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2024, Volume 45,  Issue 7

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Emphasizing the application of hyperopia reserve to promote the early prevention of myopia
HE Xiangui, LI Shiming
2024, 45(7): 913-917. doi: 10.16835/j.cnki.1000-9817.2024216
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In recent years, the role of hyperopia reserve in the prevention and control of myopia among children and adolescents has gradually gained recognition and importance. Implementing more refined preventive measures based on hyperopia reserve to further advance the prevention frontiers is crucial for reversing the trend of focusing on treatment over prevention and achieving the national health strategy goal to reduce the myopia rate among children and adolescents. The paper introduces the concept of hyperopia reserve, the ability and the detection methods to predict the onset of myopia. At the same time, it also discusses the establishment and application of reference values for hyperopia reserve and proposes a classification-based prevention and management strategy based on hyperopia reserve, aiming to provide reference ideas and directions for advancing myopia prevention.
Comparative analysis of the dietary guidelines for children and adolescents and the school lunch system at home and abroad
JIANG Le, LIU Yang
2024, 45(7): 918-922. doi: 10.16835/j.cnki.1000-9817.2024206
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Due to the differences in the level of socio-economic development, geographic environment, food supply, eating habits and other factors, dietary guidelines for children and adolescents and the school lunch system varied significantly across different countries. The article combines the successful experiences of nutrition lunch systems for children and adolescents in Japan, the United States, the United Kingdom, Sweden and Australia, then gives suggestions for school lunch system in China, aiming to provide reference and basis for the development of a scientific and feasible nutritious lunch system.
Association of parental knowledge and skills in myopia prevention and control with healthy eye behavior in primary school children
ZHANG Xiaohua, TONG Min, ZHANG Weihua, XU Jiawei, CAO Bin, SHEN Jie, TIAN Qianqian, SHI Huijing
2024, 45(7): 923-927. doi: 10.16835/j.cnki.1000-9817.2024204
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  Objective  To investigate the association of parental knowledge and skills in myopia prevention and control with healthy eye behavior in primary school children, so as to provide a basis for accurate family education.  Methods  A total of 4 979 students in grades 1-5 from eight elementary schools in Pudong New Area were sampled between October and December in 2022 by using a stratified cluster sampling method. A self-administered questionnaire was used to assess healthy eye behavior in primary school children and parental knowledge and skills in myopia prevention and control. The Chi-squared test, independent samples t-test and Logistic regression were used to analyse the association between parental knowledge and skills in myopia prevention and control and healthy eye behaviour in primary school children.  Results  Parents of primary school children with a high level of knowledge and skills in myopia prevention and control were 50.97% and 56.36%, respectively. The knowlegde entry scores for parents of lower and middle elementary school students were higher than those of parents of upper primary students with respect to their understanding, on the main causes of myopia in their children, the correct knowledge of myopia prevention and control, the role of family members in helping each other to manage and treat myopia in their children and the parents' responsibility to teach their children to use their eyes correctly and scientifically (3.05±1.21, 2.97±1.20; 5.92±0.68, 5.83±0.86; 4.46±0.88, 4.40±0.93; 3.88±1.04, 3.72±1.07); all differences were statistically significant (t=2.04, 3.39, 2.00, 4.87, P < 0.05). The differences in the scores of parents of primary school children in different grades for all items were statistically significant (t=2.93-7.31, P < 0.05) in the skill entries. Parental knowledge levels were poor for items of full scores that assessed the following: knowing the main causes of their children's myopia, awareness of the correct knowledge of myopia prevention and control measures, awareness of Comprehensive Prevention and Control Strategy for Children and Adolescents with Myopia, and concerning that their children's future education and employment will be affected by myopia, understanding the responsibility of parents for guiding children to use their eyes scientifically and correctly, with 12.71%, 22.90%, 19.30%, 21.83% and 22.47% respectively. Parental skills were poor for items of full scores that assessed the following: reminding their children to rest their eyes when doing homework, reading or writing, deliberately avoiding mobile phone use when spending time with their children, the number of times which taking children to the hospital for refractive screening in the past year, and giving their children extra learning tasks, with 33.26%, 15.12%, 9.00% and 5.36% respectively. Compared to parental knowledge in myopia prevention and control, parental skills had a more pronounced effect on the four dimensions of healthy eye behavior (reading and writing, screen time, outdoor activities, and sleep duration) among students in different grades (OR=1.41-3.37, P < 0.05).  Conclusions  Parental knowledge and skills in myopia prevention and control are still insafficient, associated with healthy eye behavior in primary school children. There is a need to strengthen accurate health education for parents on the prevention and control of myopia, to cultivate healthy eye behaviour among primary school students and reduce the incidence of myopia among them.
Analysis of the prevalence of screening myopia among Kazakh nationality primary and secondary school students in Xinjiang
LI Xiaolong, LI Ning, AINU Nurahou, YANG Lei, JUMAHAN Tokdarhan, WANG Yan, WANG Jingjing, ZHAO Yong
2024, 45(7): 928-931. doi: 10.16835/j.cnki.1000-9817.2024197
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  Objective  To investigate the prevalence of myopia among Kazakh students in Xinjiang, so as to provide the data support for myopia prevention and control.  Methods  From March to May 2022, stratified random cluster sampling was used to select 18 218 Kazakh students in grades 1 to 12 who underwent ocular examination, who were from 81 schools of Urumqi, Changji, and Tacheng in Xinjiang Uyghur Autonomous Region. The Chi-square test was used to compare differences in myopia detection rates among students of different grades, genders, regions, urban-rural distribution and school stages.  Results  The prevalence of screening myopia was 25.6% (4 660) among Kazakh primary and secondary students. The proportion of mild, moderate, and high myopia were 79.5%, 17.3% and 3.2%, respectively. The prevalence rate of screening myopia in girls was higher than that in boys (30.4%, 20.9%) (χ2=217.17, P < 0.01), and there was a significant difference in the degree of screening myopia between different genders (χ2=9.46, P < 0.05). The screening myopia detection rate of Urumqi was higher than that of Tacheng and Changji Hui Autonomous Prefecture (37.3%, 29.0%, 20.0%), and the difference between different regions was statistically significant (χ2=238.36, P < 0.01). The detection rate of screening myopia was higher in urban areas than in rural areas (33.8%, 14.4%), and the difference was statistically significant (χ2=881.54, P < 0.01). Overall, the difference in the detection rate of screening myopia among students of different schooling stages was found to be statistically significant (χ2=1 056.51, P < 0.01); and the screening myopia detection rate was higher among ordinary middle school students than vocational middle school and primary school students (37.8%, 31.7%, 15.8%). A statistically significant difference was also found in the degree of screening myopia among different schooling stages (χ2=104.70, P < 0.01).  Conclusion  The detection rate of screening myopia among Kazakh primary and secondary school students in Xinjiang is relatively low, and corresponding interventions should be taken according to the distribution characteristics of myopia among Kazakh primary and secondary school students, to reduce the occurrence of myopia among students.
