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2025 Vol. 46, No. 6

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Editorial
Improve sleep quality and promote healthy growth of adolescents
YIN Xiaojian
2025, 46(6): 761-764. doi: 10.16835/j.cnki.1000-9817.2025189
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Abstract:
Sleep quality is crucial to the physical and mental health of adolescents. High-quality sleep plays a crucial role in bodily repair and recovery of adolescents, as it promotes physical development, cognitive function, emotional regulation and social adaptability. However, sleep quality problems are common among adolescents globally, mainly manifesting in sleep deprivation and difficulties in sleeping. Based on the characteristics of adolescent physical and mental development as well as the real conditions, interventions should be implemented to improve their physical activity, nutritional intake and psychological well-being for addressing sleep issues, thereby effectively promoting physical and mental health development, as well as enhancing the health and well-being of adolescents.
Expert Viewpoint
Multi-dimensional influencing factors and strategies for prevention and control of childhood hypertension
ZHOU Jiali, WU Jing, LIU Runqi, TANG Ke, ZHU Bing, ZHANG Ronghua, SONG Peige
2025, 46(6): 765-769. doi: 10.16835/j.cnki.1000-9817.2025167
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Childhood hypertension is becoming a substantial public health challenge with profound implications for children's quality of life and long-term health. The study analyzes the global prevalence of childhood hypertension and the relationship between macro-ecological factors, meso-environmental factors, and micro-individual factors based on the perspective of life course and childhood hypertension. And it further summarizes existing prevention and control strategies: systematic prevention and control based on policy and social support, health promotion based on behavioral science theory, and dynamic monitoring and management based on individualized prevention and control, to provide a reference for promoting the advancement of childhood hypertension prevention and control strategies.
Column on Promoting Sleep Quality among Middle School Students
Association between sleep quality and mental health among middle school students
WU Huipan, LIU Yuan, YIN Xiaojian, WANG Jinxian, WANG Yi, GUO Yaru, XU Dingkun
2025, 46(6): 770-773. doi: 10.16835/j.cnki.1000-9817.2025173
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  Objective   To explore the relationship between sleep quality and mental health among middle school students, so as to provide scientific basis for improving mental health among adolescents.   Methods   From September to December 2023, a stratified cluster random sampling method was employed to select 5 713 middle school students aged 13-18 from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi. Sleep quality and mental health were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Brief Adolescent Mental Health Assessment Questionnaire. Spearman correlation analysis and linear regression analysis were used to explore the relationship between sleep quality and various dimensions of mental health among middle school students.   Results   There was a statistically significant difference in the total PSQI score among middle school students of different age groups (H=226.49, P < 0.01), and there was no statistically significant difference in the psychological health scores of middle school students in different age groups (H=5.37, P>0.05). In terms of gender, the total PSQI score for girls [5.00 (3.00, 6.00)] was higher than that for boys [4.00 (2.00, 6.00)]; additionally, boys had higher mental health scores [85.00 (75.00, 90.00)] than females [83.00 (70.00, 89.00)], with statistically significant differences (Z=-10.90, -8.16, P < 0.01). Spearman correlation analysis revealed a negative correlation between total PSQI scores and mental health scores (r=-0.51, P < 0.05) among middle school students. After controlling for variables such as maximum oxygen uptake, physical activity and nutritional status, linear regression analysis further confirmed that higher PSQI scores were associated with lower mental health scores (B=-3.76, 95%CI=-4.15 to -3.38, P < 0.01).   Conclusion   There is a negative correlation between PSQI scores and mental health scores among middle school students, indicating that improving sleep quality may contribute to better mental health among middle school students.
Association between sleep quality and executive functions among middle school students
YU Xiumin, CHEN Fule, YAN Jingfei, YIN Xiaojian, WU Huipan, WANG Yi, GUO Yaru, XU Dingkun
2025, 46(6): 774-778. doi: 10.16835/j.cnki.1000-9817.2025182
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  Objective   To explore the relationship between sleep quality and executive function among middle school students, so as to provide theoretical support for the promotion of adolescents' physical and mental health development.   Methods   From September to December 2023, 5 713 junior and senior high school students aged 13 to 18 were selected by stratified cluster random sampling method from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi. Pittsburgh Sleep Quality Index was used to conduct sleep quality survey. And conduct executive function was tested on middle school students, including inhibitory function, refresh function and conversion function tests. Spearman correlation and linear regression were used to analyze the relationship between sleep quality and executive function of middle school students.   Results   The total Pittsburgh Sleep Quality Index (PSQI) score of boys was [4.0(2.0, 6.0)] and that of girls was [5.0(3.0, 6.0)], and the difference was statistically significant (Z=-10.90, P < 0.01). The total PSQI score of boys was positively correlated with both 2-back reaction time and conversion function of executive function (r=0.04, 0.04); the total PSQI score of girls was negatively correlated with 2-back reaction time (r=-0.04) (P < 0.05). After controlling for variables such as mental health, physical activity and nutritional status, linear regression analyses showed that PSQI total score of middle school students was positively correlated with the inhibitory function and the conversion function response time [B(95%CI)=1.28(0.21-2.34), 7.62(2.34-12.90), P < 0.05]; the associations of total PSQI scores among middle school students with both 2-back and 1-back response time were not statistically significant [B(95%CI)=-5.88(-16.14-4.37), 8.05(-3.39-19.50), P>0.05].   Conclusion   Positive correlations are observed on sleep quality with inhibitory and conversion functions of executive function among middle school students.
Association of sleep quality with overweight and obesity among middle school students
HU Zhengchun, CHEN Fule, GAO Ping, YIN Xiaojian, WU Huipan, ZHANG Ting, WANG Zhe, GUO Yaru, GUO Junfeng
2025, 46(6): 779-782. doi: 10.16835/j.cnki.1000-9817.2025183
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  Objective   To explore relationship of sleep quality with overweight and obesity among middle school students, so as to provide a reference basis for improving adolescent sleep health.   Methods   From September to December 2023, 5 713 middle school students aged 13 to 18 were selected by stratified cluster random sampling method in six regions, including Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi and Urumqi. Sleep quality survey was conducted on middle school students by Pittsburgh Sleep Quality Index. Height and weight were measured, and World Health Organization's standards for growth and development of children and adolescents was used to evaluate their nutritional status. Both χ2 test and Logistic regression analysis were used to analyze the association between sleep quality and nutritional status of middle school students.   Results   The non-compliance detection rate of sleep quality was 38.4% among girls, but 29.2% among boys, and the difference was of statistical significance(χ2=54.08, P < 0.01). The detection rate of substandard sleep quality was 34.2% in the group with normal nutritional status, 38.3% in the group with overweight, 43.7% in the group with obesity and 26.0% in the group with emaciation, and the difference in the rates of substandard sleep quality among middle school students of different nutritional status was statistically significant (χ2=68.15, P < 0.01). Logistic regression analysis showed that, after controlling for mental health and physical activity, the detection rate of substandard sleep quality in the obese groups was 1.30 times higher than that in the normal group, respectively(OR=1.30, 95%CI=1.06-1.59, P < 0.01).   Conclusions   Sleep quality is correlated with overweight and obesity among middle school students, and there are gender differences. Intervention policies should be formulated according to the characteristics of different genders.
