)times; post-test(73.78±16.74)times]; grip strength [pre-test(28.77±9.23)kg; post-test(31.78±8.00)kg]; sitting up continuously for 30 seconds [pre-test(22.52±4.90)times; post-test(26.96±4.87)times]; general self-efficacy [pre-test(26.52±4.14)points; post-test(32.96±5.24)points]; body composition summary [pre-test(66.44±4.83)points; post-test(72.62±4.88)points]; and psychological composition summary [pre-test(61.21±9.88)points; post-test(63.98±9.57)points], while reducing sedentary time [pre-test(3 694.28±687.56)min; post-test(2 865.90±493.81)min] in the past 7 days, the differences were statistically significant(P<0.05). The control group exhibited no significant changes(P>0.05). Conclusion ZTEx effectively improve the low-intensity physical activity, increases sedentary breaks, and reduces prolonged sitting among college students, fostering healthier habits and improving physical/mental well-being.

Knowledge, attitude and behavior of drinking water and associated factors among primary school students in rural China

QIN Shengjie*, LIU Siyu, ZHANG Liqing, ZHANG Xinmeng, YANG Wanchen, WANG Xiaoying, TIAN Donghua, ZHANG Weijun

2025, 46(4): 509-513. doi: 10.16835/j.cnki.1000-9817.2025114

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Objective To investigate the status quo and associated factors of drinking water knowledge, attitude and behavior among primary school students in rural areas, so as to provide evidence for health behavioral intervention of drinking water in primary school. Methods Twenty-three primary schools in rural area from Hebei, Henan, Shandong and Shanxi provinces were selected by using purposive sampling method from March 1 to April 27 in 2023. Self-designed questionnaires regarding knowledge, attitude and behavior of drinking water were distributed to all students in grade 3-6, and 2 173 valid questionnaires were obtained. Multivariate Logistic regression was used to analyze the influencing factors of drinking water knowledge, attitude and behavior of primary school students. Results The attainment rates of drinking water knowledge, attitude and behavior level were 20.02%, 26.65%, and 31.20%, respectively, among primary school students. The median of daily water intake was 1 000 mL, and the average daily water intake was (1 172.99±771.89)mL. In addition, 66.31% of students water intake reached the minimum standard of 800 mL recommended. The results of multiple Logistic regression indicated that drinking water accessibility in school, health education of drinking water, and individual self-control ability were positively correlated with the knowledge (OR=1.31, 1.57, 1.58), attitude (OR=2.07, 1.65, 1.73), behavior (OR=1.40, 1.49, 1.91) of drinking water and daily water intake (OR=1.41, 1.38, 1.20) (P<0.05). Conclusions Primary school students in rural areas are generally lack of appropriate health awareness on drinking water including knowledge, attitude and behavior. Schools should take targeted measures to focus on the cultivation of students' self-control ability, so as to improve students' knowledge and attitudes of drinking water, and furthermore help students shape their healthy behaviors of drinking water.

Intervention effect of school-based horticultural activities combined with fancy rope skipping on the health behaviour of fourth-grade primary school students

ZHANG Hao*, CHEN Yi, QI Yufei

2025, 46(4): 514-518. doi: 10.16835/j.cnki.1000-9817.2025106

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Objective To explore the intervention effect of school-based horticultural activities combined with fancy rope skipping on the health behaviour of fourth-grade primary school students, so as to provide a reference method for children's health promotion. Methods Eighty-five primary school students in grade 4 of a primary school in Changsha City were selected in March 2023 by using multi-stage cluster random sampling method and randomly divided into an intervention group (43 students) and a control group (42 students). The intervention group implemented a 12-week comprehensive intervention of "school-based gardening combined with pattern skipping, once a week 90 min/time including routine practice (weeks 1-5, 7-11; the contents were vegetable and plant management, theoretical knowledge learning of pattern skipping practice, etc.) and parent-child activities (weeks 6 and 12; vegetable salad making, synchronized jumping rope competition, etc.), and the control group maintained the regular curriculum. Moderate to vigorous physical activity (MVPA) and sleep duration were monitored by accelerometers in grade 4 primary school students, combined with questionnaires to assess fruit and vegetable intake and video screen behaviour, and generalised estimating equations were used to analyse the data. Results After the intervention, there were interaction effect for school day MVPA time (Wald χ²_group×time=8.27), vegetable intake (Wald χ²_group×time=4.35), and video screen time (Wald χ²_group×time=13.27) in both groups (P < 0.01). After the intervention, the MVPA time in the intervention group increased from 30.00 (20.00, 60.00) min to 40.00 (30.00, 60.00) min from school day; vegetable intake increased from 99.85 (33.95, 229.48) g to 190.15 (131.05, 279.48) g; and video screen time increased from 225.00 (110.00, 313.75) min to 60.00 (30.00, 142.50) min (Z=-4.51, -2.00, -3.84, P < 0.05). However, there were no statistical differences in MVPA time, fruit intake and sleep time before and after intervention in the intervention group on weekends (Z=-1.35, -0.85, -0.24, P>0.05). Conclusion School-based horticultural activities combined with an integrated intervention of fancy rope skipping can significantly improve physical activity, vegetable intake and video screen behaviours on weekdays in grade 4 primary school children, in order to provide a basis for multidimensional health promotion.