Analysis of high myopia and dioptre changes among middle school students in Beijing from 2019 to 2022
WANG Lu, ZHAO Hai, SUN Bingjie, XIA Zhiwei, ZHANG Jingshu, GUO Xin
2024, 45(7): 932-935. doi: 10.16835/j.cnki.1000-9817.2024210
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  Objective  To analyze high myopia and dioptre changes in middle school students in Beijing from 2019 to 2022, so as to provide a basis for formulating preventive and control measures.  Methods  Using stratified cluster random sampling, 16 districts of Beijing were divided into four groups, each of which was respectively composed of 83, 83, 84, and 84 middle schools, in order to examine non-cycloplegic auto-refraction among the senior grades 1 to 3 students from September to October in each year (from 2019 to 2022). Finally, the dataset results of each of the four groups (21 589, 21 161, 21 561, 21 123) were compared by the Chi-square test and trend Chi-square test. Trend changes were evaluated by annual percentage change (APC).  Results  The rates of high myopia were higher in female students than in males from 2019 to 2022 (15.60%, 14.59%; 15.33%, 14.44%; 14.65%, 14.17%; 14.63%, 13.84%), and the difference in 2019 was statistically significant (χ2=4.93, P < 0.05). The rates of high myopia in middle school students in urban areas were significantly higher than those in rural areas(16.45%, 13.78%; 16.81%, 13.00%; 15.84%, 13.06%; 15.85%, 12.72%), and the differences were statistically significant (χ2=30.18, 60.43, 33.92, 42.23, P < 0.05). With the increase of grade, the rates of high myopia increased (χtrend2=674.56, 608.38, 655.21, 676.89, P < 0.05), with junior grade 3 students being the most robust. The rate of high myopia in middle school students from 2019 to 2022 decreased from 15.09 to 14.22%, with an average annual rate of 2.08% (APC=-2.08, t=-7.99, P < 0.05). The refractive error of high myopia middle school students in 2019 and 2022 were -7.44(-10.25, -6.00) and -7.38(-10.00, -6.00)D, respectively, with no statistically significant difference (H=4.30, P>0.05).  Conclusions  The rate of high myopia in middle school students in Beijing shows a decreasing trend, but it remains at a high level. It is necessary to classify the prevention and control strategy, and standardize the measures in order to manage early onset, high incidence rates, and severe myopia.
Correlation between refractive development and physical growth indices in primary school students aged 6-9 years in Guangdong Province
QU Yabin, WANG Shuang, YANG Bei, YU Shuiming, LIN Rong, HUANG Anzhong, LIN Siren, LI Meng, SHEN Shaojun, LIU Rong, CHEN Qiuxia, WANG Zixuan
2024, 45(7): 936-940. doi: 10.16835/j.cnki.1000-9817.2024213
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  Objective  To analyze the correlation between refractive errors and physical development indicators among primary school students aged 6 to 9, so as to provide a scientific basis for the development of effective prevention and control measures.  Methods  A stratified cluster random sampling method was used to recruit 2 833 elementary school students aged 6 to 9 from Guangdong Province for vision screening, ocular biometry, and physical examinations in Octorber, 2020. The Chi-square test, t-test, and ANOVA were employed to compare myopia rates and indicator values across different groups. Multiple linear regression models were used to analyze the correlations between height, weight, and body mass index (BMI) with refractive development indicators.  Results  The screening myopia rate among primary school students aged 6 to 9 was 16.7%, and the myopia rate increased with age (χ2=51.58, P < 0.01). The height and weight of the myopic group [(126.96±7.41)cm, (26.59±6.45)kg] were higher than those of the non-myopic group [(124.76±7.77)cm, (25.42±5.87)kg] (t=5.84, 3.65, P < 0.01). The mean values of spherical equivalent (SE), axial length (AL), anterior chamber depth (ACD), and AL/corneal curvature radius (CR) ratio for students aged 6 to 9 were (-0.17±1.04)D, (22.96±0.78)mm, (3.38±0.24)mm, and (2.95±0.08), respectively, with statistically significant differences across different age and myopia severity groups (t=37.08, 119.20, 41.54, 133.60; 935.30, 184.10, 73.95, 498.50, P < 0.01). After adjusting for gender, age, and residence, the multiple linear regression model showed that height was positively correlated with AL and CR, weight was positively correlated with ACD, and BMI was positively correlated with AL and ACD (β=0.191, 0.070, 0.035, 0.013, 0.007, P < 0.05). When stratified by myopia status, results for the non-myopic group were similar to the overall results, whereas in the myopic group, the correlations between height, BMI, and AL were not statistically significant (P>0.05).  Conclusions  Among primary school students aged 6 to 9, height and BMI are positively correlated with AL in the non-myopic group but no similar correlation is observed in the myopic group, indicating that factors other than physical development, such as environmental and behavioral factors, should be considered for their impact on refractive development.
Status of screening myopia among primary and middle school students in Linfen Community of Shanghai from 2019 to 2023
GU Yuerong, CHEN Ruiyang, WAN Qiuping, ZHU Chengyu, WANG Limeng, HU Hong
2024, 45(7): 941-944. doi: 10.16835/j.cnki.1000-9817.2024203
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  Objective  To analyze the prevalence and trend of screening myopia among primary and middle school students in Linfen Community of Shanghai from 2019 to 2023, so as to provide a reference for the prevention and control of myopia from the perspective of the community.  Methods  From 2019 to 2023, all primary(5) and middle(2) school students aged 6-15 years in Linfen Community of Shanghai were screened. Statistical analysis was performed using the Chi-square test and trend Chi-square test. The curve fitting model was used to fit the model of the increase rate of screening myopia among primary and middle school students in 2019, 2021 and 2023.  Results  The overall rate of screening myopia among primary and middle school students in Linfen community from 2019 to 2023 was 55.17%. The prevalence rate of screening myopia was 79.43% in boys and 81.92% in girls in middle school, and the difference was statistically significant (χ2=5.71, P=0.02). In 2019, 2021, and 2023, the peak age of screening myopia among primary and middle school students in Linfen Community gradually occurred earlier, at the age of 7(12.13%), 6(12.28%), and 6(14.99%) years old, respectively. The growth rate of screening myopia in students aged 8-12 years in 2023 was lower than that in 2019 and 2021.  Conclusions  The screening myopia rate of primary and middle school students aged 6-15 years in Linfen Community is relatively high, with primary school girls higher than boys, and growth spurt accelerates. It is suggested that prevention and control of myopia in the community should focus on preschool children and adolescent girls.
Auxiliary screening for myopia in kindergarten and primary school students in Beijing, 2023
QIN Ran, ZHAO Jinhui, LI Ting, ZHANG Jingshu, WANG Yifan, GUO Xin
2024, 45(7): 945-949. doi: 10.16835/j.cnki.1000-9817.2024205
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  Objective  To analyze cycloplegic refraction data of kindergarten and primary school students in Beijing in 2023, so as to provide scientific reference for selecting auxiliary methods for students myopia screening.  Methods  In the spring semester of 2023, a multi-stage cluster sampling method was used to select kindergartens and primary schools in one urban and one suburban district of Beijing. Two kindergartens and two primary schools were selected in the urban district, with 1 191 students undergoing cycloplegic refraction examination. And the suburban district included 66 kindergartens and 6 primary schools, with 3 555 students undergoing cycloplegic refraction examination. The examination items included pre- and post- cycloplegia optometry, axial length (AL), corneal curvature and height.  Results  In each academic stage, the area under the ROC curve (AUC) for the axial length/corneal radius of curvature (AL/CR) (Kindergarten: AUC=0.89, Lower primary school students: AUC=0.91, Upper primary school students: AUC=0.89) were higher than that of screening myopia, but the difference were not statistically significant (P>0.05). The AUC for axial length was the lowest (0.74, 0.82, 0.83) and lower than that for AL/CR with statistically significant difference (χ2=22.43, 59.04, 20.13, P < 0.05). After combining naked eye vision and AL/CR, kindergarten students showed an increased AUC from 0.83 (95%CI=0.78-0.88) to 0.93 (95%CI=0.89-0.97), and lower primary school students exhibited an increase from 0.89 (95%CI=0.86-0.91) to 0.96 (95%CI=0.95-0.97). In higher primary school students, AUC increased from 0.91 (95%CI=0.89-0.92) to 0.96 (95%CI=0.95-0.97). There was no overlap in the confidence intervals before and after combinations, and the differences were statistically significant (P < 0.05).  Conclusion  AL/CR plays a significant role in assisting with myopia screening among kindergarten and primary school students. Attention should be paid to the application of AL/CR in assisting myopia screening in kindergarten and primary school students.