Association between physical activity and sleep quality among middle school students
LIU Yuan, ZHANG Ting, YIN Xiaojian, WU Huipan, WANG Jinxian, ZHANG Yingkun, GUO Yaru
2025, 46(6): 783-787. doi: 10.16835/j.cnki.1000-9817.2025174
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  Objective   To explore the association between physical activity and sleep quality among middle school students, so as to provide reference for adolescent sleep improvement.   Methods   From September to December 2023, 5 713 middle school students aged 13-18 years were selected from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi and Urumqi by stratified cluster random sampling method. Pittsburgh Sleep Quality Index (PSQI) and Evaluation of Physical Activity Levels of Children and Adolescents Aged 7-18 Years were used to investigate and evaluate sleep quality and physical activity. Comparisons between groups were made using the t-test, Mann-Whitney U test, and associations between physical activity and sleep quality of middle school students were analyzed using Spearman correlation and linear regression methods.   Results   The total PSQI scores were 4.0(2.0, 6.0) and 5.0(3.0, 6.0) for boys and girls, respectively, with significant sex difference (Z=-10.90, P < 0.01); light physical activity(LPA) and moderate to vigorous physical activity(MVPA) of boys were 18.57 (2.86, 42.86) and 68.57 (35.71, 119.18)min, and girls were 14.29 (0.00, 30.00) and 55.71 (31.43, 92.86)min respectively, and the differences were statistically significant (Z=3.65, -8.65, P < 0.01). The results of Spearman correlation regression showed that adolescents' MVPA was negatively correlated with the total PSQI score (r=-0.04, P < 0.01). After controlling for variables such as mental health, nutritional status and maximum oxygen uptake, the results of linear regression analysis showed that PSQI total score negatively predicted MVPA among middle school students (B=-4.76, 95%CI=-7.16 to -2.36, P < 0.05).   Conclusion   The longer the duration of physical activity among middle school students, the better the quality of sleep.
Health Education and Promotion
Analysis of health-related lifestyles among primary and secondary school students in nutrition improvement program regions of China between 2021 and 2023
WANG Xiaoning, YOU Wenshuo, CAO Wei, WANG Hongliang, CHEN Mulei, LUO Ruihe, YANG Titi, LIU Yao, PAN Hui, ZHANG Jianfen, GAN Qian, XU Peipei, ZHANG Qian, XU Juan
2025, 46(6): 788-791. doi: 10.16835/j.cnki.1000-9817.2025178
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  Objective   To analyze the features of unhealthy lifestyle patterns among primary and secondary school students in the nutrition improvement program for rural compulsory education students (NIPRCES) areas in China in 2021 and 2023, so as to provide data support for lifestyle promotion and healthy development among primary and secondary school students.   Methods   Adopting a cluster random sampling method, data on primary and secondary students aged 7-15 years from nutrition and health surveillance of China NIPRCES in 2021 and 2023 were collected. The prevalence of unhealthy lifestyles among primary and secondary students such as physical inactivity, outdoor inactivity, excessive screen time, and sleep deprivation by gender, school section, urban/rural, and region were analyzed. The reporting rates of the above indicators among primary and secondary students were compared by Chi-square test.   Results   In 2021 and 2023, the rates of moderate to vigorous physical inactivity among primary and secondary school students were 79.2% and 80.4%, the rates of outdoor inactivity were 42.8% and 49.3%, the rates of excessive video time were 2.6% and 2.9%, the rates of sleep deprivation were 32.9% and 22.6%, and the differences were statistically significant(χ2=51.86, 1 071.48, 18.36, 3 296.99, P < 0.05). In 2023, the rate of outdoor inactivity for primary and secondary students increased by 6.5 percentage points compared with 2021, and the rate of sleep deprivation decreased by 10.3 percentage points compared with that in 2021. In 2021 and 2023, the reporting rates of moderate to vigorous physical inactivity, outdoor inactivity, and sleep deprivation among girls and junior high school students were higher than those among boys (χ2=174.41, 180.11; 175.75, 85.46;92.22, 151.35) and elementary school students (χ2=136.64, 5.75; 40.55, 4.71;162.80, 3 291.61); the reporting rates of moderate to vigorous physical inactivity(χ2=194.43, 118.60) and sleep deprivation (χ2=969.66, 983.72) among urban students were higher than those among rural students; the reporting rates of excessive video time for boys and junior high school students were higher than those for girls (χ2=103.62, 84.85) and elementary school students (χ2=810.09, 626.51)(P < 0.05). From a regional distribution perspective, the reporting rates of moderato to vigorous physical inactivity, outdoor inactivity, and excessive video time among primary and seconday school students in the central and western regions were lower than those in the eastern region (χ2= 663.44, 302.78; 356.97, 82.10;50.89, 81.83) (P < 0.05).   Conclusions   Unhealthy lifestyles remain prevalent among primary and secondary students in NIPRCES areas of China. These findings underscore the need to strengthen policy implementation for promoting healthy lifestyles among primary and secondary school students.
Impact of transfer cognition on healthy dietary behaviors among Tibetan and Yi ethnic grade 7 students
YU Lan, YUAN Zihao, LIU Qijiao, SHANG Ruizhe, YANG Shuyu, CHEN Zhiwei, LIU Qiaolan
2025, 46(6): 797-801. doi: 10.16835/j.cnki.1000-9817.2025169
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  Objective  To investigate the impact of transfer cognition on healthy dietary behaviors among Tibetan and Yi ethnic junior high school students by analyzing the pathway within the pre-intention phase of the health action process approach (HAPA), so as to provide a basis for developing the intervention of healthy dietary behavior among ethnic minority adolescents.  Methods  A questionnaire on healthy dietary behavior and general conditions was self-designed. From November 2023 to May 2024, a cross-sectional survey was conducted on 1 228 freshmen in junior high school(447 Yi and 781 Tibetan ethnic students) from Lhasa City, Xizang and Liangshan Yi Autonomous Prefecture, Sichuan Province, with a stratified cluster random method. A structural equation model was constructed to analyze the relevant factors of healthy dietary behavior.  Results  The scores for healthy dietary behavior and behavior intention, among Tibetan and Yi adolescents were (35.72±7.43) and (11.71±2.43). The analysis results of the mediation model showed that the direct path of transfer cognitions had no statistical significance on healthy dietary behavior, as well as risk perception on healthy dietary behavior intention [standard path coefficients (95%CI) were 0.07 (-0.01-0.14), 0.04 (-0.04-0.13), P>0.05]; the other direct paths were statistically significant [standard path coefficients (95%CI)=0.15-0.52 (0.04-0.61), P < 0.05]. The mediating effect of transfer cognitions on healthy dietary behavior through healthy dietary behavior intention among Tibetan and Yi junior high school students was 0.06 (95%CI=0.04-0.09), and the chain mediation effect through action self-efficacy and healthy dietary behavior intention on healthy dietary behavior was 0.06 (95%CI=0.04-0.09) (P < 0.01). All mediating effects accounted for 30.6% of the total effect.  Conclusions  Transfer cognitions could not directly influence healthy dietary behavior among Tibetan and Yi junior high school students, but rather exert an indirect effect through multiple pathways in the pre-intentional phase of the HAPA model. Interventions targeting dietary behavior should focus on enhancing adolescents' transfer cognitions.
Analysis of current situation and countermeasures of sex education in special education schools in Luzhou
HAN Shuzhen, WEI Huihui, YANG Wenjie, WANG Yiru, TANG Mingyao, XIAO Mingxia, HUANG Xin, JU Rong, ZHANG Rong
2025, 46(6): 802-805. doi: 10.16835/j.cnki.1000-9817.2025188
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  Objective  To analyze the implementation status and challenges of sex education in special education schools, so as to provide a scientific basis for formulating effective promotion strategies.  Methods  From November 2023 to January 2024, a census survey was conducted among 120 in-service teachers from 7 special education schools in Luzhou. The questionnaire covered the current status of sex education in schools, teachers' attitudes and knowledge toward sex education, and their coping methods for students' inappropriate sexual behaviors.  Results  About 77.5% of teachers reported having provided sex education to students, but 93.2% indicated a lack of specialized sex education textbooks for special children, 90.4% reported no full-time teachers for sex education, and the methods of sex education were relatively limited (50.0% mainly based on lecture method). Nearly 95.8% of teachers held a positive attitude toward sex education, with 98.3% supporting its implementation. Only 26.7% of teachers demonstrated a good grasp of sex education knowledge, with the best-understood topic being "recognition and protection of private parts" (21.6%). When dealing with students' inappropriate sexual behaviors, the active response rate of teachers was 23.9%, with the highest active response rate observed for "intentionally hugging or kissing the opposite sex" (39.7%).  Conclusions  The special education schools in Luzhou lack comprehensive sex education curricula, teaching materials and full-time teachers, sufficient knowledge among teachers, and adequate proactive responses to students' inappropriate sexual behaviors. Greater emphasis should be placed on sex education for special children, including the training of dedicated teachers, to provide comprehensive and high-quality sex education services for special children.