Analysis of influencing factors for maternal intentions to vaccinate age-appropriate girls against human papillomavirus

QIU Xiaofei*, KANG Xiao, ZHUANG Wenwen, GAO Riyue, ZHANG Delei, SHAO Yanyan, LI Xuedan, YANG Feng

2025, 46(4): 519-523. doi: 10.16835/j.cnki.1000-9817.2025097

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Objective To investigate the intentions of mothers of age-appropriate girls in Qingdao to vaccinate their daughters against human papillomavirus (HPV), so as to provide theoretical guidance for targeted health education in the future. Methods A multi-stage random sampling method was adopted to conduct a cross-sectional study among 2 244 mothers of girls aged 12-14 years in Qingdao from March to December 2023. The Mann-Whitney U test was used for group comparisons, and Logistic regression was performed to analyze the factors that influenced maternal intention to vaccinate their age-appropriate daughters against HPV. Results Among the surveyed mothers, 89.22% (n=2 002) intended to vaccinate their daughters against HPV, and 68.58% (n=1 539) had fully vaccinated or had plans to complete it for themselves. The knowledge score of mothers intended to vaccinate their daughters was 10 (8, 11). The multivariate Logistic regression analysis showed that mothers aged >45 years (OR=0.19), those with an annual family income of 60 000- < 150 000 yuan (OR=0.65), 150 000-<300 000 yuan (OR=0.58), 300 000-500 000 yuan (OR=0.22), and those with higher knowledge scores (OR=0.90) were more likely to vaccinate their daughters (P<0.05). Mothers with a junior college or undergraduate degree (OR=1.66), those who never or occasionally screened for HPV (OR=1.58), those who were intended to be vaccinated, not planning to complete the full-course vaccination, or over-aged and unvaccinated (OR=7.13), those who were not concerned about their daughters' HPV infection (OR=2.54), and those whose daughters were not in adolescence (OR=1.93) were less intended to vaccinate their daughters (P<0.05). The primary reasons for vaccine hesitancy were vaccine safety concerns (65.06%), followed by the belief of mothers that "the children is to young, and can be vaccinated when they are older" (13.25%). Conclusions Mothers of eligible girls in Qingdao have relatively higher intentions to vaccinate their daughters against HPV, and willingness is influenced by factors such as the mother's vaccination status, knowledge level, and daughter's development stage. It is recommended to strengthen targeted health education, improve the cognitive level and acceptance of mother, and increase the vaccination rate of HPV vaccines.

A qualitative study on the awareness and management strategy improvement of childhood hypertension

ZHOU Jiali*, ZHANG Chenhao, SUN Weidi, HOU Leying, LUO Zeyu, ZHU Bing, ZHANG Ronghua, SONG Peige

2025, 46(4): 524-527. doi: 10.16835/j.cnki.1000-9817.2025120

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Objective To summarize strategies for improving childhood hypertension, so as to provide evidence-based recommendations for poliy-making and practice childhood hypertension management in China. Methods From March to April 2024, child health stakeholders from five districts in Hangzhou were selected using a combination of stratified and convenience sampling methods. Data were analyzed using a grounded-theory approach. During the in-depth interview phase, six policymakers were interviewed. Focus group discussions were conducted with school administrators, healthcare providers, and parents, comprising a total of 62 participants. Results Through three-level coding, 116 initial categories were identified(e.g., "trend of younger age" "difficulty in behavior change"), 35 main categories (e.g., "higher incidence compared to the past" "caused by comprehensive influencing factors"), and 12 core categories (e.g., "epidemic status" "influencing factors"). Finally, the cognitive status, problem analysis, and management strategies of children hypertension were constructed. Conclusion Effective prevention and control of childhood hypertension requires coordinated efforts among governments, schools, families, and society to establish a comprehensive management system, with dynamic monitoring and evaluation to optimize policy implementation.

Cross-lagged analysis of overall family functioning and Internet altruistic behaviors in college students

YAN Hanqin, CHEN Siyu, CHEN Jian

2025, 46(4): 528-532. doi: 10.16835/j.cnki.1000-9817.2025099

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Objective To explore the longitudinal-causal relationship between college students' overall family functioning and their Internet altruistic behaviors, so as to provide ideas for developing mental health education in universities. Methods By using a convenience sampling method, the Overall Family Functioning Rating Scale and the Internet Altruistic Behaviors Scale were adopted to conduct a two-stage follow'up survey (T1:November 2023, T2:October 2024) among 705 students from seven universities in Jiangsu Province over a period of one year. Repeated measures ANOVA, Pearson correlation analysis, and cross-lagged analysis were used for statistical analysis. Results The overall family functioning of college students was relatively stable over time (T1:2.99±0.83; T2:3.01±0.57) [F_{(1, 703)}=0.68, P>0.01]; however, the main effect of gender was statistically significant [boys: T1(2.98±0.78), T2(2.99±0.67);girls: T1(3.01±0.91), T2(3.01±0.42);F_{(1, 703)}=6.91, P < 0.01], with female college students having a higher overall family functioning level than male college students. The Internet altruistic behaviors of college students showed certain dynamic changes (T1:2.86±0.39; T2:3.05±0.46) [F_{(1, 703)}=10.19, P < 0.01], and the post-test Internet altruistic behaviors levels of both male and female college students were higher than those of the pre-test; network altruistic behavior was not statistically significant on the sex main effect [bodys: T1(2.87±0.44), T2(3.05±0.31);girls: T1(2.85±0.36), T2(3.06±0.65);F_{(1, 703)}=2.50, P>; 0.05]; the interaction between time and gender for Internet altruistic behaviors were statistically significant [F_{(1, 703)}=6.64, P < 0.01]; the concurrent and lagged correlations between the overall family functioning and Internet altruistic behaviors of college students were all positive (r=0.35-0.57, P < 0.01); the pre-test overall family functioning could positively predict the post-test Internet altruistic behaviors (β=0.15, P < 0.01). Conclusions The overall family functioning of college students is relatively stable, while their Internet altruistic behaviors show certain development and changes. The overall family functioning of college students can directly predict their Internet altruistic behaviors, and there is a certain degree of causal relationship between the two.