Trend analysis of malnutrition among primary and middle school students of Han nationality in Hainan Province from 2005 to 2019
ZUO Xin, LI Yingqi, ZHAO Yingying, GUAN Changrong, LIANG Qiqing, TIAN Ye, LIU Yumei
2024, 45(7): 950-954. doi: 10.16835/j.cnki.1000-9817.2024199
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  Objective  To understand the trends in malnutrition among primary and middle school students of Han nationality in Hainan Province from 2005 to 2019, so as to provide a basis for improving nutrition intervention measures for children and adolescents.  Methods  A sample of 32 949 Han nationality primary and middle school students aged 7-18 years old in Hainan Province were investigated in 2005, 2010, 2014 and 2019 based on national survey on student physical fitness and health. The Malnutrition Screening Standard of School-age Children and Adolescents was used to screen malnutrition. Statistical analysis was performed using the χ2 test and the χtrend2 test.  Results  In the four surveys conducted during 2005 to 2019, the prevalence of malnutrition among primary and middle school students were 22.12%, 18.80%, 15.89% and 9.56%, respectively, with an increase of -12.56% and an average annual increase of -5.82%. The decreasing trend of malnutrition by year was statistically significant (χtrend2=600.72, P < 0.01), and the proportion of emaciation type was the highest (8.87%-20.15%). The detection rates of malnutrition among all students aged 7 to 18 showed a decreasing trend from 2005 to 2019 (χtrend2=56.44, 60.04, 61.48, 42.49, 51.81, 50.81, 72.86, 101.34, 86.38, 24.81, 17.72, 10.38, P < 0.01). From 2005 to 2019, the detection rates of malnutrition in boys were higher than that of girls (in 4 surveys), and that in rural students from 2005 to 2014 of 3 surveys were higher than that in towns (χ2=92.07, 35.16, 25.29, 29.98; 64.35, 4.26, 6.32, P < 0.05).  Conclusions  The malnutrition of Han nationality primary and middle school students aged 7-18 years in Hainan Province show a trend of improvement year by year from 2005 to 2019, despite the overall high detection rate. Wasting is the most common type of malnutrition. The epidemic of malnutrition varies by age, sex and areas. Further targeted measures should be taken to strengthen intervention in the diet of primary and middle school students, to improve the nutritional status of children and adolescents.
Smoking behavior and associated factors among college and middle school students from Inner Mongolia Autonomous Region
YANG Tian, ZHANG Xiuhong, KANG Zhaoting, GAO Jianqiong, WEI Nana, DING Zuopan
2024, 45(7): 955-959. doi: 10.16835/j.cnki.1000-9817.2024217
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  Objective  To understand smoking behavior and related factors among college and middle school students in Inner Mongolia Autonomous Region, so as to provide a technical basis for targeted tobacco control interventions.  Methods  In September 2023, a total of 93 647 students in Inner Mongolia Autonomous Region were randomly selected by stratified cluster sampling from 12 league cities and 103 banner counties (cities districts) to conduct a questionnaire survey. The χ2 test and binary Logistic regression analyses were used to explore the current situation of adolescent smoking and its related factors.  Results  The prevalence of college and middle school students who tried smoking was 10.2%, and the prevalence of current smokers was 4.4%. The binary Logistic regression model showed that students in high school, vocational high school, university, males, those from unstable family, boarders, individuals who sew someone smoking at home, at school, in public places, drinking alcohol, inhaling volatile solvents for pleasure, using cough suppressant except for coughing, using sedative without a doctor's permission, being scolded by parents, experiencing school bullying, being addicted to the Internet, having depressive symptoms, anxiety symptoms, and low self-esteem were more likely to attempt smoking and currently smoke (attempt smoking: OR=1.38, 2.59, 1.75, 3.24, 1.18, 1.43, 1.25, 1.43, 1.43, 0.79, 9.18, 1.42, 1.17, 1.65, 1.52, 1.31, 1.58, 1.41, 1.11, 1.17; current smoking: OR=1.61, 4.76, 3.76, 4.45, 1.17, 1.44, 1.27, 1.58, 1.69, 0.68, 7.99, 1.64, 1.12, 2.31, 1.48, 1.37, 1.26, 1.31, 1.35, P < 0.05). Teenagers with parents who had graduated from high school and eat breakfast every day had a relatively low risk of trying and current smoking (OR=0.78, 0.83, 0.79, 0.84, 0.78, 0.68, P < 0.05).  Conclusions  Adolescent smoking behaviours in Inner Mongolia Autonomous Region exhibit obvious clustering pattern in the school setting. Associated factors includes demographic characteristics, secondhand smoke exposure, daily behaviours and substance abuse, and psychological behaviours. Schools, families and society should work together to create a smoke-free environment to protect adolescents from the harms of tobacco.
Effects of high-intensity interval training on adipokines in obese male college students
ZHAO Rui, ZHOU Wei, ZHAO Yanmin, YANG Binyi
2024, 45(7): 960-964. doi: 10.16835/j.cnki.1000-9817.2024198
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  Objective  To explore the effects of 8-week high-intensity interval training on body shape and adipokines of obese male college students, so as to provide practical reference for weight loss of obese college students.  Methods  A total of 30 male college students [age (20.10±0.55)years] with body mass index (BMI) ≥28 kg/m2 were recruited in March 2022 at China University of Petroleum (East China). The 8-week high-intensity interval training (HIIT) intervention was conducted from 11 April to 10 June 2022, 3 times a week (Monday, Wednesday, Friday), each time for 16:30-17:30. Body composition and adipokine levels were assessed before and after the intervention. All indicators were compared by paired-samples t-tests and single factor repeated measurement analysis of variance before and after intervention, and Pearson correlation analyses were used to test for associations between variables.  Results  After 8 weeks of intervention, BMI, waist circumference and body fat of obese male college students decreased from (31.36±4.41)kg/m2, (107.52±9.66)cm and (28.04±5.79)kg to (30.40±4.37)kg/m2, (100.67±8.29)cm and (22.56±5.22)kg, respectively (t=3.84, 8.02, 9.29). Fat-free body mass index increased from (70.19±5.54)kg/m2 to (75.34±5.25)kg/m2 (t=-8.65) (P < 0.01). There were statistically significant differences in the levels of Leptin, Adiponectin, and Irisin before intervention, at week 4 and at week 8 (F=26.05, 35.62, 4.95, P < 0.05). There was no statistically significant difference in the content of reticulin (F=3.62, P>0.05).  Conclusions  The 8-week of HIIT can effectively improve body shape of obese male college students and affect the effects of adipokines in the body. HIIT can be added to sports exercise to improve the health status of obese college students.
Analysis of the current situation and related factors in physical exercise behaviors among high school students in Taizhou City
ZHANG Yan, DING Hairong, XUE Hao, QIU Dayong, ZHANG Zihao
2024, 45(7): 965-968. doi: 10.16835/j.cnki.1000-9817.2024207
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  Objective  To analyze the current situation and related factors of physical exercise behavior among high school students, so as to provide theoretical basis for improving their health level.  Methods  In May 2022, a stratified cluster random sampling method was used to select 17 high schools in the jurisdiction of Taizhou City. A total of 3 402 high school students were selected by class to conduct a survey on the prevalence and related factors of physical exercise behavior by Chinese Sports Activity Level Scale. And binary Logistic regression analysis was conducted to analyze the influencing factors.  Results  Among the surveyed high school students, the rate of poor physical exercise behavior reached 53.4%. The rates of poor physical exercise behavior varied within the group in terms of gender, urban and rural areas, whether they were only children, maternal education, parental emotions, parental exercise habits, parenting styles, family income and academic performance were statistically significant (χ2=12.38, 11.73, 742.71, 28.86, 24.38, 39.98, 71.92, 33.34, 176.97, P < 0.01). High school students of grade 3, female students, parents with low education, parents who occasionally and never exercise, intergenerational discipline, low family income, and average academic performance were the tendency factors for poor physical exercise behavior(OR=1.39, 1.18, 1.62, 1.30, 1.36, 2.21, 1.53, 1.46, 1.52, P < 0.05).  Conclusions  The rate of poor physical exercise behavior among high school students in Taizhou City is relatively high and is affected by various factors such as age, gender, academic performance, and family background. It should actively reduce the impact of unfavorable factors, promote high school students to participate in physical exercise, and improve the health level of high school students.