Meta-analysis of physical activity on the improvement of health-related quality of life among children and adolescents
LIU Shanjie, LI Gai, SONG Yunfeng, OUYANG Lingqing, XU Chi
2025, 46(6): 806-810. doi: 10.16835/j.cnki.1000-9817.2025192
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  Objective  To systematically review the effect of physical activity (PA) on health-related quality of life (HRQoL) among children and adolescents and the magnitude of association, so as to provide an evidence-based support for optimizing health promotion strategies for children and adolescents.  Methods  Medline (PubMed), EMBASE, the Cochrane Library, SCIELO, PEDro, CNKI, Wanfang and VIP databases were searched to collect literature on PA and HRQoL in children and adolescents, which were published up to January 1, 2025. Cochrane ROB tool and specific evaluation system were used to assess literature quality, Stata 16.0 software was used for Meta-analysis. For descriptive studies, correlation(r) and 95% confidence interval(CI) were used as effect indicators, and the inverse variance method was used to merge the data. Standardized mean difference(SMD) and 95%CI were used to calculate the combined effect size of intervention studies.  Results  A total of 22 studies involving 27 303 healthy children and adolescents were included, including 9 descriptive studies and 13 intervention studies. The results of descriptive analysis showed that PA level was positively correlated with HRQoL (r=0.27, 95%CI=0.21-0.32, P < 0.01). The analysis of intervention studies showed that PA had significant effects on overall HRQoL (SMD=0.10, 95%CI=0.05-0.16), physical functioning (SMD=0.16, 95%CI=0.08-0.23), and mental functioning (SMD=0.17, 95%CI=0.10-0.25)(P < 0.01). Subgroup analysis found that the effects of physical activity on overall HRQoL, physiological function, and psychological function in children and adolescents were maximized when the intervention duration was less than 6 months (SMD=0.13, 0.18, 0.20), the frequency was≥5 times per week (SMD=0.13, 0.19, 0.24) and there was a supplementary plan(SMD=0.10, 0.18, 0.23)(P < 0.01).  Conclusion  PA is an important factor affecting the HRQoL of healthy children and adolescents, and the systematic PA intervention has a effect on improving the HRQoL.
Relationship between the use of disposable plastic food containers and executive function among primary school students in a district of Chongqing
WANG Wenhe, WU Dan, LIU Shudan, YE Siyan, CUI Chengpeng, LIU Qin
2025, 46(6): 811-815. doi: 10.16835/j.cnki.1000-9817.2025113
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  Objective  To investigate the impact of disposable plastic food container usage on the executive function among primary school students, so as to provide the evidence for the formulation of relevant health policies.  Methods  From November 2023 to May 2024, a convenience sampling method was employed to select 1 118 grade 1-3 students from three primary schools in a central district of Chongqing. A self-developed questionnaire was used to collect demographic characteristics and data on disposable plastic food container usage. Executive function of primary school students was assessed using the Childhood Executive Functioning Inventory (CHEXI). Multivariate linear regression analysis was conducted to explore the associations between disposable plastic food container usage and heating with executive function among primary school students.  Results  Median scores for working memory, inhibition and total executive function among primary school students were 32 (26, 39), 33 (28, 38), and 66 (54, 75), respectively. Multivariate linear regression analysis showed that among girls, higher frequencies of eating meals from plastic lunchboxes were associated with higher CHEXI working memory scores (β=1.29), inhibition scores (β=1.57), and total executive function scores (β=2.85) (P < 0.05). Compared to girls who did not use plastic cups or drank bottled water, those who used plastic cups for drinking or drank bottled water had higher scores in working memory (β=2.63), inhibition (β=2.10), and total executive function (β=4.73); compared to girls who did not eat canned food from metal cans, those who ate such food had higher scores in working memory (β=3.62), inhibition (β=1.89), and total executive function (β=5.50) (P < 0.05).Among boys, higher frequencies of eating meals from plastic lunchboxes were associated with higher inhibition scores (β=1.13) (P < 0.05). Compared to girls who ate with a plastic lunch box and did not heat it when they ate, girls who more frequent heating plastic lunchboxes with food inside had higher working memory scores (β=5.39), inhibition scores (β=4.29), and total executive function scores (β=9.68) (P < 0.05).  Conclusions  The use of disposable plastic food containers may adversely affect executive function of primary school students, with a more pronounced effect observed in girls. Strengthened regulation of disposable plastic products and health education are urgently needed.
Preliminary development with reliability and validity testing of health literacy assessment scale for junior high school students
QI Tiantian, ZHU Fan, ZHU Guiyin, GUO Shihao, YANG Shuang, WU Huiyun, HU Bin, JIANG He, MA Yinghua
2025, 46(6): 816-820. doi: 10.16835/j.cnki.1000-9817.2025164
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  Objective  To develop and validate a health literacy assessment scale for junior high school students, providing an effective tool for evaluating and monitoring health literacy among Chinese adolescents.  Methods  Based on school health education policy documents, a health literacy assessment framework was constructed, comprising five horizontal and four vertical dimensions. From May to June and August to September in 2024, the framework was refined through Delphi expert consultations and focus group discussions, leading to the development of the Health Literacy Assessment Scale for Junior High School Students. In September 2024, a convenience sample of 625 students from three junior high schools in Beijing and Tianjin completed the questionnaire. Item analysis, reliability, and validity tests were conducted to evaluate the scale.  Results  The recovery rate for two rounds of expert consultation questionnaires was 100%. The expert authority coefficients (Cr) were 0.86 and 0.87 respectively (both >0.70), with Kendall W values of 0.34 and 0.27 (P < 0.05). The focus group discussions followed a rigorous structure, and after multiple rounds of item screening and revision, the version 3.0 of the junior high school students' health literacy assessment scale was developed, comprising 57 items. Three items that failed to meet the comprehensive screening criteria were preliminarily removed, and the final scale contained 54 items. The scale demonstrated excellent reliability, with an overall Cronbach's α coefficient of 0.92 and split-half reliability of 0.93. Confirmatory factor analysis [χ2/df=2.094, root mean square error of approximation (RMSEA)=0.042, comparative fit index (CFI)=0.911, Tucker Lewis index (TLI)=0.907] indicated good model fit indices.  Conclusions  The preliminary development of the health literacy assessment scale for junior high school students follows a rigorous item screening process with well-designed dimensions, demonstrating good reliability and validity, thus serving as an appropriate evaluation tool for adolescent health literacy.