Meta-analysis of the effects of different intervention modalities on non-suicidal self-injury in adolescents

ZHENG Mengyao, HE Changjiu, LIU Xin, LIANG Fangling, DU Hui

2025, 46(4): 533-538. doi: 10.16835/j.cnki.1000-9817.2025126

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Objective To explore the effectiveness of different intervention modalities on non-suicidal self-injury (NSSI) in adolescents, so as to provide an evidence-based basis for the intervention strategy of NSSI in adolescents. Methods Randomized controlled trials on interventions for adolescent NSSI were retrieved from databases, such as CNKI, Wanfang, VIP, CBM, Web of Science, PubMed, Embase, and Cochrane Library, spanning from the inception of these databases to March 5, 2025. Network Meta-analysis was performed by using Stata 17.0 and Review Manager 5.3 software, and the standardized mean difference (SMD) and 95%CI were used as the effect indicators to compare the differences in the effectiveness of the interventions and rank the effect. Results A total of 26 articles with 2 034 adolescents with NSSI were included in the study, including 10 intervention modalities: dialectical behavior therapy, emotional regulation intervention, mentalization-based therapy, family therapy, cutting down programme, cognitive behavioral therapy, narrative therapy, stepped care approach, positive psychological intervention, and acceptance and commitment therapy. The results showed that compared with the treatment as usual, positive psychological intervention [SMD(95%CI)=-2.12(-3.51 to-0.74)], stepped care intervention [SMD(95%XI)=-2.07(-3.43 to-0.71)], and dialectical behavior therapy [SMD(95%CI)=-1.70(-2.60 to-0.80)], cognitive behavioral therapy [SMD(95%CI)=-1.54(-2.61 to-0.48)], and acceptance and commitment therapy [SMD(95%CI)=-1.50(-2.68 to-0.32)] were statistically significant differences in reducing adolescents' NSSI behaviors(P < 0.05). Positive psychological intervention, stepped care intervention, and dialectical behavior therapy were more effective than the mentalization-based therapy and the cutting down programme (SMD=-2.08, -2.03, -1.66, -2.06, -2.01, -1.64, P < 0.05); the area under the cumulative ranking probability graph revealed that positive psychological intervention may have the best effect in improving NSSI among adolescents (82.5). Conclusions Positive psychological interventions show the best results in improving adolescent NSSI among multiple intervention modalities. It is recommended to give priority to positive psychological interventions in clinical interventions.

Associations of parenting style and depressive symptoms with nightmare disorder in adolescents

ZHU Qisha, ZHAO Yuan, CHEN Qiuxia, HU Jun, XU Ou

2025, 46(4): 539-543. doi: 10.16835/j.cnki.1000-9817.2025128

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Objective To explore the relationship between parenting styles and depressive symptoms in adolescents with nightmare disorder, so as to provide a scientific basis for formulating effective family intervention measures and psychological counseling. Methods From January 2023 to August 2024, 90 adolescents diagnosed with nightmare disorder and admitted to Hangzhou Seventh People's Hospital, along with 176 healthy controls from the urban areas of Hangzhou, were recruited as participants in the study. All participants were assessed using the Nightmare Experience Questionnaire (NEQ), Family Relationship Questionnaire (FRQ), and Plutchik-van Praag Self-report Depression Scale (PVP). The t-test and Chi-square test were conducted to compare two groups. Pearson correlation and stepwise multiple linear regression were employed to explore the correlations between PVP and NEQ or FRQ. The Process model was used to testing the mediating effects among NEQ/FRQ/PVP. Results The nightmare disorder group had higher scores in nightmare frequency, the four factors of NEQ (physical effect, negative emotion, meaning interpretation, horrible stimulation), and PVP than the healthy control group (24.86±18.89, 10.12±3.67, 19.01±3.51, 17.02±3.31, 15.14±3.26, 14.02±4.38; 2.34±1.04, 6.49±2.18, 17.63±4.76, 13.91±4.24, 12.40±4.49, 9.39±3.28)(t=15.79, 10.11, 2.43, 6.09, 5.14, 27.46, P < 0.05). The nightmare disorder group reported significantly lower scores in FRQ general attachment and maternal encouragement than the healthy control group (7.22±2.81, 16.39±3.28) (t=-5.53, -4.95). In contrast, they exhibited significantly higher scores in maternal abuse, maternal dominance, paternal freedom release, and paternal dominance than the healthy control group (8.23±1.80, 13.11±3.73, 18.36±3.37, 12.04±3.29; 6.07±1.85, 8.48±3.80, 15.15±2.51, 9.47±3.03) (t=6.70, 8.96, 5.90, 7.04, P < 0.01). The results of Pearson correlation analysis showed that, in the nightmare disorder group, the PVP score was positively correlated with negative emotion, nightmare frequency, maternal abuse, and maternal dominance score (r=0.14, 0.63, 0.26, 0.51, P < 0.05). The results of multiple linear regression analysis showed that when using FRQ score to predict NEQ score, the adjusted R² in the nightmare disorder group was 0.01-0.59. Mother abuse could prediced physical effect (β=0.33); maternal dominance significantly predicted negative emotion, horrible stimulation, and nightmare frequency (β=0.29, 0.30, 0.79); paternal freedom release could predict negative emotion (β=0.26), paternal dominance predicted both negative emotion and nightmare frequency (β=0.22, 0.45) (P < 0.05). Mediation analysis further revealed that, in the nightmare disorder group, PVP scores served as a mediating variable between FRQ and NEQ. Conclusion Abusive, controlling, and neglectful family upbringing styles as well as depression maybe are key factors that may contribute to the development of nightmare disorder among adolescents.

