Objective: To understand the emotional and behavioral problems among preschool children in Ezhou city, and to analyze its association with screen time,to provide a reference for making preventive measures. Methods: 1 720 children were selected from 9 kindergartens in Ezhou by cluster sampling method. Questionnaires were completed by the children’s parents or primary caregivers. Results: High total difficulty score accounted for 9.8%(169/1 720) of all participants,the abnormal proportion of peer communication problems is the highest. The average screen time was (1.95±1.88) hours, among them 2.6% spent more than 2 hours. The average screen time on weekends was (2.84±2.58) hours, among them 19.1% spent more than 2 hours. The results of multiple linear regression analysis showed that weekday, weekend and total screen times was associated with children’s total difficulty score, emotional problems, conduct problems, peer interaction and hyperactivity(P<0.05). Furthermore, with the duration of screen time increased, the susceptibility of emotional and behavioral problems in these four dimensions increased. Conclusion Screen time is associated with emotional and behavioral problems among preschool children. Schools and parents should pay attention to interventions that target family TV viewing practices, and parent-child interaction and communication.

Objective: To investigate the underlying influential factors related to emotional overeating behavior among college students,and to provide a reference for formulating intervention strategies for prevention of unhealthy eating behavior of college students. Methods: A questionnaire designed based on the social ecosystem theory was used to assess the potential influential factors of at personal, social, physical and macro level emotional overeating behavior of 2 045 college students. The Emotional Overeating Questionnaire was used to measure the frequency of emotional overeating behavior among normal weight college students. Binary Logistic regression analysis was performed to analyze the association between dietary norms and the influence emotional overeating behaviors. Results: In the full adjusted model, dietary norms (OR=1.28,95%CI=1.16-1.41)，emotion scale (OR=1.46, 95%CI=1.24-1.73) and close friends attitude(OR=0.75, 95%CI=0.59-0.95)were associated with emotional overeating behaviors. Sex, urban and rural origin, monthly living expenses, parental attitude, distance to frequent fast food restaurants outside the school, and the unmarked proportion of nutritional content and calorie information on food packaging were not associated with emotional overeating behaviors (P>0.05). Conclusion Dietary norms and emotion scale might increase the risk of motional overeating, close friends attitude might reduce the risk of emotional overeating. For reducing the frequency of unhealthy eating behavior, our results implied that 1) it s necessary to improve mental health of the college students; strengthening health education in order to make them distinguish the unhealthy dietary norms is important; peer education might be effective.

Objective To explore the relation between coping style and critical thinking among nursing students in order to provide the powerful evidence for instructing nursing students to take the correct coping style so as to improve their critical thinking .Methods Sixty-three nursing students in Grade 2010 in School of Nursing, Jilin University were surveyed by critical thinking disposition inventory ( CTDI-CV) and simple coping style questionnaire (SCSQ).Results The average score of CTDI-CV was (278.35 ±33.14) in the nursing students, and the percent of students with less than 280 was 58.73%, and the percent of students with 280 to 350 was 36.51%, and the percent of students with more than 350 was 4.76%.The score of positive coping styles in the nursing students was (1.86 ±0.626), and was higher than that of the national norm , and the difference was not statistically significant (t =0.207,P>0.05).The score of negative coping styles in the nursing students was (1.18 ±0.566), and was lower than that of the national norm , and the difference was statistically significant (t=-5.745,P <0.01).Nursing undergraduates positive coping style was positively correlated with CTDI-CV scores ( P<0.05), negative coping styles and negatively correlated with CTDI-CV scores (P<0.01).Negative coping style and the critical mind all dimensions are in different degree of negative correlation, positive coping styles and open mind , systematic ability, self-confidence were positively correlated (P<0.01).Conclusions Developing positive coping styles in the nursing students can improve their critical thinking .