Student Nutrition
Iodine nutritional status of children aged 8-10 in Wuhan from 2019 to 2023
WANG Shuai, CHEN Fang, YANG Yan, LUO Huatang, LIU Cong, XU Wenxiu
2025, 46(6): 792-796. doi: 10.16835/j.cnki.1000-9817.2025175
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  Objective  To explore the iodine nutrition status of children in Wuhan from 2019 to 2023, and to evaluate the effect of iodine deficiency disorders control in focus groups in Wuhan, so as to provide a basis for consolidating elimination of iodine deficiency disorders.  Methods  A total of 13 000 non-boarding primary school students aged 8-10 were selected from 13 districts of Wuhan by stratified random sampling method.Household salt samples were collected to measure salt iodine content, random urine samples were analyzed for urinary iodine concentration. And B-ultrasound was used to measure thyroid volume in students. The median of salt iodine, coverage rate of iodized salt, consumption rate of qualified iodized salt, median of urinary iodine, and the goiter rate were calculated. And Mann-Whitney U test, Kruskal-Wallis H test and Chi-square test were applied to compare between groups. Chi-square trend test was used to analyze the changing trends of coverage rate of iodized salt, consumption rate of qualified iodized salt and goiter rate among children in Wuhan.  Results  The median of iodine content of children's household salt was 23.8 (21.7, 26.1) mg/kg, and the coverage rate of iodized salt was 98.7%, and the consumption rate of qualified iodized salt was 94.5%. The consumption rates of qualified iodized salt showed an overall upward trend from 2019 to 2023 (χtrend2=5.57, P < 0.05). The median of urinary iodine of children was 220.1 (136.7, 326.0) μg/L, and boys had higher median of urinary iodine than girls (Z=6.60, P < 0.01). The median of urinary iodine of children in suburbs was higher than those in urban areas (Z=11.00, P < 0.01). A total of 4 600 children were examined for thyroid volume, and the range of goiter rates were 1.1% to 3.4%, with an average goiter rate of 2.5%, which showed an overall downward trend from 2019 to 2023 (χtrend2=5.11, P < 0.05).  Conclusions  The iodine nutrition is sufficient and iodine nutrition status is good among children in Wuhan. It should continue to carry out monitoring and evaluation of children's iodine nutrition, guide the public to supplement iodine scientifically, so as to maintain the appropriate level of iodine for children.
Mental Health
Network analysis of anxiety, depression and perceived stress with eating behaviors in adolescents
HE Jingbo, ZHANG Yiyang, LIAO Baoyi, DENG Xianxian, SUN Mingjun, ZHANG Ziyi, WU Yankun, XIE Jiahong, YAO Yisong, YONG Na
2025, 46(6): 821-826. doi: 10.16835/j.cnki.1000-9817.2025185
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  Objective  To explore the network structure of eating behaviors with anxiety, depression and perceived stress in adolescents, so as to provide a basis for effective prevention and intervention of eating behavior problems and negative emotions in adolescents.  Methods  Based on the Psychology and Behavior Investigation of Chinese Residents (2021) database, the study was conducted among 3 087 adolescents. Sakata Eating Behavior Scale Short From(EBS-SF) was used to investigate their eating behaviors. The Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder Scale-7 Item(GAD-7), and Perceived Stress Questionnaire-3 Item (PSQ-3) were used to evaluate their depression, anxiety and perceived stress. Network analysis method was applied to construct a network of eating behaviors and negative emotional symptoms among adolescents, so as to evaluate the centrality, bridge strength, stability and accuracy of each item.  Results  The total scores of eating behaviors, depression, anxiety and stress perception in adolescents were 17.41±4.53, 6.95±6.08, 4.86±5.03, 9.34±3.80, respectively. The symptom with the highest intensity and expected impact was "I am only satisfied when I buy more food than I need", with a node intensity and expected impact value of 4.37. The nodes Depression and Anxiety were the most closely connected(weight=0.87). There were no statistically significant differences in the network structure(M=0.13, 0.11) and network connection strength(female and male: 4.16, 4.06, s=0.10;urban and rural areas: 4.08, 4.07, s=0.01) between different sexes and residents (P>0.05).  Conclusion  The negative impact of comorbidities such as anxiety, depression, perceived stress and eating behaviors among adolescents can be reduced through targeted prevention and intervention of core symptoms and bridging symptoms.
Correlation between attentional cognitive function and symptoms in school-aged children with attention deficit hyperactivity disorder
DUAN Guiqin, ZHAO Mingfang, WANG Ganyu, YIN Jiabao, NIE Wenhao, JIN Tingting, WANG Xiaoyu
2025, 46(6): 827-831. doi: 10.16835/j.cnki.1000-9817.2025187
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  Objective  To investigate the attention cognitive function and symptom correlations of school-aged children with attention deficit hyperactivity disorder (ADHD)using event-related potential (ERP) technology, so as to provide references for the early diagnosis of children with ADHD.  Methods  A total of 52 school-aged children diagnosed with ADHD at the outpatient department of the Third Affiliated Hospital of Zhengzhou University from September 2022 to September 2024 and 50 age-/sex-matched healthy controls were selected. The ERP experiment adopted the auditory Oddball task to conduct comparative analyses of the amplitude and latency of the mismatch negative(MMN) at the Fz, Cz, and Pz points of the scalp electrode and the P3a component respectively. The symptom assessment scales adopted the Swanson, Nolan, and Pelham-Ⅳ Rating Scale (SNAP-Ⅳ) and the Parent Symptom Questionnaire (PSQ), which were filled out by the parents. Spearman correlation analysis was used to analyze the correlation between ERP components and symptoms in school-aged children with ADHD.  Results  The latency of MMN components in the healthy control group on the Fz lead was (188.30±2.06)ms, and the amplitude was (-15.54±1.35)μV; the latency of the P3a component on the Pz lead was (312.82±7.80)ms, and the amplitude was (3.80±0.18)μV. The latency of MMN components in the ADHD group on the Fz lead was (188.94±1.39)ms, and the amplitude was (-14.78±1.40)μV; the latency of the P3a component on the Pz lead was (317.21±5.65)ms, and the amplitude was (3.70±0.13)μV. Compared with normal children, the MMN of children with ADHD had smaller amplitudes in the Fz and Cz leads, and the P3a had greater latency and smaller amplitudes in the Cz and Pz leads (t=2.79, 2.20;-2.04, -3.25;2.35, 3.21, P < 0.05). Correlation analysis showed that the latency of MMN in children with ADHD was positively correlated with the inattention score in the SNAP-Ⅳ(r=0.22), and the amplitude of MMN was negatively correlated with the inattention score in the SNAP-Ⅳ and the learning problem score in PSQ (r=-0.26, -0.34)(P < 0.05). The latency of P3a was positively correlated with the scores of inattention in the SNAP-Ⅳ and the score of learning problems in the PSQ (r=0.26, 0.24); the amplitude of P3a was negatively correlated with the scores of attention deficit and hyperactivity/impulsivity in the SNAP-Ⅳ and the scores of learning problems and impulsivity/hyperactivity in the PSQ(r=-0.26, -0.22, -0.25, -0.32)(P < 0.05).  Conclusions  School-aged ADHD children exhibit abnormal MMN/P3a components, indicating attention-related cognitive dysfunction. Symptoms such as inattention, learning problems and hyperactivity/impulsivity in children with ADHD are related to abnormal components of MMN and P3a.
Cross-lagged analysis of anxiety and depressive symptoms, uncertainty stress with academic buoyancy in college students
LIU Yuxuan, WANG Yuhao, WANG Yihan, WANG Yingxue, HU Xinyi, TIAN Susu, TIAN Jiayi, WANG Wei
2025, 46(6): 832-836. doi: 10.16835/j.cnki.1000-9817.2025168
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  Objective   To examine the reciprocal relationships of anxiety and depressive symptoms, uncertainty stress with academic buoyancy among college students, providing evidence for mental health promotion and academic resilience enhancement.   Methods   A multi-stage cluster random sampling method was used to selected 741 undergraduates from grade 1 to 2 of a university in Xuzhou, Jiangsu Province. Participants completed two waves of surveys (T1: October 2022; T2: October 2023) using the Uncertainty Stress Scale, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Academic Buoyancy Scale. Cross-lagged models analyzed bidirectional relationships between three mental health variables and academic buoyancy, followed by latent variable modeling integrating all mental health dimensions.   Results   Cross-lagged model results revealed that T1 uncertainty stress negatively predicted T2 academic buoyancy (β=-0.14), while T1 academic buoyancy negatively predicted T2 uncertainty stress (β=-0.11); T1 depressive symptom negatively predicted T2 academic buoyancy (β=-0.08), while T1 academic buoyancy negatively predicted T2 depressive symptom (β=-0.09); furthermore, T1 academic buoyancy negatively predicted T2 anxiety symptom(β=-0.10) (P < 0.05). Results from the latent variable cross-lagged model of psychological problems (constructed from the three mental health variables) indicated that T1 psychological problems negatively predicted T2 academic buoyancy (β=-0.09), while T1 academic buoyancy negatively predicted T2 psychological problems (β=-0.09) (P < 0.05).   Conclusions   Longitudinal bidirectional relationships exist between mental health status and academic buoyancy in college students. Better mental health facilitates higher academic buoyancy.