Relevance between parental psychological control and Internet gaming disorder in middle school students

JIANG Hong, WANG Lina, ZHANG Hua, ZHANG Wei,

2025, 46(4): 544-547. doi: 10.16835/j.cnki.1000-9817.2025129

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Objective To analyze the relationship between parental psychological control and Internet Gaming Disorder (IGD) among junior high school students, so as to provide evidence for preventing IGD development in adolescents. Methods From August 2019 to February 2020, a survey was conducted among 1 169 junior high school students from three middle schools in Xi'an using stratified cluster sampling. The Parental Psychological Control Scale and IGD Scale were administered to assess parental psychological control and IGD prevalence. Univariate and binary Logistic regression analyses were used to explore IGD risk factors and their correlation with parental psychological control. Results The detection rate of IGD in middle school students was 19.9%(184/1 169). Multivariate Logistic regression revealed that compared to those with lower parental psychological control scores(≤21 points), students with higher parental psychological control scores (>21 points) had a higher risk of IGD (OR=1.82, 95%CI=1.21-2.74), a 1.58-fold higher risk of self-perceived gaming addiction (95%CI=1.07-2.30), as well as reduced likelihood of seeking external help to reduce gaming time (OR=0.66, 95%CI=0.47-0.94) (P < 0.05). Conclusions Parental psychological control may elevate the risks of IGD and self-perceived addiction while diminishing proactive help-seeking behaviors to reduce gaming time. Parents should enhance communication with adolescents and provide positive guidance to mitigate potential gaming-related harms.

Correlation between bedtime screen use behavior and sleep health among fourth- and fifth-grade primary school students

ZHU Guiyin, ZHU Fan, QI Tiantian, GUO Shihao, YANG Shuang, MA Yinghua

2025, 46(4): 548-551. doi: 10.16835/j.cnki.1000-9817.2025131

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Objective To investigate the association between bedtime screen use and sleep health among fourth- and fifth-grade primary school students, so as to provide evidence to support interventions for improving sleep quality. Methods From April to June 2024, a survey was conducted among 4 232 fourth- and fifth-grade students from nine primary schools in a district of Beijing. A self-designed questionnaire assessed bedtime screen use behavior and sleep health indicators. Generalized linear models and Logistic regression were used to analyze the associations. Results Among the surveyed students, 28.3% reported bedtime screen use. Mean sleep duration every day was (9.31±0.90) hours on school days and (10.08±1.36) hours on weekends. Compared to non-users, students with bedtime screen use exhibited every day: later bedtimes on school days (10.18 min delay, 95%CI=6.88-13.47) and weekends (22.09 min delay, 95%CI=17.33-26.85) (P < 0.05); later weekend wake times (7.97 min delay, 95%CI=1.78-14.16, P < 0.05); reduced sleep duration on school days (-9.82 min, 95%CI=-13.62 to -6.03) and weekends (-14.12 min, 95%CI=-20.24 to -8.00) (P < 0.05); greater weekend-school day bedtime discrepancy (β=1.15, 95%CI=1.08-1.23, P < 0.01). Additionally, they had lower odds of falling asleep within 20 minutes (OR=0.62, 95%CI=0.54-0.72), daytime alertness (OR=0.66, 95%CI=0.56-0.77), and subjective sleep satisfaction (OR=0.57, 95%CI=0.49-0.66)(P < 0.01). Conclusions Bedtime screen use is associated with adverse effects on multiple dimensions of sleep health in primary school students. Reducing screen exposure before bed may help improve their sleep quality.

Association between sleep characteristics, physical activity patterns with depressive and anxiety symptoms in college students

ZHU Juncheng, XIONG Jianping, TANG Lijun, XIAO Haibin, CAI Zongsen, SONG Yongjing, SONG Jiancai, LU Jinkui

2025, 46(4): 552-557. doi: 10.16835/j.cnki.1000-9817.2025104

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Objective To explore the relationship between sleep characteristics, physical activity patterns, with depressive and anxiety symptoms in college students, so as to provide reference for student mental health promotion. Methods From September to November 2023, a convenience sampling method was used to select 7 954 college students aged 18-22 years from 9 universities in Shanghai, Hubei, and Jiangxi. Assessments were conducted using the International Physical Activity Questionnaire Short-Form (IPAQ-SF), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI) to evaluate physical activity, depressive and anxiety symptoms, and sleep quality, respectively. Logistic regression analysis was employed to explore the impact of sleep characteristics and physical activity patterns on depressive and anxiety symptoms and their comorbidity among college students. Results The detection rates for depressive symptoms, anxiety symptoms, and comorbid depression and anxiety symptoms were 25.67%, 35.39%, and 23.15%, respectively. Factors such as gender, grade, household registration, parental education level, annual family income, family structure, and dietary habits were all associated with the detection rates of depressive and anxiety symptoms and their comorbidity (χ²=4.41-118.39, P < 0.05). Physical activity patterns, sleep duration, sleep quality, and sleep-wake characteristics were also associated with the occurrence of depressive and anxiety symptoms and their comorbidity (χ²=9.66-627.70, P < 0.05). Logistic regression analysis showed that college students who stayed up late and slept less than 7 had the highest risk of depressive and anxiety symptoms and their comorbidity (OR=1.93, 1.85, 1.88, P < 0.05). Compared to regular physical activity patterns, insufficient physical activity patterns were associated with an increased risk of depressive and anxiety symptoms (all OR=1.18, P < 0.05). Further stratified analysis results showed that the risk of depression, anxiety and their comorbidity increased in college students who stayed up late and slept less than 7 h, went to bed before midnight and slept less than 7 h, or went to bed before midnight and slept more than 7 h but did not have sufficient physical activity (P < 0.05). Conclusions Sleep characteristics and physical activity patterns significantly affect depressive and anxiety symptoms in college students. Universities should strengthen sleep management and implement flexible physical activity interventions to help students establish healthy lifestyles.