Objective To investigate the relationship between serum thyrotrophin(TSH)and dyslipidemia in subclinical hypothyroid and euthyroid subjects. Methods An epidemiological study on diabetes and thyroid diseases was performed in Dadong community, Shenyang city, in 2007. 110 subjects with subclinical hypothyroidism(SCH)and 1 240 euthyroid subjects were enrolled in the study. Neither history of thyroid diseases nor administration of thyroid-related and lipid-regulating medicines were reported in these subjects. The levels of serum thyroid hormones, lipids, fasting plasma glucose(FPG), and insulin were determined. Results (1)Patients with SCH had significantly lower HDL-C levels than those who were euthyroid.(2)According to the guideline of treatment of adult dyslipidemia in China, the lipid profiles were each categorized. Mean TSH levels were higher in subjects in the dyslipidemia subclass than subjects in the normal subclass. The differences were significant in high LDL-C subclass in overweight individuals. In euthyroid overweight women, mean TSH levels were significantly higher in high LDL-C subclass. In the euthyroid population, TSH was positively associated with total cholesterol in overweight population. The association was not modified by the homestasis model assessment for insulin resistance(HOMA-IR)values.(3)TSH was associated positively with serum triglycerides and negatively with serum HDL-C in women. TSH was positively associated with total cholesterol in overweight population and positively associated with total cholesterol and LDL-C in overweight women after adjustment for age, sex, and body mass index. Conclusion Raised serum TSH seems to be a risk factor of dyslipidemia in subclinical hypothyroid and euthyroid subjects, which is independent of insulin sensitivity.

Objective:To identify the risk factors for early neurological complications after revascularization in adult patients with moyamoya disease.Methods:The medical records of patients of both sexes with moyamoya disease, aged 18-65 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, who underwent revascularization in our hospital from January 2017 to June 2019, were retrospectively collected.According to the occurrence of early postoperative neurological complications, patients were divided into early postoperative neurological complication group and non-early postoperative neurological complication group.The factors such as patient′s age, gender, preoperative clinical symptoms, previous history of hypertension, history of diabetes, history of coronary heart disease, American Society of Anesthesiologists physical status, methods of anesthesia, type of operation, anesthesia time, time for start of operation, operation time, intraoperative urine volume, times of intraoperative vasoactive drugs used, and time of the post-anaesthesia observation room (PACU) stay were collected.Logistic regression analysis was used to identify the risk factors for postoperative early neurological complications.Results:A total of 510 adult patients with moyamoya disease underwent revascularization were enrolled in this study, and the incidence of early postoperative neurological complications was 9.0%.The results of logistic regression analysis showed that preoperative ischemia, intraoperative use of vasoactive drugs more than 3 times and PACU stay time>90 min were risk factors for postoperative neurological complications ( P<0.05). Conclusion:Preoperative ischemia, intraoperative use of vasoactive drugs >3 times and PACU stay time>90 min are risk factors for early neurological complications after revascularization in the patients with moyamoya disease.

To study the carriage status of drug susceptibility, clonal complex groups, serotypes, surface proteins and virulence genes of Streptococcus agalactiae from respiratory specimen sources. A total of 35 strains of S.agalactiae meeting the criteria were collected from 3 hospitals in 2 locations, Tangshan and Jinan. The age span of the patients was 3 days-92 years, and the percentage of elderly patients≥60 years was 71.5%.The susceptibility to 9 antimicrobial drugs was measured and analyzed using the micro broth dilution method. The strains were 100.0% sensitive to penicillin, linezolid, vancomycin, and ceftriaxone; However, it exhibits high resistance rates to erythromycin, clindamycin and levofloxacin, at 97.1%, 85.7% and 82.9% respectively; and the resistance rates to tetracycline and chloramphenicol were 34.3% and 14.2%, respectively. Genome sequence determination and analysis showed that 16 resistance genes were detected in 35 strains, among which: macrolide and lincosamide resistance genes were mainly ermB, with a carrying rate of 74.2%; tetracycline resistance genes were mainly tetM, with a carrying rate of 25.7%; in addition, the mutation rates of the quinolone resistance determinants gyrA and parC were 88.5% and 85.7%, respectively. 35 strains belonged to 6 ST types and 4 clonal groups, with CC10/ST10 as the main one, accounting for 62.8%; they contained 4 serotypes of Ⅰb, Ⅱ, Ⅲ, and Ⅴ, as well as 1 untyped strain, with serotype Ⅰb as the main one, accounting for 65.7%. The strains carried three pilus types, PI1+PI2a, PI2a and PI2b types, respectively, and detected five surface proteins, alpha, alp1, rib, srr, and r df_0594, and seven virulence factors, cba, cfb, cylE, fbsA, hylB, l mb, and pavA. Overall, S.agalactiae isolated from respiratory tract specimens is predominantly sourced from elderly patients, with CC10 strains being most prevalent. These strains harbor multiple drug-resistant and virulence genes, demonstrating elevated resistance rates to macrolides, lincosamides, and quinolones. This emphasizes the necessity for vigilant attention to the health threat posed by S. agalactiae from respiratory tract speciments of elderly patients.