Association between moderate-to-vigorous physical activity and weight-adjusted waist index with psychological sub-health among middle school students
GAO Xuxiu, ZHANG Jianfeng
2025, 46(6): 837-841. doi: 10.16835/j.cnki.1000-9817.2025179
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  Objective   To examine the association between moderate-to-vigorous physical activity (MVPA) and weight-adjusted waist index (WWI) with psychological sub-health in middle school students, so as to provide a basis for mental health intervention and promotion.   Methods   From September to November 2023, a stratified cluster random sampling method was used to survey 47 372 middle school students aged 12-17 in Jiangsu, Xinjiang, Guangdong, Jilin and Henan provinces from eastern, western, southern, northern and central of China. MVPA, WWI, and psychological subhealth were assessed, with WWI categorized into quartiles (Q1-Q4). Data were analyzed using χ2 test, Logistic regression analysis and Logistic regression analysis of generalized linear models.   Results   The overall prevalence of psychological sub-health among middle school students was 21.0%, with higher rates in boys(21.4%) than girls(20.5%) (χ2=6.49, P < 0.05). The detection rates of emotional problems, behavioral problems and social adaptation difficulties in middle school students were 27.8%, 26.9% and 17.5%, respectively. The combination of MVPA and WWI groups was used as independent variables, and the covariates were adjusted to perform Logistic regression analysis of generalized linear model; while the Q1 group with MVPA>60 min/d was used as the reference group, the Q4 group with MVPA < 30 min/d had the highest risk of psychological sub-health detection(OR=1.58, 95%CI=1.38-1.81), and the detection risks of psychological sub-health among middle school students in Q1-Q3 groups were 1.34(1.17-1.53), 1.30(1.13-1.49) and 1.42(1.24-1.62)(P < 0.01).   Conclusions   MVPA and WWI are significantly associated with psychological sub-health in middle school students. Lower MVPA and higher WWI in middle school students correlate with increased sub-health risks. Interventions should aim to enhance MVPA levels and reduce WWI to improve mental well-being in middle school students.
Association of depressive symptom characteristics with sleep quality and psychological resilience in adolescents
WEI Jialin, MA Zhujiang, ELI Buzohre
2025, 46(6): 842-846. doi: 10.16835/j.cnki.1000-9817.2025176
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  Objective   To explore the latent class characteristics of depressive symptoms in adolescents and their association with sleep quality and psychological resilience, so as to provide references for identifying high-risk groups and developing tiered intervention strategies.   Methods   From March to May 2024, 3 155 students from grade 5-9 of five primary and secondary schools in Shihezi and Changji, Xinjiang, were selected via convenience sampling. Anonymous self-report questionnaires were administered using 10-item Center for Epidemiological Studies Depression Scale (CES-D-10), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and Pittsburgh Sleep Quality Index (PSQI). Latent profile analysis (LPA) was conducted for depressive symptoms, and multivariate Logistic regression models were used to examine associations of latent classes with sleep quality and psychological resilience of adolescents.   Results   The CES-D-10 score of adolescents was 7.0 (4.0, 12.0), and the PSQI score was 5.0 (3.0, 7.0). LPA identified four subgroups: low depressive symptom group (57.7%), moderate depressive-typical symptom group (15.2%), moderate depressive-functional retention group (16.6%) and high depressive symptom group (10.5%). Logistic regression revealed that compared to the low-symptom group, moderate depressive-typical symptom group, moderate depressive-functional retention group and high depressive symptom group exhibited poorer sleep quality (OR=1.54, 1.51, 1.77) and lower psychological resilience (OR=0.94, 0.96, 0.92) (P < 0.05).   Conclusion   Poor sleep quality and insufficient psychological resilience are universal risk factors for adolescent depression, with younger age associated with higher vulnerability.
Analysis of psychological crisis-related factors of college students based on the dual-factor model of mental health
SUN Yujing, YIN Fei, WANG Mingliang, JIANG Wenlong, ZHANG Jing
2025, 46(6): 852-856. doi: 10.16835/j.cnki.1000-9817.2025137
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  Objective   To analyze the current status and influencing factors of psychological crisis among college students, so as to provide a scientific basis for the formulation of psychological crisis intervention plans in colleges and universities.   Methods   From September to December 2024, 645 college students from a medical undergraduate university in Heilongjiang Province were selected with a convenience sampling method. A convergent mixed analysis design was used. Quantitative analysis was conducted using College Students' Psychological Crisis Screening Scale, Emotion Regulation Questionnaire, Short-Egna Minnen av Barndoms Uppfostran and Perceived School Climate Scale. Binary Logistic regression analysis was used to explore the related factors of psychological crisis among college students. Qualitative research was conducted on 15 college students with psychological crisis identified in the quantitative analysis by a purposive sampling method. The interview data were organized and analyzed using the thematic framework analysis method.   Results   Among the surveyed college students, 92 (14.3%) had psychological crisis. Binary Logistic regression analysis results showed that positive parenting style (OR=0.97, 95%CI=0.95-0.99), negative parenting style (OR=1.01, 95%CI=1.00-1.02), cognitive reappraisal (OR=0.88, 95%CI=0.83-0.92), expressive suppression (OR=1.08, 95%CI=1.02-1.15), and perceived campus atmosphere (OR=0.97, 95%CI=0.95-0.98) were all related factors of psychological crisis among college students (P < 0.05). The qualitative analysis results showed that there were three themes for the influencing factors of college students' psychological crisis, including differential impact of emotion regulation strategies on psychological state, shaping of psychological state of college students by family and bidirectional effect of perceived campus atmosphere on psychological state. Mixed analysis results showed that the influencing factors of college students' psychological crisis were consistent in terms of emotion regulation strategies, and were expansive in terms of parenting style and perceived campus atmosphere.   Conclusion   Schools and mental health service departments can reduce the risk of psychological crisis by optimizing cognitive reappraisal and reducing expressive suppression, improve the level of psychological crisis by strengthening positive family interaction and blocking negative parenting style, and maintain the mental health level of college students by building a supportive campus environment and alleviating high pressure.