A cross-lagged study on body dissatisfaction, weight bias internalization, and eating disorders among junior high school students

TIAN Meng, CAI Yiqing, JIANG Qin

2025, 46(4): 563-568. doi: 10.16835/j.cnki.1000-9817.2025103

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Objective To explore the dynamic association and gender difference among body dissatisfaction, weight bias internalization and eating disorders in junior high school students, so as to provide the reference for the rational implementation of relevant intervention activitites. Methods From June to December 2023, a cluster sampling method was used to select 698 students from a middle school in Fuzhou for three follow-up surveys for a period of 6 months (T1:June 2023, T2:September 2023, T3:December 2023). The Eating Disorders Inventory-Body Dissatisfaction (EDI-BD), the Chinese Version of the Weight Bias Internalization Scale for Mainland Chinese Children and Adolescents (C-WBIS), and the Chinese Version of the Eating Disorder Examination Questionnaire (C-EDE-QS) were used for investigation. Analysis of variance, t test, Pearson correlation analysis and cross-lagged analysis were used for statistical analysis. Results T1 there were statistically significant differences in body dissatisfaction scores among junior high school students of different grades and with or without left-behind experience (t=-3.25, 2.12, P < 0.05). There were statistically significant differences in weight bias internalization (t=-3.03, -2.43, 2.43) and eating disorders (t=-4.64, -2.04, 2.63) among junior high school students of different genders, grades and with or without left-behind experience (P < 0.05). Cross-lagged analysis showed that body dissatisfaction was a predictor of weight bias internalization (β_T1-T2=0.22, β_T2-T3=0.12) and eating disorders (β_T1-T2=0.09, β_T2-T3=0.17, P < 0.01). Eating disorders could predict body dissatisfaction (β_T1-T2=0.15, β_T2-T3=0.13) and weight bias internalization (β_T1-T2=0.14, β_T2-T3=0.23, P < 0.01). The mutual predictive effect of body dissatisfaction, weight bias internalization and eating disorders varied with gender. T2 weight bias internalization in girls had a predictive effect on T3 body dissatisfaction (β=0.11). T1 and T2 eating disorders in girls had a predictive effect on T2 and T3 weight bias internalization (β_T1-T2=0.26, β_T2-T3=0.21) (P < 0.01). Conclusions Body dissatisfaction, weight bias internalization, and eating disorders of the junior high school students are interconnected. And there is a certain two-way correlation and gender difference between body dissatisfaction, weight bias internalization and eating disorders in junior high school students.

Effects of interpersonal synchronization intervention on improving social behavior deficits children with autism spectrum disorder

ZHANG Yan, BAO Xinzhe, BAI Aorui

2025, 46(4): 569-572. doi: 10.16835/j.cnki.1000-9817.2025101

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Objective To investigate the efficacy of interpersonal synchronous intervention on improving social behavioral deficits in children with autism spectrum disorder (ASD), in order to provide effective guidance for optimizing social intervention programs for ASD children. Methods From September 2022 to March 2023, 84 ASD children aged 7-12 years were recruited from the Children and Adolescents Mental Health Medical Center of Inner Mongolia Autonomous Region Mental Health Center. The test subjects were randomly divided into an intervention group (42 cases) and a control group (42 cases). A 7-month social interactive game intervention plan was implemented in the intervention group, with an average of 2 times per week, each lasting 70 minutes, for a total of 56 interventions; the control group only participates in routine social activites such as daily communication and cooperation. And tests were conducted on communication behavior indicators (language expression, language comprehension, and cognitive speaking) and maladaptive behavior indicators (action characteristics, emotional expression, and social communication) of two groups of ASD children before and after intervention, and the differences in various social behavior indicators between the two groups of ASD children before and after intervention were compared through paired sample t-test. Results Before the intervention, there were no significant differences in language expression, language understanding and cognitive oral scores of children with ASD between the intervention and control groups (t=1.43, 1.65, 1.67, P>0.05). The language expression (76.29±2.34) and cognitive speaking (84.24±2.13) scores of the intervention group before intervention were lower than those after intervention (79.28±3.16, 88.39±2.35) (t=-4.17, -4.66), and the language understanding score (85.64 ± 2.30) was higher than that after intervention (83.33±1.28) (t=5.41)(P < 0.05). Before intervention, there were no statistically significant differences in non adaptive behavior factors (motor characteristic, emotional expression, and social communication)between groups (t=1.05, 1.46, 1.69, P>0.05). After intervention, the intervention group had higher scores in motor characteristics (79.55±3.32), emotional expression (73.20±3.21), and social communication (78.22±4.05) compared to the control group (72.24±3.43, 69.33±4.18, 76.21±3.14) (t=7.10, 5.51, 4.24, P < 0.05). Conclusion The interpersonal synchronous intervention program has shown good improvement in the treatment of social behavior disorders in children with ASD.

Assessment of muscle fatigue in school-age children under different sitting postures

LUO Ling, HU Huimin, NIU Wenlei, HAO Anna

2025, 46(4): 558-562. doi: 10.16835/j.cnki.1000-9817.2025115

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Objective To investigate the effects of poor sitting postures on muscle fatigue in school-age children, so as to provide evidence for developing healthy sitting guidelines. Methods In May 2024, 30 children aged 6-12 were recruited from Changping District in Beijing. A combination of surface electromyography (sEMG) and psychophysical scales were used to assess muscle fatigue at varying deviation angles under four sitting postures (forward head tilt, lateral head tilt, uneven shoulder height, and forward trunk inclination). One-way ANOVA and LSD post hoc multiple comparisons were employed to analyze the differences in electromyographic (EMG) data among various deviation angles under different sitting postures. Results The mean integrated electromyography (I_EMG) of representative muscles showed statistically significant differences (P < 0.05) across deviation angles in all postures, with muscle fatigue worsening as deviation angles increased. Forward head tilt: significant I_EMG differences were observed in the left/right sternocleidomastoid and left/right splenius capitis (F=13.74, 13.21, 5.43, 6.11, P < 0.05). Lateral head tilt: significant differences were found in the right sternocleidomastoid muscle (SCM), right splenius capitis, and left trapezius (F=5.13, 4.73, 12.13, P < 0.05). Uneven shoulder height: significant differences occurred in the right SCM, bilateral splenius capitis, and left trapezius (F=12.46, 12.56, 32.49, 5.98, P < 0.05).Forward trunk inclination, significant differences were identified in the left/right SCM, left/right splenius capitis, and left/right lumbar muscles (F=4.45, 9.84, 14.49, 26.44, 8.02, 18.34, P < 0.01). Temporal analysis revealed varying fatigue onset times across postures: severe fatigue occurred earlier in lateral head tilt and forward trunk inclination, while excessive forward head tilt, lateral head tilt, and uneven shoulder postures predominantly induced mild to moderate fatigue. Conclusions Under different sitting postures, both the integrated I_EMG of relevant muscles and subjective evaluations in school-aged children increase with greater postural deviattion. Head tilt and trunk-leaning postures require particular intervention, with emphasis on uneven-shoulder alignment and trunk inclination control.