Status and associated factors of the knowledge and health education needs about sexual abuse of middle school students in rural areas
TANG Zhengyan, ZHANG Yongai, LI Xiaomei
2024, 45(7): 969-973. doi: 10.16835/j.cnki.1000-9817.2024214
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  Objective  To explore the status and associated factors of the knowledge and health education needs about child sexual abuse of middle school students by sex, so as to provide a basis for targeted safety education of preventing child sexual abuse.  Methods  From June to July 2023, 1 256 junior high school students from 2 middle schools in southern area of Shaanxi Province were selected by a convenience sampling method. A self-designed general information questionnaire, Children's Sexual Assault Cognition Questionnaire, and Health Education Needs Questionnaire were used for questionnaire survey. Group comparisons were conducted using t-tests, analysis of variance, and Chi-square tests. Multiple linear regression analysis was used to explore the factors related to cognitive scores of sexual assault, and binary Logistic regression analysis was used to explore the factors related to the willingness of middle school students to receive sexual assault safety education.  Results  The correct response rate of the participants for knowledge of sexual assault cognition (CSA) was (80.97±12.09)%. For each item, the correct response rate ranged 46.7%-97.2%. The correct rate (78.98±12.23)% of male students' knowledge of CSA was lower than female students (83.17±11.55)% statistically (t=-6.23, P < 0.01). The factors influencing the participants' knowledge of CSA included gender (β=0.16), mother's occupation (β=0.07) and experience of CSA safety education (β=0.10) (P < 0.05). Most students (92.7%) were willing to receive CSA education. Girls (OR=1.72, 95%CI=1.06-2.77) and students who previously received CSA education (OR=6.98, 95%CI=4.44-10.96) had more willingness to receive CSA education (P < 0.05). A total of 71.8% of middle school students preferred their parents as educators, while 43.4% of students chose on-site instruction as the preferred method of CSA education.  Conclusions  Middle school students have a strong willingness to accept CSA safety education. Knowledge of CSA and willingness to receive CSA safety education are related to gender and previous educational experience.
Analysis of potential categories of sexual behaviors among male students who have sex with men and the status of pre-exposure prophylaxis use
CHENG Zhaoyu, LIU Xuan, XIAN Yidan, WEI Siyue, LIU Yuanyuan, LIU Fengli, YANG Jie, YU Maohe, LI Changping, CUI Zhuang
2024, 45(7): 974-977. doi: 10.16835/j.cnki.1000-9817.2024215
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  Objective  To analyze the use of pre-exposure prophylaxis (PrEP) among male students who had sex with men (MSM) with different sexual behavior patterns using potential categories, so as to provide evidence for determining the use patterns of PrEP consistent with MSM.  Methods  A questionnaire survey was conducted by proportional sampling method on MSM in 31 provincial administrative regions in mainland China from 20 October to 30 December 2021, a total of 1 040 students were selected for the study. Latent variable analyses were conducted on a total of seven sexual behavioral characteristics, including knowledge of sexual partner HIV infection, frequency of condom use, number of sexual partners, engaging in group sex, provision of commercial sex, use of sex aids, and history of sexually transmitted infections (STIs) in the past year. And demographic characteristics were analyzed by Logistic regression analysis. The rates of PrEP awareness, willingness to use and usage rate in different sexual behavior risk groups were investigated.  Results  Student MSM could be divided into two potential category groups: a low-risk behavior group (82.4%) and a high-risk behavior group (17.6%). The PrEP usage rate (15.8%) was higher in the high-risk behavior group, and the difference was statistically significant compared to the low-risk behavior group (7.2%) (χ2=13.43, P < 0.05). Student MSM residing in the northeast, south, and northwest of China, in the pilot city, and with a sex role of "0.5" (possible acceptance and insertion of sexual behavior) were more likely to be in the high-risk behavior group (OR=3.13, 3.07, 3.87, 2.22, 1.66, P < 0.05).  Conclusion  Student MSM in high-risk and low-risk sexual differs in the behavior of PrEP, and targeted interventions should be implemented to promote the use of PrEP and reduce HIV infection in this population.
Second-hand smoke exposure and related factors of non-smoking junior middle school students in Beijing from 2013 to 2021
SHI Jianhui, XU Luting, MENG Yaohan, HAN Mei, LIU Xiurong
2024, 45(7): 978-982. doi: 10.16835/j.cnki.1000-9817.2024196
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  Objective  To analyze the second-hand smoke exposure and related factors of non-smoking junior middle school students in Beijing, so as to provide a data support for formulating tobacco control measures.  Methods  The multi-stage cluster random sampling method was used to select junior middle school students in Beijing. The valid data of 4 494, 4 915 and 3 792 non-smoking middle school students were obtained from three waves of youth tobacco epidemic surveillance in 2013 (September to October), 2019 (August to November) and 2021 (September to December) wave, respectively. The information was collected by the national youth tobacco epidemic surveillance questionnaire. The complex sampling data analysis module of SPSS 21.0 was used to descriptive analysis and multivariate Logistic regression.  Results  The proportions of second-hand smoke exposure of non-smoking junior middle school students in the four types of places in the past 7 days in 2013, 2019 and 2021 in Beijing were 76.4%, 71.4% and 65.7%, respectively, with statistically significant differences (χ2=126.10, P < 0.01). The proportions of that found someone smoking in the campus in the three waves of survey were 34.7%, 27.9% and 21.1% (χ2=209.78), the proportion of that found teachers smoking daily were 2.7%, 1.8% and 1.3% (χ2=22.14) (P < 0.01), respectively. Multivariate Logistic regression analysis showed both parents smoking (OR=8.47, 95%CI=4.36-16.48), father smoking (OR=3.51, 95%CI=2.75-4.49), and friends smoking (OR=1.88, 95%CI=1.39-2.55) were the influencing factors of second-hand smoke exposure in four types of places of non-smoking junior middle school students in 2013. Both parents smoking (OR=2.37, 95%CI=1.33-4.22), father smoking (OR=2.80, 95%CI=2.33-3.37), friends smoking (OR=2.24, 95%CI=1.71-2.92), and teaching the tobacco hazards in class (OR=0.77, 95%CI=0.64-0.93) were the influencing factors of second-hand smoke exposure in four types of places for non-smoking middle school students in 2019. Both parents smoking (OR=3.93, 95%CI=2.29-6.75), fathers smoking (OR=3.30, 95%CI=2.72-3.99), and teaching the tobacco hazards in the class (OR=0.81, 95%CI=0.68-0.97) were the influential factor of second-hand smoke exposure in four types of places of non-smoking junior middle school students in 2021 (P < 0.05).  Conclusions  The second-hand smoke exposure of non-smoking middle school students in Beijing has improved, but still is a high level. It is necessary to take corresponding measures to effectively protect non-smoking junior middle school students from the harm of second-hand smoke.