Disease Control
Association between physical activity and inflammatory markers in college students
JIANG Tangjun, LI Tingting, TAO Shuman, ZOU Liwei, YANG Yajuan, TAO Fangbiao, WU Xiaoyan
2025, 46(6): 847-851. doi: 10.16835/j.cnki.1000-9817.2025186
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  Objective   To analyze the association and dose-response relationship between physical activity and inflammatory markers in college students, so as to provide a reference for promoting cardiometabolic health in college students.   Methods   A cluster random sampling method was used to select 747 college students from two universities in Hefei, Anhui Province and Shangrao, Jiangxi Province from April to May 2019. Physical activity was assessed by using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), and peripheral blood was collected to detect plasma inflammatory factor levels [including hypersensitive C-reactive protein (hsCRP), interleukin-10 (IL-10), interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)]. The differences between the groups were compared by using the χ2 test and the Kruskal-Wallis rank sum test, and the association between physical activity and inflammatory markers was analyzed by using the Generalized Linear Model. The dose-response relationship between physical activity and inflammatory markers was analyzed using the Restricted Cubic Spline Model.   Results   The proportions of low physical activity, moderate physical activity, and high physical activity groups of college students were 15.9%, 53.7% and 30.4%, respectively. The levels of hsCRP, IL-10, IL-1β, IL-6 and TNF-α in the high physical activity group were 0.38(0.21, 1.10)mg/L, 70.74(47.90, 116.43)pg/mL, 1.75(1.21, 2.64)pg/mL, 4.33(2.93, 6.82)pg/mL, 5.27(3.89, 7.30)pg/mL, the levels in the low physical activity group were 0.80(0.31, 1.30)mg/L, 73.88(47.90, 124.24)pg/mL, 1.88(1.42, 2.81) pg/mL, 4.82 (3.64, 6.67) pg/mL, 5.63 (4.34, 7.62)pg/mL, the levels in the moderate physical activity group were 0.63(0.25, 1.30)mg/L, 89.78(58.21, 127.65)pg/mL, 2.21(1.59, 3.27)pg/mL, 5.15(3.72, 7.72)pg/mL, 5.87(4.63, 8.00)g/mL, and the differences were statistically significant (H=10.66, 11.38, 27.79, 14.13, 9.44, P < 0.05). After adjusting for variables such as gender, body mass index, smoking, alcohol consumption and health status, the results of Generalized Linear Model showed that compared with the high physical activity group, the low physical activity group (OR=2.20, 95%CI=1.46-3.31) and the moderate physical activity group (OR=1.65, 95%CI=1.22-2.25) were more likely to have high levels of hsCRP, and the moderate physical activity group was more likely to have high levels of IL-1β (OR=1.85, 95%CI=1.36-2.51), IL-6 (OR=1.44, 95%CI=1.06-1.96), and TNF-α (OR=1.43, 95%CI=1.05-1.94) (P < 0.05). The Restricted Cubic Spline Model showed that there was no linear dose-response relationship between the time of moderate-to-vigorous physical activity weekly and IL-10, IL-6, II-1β, and TNF-α (P < 0.05).   Conclusion   There is an association between physical activity and inflammation in college students, and moderate to high intensity per week could reduce inflammation levels to promote cardiometabolic health in college students.
Elevated blood pressure and its association with dietary patterns among Chinese children and adolescents aged 7-17 years
YOU Wenshuo, GUO Qiya, CAO Wei, YANG Titi, XU Peipei, GAN Qian, PAN Hui, WANG Xiaoning, YANG Zhenyu, ZHANG Qian, ZHAO Wenhua, XU Juan
2025, 46(6): 863-867. doi: 10.16835/j.cnki.1000-9817.2025191
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  Objective   To understand the prevalence of elevated blood pressure and its association with dietary patterns in children and adolescents in China, providing evidence for developing dietary intervention of hypertension in children and adolescents.   Methods   Data were derived from the China Children's Nutrition and Health System Survey and Application Project(2019-2021). A stratified cluster random sampling method was used to include 7 933 participants from 28 survey sites in seven major regions of Northeast, North, Northwest, East, Central, South and Southwest China. Multivariate Logistic regression models were used to analyze associations between demographic characteristics, nutritional status and elevated blood pressure. Exploratory factor analysis identified dietary patterns, which were divided into three quartile groups (T3, T2, T1) based on factor scores (compliance for dietary pattern) from high to low, and multivariate Logistic regression model assessed the correlation between elevated blood pressure and dietary patterns.   Results   The prevalence of elevated blood pressure was 15.4% among Chinese children aged 7-17 years. Significant differences were observed across nutritional status (reference: underweight; normal weight: OR=1.57; overweight: OR=2.61; obesity: OR=3.85), urban/rural residence (reference: rural; urban: OR=0.86), and paternal education (reference: junior high school and below; bachelor degree or above: OR=0.68) (P < 0.05). The detection rates of high blood pressure in T3 group children and adolescents with four dietary patterns (staple food, animal based food, snacks, vegetables and fruits) were 15.7%, 14.6%, 16.8%, and 15.8%, respectively. After adjusting for residence, paternal education, and nutritional status, the "snack dietary pattern" (mainly candy, sugar-sweetened beverages, and processed snacks) showed positive associations with elevated blood pressure in T2 (OR=1.21) and T3 (OR=1.19) tertiles (P < 0.05).   Conclusions   The snack dietary pattern is a related factor for elevated blood pressure in children and adolescents. Restricting unhealthy snack intake may promote cardiovascular health.
Risk assessment analysis of infectious disease prevention and control in schools of Shangcheng District, Hangzhou
YAO Ying, YU Kuangming, SUN Jiayi, JIANG Siqing, WANG Hui
2025, 46(6): 868-872. doi: 10.16835/j.cnki.1000-9817.2025165
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  Objective   To establish a risk assessment system for infectious disease prevention and control in schools in Shangcheng District, Hangzhou and determine risk levels for each school, and propose corresponding risk management measures, so as to provide a scientific reference for infectious disease prevention and control in primary and secondary schools.   Methods   Based on the Failure Mode and Effects Analysis (FMEA) method, potential failure analysis and current situation investigation of infectious disease prevention and control risks were conducted in 110 primary and secondary schools from 2022 to 2024 in Shangcheng District, Hangzhou. Risk levels were classified using K-Means cluster analysis.   Results   Through expert panel discussions using FMEA, 6 first-level indicators and 28 second-level indicators were identified. The top three risk priority numbers were implementation of required prevention and control measures for clustered infectious disease outbreaks in schools in the past three years (189.00), student morning/afternoon health checks (168.00), and reporting status of clustered infectious disease outbreaks in schools in the past three years (144.00). The comprehensive prevention scores of schools ranged from 61.00 to 98.00 (mean: 87.40). There were no statistically significant differences in the average scores(primary school: 88.17±7.39, nine-year consistent education: 86.26±7.68, junior high school: 85.55±8.20, and high school: 88.72±4.91) and risk level distribution of schools with different educational stages(F/H=0.95, 1.47, P>0.05).K-Means cluster analysis divided the schools into 5 risk levels with cluster centers at 93.25, 85.78, 79.69, 70.29, 61.00 (F=309.21, P < 0.05), with 80% of schools classified as low-risk or below.   Conclusion   The infectious disease prevention and control risk assessment system for primary and secondary schools can be established, and hierarchical management can be conducted according to school risk levels, thereby improving the efficiency and effectiveness of school infectious disease prevention and control, and enhancing the precision and sustainability of prevention efforts.
Analysis of factors influencing insufficient hyperopia reserve and refractive parameters in preschool children in Hefei
ZHANG Bolin, ZHANG Shanshan, WAN Qianqian, TONG Min, LÜ Pingping, WANG Ke, SHI Huijing
2025, 46(6): 873-877. doi: 10.16835/j.cnki.1000-9817.2025162
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  Objective   To investigate the current status of refractive errors and insufficient hyperopia reserve in preschool children aged 3-6 years in Hefei and to analyze influencing factors, so as to provide a scientific basis for formulating targeted myopia prevention policies and comprehensive interventions.   Methods   In May 2022, a stratified cluster random sampling method was used to select 897 preschool children from 8 kindergartens across four districts (Baohe, Yaohai, Shushan, and Economic and Technological Development Zone) in Hefei, and Children's Visual Health-related Behavior Assessment Scale was used to collect personal information and environmental factors. Pre- and post-cycloplegic refraction tests were conducted to assess insufficient hyperopic reserve and refractive development levels. Group comparisons were conducted using χ2 test, t-test or analysis of variance. Multivariate regression analysis was performed to identify key factors influencing hyperopic reserve, axial length and spherical equivalent in preschool children.   Results   The detection rates of refractive errors among preschool children were 6.8% for hyperopia, 1.6% for myopia, and 11.1% for astigmatism. Notably, the prevalence of myopia was significantly higher in boys (2.3%) than in girls (0.7%) (χ2=3.88, P < 0.05). Additionally, 8.8% of the children exhibited insufficient hyperopic reserve. The results of multiple regression analysis showed that preschool children with high myopia in the father, high myopia in the mother, longer daily duration of near work, and longer daily electronic product use time had increased risks of axial growth (β=0.12, 0.09, 0.15, 0.11), SE reduction (β=-0.10, -0.07, -0.18, -0.13), and insufficient hyperopic reserve (OR=1.87, 2.22, 1.40, 1.28) (P < 0.05). While, preschool children with longer sleep time and daily outdoor activity duration had lower risks of axial growth (β=-0.11, -0.10), SE reduction (β=0.39, 0.51), and insufficient hyperopia reserve (OR=0.54, 0.51) in preschool children (P < 0.05).   Conclusions   The rates of refractive errors and insufficient hyperopia reserve in preschool children in Hefei are relatively low, which are influenced by many factors. Parents, kindergartens and relevant departments should implement early vision monitoring and intervention for preschool children, and cultivate their scientific eye-use habits.