Objective To analyze the influencing factors of mechanical phlebitis(MP)during peripherally inserted central catheterization(PICC)in very/extremely low birth weight infants(VLBWI/ELBWI)in neonatal Intensive Care Unit(NICU).Methods The clinical data of VLBWI/ELBWI who underwent PICC catheterization were retrospectively analyzed.Multivariate Logistic regression model was used to analyze the influencing factors of MP.Results The incidence of MP after implementa-tion of PICC in VLBWI/ELBWI was 26.1％(116/444).Univariate analysis showed that the position of catheter tip,catheter vein,gestational age,body mass at birth,gestational age when cathetering,body mass when cathetering,puncture times and length were influencing factors for MP in VLBWI/ELBWI(P＜0.05).Multivariate Logistic regression analysis showed that abnormal position ofcathe-ter tip(OR=2.526;95％CI,1.532 to 4.164)and puncture times ≥ 2 times(OR=1.952;95％CI,1.017 to 3.747)were independent risk factors.Conclusion The abnormal catheter tip position and the number of puncturing ≥2 times increase the risk of mechanical phlebitis in VLBWI/ELBWI after PICC.Early intervention should be taken as soon as possible to avoid the occurrence of MP so as to relieve infants'pain and improve the quality of clinical care.

To study the carriage status of drug susceptibility, clonal complex groups, serotypes, surface proteins and virulence genes of Streptococcus agalactiae from respiratory specimen sources. A total of 35 strains of S.agalactiae meeting the criteria were collected from 3 hospitals in 2 locations, Tangshan and Jinan. The age span of the patients was 3 days-92 years, and the percentage of elderly patients≥60 years was 71.5%.The susceptibility to 9 antimicrobial drugs was measured and analyzed using the micro broth dilution method. The strains were 100.0% sensitive to penicillin, linezolid, vancomycin, and ceftriaxone; However, it exhibits high resistance rates to erythromycin, clindamycin and levofloxacin, at 97.1%, 85.7% and 82.9% respectively; and the resistance rates to tetracycline and chloramphenicol were 34.3% and 14.2%, respectively. Genome sequence determination and analysis showed that 16 resistance genes were detected in 35 strains, among which: macrolide and lincosamide resistance genes were mainly ermB, with a carrying rate of 74.2%; tetracycline resistance genes were mainly tetM, with a carrying rate of 25.7%; in addition, the mutation rates of the quinolone resistance determinants gyrA and parC were 88.5% and 85.7%, respectively. 35 strains belonged to 6 ST types and 4 clonal groups, with CC10/ST10 as the main one, accounting for 62.8%; they contained 4 serotypes of Ⅰb, Ⅱ, Ⅲ, and Ⅴ, as well as 1 untyped strain, with serotype Ⅰb as the main one, accounting for 65.7%. The strains carried three pilus types, PI1+PI2a, PI2a and PI2b types, respectively, and detected five surface proteins, alpha, alp1, rib, srr, and r df_0594, and seven virulence factors, cba, cfb, cylE, fbsA, hylB, l mb, and pavA. Overall, S.agalactiae isolated from respiratory tract specimens is predominantly sourced from elderly patients, with CC10 strains being most prevalent. These strains harbor multiple drug-resistant and virulence genes, demonstrating elevated resistance rates to macrolides, lincosamides, and quinolones. This emphasizes the necessity for vigilant attention to the health threat posed by S. agalactiae from respiratory tract speciments of elderly patients.