Effect of physical activity on neurocognitive function in children with autism spectrum disorder: a systematic review
ZHANG Qiang, ZHONG Xiaoke, HUANG Chen, JIANG Changhao
2024, 45(7): 983-987. doi: 10.16835/j.cnki.1000-9817.2024218
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  Objective  To analyse the effects of physical activity on neurocognitive function in children with autism spectrum disorder (ASD), so as to provide a theoretical basis and specific guidance for the clinical cognitive function rehabilitation practice of ASD children.  Methods  Relevant literature on the effects of physical activity on neurocognitive function in children with ASD were searched in the China National Knowledge Infrastructure (CNKI), Wanfang, Web of Science, and EBSCO databases from their inception to March 2024 using specific subject terms. Information on authors, countries, publication dates, study populations, diagnostic criterion, interventions, measurement tools and study results were extracted post-screening. The methodological quality of the articles was assessed using the PEDro Scale, followed by a systematic review.  Results  A total of seventeen articles and were included in the study and English literature, most of them were of good quality. The study included 10 randomized controlled trials, 4 quasi-experimental designs, and 3 pre-and post-test designs. The rehabilitative effects of physical activity on children with ASD were primarily observed in enhanced attention and executive function, as well as improvements in brain structure and function. Children with ASD showed varying cognitive effects in physical and skill-based programs, with skill-based activities like basketball and table tennis notably improving cognitive function.  Conclusion  Physical activity is an effective intervention that enhances cognitive abilities such as attention and executive function, as well as brain structure and function in children with ASD.
Relationship between parenting style and emotional behavior problems in children with development dyslexia
YIN Feifei, ZHANG Jing, ZHONG Lin, LI Dan, XIAO Xinyu, ZUO Pengxiang
2024, 45(7): 988-992. doi: 10.16835/j.cnki.1000-9817.2024208
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  Objective  To explore the relationship between parenting style and emotional behavior problems in children with development dyslexia (DD), so as to provide reference for family support and intervention measures.  Methods  From June to September 2023, 201 children in DD group and typically developing matched by age and sex were selected from the students in grades 3-6 of 4 primary schools in a district of Xinjiang by random cluster sampling method. The Children's Version of the Parenting Style Scale and the Strength and Difficulty Scale were administered, and the occurrence of children's emotional behavior problems and parentingstyles in the two groups were compared by Chi-square test and Wicoxon rank sum test. The correlation between parents' parenting styles and children's emotional behavior problems was analyzed by generalized linear regression.  Results  The detection rates of emotional behavior problems were 45.77% in DD group and 15.42% in normal control children group. The differences in parenting styles between fathers and mothers of the DD group and the normal control group were statistically significant in terms of emotional warmth, parenting anxiety, and overprotection (Z=4.02, 29.03; 4.94, 26.32; 23.47, 5.30, P < 0.05). Generalized linear regression analysis showed that father affective warmth was positively correlated with emotional symptoms, hyperactivity, peer interaction problems and prosocial behaviors (β=0.08, 0.05, 0.05, 0.09, P < 0.05). The emotional warmth of mothers in DD group was negatively correlated with emotional symptoms, conduct problems, hyperactivity and peer interaction problems (β=-0.18, -0.08, -0.07, -0.08, P < 0.05).  Conclusions  Parenting style is an important factor affecting the emotional behavior problems of DD children. Improving parenting style can reduce the occurrence of emotional behavior problems of DD children.
Effect of maternal emotional symptoms on emotional and behavioral problems in preschool children
ZHU Min, ZHA Jinhong, JIA Liyuan, LI Ruoyu, YU Min, HE Haiyan, WAN Yuhui
2024, 45(7): 993-997. doi: 10.16835/j.cnki.1000-9817.2024226
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  Objective  To explore the mediating role of psychological and physical aggression in the association between maternal emotional symptoms with emotional and behavioral problems in preschool children, so as to provide references for effective intervention of risk factors related to children's emotional and behavioral problems.  Methods  A longitudinal study was conducted to select 12 kindergarten children and their mothers in Wuhu City, Anhui Province by using stratified clustering sampling. The baseline survey was carried out in June 2021, followed up every six months, and a total of 3 follow-ups were administered. Totally 853 valid questionnaires of junior class children were included by the survey data from baseline, second and thirl follow-ups. The Depression Anxiety and Stress Scale-21 (DASS-21), the Parent-Child Conflict Tactics Scales (CTSPC) and the Strength and Difficulties Questionnaire (SDQ) were used to measure maternal emotional symptoms, psychological and physical aggression, and children's emotional and behavioral problems, respectively.  Results  The physical aggression of mothers towards children in boys was higher than in girls (t=3.53, P < 0.05). The results of correlation analysis showed that maternal depressive symptoms were positively correlated with psychological aggression, physical aggression and children's SDQ scores (r=0.20, 0.21, 0.18, P < 0.01), maternal anxiety symptoms were positively correlated with psychological aggression, physical aggression and children's SDQ scores (r=0.24, 0.22, 0.10, P < 0.01), respectively; maternal stress symptoms were positively correlated with psychological aggression, physical aggression. The SDQ scores were positively correlated (r=0.26, 0.25, 0.18, P < 0.01), and the scores of maternal psychological aggression and physical aggression were positively correlated with the SDQ scores of children (r=0.12, 0.16, P < 0.01). The mediating analysis showed that after controlling for related confounding factors, psychological aggression played a partial mediating effect in the association between maternal depressive symptoms and children's emotional and behavioral problems, and the mediating effect ratio was 8.05%. Physical aggression played a partial mediating effect in the association between maternal depression, anxiety and stress symptoms and children's emotional and behavioral problems, which were 15.94%, 11.73% and 12.54% (P < 0.05), respectively.  Conclusions  Psychological and physical aggression play mediating roles in the association between maternal emotional symptoms and children's emotional and behavioral problems, and actively improving maternal emotional symptoms and their children's discipline methods can help reduce the occurrence of emotional and behavioral problems in preschool children.
Establishment and validation of depressive symptom predictive model in middle school students
TAN Zhenkun, ZHANG Zhuo, ZHANG Ying, PING Junjiao, LUO Jiali, ZHANG Jie, LIU Xinxia
2024, 45(7): 998-1002. doi: 10.16835/j.cnki.1000-9817.2024219
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  Objective  To investigate the influencing factors of depressive symptoms and to construct and verify the prediction model of depressive symptoms in middle school students, so as to provide risk assessment tools for effectively screening depressive symptom.  Methods  Physical examination and questionnaire survey were conducted among middle school students in one city in Guangdong Province from September to October in 2021 (n=2 376) and from September to October in 2022 (n=4 344) by a multistage cluster sampling method, and a nomographic prediction model of depressive symptoms in middle school student was constructed. The questionnaire survey was conducted using the student health status and influencing factors questionnaire (secondary school version) and the Center for Epidemiological Studies Depression Scale (CES-D) to measure the lifestyle and depressive symptom of middle school students.  Results  The detection rate of depressive symptoms in 2021 was 23.3%. Multivariate Logistic regression analysis showed that irregular breakfast (OR=2.64), school bullying (OR=4.28), being beaten by parents (OR=2.86), using mobile devices for a long time (OR=1.08) and sitting for a long time (OR=1.05) were positively related to depressive symptoms in middle school students (P < 0.05). Long sleep duration (OR=0.78) and outdoor activity durations of 1- < 2, 2- < 3 and ≥3 h/d (compared with < 1 h/d, OR=0.63, 0.61, 0.49) were negatively related to depressive symptoms in middle school students (P < 0.05). Multivariate Logistic regression analysis showed that 7 statistically signifucant predictive factors constructed a nomogram, and the AUC of the nomogram was 0.77, which had been verified internally and externally with good differentiation and reliability.  Conclusions  The nomogram prediction model of depressive symptoms provides a convenient and effective risk assessment tool for depressive symptoms among middle school students. The life behavior, diet behavior and injury behavior of middle school students play an important role in the formation of depressive symptoms. It should pay attention to the impact of the behavioral factors on the mental health of middle school students.