Trends in disease burden due to childhood asthma from 1990 to 2021 and future projections in China

ZANG Xiao, ZOU Yanzheng, TAO Luqiu, JIANG Shangde, MEI Wei, MA Lianzheng, TAN Gao, LIU Tao, LIU Xiaoli, HONG Shanchao, WANG Wei

2025, 46(4): 573-578. doi: 10.16835/j.cnki.1000-9817.2025124

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Objective To investigate the trends in disease burden due to childhood asthma in China from 1990 to 2021 and to project the disease burden from 2022 to 2035, so as to provide insights into formulation of the control interventions for childhood asthma in China. Methods The prevalent case, age-standard prevalence, disability-adjusted life years (DALYs) and age-standard DALYs rate of children with asthma at ages of 0 to 14 years and their 95% uncertainty interval (UI) in China from 1990 to 2021 were extracted from the Global Burden of Disease (GBD) database. The temporal trends in the disease burden of childhood asthma were evaluated with estimated annual percentage change (EAPC) and its 95% confidence interval (CI), and the disease burden due to asthma was projected among children at ages of 0 to 14 years in China using a Bayesian age-period-cohort (BAPC) model from 2022 to 2035. Results There were 9.368 3 million (95%UI=6.410 7 million to 14.026 1 million) prevalent cases of asthma among children at ages of 0 to 14 years in China in 2021, contributing to 0.387 9 million (95%UI=0.216 1 million to 0.668 8 million) DALYs loss. The prevalent cases and DALYs of asthma decreased by 37.28% and 52.55% among children at ages of 0 to 14 years in China in 2021 compared with 1990, and the age-standardized prevalence [EAPC=-0.70%, 95%CI=-1.26% to-0.13%)] and DALY rates [EAPC=-1.71%, 95%CI=-2.32% to-1.10%)] also appeared a tendency towards a decline. From 1990 to 2021, the prevalent cases, prevalence, DALYs and DALYs rate of asthma were all higher among male children than among female children, and the disease burden of asthma was higher among children at ages of 5 to 9 years than at other age groups. BAPC model predicted a decline in both prevalent cases and DALYs of asthma among children at ages of 0 to 14 years in China from 2022 to 2035, with 6.759 6 million prevalent cases and DALYs of 0.228 4 million person-years in 2035, while the prevalence and DALYs rates were projected to rise to 5 143.35/10⁵ and 173.75/10⁵ in 2035. Conclusions Despite a reduction in the disease burden of asthma among children at ages of 0 to 14 years in China from 1990 to 2021, the prevalence remained high. The disease burden due to asthma is projected to appear a decline among children at ages of 0 to 14 years in China from 2022 to 2035; however, the prevalence and DALYs rates still rise. Intensified control measures and targeted interventions are required to reduce the disease burden of childhood asthma.

The two-year follow-up study on the association between new caries risk in school-aged children and multi-dimensional sleep indicators

LU Xiuzhen, HUANG Chuanlong, LI Yang, ZUO Min, SUN Ying, CHEN Xin.

2025, 46(4): 579-583. doi: 10.16835/j.cnki.1000-9817.2025125

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Objective To explore the prospective association between multidimensional sleep indicators and the risk of newly-onset dental caries, providing a reference for children's oral health-related sleep intervention. Methods In October 2021, 1 417 students in grades 1 to 4 (aged 6 to 11) from two elementary schools in Bengbu, Anhui Province, were selected by cluster sampling method. Surveys and follow-up visits were conducted at baseline (T1), November 2022 (T2), May 2023 (T3), and November 2023 (T4), respectively, including parental questionnaires, oral health and physical examination. Bedtime, sleep duration, sleep midpoint, social jet lag, weekend catch-up sleep, and sleep habits were collected and calculated. A multifactorial Cox proportional risk regression model was used to analyze the association between multidimensional sleep indicators and newly-onset caries in school-aged children after 2 years. Results The prevalence of dental caries in children was 65.1% at baseline, and the prevalence was 59.0% at the end of the 2-year follow-up. Cox proportional risk regression model showed that for every 1-point increase in the children's bedtime resistance, nocturnal awakenings, parasomnias, and daytime sleepiness scores, the risk of newly-onset caries increased by 12% (HR=1.12, 95%CI=1.08-1.15), 22% (HR=1.22, 95%CI=1.15-1.29), 12% (HR=1.12, 95%CI=1.08-1.17), and 15% (HR=1.15, 95%CI=1.12-1.19), respectively; the risk of newly-onset caries increased by 23% for each 1 h increase in the length of weekend catch-up sleep (HR=1.23, 95%CI=1.14 -1.33); compared with children who went to bed before 21:00 on school days, those who went to bed later than 22:00 had a 57% higher risk of newly-onset caries (HR=1.57, 95%CI=1.22-2.03). Compared to children who slept adequately (≥9 h/d), those with insufficient sleep had a 67% higher risk of new caries (HR=1.67, 95%CI=1.43-1.95) (P < 0.01). Conclusions These findings suggest a significant association between sleep patterns/sleep disorders and the development of childhood dental caries. Incorporating sleep behavior optimization and sleep quality improvement into comprehensive caries prevention and oral health management protocols may represent a promising intervention strategy to enhance children's oral health outcomes.