Objective To analyze the influencing factors of mechanical phlebitis(MP)during peripherally inserted central catheterization(PICC)in very/extremely low birth weight infants(VLBWI/ELBWI)in neonatal Intensive Care Unit(NICU).Methods The clinical data of VLBWI/ELBWI who underwent PICC catheterization were retrospectively analyzed.Multivariate Logistic regression model was used to analyze the influencing factors of MP.Results The incidence of MP after implementa-tion of PICC in VLBWI/ELBWI was 26.1％(116/444).Univariate analysis showed that the position of catheter tip,catheter vein,gestational age,body mass at birth,gestational age when cathetering,body mass when cathetering,puncture times and length were influencing factors for MP in VLBWI/ELBWI(P＜0.05).Multivariate Logistic regression analysis showed that abnormal position ofcathe-ter tip(OR=2.526;95％CI,1.532 to 4.164)and puncture times ≥ 2 times(OR=1.952;95％CI,1.017 to 3.747)were independent risk factors.Conclusion The abnormal catheter tip position and the number of puncturing ≥2 times increase the risk of mechanical phlebitis in VLBWI/ELBWI after PICC.Early intervention should be taken as soon as possible to avoid the occurrence of MP so as to relieve infants'pain and improve the quality of clinical care.

Objective To explore the influencing factors of visual acuity recovery in patients with high myopia after posterior chamber phakic intraocular lens(ICL)implantation.Methods A prospective study was conducted on 210 pa-tients(420 eyes)with high myopia who underwent ICL implantation at the Second Affiliated Hospital of Zhengzhou Univer-sity from May 2021 to March 2023.The patients were divided into a good recovery group[best corrected visual acuity(BC-VA)recovery ≥0.3 D]and a poor recovery group(BCVA recovery＜0.3 D)based on their visual acuity recovery status three months after surgery.The baseline data of patients in the two groups were compared,and the factors affecting visual acuity recovery were analyzed using Logistic regression.The receiver operating characteristic(ROC)curve was used to an-alyze the predictive value of the Logistic regression model for poor visual acuity recovery in patients with high myopia after ICL implantation.Results Three months after surgery,149 patients(298 eyes)were in the good recovery group,and 61 patients(122 eyes)were in the poor recovery group.There were no significant differences in gender,age,years of myopi-a,body mass index,and academic performance between the two groups(all P＞0.05).The proportions of patients with corneal astigmatism＜1.30 D(55.74％),corneal diopter＜45 D(59.02％),Pittsburgh Sleep Quality Index(PSQI)＜7 points(63.93％),and average central radius of curvature[(7.82±0.27)mm]in the poor recovery group were lower than those in the good recovery group[83.89％,81.88％,85.91％,and(7.90±0.24)mm,respectively].The central flat me-ridian curvature(k1)of the anterior corneal surface[(43.27±1.43)D],steep meridian curvature(k2)of the anterior corneal surface[(44.84±1.53)D],and arch height[(628.49±67.28)μm]in the poor recovery group were higher than those in the good recovery group[(42.73±1.42)D,(44.12±1.47)D],and[(417.56±80.14)pm],with significant differences(all P＜0.05).Logistic regression analysis showed that corneal astigmatism,corneal diopter,k1,k2,arch height,and PSQI score were independent influencing factors of poor visual acuity recovery after ICL implantation in pa-tients with high myopia(all P＜0.05).ROC curve analysis showed that the area under the ROC curve for predicting poor visual acuity recovery after ICL implantation in patients with high myopia by Logistic regression model was 0.938(95％CI:0.896-0.966),the sensitivity was 83.61％,and the specificity was 91.95％(P＜0.05).Conclusion The visual acuity recovery after ICL implantation in patients with high myopia is affected by corneal astigmatism,corneal diopter,k1,k2,arch height,and PSQI score.The Logistic regression model based on these factors has high predictive value for visual acui-ty recovery after ICL implantation.