Association between adverse experience and subsequent incidence of depressive symptoms among middle school students in Liangshan
FAN Hui, TAO Yifeng, GUAN Tao
2024, 45(7): 1003-1007. doi: 10.16835/j.cnki.1000-9817.2024212
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  Objective  To assess the association of adverse experiences and subsequent incidence of depressive symptoms among middle school students in Liangshan, so as to provide a basis for preventing the occurrence of depression symptoms among middle school students.  Methods  In October 2021, a convenient sampling combined with cluster random sampling method was employed to select 888 students from three high schools (junior first year and second year, senior first year) in Liangshan for a questionnaire survey. In March 2023, a follow-up survey was conducted to collect data on adverse experiences (such as school bullying, domestic violence, and lack of parental understanding). Depressive symptoms were assessed using the Chinese version of the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regression model analysis was used to examine the relationship between the number of adverse experiences at baseline and the incidence of depressive symptoms during the follow-up period.  Results  The detection rate of depressive symptoms among middle school students was 9.4% at follow-up. School bullying (OR=2.26, 95%CI=1.37-3.73), domestic violence (OR=2.56, 95%CI=1.55-4.21), and lack of parental understanding (OR=1.91, 95%CI=1.15-3.16) at baseline were positively associated with the incidence of depressive symptoms at follow-up (P < 0.05). Compared with participants with no adverse experiences at both baseline and follow-up, those with adverse experiences at both baseline and follow-up were more likely to exhibit depressive symptoms at follow-up, regardless of the type of adverse experiences (P < 0.01). The incidence of depressive symptoms increased with the increase of baseline adverse experiences (P < 0.01). Compared to the participants with no adverse experiences at both baseline and follow-up, those with adverse experiences at baseline but not at follow-up did not show a statistically significant difference in the likelihood of developing depressive symptoms at follow-up (OR=0.78, 95%CI=0.13-4.80, P>0.05).  Conclusions  Adverse experiences increase the risk of developing depressive symptoms among middle school students. Participants who have reversed adverse experiences show no increased risk of depressive symptoms compared to those with no adverse experiences. Measures should be taken to prevent the occurrence of depression symptoms among middle school students based on their adverse experiences during their middle school years.
Analysis of the relationshiop and mediating factors between sleep quality and emotional regulation difficulties in millde school students
CHEN Ping, WANG Wenjuan, SHENG QingChao, YU Hang, ZHU Yuqiong, WU Chengcong, LI Tiancheng, JI Chenguang, JIANG Yulian
2024, 45(7): 1008-1011. doi: 10.16835/j.cnki.1000-9817.2024220
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  Objective  To explore the relationship of sleep quality and emotional regulation difficulties in middle school students, and to analyze its mediating role of daytime dysfunction, social rejection and self-control ability, so as to provide a scientific reference for improving middle school students' mental health.  Methods  From October to November, 2023, the Pittsburgh Sleep Quality Index, Adolescent Social Rejection Questionnaire, Brief Self-control Scale and Difficulties in Emotion Regulation Scaleshort Form (DERS-16) were used to assess 806 students recruited from four middle schools in Bengbu City by a convenient cluster random sampling method. And model-6 of PROCESS and 5 000 Bootstraps were used to make a chain-mediating model analysis.  Results  Daytime dysfunction was positively correlated with sleep quality(r=0.57), social rejection(r=0.19), self-control(r=0.29, P < 0.01). Self-control was positively correlated with emotional regulation difficulties(r=0.54, P < 0.01).Poor sleep quality showed a significant positive association with on daytime dysfunction, and daytime dysfunction further affected social rejection, self-control ability and emotional regulation difficulties (β=0.86, 0.60, 1.27, 1.56, P < 0.05). Meanwhile, daytime dysfunction, social rejection and self-control played a serial mediating role in the relationship between sleep quality and emotional regulation difficulties (Estimate=0.11, 95%CI=0.04-0.20, P < 0.05).  Conclusion  The study reveals the complex relationship between sleep quality and emotional regulation difficulties in middle school students and provides a new theoretical basis for adolescent sleep improvement and mental health interventions.
Meta-analysis of the relationship between childhood abuse and social anxiety
HUANG Yue, DU Xin, XUE Yunzhen, ZHENG Chuanwei, ZHANG Yuran
2024, 45(7): 1012-1016. doi: 10.16835/j.cnki.1000-9817.2024221
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  Objective  To understand the relationship between childhood abuse and social anxiety and its influencing factors, so as to provide a theoretical basis for the intervention targeting social anxiety in adolescents.  Methods  The Meta-analysis was conducted on the 30 selected articles using random-effects models, comprising 93 independent effect sizes and a total sample of 19 354. Odds ratio (OR) was used to integrate the relationship between childhood abuse and social anxiety.  Results  There was a significant positive correlation between childhood abuse and social anxiety (r=0.22), and its subtypes (emotional abuse, emotional neglect, emotional maltreatment, physical abuse, physical neglect, sexual abuse) could also positively predict social anxiety (OR=3.14, 1.97, 2.42, 1.78, 1.68, 1.54)(P < 0.01). The moderating effect showed that cultural background could significantly moderate the relationship between emotional neglect and the composite index and social anxiety (Qb=3.95, 3.93), and the relationship between emotional abuse and composite index and social anxiety were significantly moderated by age (Qb=7.65, 8.72)(P < 0.05).  Conclusions  Childhood abuse is a positive predictor of social anxiety. Cultural background and age have a significant moderating effect on the relationship between childhood abuse and social anxiety, but gender has no significant moderating effect.
Prevalence of depression and anxiety symptoms and its relationship with bullying and violent behaviors among middle school students in Beijing
ZHAO Hai, WANG Lu, SUN Bingjie, GUO Xin
2024, 45(7): 1017-1020. doi: 10.16835/j.cnki.1000-9817.2024222
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  Objective  To investigate the prevalence of depression and anxiety and its relationship with bullying and violent behaviors among middle school students in Beijing, so as to provide a scientific basis for promoting the mental health of middle school students.  Methods  A total of 18 379 junior high school, general high school, and vocational high school students from 16 districts of Beijing were selected by stratified cluster random sampling from September to November, 2023. The χ2 test was used to analyze the depression or anxiety symptom and injury-related behaviors such as bullying among middle school students. Logistics regression was used to analyze the correlation between depression or anxiety symptom and injury correlation behaviors among middle school students.  Results  The detection rates of depression symptoms and anxiety symptoms were 18.2% and 8.6% among middle school students in Beijing, and the comorbidity was 7.6%. The reporting rate of school bullying was 3.3%. The results of Logistic regression showed that girls (OR=1.23), high school students (OR=1.85) and vocational high school students (OR=1.91), school bullying (OR=3.83), being scolded and beaten by parents (OR=3.32) and being exposed to cyber violence (OR=4.43) were positive factors related to depression symptoms; and non-residential students (OR=0.87) was a negative factor related to depression symptoms (P < 0.05).Girls (OR=1.32), high school students (OR=1.77) and vocational high school students (OR=1.50), school bullying(OR=3.63), being scolded and beaten by parents (OR=3.41) and being exposed to cyber violence (OR=3.33) were positive factore related to anxiety symptoms (P < 0.05).  Conclusions  The depression and anxiety symptoms among middle school students in Beijing are closely related to the behaviors of school bullying and experiencing violence from parents or the Internet. Various measures should be taken to reduce the situation of school bullying, being scolded and beaten by parents and cyber violence among middle school students to promote their mental health.