Investigation on an outbreak of acute hemorrhagic conjunctivitis at a boarding middle school in Guangdong Province
LUO Lixian, ZENG Biao, YI Yao, WENG Jiaxi, WAN Liwei, YE Zheng, TAN Chunrong, KANG Min, ZHANG Yingtao
2025, 46(6): 878-882. doi: 10.16835/j.cnki.1000-9817.2025158
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  Objective   To investigate the characteristics and risk factors of an outbreak of acute hemorrhagic conjunctivitis (AHC) in a boarding middle school in Guangdong Province, in order to provide a scientific evidence for effective prevention and control of campus AHC outbreaks.   Methods   From September 1st to 28th 2023, case identification was conducted among 559 students and 60 faculty members using standardized definition. Descriptive analysis was conducted on the three distrubution patterns of the outbreak. Questionnaires were designed, and a case-control study was adopted to analyze the possible risk factors of the disease transmission. The propensity score matching (PSM) method was used to control the difference of baseline data.   Results   A total of 269 cases of AHC were identified, with an attack rate of 43.46%. The pathogen was confirmed as Coxsackie virus A24 variant (CA24v). Among these, 264 cases were students (attack rate of 47.23%) and 5 were staff (attack rate of 8.33%). A total of 153 pairs of PSM were successfully matched. After PSM matching, there were no statistically significant differences in gender, grade and class between the case group and the control group (χ2=0.12, 5.41, 11.24, P>0.05). The results of multivariate Logistic regression analysis showed that middle school students whose towels contacted with others (OR=1.81), and direct contact with other AHC cases recently (OR=4.89) were more likely to have AHC; while wearing glasses (OR=0.43) and frequent use of hand sanitizer (OR=0.37) were less likely to have AHC (P < 0.05).   Conclusion   The outbreak of AHC is caused by CA24v, demonstrating rapid spread and extensive impact within the school setting.
Incremental effectiveness of two-dose of mumps-containing vaccine in chidren
MA Bingxin, JIN Yuhui, WU Qile, SUN Hui, WANG Yao, CHEN Yafei, ZHU Xinyu, PAN Fan, ZHANG Huan, SONG Jian, QIN Wei
2025, 46(6): 883-887. doi: 10.16835/j.cnki.1000-9817.2025177
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  Objective   To evaluate the incremental vaccine effectiveness (VE) of two-dose of the mumps-containing vaccine (MuCV) in chidren, so as to provide a basis for optimizing mumps immunization strategies.   Methods   A 1∶2 frequency-matched case-control study was conducted by using reported mumps cases in childcare centers or schools from Lu'an, Hefei, Ma'anshan and Huainan cities of Anhui Province from September 1, 2023 to June 30, 2024, as a case group(383 cases). And healthy children in the same classroom were selected as a control group(766 cases). The MuCV immunization histories of participants were collected to estimate the incremental VE of the second dose of MuCV against mumps. Group comparisons were performed using the Chi-square test or t-test. For matched case-control pairs, the Cox regression model was employed to calculate the odds ratio (OR) with 95% confidence interval (CI) for two-dose MuCV vaccination and to estimate the incremental vaccine effectiveness (VE).   Results   There were no statistically significant differences between the case and control groups regarding gender, age, dosage of MuCV vaccination and the time interval since the last dose vaccination(χ2/t=0.05, 0.20, 0.94, -0.02, P>0.05). The proportions of the case and control groups vaccinated with two doses of MuCV were 26.63% and 29.37%, respectively, and the overall incremental VE of the second dose of MuCV was 40.73% (95%CI=3.03%-63.77%, P < 0.05). Subgroup analyses revealed that the incremental VE for children with a period of ≥1 year between the two doses of MuCV was 54.13% (95%CI=1.90%-78.56%, P < 0.05), while for children with a period of < 1 year, it was 30.63% (95%CI=-28.59%-62.58%, P>0.05). The incremental VE of the second dose of MuCV was 30.36% (95%CI=-25.95%-61.50%, P>0.05) in kindergarten children and 66.73% (95%CI=14.92%-86.99%, P < 0.05) in elementary and secondary school students. The incremental VE was 28.78% (95%CI=-27.46%-60.21%, P>0.05) within five years of the last dose of MuCV vaccination and 66.07% (95%CI=-41.56%-91.87%, P>0.05) for vaccinations administered beyond five years.   Conclusions   The second dose of MuCV may offer additional protection for children; however, extending the interval between two-dose of MuCV (< 1 year) has shown limited incremental protective effects. Therefore, it is crucial to consider optimizing current immunization strategies for mumps.
Association between polymorphisms in the glucose metabolism and lipid regulation genes with metabolic abnormalities in childhood obesity
XIA Zhiwei, GONG Zhaolong, LIU Tingting, WANG Lu, ZHAO Hai, SUN Bingjie, LI Yan, YIN Jiyong, HUO Junsheng
2025, 46(6): 888-893. doi: 10.16835/j.cnki.1000-9817.2025172
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  Objective   To explore the association between CDKAL1 rs35261542, FAIM2 rs3205718, and VGLL4 rs2574704 polymorphisms with childhood obesity and related metabolic phenotypes to provide evidence for personalized prevention and management strategies.   Methods   Based on the 2023 Long-term Nutritional Health Effects of Early Childhood Nutrition Package Intervention project, the study enrolled 1 078 children aged 5-7 years from four counties in Henan (Songxian and Ruyang countries) and Guizhou (Guiding and Fuquan countries) provinces. Using BMI Z-scores, 87 overweight and obese(OVOB) children were selected and matched by sex, age, and BMI Z-score with 117 normal-weight controls. Participants were further stratified into four metabolic phenotype groups: metabolically healthy normal weight (MHNW, n=51), metabolically unhealthy normal weight (MUNW, n=66), metabolically healthy obesity (MHO, n=31) and metabolically unhealthy obesity (MUO, n=56) based on four conventional cardiometabolic risk factor (CR) criteria. Data were collected through questionnaires, anthropometric measurements, serum biochemical tests, and KASP genotyping. The distribution of three genetic polymorphisms (CDKAL1 rs35261542, FAIM2 rs3205718, VGLL4 rs2574704) across metabolic subgroups was analyzed. Multivariate Logistic regression models assessed associations between these polymorphisms and obesity/metabolic phenotypes.   Results   Multivariate Logistic regression analysis showed that Homozygous mutant AA genotype of CDKAL1 rs35261542 was positively associated with OVOB(OR=3.63), MHO (OR=11.04), MUO (OR=4.88) (P < 0.05). Homozygous TT genotype of FAIM2 rs3205718 increased OVOB risk (OR=4.44, P < 0.05) but showed no association with metabolic phenotypes (P>0.05). Homozygous mutant TT of VGLL4 rs2574704 reduced the risks of MHO and MUO (OR=0.30, 0.24, P < 0.05). Cumulative genetic effects analysis demonstrated carriers of 1 or 2 risk genotypes of rs35261542 and rs3205718 had progressively higher OVOB risk (OR=2.53, 20.79), and the combination of rs35261542 and rs2574704 increased risks for both MHO (OR=8.50) and MUO (OR=5.00) (P < 0.05).   Conclusions   The AA genotype of rs35261542 (CDKAL1) positively correlates with childhood obesity and metabolic abnormalities. The TT genotype of rs3205718 (FAIM2) increases obesity risk but not metabolic phenotypes. The TT genotype of rs2574704 (VGLL4) shows protective effects against metabolic dysfunction. Risk genotypes exhibit dose-dependent cumulative effects on obesity and metabolic outcomes.