Latent infection and preventive treatment among students in 5 tuberculosis outbreaks in schools in Hunan Province

ZHANG Chuanfang, LIANG Jun, XU Zuhui, FAN Jiangjing

2025, 46(4): 584-587. doi: 10.16835/j.cnki.1000-9817.2025100

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Objective To analyze the latent tuberculosis infection and preventive treatment in the school tuberculosis epidemic, so as to provide theoretical and technical support for tuberculosis prevention and control in schools. Methods Information on latent infection, preventive treatment and tuberculosis incidence were collected from five tuberculosis outbreaks in schools in Hunan Province from January to December 2023. Statistical analysis was conducted by using Chi-square test and Fisher's exact test. Results The prevalence of tuberculosis patients in close contacts (7.69%) and the latent infection rate of Mycobacterium tuberculosis (31.87%) were higher than those in non-close contacts (0.12%, 6.29%), and the differences were statistically significant (P < 0.01). The subsequent incidence of close contacts with latent infection was higher (8.62%) than that of non-close contacts (0), the rate of close contacts receiving prophylactic treatment (63.30%) was higher than that of non-close contacts (47.37%), and the proportion of close contacts receiving prophylactic treatment (68.12%) was higher than that of non-close contacts (45.56%), and the differences were statistically significant (P < 0.05). The latent infection rate of Mycobacterium tuberculosis in college students (13.58%) was higher than that in middle school students (7.08%) (χ²=37.77, P < 0.01). The proportion of college students receiving preventive treatment (100.00%) was higher than that of middle school students (40.34%), and the subsequent incidence of latent infection (6.67%) was higher than that of middle school students (0.54%); the rate of middle school students who should receive preventive treatment (70.41%) was higher than that of college students (30.77%), and the rate of middle school students who received preventive treatment (100.00%) was higher than that of college students (62.50%), and the differences were statistically significant (P < 0.01). Among the latent infected persons, 144 who completed preventive treatment did not get sick, and 10 of the 177 who did not complete preventive treatment got sick, with an incidence rate of 5.65%. The incidence rate of close contacts (19.23%) was higher than that of non-close contacts (0) (P < 0.01). There was no significant difference in the incidence of pulmonary tuberculosis between university (8.18%) and middle school (1.49%) among latent infected persons who did not complete preventive treatment (P=0.09). Conclusion Actively promoting preventive treatment for latent infections, especially among close contacts, and ensuring that all eligible individuals receive treatment can reduce tuberculosis incidence in schools and help control the scale of school tuberculosis outbreaks.

Exploration of muscle mass index and its association with cardiovascular risk factors among adolescents in Xinjiang's agricultural and pastoral areas

ZHAO Yali, LIU Weichen, LIU Shengze, Alimujiang

2025, 46(4): 588-591. doi: 10.16835/j.cnki.1000-9817.2025105

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Objective To explore the muscle mass index (MMI) among adolescents in Xinjiang's agricultural and pastoral areas and its association with cardiovascular risk factors, providing references and basis for the prevention and intervention of cardiovascular diseases among adolescents in these regions. Methods From March to July 2023, a total of 1 842 students aged 13-18 years from four middle schools in Yili agricultural and pastoral areas of Xinjiang were selected using cluster random sampling. Measurements of muscle mass, physical indicators, questionnaires, and blood samples were conducted and analyzed. Statistical analyses were performed using one-way analysis of variance, Kruskal-Wallis H test, Mann-Whitney U test, and Logistic regression analysis. Results There were significant differences in weight, body mass index (BMI), waist circumference, muscle mass, systolic blood pressure, diastolic blood pressure, total cholesterol, high-density lipoprotein cholesterol and fasting blood glucose among adolescents with severe, insufficient, good, and sufficient MMI in Xinjiang's agricultural and pastoral areas(F=326.78, 634.76, 261.67, 134.56, 80.14, 16.78, 5.84, 21.67, 3.42, P < 0.01). Logistic regression analysis showed that, after adjusting age and BMI, the risk of cardiovascular risk factors aggregation in adolescents with good (OR=0.55-0.62) and adequate (OR=0.52-0.57) MMI were lower than that in adolescents with insufficient MMI (P < 0.05). After gender stratification, the risk of cardiovascular risk factors aggregation in adolescents with good MMI for boys (OR=0.48-0.62) and with good MMI for girls (OR=0.61) were also lower than that in adolescents with insufficient MMI (P < 0.05). Conclusions MMI in adolescents from agricultural and pastoral areas of Xinjiang are positively correlated with cardiovascular health. Future efforts should focus on muscle strength training for adolescents in these areas, as improving MMI can play a positive role in promoting cardiovascular health in adolescents.

Incidence of statutory and key-monitored infectious diseases among students in Beijing from 2016 to 2020

XU Wenjie, BAI Chengxu, CHEN Dongni, XIA Zhiwei, WU Shuangsheng, GUO Xin, YANG Peng

2025, 46(4): 592-596. doi: 10.16835/j.cnki.1000-9817.2025098

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Objective To analyze the incidence of statutory and key-monitored infectious diseases among school students in Beijing from 2016 to 2020, so as to provide a reference for developing the prevention and control of infectious diseases in schools. Methods A descriptive statistical analysis was conducted on student cases aged 6-22 years in Beijing from 2016 to 2020 selected from the China Disease Surveillance Information Reporting Management System. Rate comparisons were performed using the χ² test and trend χ² test. Results From 2016 to 2020, the overall incidence of statutory and key-monitored infectious diseases among students in Beijing showed an upward trend ($\chi _{{\rm{trend}}}^2$=582.42), the incidence rates of Category B and other infectious diseases exhibited a downward trend ($\chi _{{\rm{trend}}}^2$=82.71, 18.34), while Category C infectious diseases demonstrated a significant upward trend ($\chi _{{\rm{trend}}}^2$=911.75) (P < 0.01). Among Category B infectious diseases, scarlet fever, bacillary dysentery, tuberculosis, and HIV/AIDS were predominant, with annual average incidence rates of 61.33/100 000, 35.38/100 000, 13.88/100 000, and 3.78/100 000, respectively. Except for HIV/AIDS, the reported incidence rates of other infectious diseases showed a declining trend. Among Category C infectious diseases, influenza, other infectious diarrhea, hand-foot-mouth disease, and mumps were predominant, with annual average incidence rates of 956.13/100 000, 114.39/100 000, 111.37/100 000, and 28.24/100 000, respectively. Influenza showed a significant upward trend ($\chi _{{\rm{trend}}}^2$=1 508.30), while the other infectious diarrhea, hand-foot-mouth disease, and mumps exhibited a downward trend ($\chi _{{\rm{trend}}}^2$=13.84, 25.78, 6.13) (P < 0.05). Among other infectious diseases, varicella was predominant ($\chi _{{\rm{trend}}}^2$=17.47, P < 0.05). Scarlet fever, influenza, hand-foot-mouth disease, and mumps had higher incidence rates among primary and middle school students; other infectious diarrhea and varicella were more prevalent among high school students; tuberculosis and bacillary dysentery were more common among high school and college students; and HIV/AIDS had higher incidence rates among college and high school students. Conclusion From 2016 to 2020, the incidence of Category B infectious diseases among students in Beijing showed a declining trend, while influenza, a Category C infectious disease, exhibited a significant upward trend.