Association between lifestyle and fat mass index in different positions of children and adolescents
MA Qi, CHEN Manman, MA Ying, GAO Di, LI Yanhui, DONG Yanhui, MA Jun, XING Yi
2024, 45(7): 1021-1025. doi: 10.16835/j.cnki.1000-9817.2024201
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  Objective  To explore the association between lifestyle and fat mass index (FMI) in different positions of children and adolescents aged 7-18, so as to provide a scientific basis for health promotion in children and adolescents.  Methods  A total of 1 531 students aged 7-18 was selected by intentional sampling from 4 schools in Tongzhou District, Beijing from September to December in 2020 and August in 2022. Questionnaire survey was used to collect lifestyle including dietary behavior, moderate to vigorous physical activity, smoke and drink behaviors, sleep time and sleep quality. Dual energy X-ray absorptiometry was employed to assess fat mass, and calculated total, android, trunk, hip, gynoid and leg fat mass index (FMI). The t-test and Chi-square test were used to compare the differences of different lifestyle. Logistic regression was used to analysis association between lifestyle and body composition in different positions.  Results  Compared with healthy lifestyle, unhealthy lifestyle had higher risk for high-trunk FMI (OR=1.40, P < 0.05). After adjusted for sex and age, unhealthy lifestyle had higher risk for high-total FMI, high-android FMI, high-trunk FMI (OR=1.37, 1.37, 1.50, P < 0.05), compared with healthy lifestyle. Stratified analysis found the associations between unhealthy lifestyle and high-total FMI, high-android FMI, high-trunk FMI, and high-thigh FMI were only significant in girls with 7-12 years old (OR=2.13, 2.46, 2.13, 2.13, P < 0.05).  Conclusions  Unhealthy lifestyle is associated with high-total FMI, high-android FMI and high-trunk FMI. A healthy lifestyle should be maintained during puberty, especially before puberty, to help children and adolescents reduce body fat and promote a balanced distribution of body composition.
Association of adverse childhood experiences and non-suicidal self-injurious interactions with suicide-related behaviors in junior high school students
LIU Aini, LUO Yu, ZHANG Ronghuinan, YANG Siwei, WANG Hong
2024, 45(7): 1026-1030. doi: 10.16835/j.cnki.1000-9817.2024200
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  Objective  To explore the association between adverse childhood experiences (ACEs) and non-suicidal self-injury (NSSI) and suicide-related behaviors among junior high school students, so as to provide a reference basis for the prevention of junior high school students' suicide.  Methods  From May to June 2023, a total of 7 392 junior high school students in three districts and counties of Chongqing were selected for self-administered questionnaire survey by stratified cluster sampling and convenience sampling methods. The questionnaire survey was conducted using the Chinese version of the Childhood Trauma Scale, Adolescent NSSI Assessment Questionnaire, and Suicide Related Behavior Questionnaire. Statistical analysis was performed by using χ2 test, multifactorial Logistic regression model, and additional interaction analysis was used to calculate the estimated relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S), as well as 95%CI.  Results  The detection rate of NSSI among junior high school students was 38.03%, the detection rate of ACEs was 41.76%, and the detection rates of suicidal ideation, suicide planning, and suicide attempt were 27.99%, 9.90%, and 4.75%, respectively. ACEs and its dimensions, and NSSI were the influencing factors for suicide-related behaviors (OR=1.83-10.66, P < 0.01). The result of the additive interaction showed that ACEs and NSSI, PN and NSSI, EA and NSSI, EN and NSSI all had additive interactions on suicide-related behaviors (RERI=0.45-39.15, AP=0.10-1.09, S=1.02-3.92). And ACEs and its dimensions had additive interactions with NSSI on suicide-related behaviors, for junior high school students with both ACEs and NSSI had 11.45, 20.38, and 28.76 times the risk of suicidal ideation, suicidal planning, and suicidal attempts as compared to junior high school students without ACEs and without NSSI (P < 0.05).  Conclusions  ACEs and NSSI among junior high school students have an additive interaction effect on suicide related behaviors. ACEs and NSSI should be reduced to prevent suicidal behavior among middle school students.
Acute effects of exposure to PM2.5 components on the lung function of primary school students
CHEN Lu, ZHANG Jingwei, YUAN Wen, DONG Yanhui, CUI Yushan
2024, 45(7): 1031-1035. doi: 10.16835/j.cnki.1000-9817.2024225
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  Objective  To analyze the acute effects of exposure to fine particulate matter (PM2.5) components on primary school students' lung function, so as to provide a scientific basis for protecting children's respiratory health.  Methods  From 2019 to 2021, the study selected a total of 2 120 primary school students from grades 3 to 5 in Tianjin using a stratified random sampling method to undergo lung function tests. At the same time, the short-term exposure levels were simulated by combining PM2.5 components and student addresses, and the acute impact of PM2.5 exposure on primary school students' lung function was analyzed by generalized linear models (GLM) and weighted quantile sum (WQS) regression models.  Results  The average daily concentration of PM2.5 in the air of Tianjin from 2019 to 2021 was 81.14 μg/m3, which was higher than the national standard. The results of lung function testing showed that there was no statistically significant difference in lung function measurement indicators such as forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), peak expiratory flow (PEF), 75% forced expiratory volume in 75 (FEF75), and 25% forced expiratory volume in 25 (FEF25) among primary school students in different regions of Tianjin (F=1.23, 0.87, 2.34, 1.56, 0.98, P>0.05). But the GLM analysis results showed that all components of PM2.5 in the air had adverse effects on the lung function indicators of primary school students. When the concentrations of fluorene (FLU) and pyrene (PYR) increased by 10 ng/m3, the FVC of primary school students decreased by 166.44 and 61.94 L respectively. The WQS regression model analysis results showed that the mixed exposure of PM2.5 components particularly significant damaging effects on lung function indicators in primary school students, especially the FLU and PYR components in polycyclic aromatic hydrocarbons, as well as the heavy metal lead.  Conclusions  Both single and mixed exposure to various PM2.5 components in the air have adverse effects on the lung function of primary school students. Among them, the influences of FLU and PYR in polycyclic aromatic hydrocarbons, as well as heavy metal Pb, are particularly significant.Potential pollution sources should be controlled to protect the respiratory health of primary school students by comprehensive prevention and control measures.
Association between preschoolers' physical activity levels and parental sports concept and behavior
ZHANG Mengnan, WANG Xiaojuan, CHENG Tong, XU Mengxue, REN Xia, JIANG Yuanyuan, ZHANG Xuejiao, YANG Lin, ZHANG Ting, ZHU Zonghan, GUAN Hongyan
2024, 45(7): 1036-1039. doi: 10.16835/j.cnki.1000-9817.2024211
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  Objective  To analyze the impact of parental sports concept and behavior on physical activity in preschool children, so as to provide a foundation for future guidance on fostering children's physical activity within the family context.  Methods  From November to December 2020, a clustered convenience sampling method was employed to conduct surveys, and a total of 283 children were selectal from one kindergarten each in Beijing, Shenyang, and Xi'an. Participating children wore ActiGraph GT9X accelerometers continuously for one week to collect data on different intensity levels of physical activity. Physical Activity afterschool Questionnaire for Preschooler (P-PAQ) was utilized to assess parental sports concept and behavior. The gender differences in physical activity level and physical activity compliance rate were analyzed by using t-test, Mann-Whitney U test, and Chi-square test; and the relationship between parental exercise concepts and behaviors and physical activity of preschool children was analyzed using Spearman rank correlation analysis and multiple linear regression analysis.  Results  Parental sports concept was significantly positively correlated with average daily moderate-to-vigorous physical activity (MVPA) and total physical activity (TPA) in children (r=0.12-0.16, P < 0.05). Parental sports behavior was significantly positively correlated with children's average daily TPA (r=0.25, P < 0.05). Multiple linear regression revealed that parental sports concept was positively correlated with average daily MVPA and TPA in both boys and girls (B=0.65-0.83), while parental sports behavior only was positively correlated with boys' average daily MVPA and TPA (B=0.24-0.25)(P < 0.05).  Conclusions  Parental sports concept and behavior can impact physical activity levels in preschool children, exhibiting gender differences. Future guidance on physical activity in family upbringing should consider both parental sports concept and behavior, and pay attention to the influence of children's gender.