Construction of quality control evaluation indicators for common diseases surveillance among students
CUI Mengjie, MENG La, MA Qi, XING Yi
2025, 46(6): 894-898. doi: 10.16835/j.cnki.1000-9817.2025171
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  Objective   To construct a quality control evaluation indicator system for the surveillance of common diseases among students, so as to provide a reference for the quality control of surveillance projects.   Methods   Based on literature review and expert interviews, a preliminary framework and candidate indicators were developed from June to August in 2024. Twenty domain experts participated in two rounds of Delphi consultations conducted via email, providing importance ratings, judgment basis, familiarity levels, and feasibility assessments for each indicator. And a quality control evaluation indicator system for the surveillance of common diseases among students was ultimately constructed.   Results   The consulted experts aged 33-53, with an average age of (45.25±5.03) years, were from government health administration departments(n=1), centers for disease control and prevention at different levels(n=16), academic and research institutions(n=3). Their work experience in school health-related fields ranged from 6 to 33 years, with an average of (16.70±8.25) years. The activeness of experts in both rounds of consultation was 100%, the mean expert authority coefficient was 0.90, and the mean feasibility evaluation was 0.75. Kendall's W test showed that the expert coordination coefficient for the first round was 0.26, and for the second round, it was 0.33 (P < 0.01). After two rounds of expert consultation, a set of quality control evaluation indicators for the surveillance of common diseases among students was ultimately constructed, including 6 first-level indicators, 19 second-level indicators, and 37 third-level indicators.   Conclusion   The scientifically developed evaluation indicator system facilitates high-quality implementation of student common disease surveillance programs.
Joint effect of sitting posture habits and screen viewing distance on screening myopia among primary school students
ZHAO Ruilan, PENG Tao, ZHEN Guoxin, ZHAO Fangfang, LI Li, SONG Qingqing, ZHU Fan, MA Yinghua
2025, 46(6): 903-907. doi: 10.16835/j.cnki.1000-9817.2025161
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Abstract:
  Objective   To explore the association of screening myopia and sitting posture habits as well as screen viewing distance among primary school students, providing a scientific basis for myopia prevention and intervention among primary school students.   Methods   From April to June 2024, a convenient sampling method was used to enroll 1 394 fourth-grade students from four primary schools in a district of Beijing for vision examinations and questionnaire surveys. Logistic regression models were employed to analyze the relationship of screening myopia detection and sitting posture habits as well as viewing distance.   Results   The screening myopia prevalence among primary school students was 63.8%. About 13.1% of students self-reported poor sitting posture, and 47.1% self-reported a viewing distance of ≤20 cm. After adjusting for covariates including age, gender, school, sleep quality, parental myopia status, physical fitness level, daily high-intensity physical activity, weekend outdoor activity time and types of after-school services, Logistic regression analysis showed that students with poor sitting posture were more likely to have screening myopia than those with normal sitting posture (OR=1.73, 95%CI=1.03-2.92); students with a viewing distance of ≤20 cm were more likely to have screening myopia than those with a viewing distance of >20 cm(OR=1.32, 95%CI=1.02-1.71)(P < 0.05). The association between sitting posture and screening myopia was more significant among boys(OR=2.00, 95%CI=1.03-3.88, P < 0.05). A multiplicative interaction was observed between sitting posture and viewing distance. Compared to primary school students with normal posture and a viewing distance of >20 cm, those with poor posture and a viewing distance of >20 cm were more likely to have screening myopia (OR=1.82, 95%CI=1.12-2.96, P < 0.05).   Conclusions   Both sitting posture habits and screen viewing distance are related to screening myopia in primary school students. Poor sitting posture poses a higher risk than screen distance, and the two factors exhibit an interactive effect on myopia risk.
Growth, Development and Surveillance
Analysis of physical fitness test results for freshmen with different nutritional status at Civil Aviation University of China from 2014 to 2024
SHEN Shunfa, PENG Ziye, CHEN Xuedong, LI Huichao, ZHAO Kun, PEI Zhengcun
2025, 46(6): 857-862. doi: 10.16835/j.cnki.1000-9817.2025190
Abstract(35) HTML (19) PDF(5)
Abstract:
  Objective   To analyze the status and trends of physical fitness test data among college freshmen with different body mass index (BMI) groups from 2014 to 2024, providing the scientific evidence for monitoring and intervening in college students' physical health.   Methods   A census was conducted on all 67 949 freshmen at Civil Aviation University of China from 2014 to 2024. Physical tests included vital capacity, sit-and-reach, sit-ups, 50 m sprint, standing long jump, pull-ups, and 800 m/1 000 m run. Freshmen were divided into underweight, normal weight, overweight and obese groups according to WHO BMI standards. The Kruskal-Wallis H test was used to compare differences in physical fitness indicators across gender and BMI groups, while the Mann-Kendall trend test was employed to detect upward or downward trends in physical indicators over time.   Results   From 2014 to 2024, statistically significant differences were observed in vital capacity, 50 m sprint, standing long jump, and sit-and-reach among different BMI groups for both genders (boy: Z=2 396.40, 4 160.33, 4 662.23, 531.85; girl: Z=593.37, 308.86, 499.37, 128.70). Significant differences were also found in 1 000 m run and pull-ups for boys, and 800 m run and sit-ups for girls across BMI groups (boy: Z=6 574.80, 6 880.48; girl: Z=528.56, 146.18) (P < 0.01). Overall physical test scores showed a declining trend during 2014-2024, particularly pronounced in overweight and obese groups. Male vital capacity in 2014 exceeded national survey data(d=320 mL), with the gap widening to 734 mL by 2019, while the female vital capacity difference increased from 271 mL in 2014 to 576 mL in 2019. Male 1 000 m run times were 23.0 s and 17.5 s faster than national data in 2014 and 2019 respectively, while female 800 m run times were 22.3 s and 21.5 s faster than corresponding national data.   Conclusions   Physical health status among freshmen at this university varies across BMI groups and changes over time. Although overall test scores remain higher than national levels, the declining trend in physical fitness performance requires attention.
Review
Research progress on refractive screening methods for children and adolescents
CHEN Qiwen, FANG Jing
2025, 46(6): 899-902. doi: 10.16835/j.cnki.1000-9817.2025166
Abstract(36) HTML (16) PDF(6)
Abstract:
Myopia is the most common type of refractive error. In recent years, the onset of myopia has shown a trend towards younger ages, making vision screening and myopia prevention among children and adolescents particularly significant. The study reviews the effectiveness and limitations of various vision screening protocols, including ciliary muscle paralysis optometry, combined uncorrected visual acuity and non-cycloplegic auto-refraction, axial length to corneal radius of curvature, as well as Suresight and Spot vision screening devices, to offer a scientific foundation for the future enhancement of vision health screening and improvement among Chinese children and adolescents.
Research progress on the influencing factors and intervention strategies for adolescent nutritional literacy
JI Ying, LI Wencui, YERASL Erzat, YU Zhilei, JING Sihan, ZHU Jingfen
2025, 46(6): 908-912. doi: 10.16835/j.cnki.1000-9817.2025163
Abstract(47) HTML (24) PDF(15)
Abstract:
Nutritional literacy is an important component of health literacy and closely related to adolescents' dietary habits and health conditions. Improving nutrition literacy not only helps adolescents to make healthier dietary choices but also aids in disease prevention. The article systematically reviews the individual and environmental factors influencing adolescent nutrition literacy, with a focus on exploring innovative intervention strategies based on traditional school interventions, new media platforms and virtual reality technology, so as to provide a theoretical foundation and practical guidance for improving the nutrition literacy and overall health of Chinese adolescents.

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