Associations between caregivers' nutrition literacy and pediatric nonalcoholic fatty liver disease of children aged 8- 10

YANG Yifan, LI Li, ZHANG Pingping, WANG Youxin, WANG Mingyue, YANG Shuhan, WU Yuying, WANG Hui

2025, 46(4): 597-600. doi: 10.16835/j.cnki.1000-9817.2025102

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Objective To explore the associations between caregivers' nutrition literacy and pediatric nonalcoholic fatty liver disease (NAFLD), so as to provide scientific evidence for the key contents of family intervention measures. Methods In September 2022, a study involving 1 609 third-grade students and their caregivers from six schools in Yinzhou, Haishu, and Zhenhai Districts of Ningbo City, Zhejiang Province, was conducted. Venous blood samples were collected to measure lipid profiles and investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) among the children. Family Food Environment Questionnaire was used to assess the nutrition literacy levels of the caregivers. Generalized linear regression analysis was employed to explore the correlation between caregivers' nutrition literacy levels and the prevalence of NAFLD in children. Results Among the surveyed students, 191 were in the NAFLD group, whereas 1 418 were in the non-NAFLD group. The median nutrition literacy score of caregivers in the NAFLD group and non-NAFLD group all were 11.00 (9.00, 12.00), which was not significantly different (Z=-0.40, P=0.71). The generalized linear regression results revealed that the level of nutrition literacy of caregivers had no significant effect on children's Triglyceride-glucose (TyG) index and Triglyceride-glucose-Waist-to-height ratio (TyG-WHtR) [β(95%CI) were 0.001(-0.005-0.006) and 0.000(-0.014-0.014), P>0.05]. Conclusions The nutrition literacy level of caregivers has no significant correlation with the direct incidence of NAFLD in children. As for family intervention measures, it is necessary not only to improve the nutrition literacy level of caregivers but also to effectively apply nutritional knowledge in practice to optimize health management.

Environmental contamination status of norovirus outbreaks in schools and nurseries in Linhai City

ZHENG Jianjun, WANG Xi, HONG Danyang, LI Yaling, XU Qiumeng, ZHANG Huili, HAN Qian, LU Da, ZHENG Qiao

2025, 46(4): 601-603. doi: 10.16835/j.cnki.1000-9817.2025121

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Objective To investigate the environmental contamination of norovirus in nurseries and primary/secondary schools, so as to provide a scientific basis for effective prevention and control measures. Methods A total of 483 external environmental samples were collected from 34 cluster outbreaks of norovirus gastroenteritis in kindergartens and primary/secondary schools in Linhai City from 2021 to 2024. Pathogen detection was conducted using a rapid nucleic acid extraction kit and real-time fluorescence RT-PCR, and the results were analyzed using the χ² test or Fisher's exact test. Results Among the collected external environmental samples, the total positive rate of surface contamination was 13.66%. The positive rates in kindergartens and primary/secondary schools were 12.20% and 15.82%, respectively. In kindergartens, the five surfaces with the highest detection rates were desks/chairs (23.33%), toilet stool troughs (20.69%), urinal troughs (12.00%), washbasins/sinks (11.11%), and toilet mops (9.38%). In primary/secondary schools, the top five were toilet stool troughs (38.30%), urinal troughs (23.53%), toilet door handles (13.04%), toilet mops (12.50%), and drinking cups (11.11%). The difference in positive detection rates among different external environments in primary/secondary schools was statistically significant (Fisher's exact probability test, P < 0.01). The positive detection rate in sanitary toilets was higher than that in classroom environments (χ²=17.38), while the positive detection rate in classroom environments of kindergartens was higher than that in primary/secondary schools (χ²=5.42)(P < 0.05). Conclusions Norovirus exhibits a high contamination rate in nurseries and schools, particularly in restroom areas. Strengthening sanitation and disinfection in high-risk environments, and improving hygiene awareness among children and staff, are essential for the effective prevent and control of norovirus.

Research progress on cyberchondria among college students

DAI Bao, YANG Liying, ZHENG Yiqing

2025, 46(4): 604-608. doi: 10.16835/j.cnki.1000-9817.2025123

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Cyberchondria is a growing mental health concern in the digital age, significantly impacting college students' physical and psychological well-being as well as their daily functioning. The paper systematically reviews existing domestic and international literature to synthesize key aspects of cyberchondria among college students, including its conceptualization, measurement tools, prevalence, contributing factors, consequences, and intervention approaches. Building on the foundation, the study identifies critical gaps and proposes future research directions. By establishing a comprehensive theoretical framework, the work aims to inform subsequent studies and targeted interventions, ultimately supporting the promotion of mental and physical health among college students affected by cyberchondria.

Current Issue 2025 Vol. 46, No. 4

Current Issue
2025 Vol. 46, No. 4