Application value of neck circumference in screening for overweight and obesity among children and adolescents
LIU Fang, YUAN Shuxian, LI Yuan, HAO Huimin, LIN Yifan, CHEN Yongxing, WEI Haiyan
2024, 45(7): 1040-1044. doi: 10.16835/j.cnki.1000-9817.2024209
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  Objective  To discuss the clinical value of neck circumference in screening for overweight and obesity in children and adolescents, so as to provide a theoretical basis and new ideas for overweight and obesity screening.  Methods  From May to July 2023, a total of 2 493 children and adolescents aged 3 to 16 were sampled from three schools by the cluster random sampling method. General data, neck circumference, body mass index (BMI), waist-to-height ratio, and other information were collected. Mann-Whitney rank-sum test, Spearman correlation analysis, and receiver operating characteristic (ROC) curve analysis were used to statistically analyze the data.  Results  The prevalence of overweight and obesity in children and adolescents aged 3 to 16 was 33.05%, and the prevalence of abdominal obesity was 28.33%.The neck circumferences of boys and girls in the overweight and obese group showed statistically significant differences from the normal weight group during the pre-school, school-age, and adolescence periods (Z=-16.69-4.54, P < 0.05). The neck circumferences of children of different genders were moderately positively correlated with BMI (r=0.50-0.79, P < 0.01). ROC curve analysis showed that neck circumference had good accuracy in assisting the screening for the occurrence of overweight and obesity in boys and girls during the pre-school, school-age, and adolescence periods [the AUC for boys: 0.80(0.71-0.89), 0.89(0.86-0.91), 0.84(0.81-0.87); the AUC for girls: 0.76(0.67-0.86), 0.81(0.74-0.88), 0.73(0.68-0.77), P < 0.01], the optimal neck circumference cut-off values for boys were 26.95, 28.95, 33.55 cm, and for girls were 25.05, 26.55, 28.35 cm respectively. The neck circumferences of boys and girls were moderately positively correlated with the waist-to-height ratio during the school-age and adolescence periods (r=0.41-0.70, P < 0.01). ROC curves showed that neck circumferences had good accuracy in assisting the screening for the occurrence of abdominal obesity in boys and girls during the school-age and adolescence periods [the AUC for boys: 0.89(0.86-0.92), 0.82(0.78-0.85); the AUC for girls: 0.84(0.75-0.93), 0.87(0.75-0.93)], the optimal cut-off values for boys were 28.95, 32.75 cm; for girls were 26.45, 31.85 cm respectively.   Conclusion  The neck circumference can be applied to screen for overweight and abdominal obesity in children and adolescents, and can provide new ideas for the prevention and control of overweight and obesity in children and adolescents.
Analysis of the prevalence and related factors for comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing
LUO Huijuan, SUN Bingjie, ZHAO Hai, CHEN Dongni, WANG Lu, GAO Ruoyi, KUANG Huining, E Boran, GUO Xin
2024, 45(7): 1045-1049. doi: 10.16835/j.cnki.1000-9817.2024166
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  Objective  To analyze the current status and related factors of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing, so as to provide a basis for comprehensive public health interventions for common diseases.  Methods  Through stratified cluster random sampling in October 2022, a total of 11 262 junior high school, senior high school, and vocational high school students in 16 districts of Beijing were surveyed with self-administered questionnaires, physical examinations and visual acuity examinations. The χ2 test and binary Logistic regression model were used to analyze group differences in the comorbidity of myopia, obesity and depression symptoms and factors influencing the comorbidity. Stratified analysis was applied to analyze the associations between health risk behaviors and the comorbidity.  Results  The detection rate of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing was 3.35%, the comorbidity rate among vocational high school students (4.61%) was higher than that in junior high school students (2.80%) and senior high school students (3.41%). The comorbidity rate was higher among students in suburban areas (3.66%) than that in urban areas (2.92%), and the differences was statistically significant (χ2=15.02, 4.63, P < 0.05). Binary Logistic regression analyses indicated that middle school students with poor dietary behaviors (OR=1.59) and excessive screen time (OR=1.70) were associated with elevated risk of comorbidity of myopia, obesity, and depression symptoms. Both boys and girls with poor dietary behaviors (OR=1.63, 1.69) and excessive screen time (OR=1.45, 2.23) had elevated likelihood of comorbidity of myopia, obesity and depression symptoms. Students in junior high school and senior high school with poor dietary behaviors (OR=2.16, 1.47) and excessive screen time (OR=2.20, 1.63) had elevated likelihood of comorbidity of myopia, obesity, and depression symptoms (P < 0.05).  Conclusions  The current status of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing is concerning. Schools and parents should work together to guide students to develop healthy behaviors such as balanced diet and moderate video, in order to achieve the goal of controlling myopia, obesity and depression symptoms.
Progress of research on the relationship between vitamin D deficiency and obesity among children
WANG Xiaoning, GUO Qiya, ZHANG Qian, XU Juan
2024, 45(7): 1050-1054. doi: 10.16835/j.cnki.1000-9817.2024170
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Vitamin D (Vit D) deficiency is prevalent worldwide, and the prevalence of childhood obesity is increasing globally. Many studies have supported that Vit D deficiency may be an important cause of childhood obesity, and the level of serum Vit D among obese children decreases, simultaneously. Both Vit D deficiency and obesity among children interact through direct factors, molecular mechanisms and environmental factors, but the mechanism of interaction has not been fully elucidated. In the future, higher level research in evidence-based medicine could be conducted to explore the association between childhood obesity and Vit D deficiency and the possible mechanisms of their interaction, in order to provide scientific evidence for the prevention and control of Vit D deficiency and obesity among children.
Research progress on the association between vitamin D and mental health among children and adolescents
WANG Lüyao, XU Baoyu, TANG Ting, WANG Jun, SU Puyu, WANG Gengfu
2024, 45(7): 1055-1058. doi: 10.16835/j.cnki.1000-9817.2024223
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Vitamin D, as an important nutrient, has been widely recognized for its significant role in the growth and development of children and adolescents, but its association with mental health is still under exploration. The article reviews and summarizes the related researches on vitamin D and common mental health problems of children and adolescents, including depression symptoms, anxiety symptoms, and suicidal ideation and behaviors, and possible biological mechanisms of vitamin D influencing mental health, to provide scientific evidence and ideas for improving the mental health of children and adolescents in China, as well as insights for future studies.
Current status and progress in the prevention and control of spinal curvatures in Chinese children and adolescents
SONG Xinli, YUAN Wen, JIANG Jianuo, LIU Zhonghui, CHEN Lu, SONG Yi, MA Jun, DONG Yanhui
2024, 45(7): 1059-1064. doi: 10.16835/j.cnki.1000-9817.2024224
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Spinal curvatures has emerged as the third major chronic condition seriously threatening the physical and mental health of Chinese children and adolescents, with significant regional differences. Its etiology is complex and diverse, and early prevention and treatment are feasible, whereas treatment in later stages entails considerable difficulty and economic burden. Currently, the prevention and control of student spinal curvatures has been elevated to a national health strategy. A series of policy documents have been successively issued, and it has greatly facilitated the institutionalization and normalization of national routine screening for student spinal curvatures. However, it is still inadequate considering current prevention and control system for spinal curvatures in children and adolescents. There is an urgent need to establish a closed-loop model based on China's institutional advantages, comprising Initial Screening-Diagnosis-Treatment-Preventive Control-Follow-up Assessment, to strengthen the safeguarding of spinal health in children and adolescents.

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