ObjectiveTo investigate the current status and related factors of maternal influenza vaccination willingness among pregnant and postpartum women in Shanghai and Liaoning Province, China, and to explore the facilitators and barriers affecting vaccination uptake, so as to provide references for future practices in promoting maternal influenza immunization in China. MethodsA convergent mixed-methods research was conducted. From January to March 2024, a questionnaire survey was conducted among women attending prenatal and postnatal care at 7 medical institutions in Shanghai and Dalian, Liaoning Province, which aimed to assess pregnant women’s knowledge about influenza vaccine and their willingness to vaccination during pregnancy, as well as to identify the related factors. In addition, purposive sampling method was used to conduct in-depth interviews with pregnant women and perinatal healthcare service providers to explore their perspectives on influenza vaccination during pregnancy, including the reasons for their willingness or unwillingness to receive ( or recommend) the vaccine, and the relevant facilitators and barriers to vaccination. ResultsA total of 366 pregnant and postpartum women participated in the questionnaire survey, and 9.56% (35/366) of them were willing to receive the influenza vaccine during pregnancy. The results of multivariate logistic stepwise regression analyses showed that primipara (aOR=0.158, 95%CI: 0.037‒0.671, P=0.012), family members’ support for influenza vaccination during pregnancy (aOR=0.015, 95%CI: 0.003‒0.082, P<0.001) were associated with higher willingness to receive influenza vaccine during pregnancy. Absence of influenza infection during pregnancy (aOR=5.383, 95%CI: 1.801‒16.092, P<0.001), and lack of knowledge regarding influenza vaccination during pregnancy (aOR=11.294, 95%CI: 3.593‒35.496, P<0.01) were associated with lower willingness to receive influenza vaccine during pregnancy. Qualitative findings indicated that the facilitators to vaccination willingness among pregnant and postpartum women included the recommendation of healthcare service providers, adequate knowledge of influenza vaccine information and family members’ support for vaccination. Conversely, the barriers to vaccination willingness included low recommendation from the healthcare service providers, lack of knowledge about the safety of influenza vaccine during pregnancy and inadequate attention to influenza and influenza vaccine. ConclusionThe willingness to receive influenza vaccination among pregnant and postpartum women in Shanghai and Liaoning Province is relatively low. It is recommended that China should promptly improve the evidence-based system for the safety and efficacy of influenza vaccines for pregnant and postpartum women, along with an establishment of the mechanism for addressing adverse reactions. Furthermore, it is essential to enhance educational outreach to pregnant and postpartum women, their families, and healthcare service providers, thereby increasing the accessibility of information regarding influenza vaccination, which are expected to enhance the willingness of pregnant and postpartum women to receive the vaccine.

Objective: To investigate the prevalence and influencing factors of depression among middle school students in Jiading District, Shanghai Municipality, so as to provide the evidence for developing mental health intervention strategies among middle school students. Methods: Students from 3 junior high schools and 3 senior high schools in Jiading District were selected from June 2022 to June 2023 using a stratified random cluster sampling method. Basic information including gender and educational stage was collected through questionnaire surveys. Depression, mental health literacy, cognitive emotion regulation, family cohesion, school climate, stress, and life satisfaction were assessed using the Children's Depression Inventory, the Mental Health Literacy Assessment Scale, the Chinese version of the Cognitive Emotion Regulation Questionnaire, the Family Adaptability and Cohesion Scale, the Perceived School Climate Scale, Depression-Anxiety-Stress Scale, and the Life Satisfaction Scale, respectively. Factors affecting depression among middle school students were analyzed using a multivariable logistic regression model. Results: There were 1 117 boys (53.94%) and 954 girls (46.06%), with a mean age of (15.20±1.77) years. There were 1 193 (57.61%) junior high school students and 878 (42.39%) senior high school students. Depression was detected in 577 students, with a prevalence of 27.86%. Multivariable logistic regression analysis identified gender (boy, OR=0.652, 95%CI: 0.512-0.832), educational stage (senior high school, OR=2.519, 95%CI: 1.584-4.008), mental health literacy (OR=0.958, 95%CI: 0.951-0.966), cognitive emotion regulation (adaptive cognitive emotion regulation strategies, OR=0.970, 95%CI: 0.958-0.982; maladaptive cognitive emotion regulation strategies, OR=1.103, 95%CI: 1.084-1.123), family cohesion (OR=0.910, 95%CI: 0.899-0.921), school climate (OR=0.720, 95%CI: 0.694-0.747), stress (OR=1.127, 95%CI: 1.104-1.150), life satisfaction (OR=0.817, 95%CI: 0.799-0.836) as factors affecting depression among middle school students. Conclusions Depression among middle school students in Jiading District is associated with gender, educational stage, mental health literacy, cognitive emotion regulation, family cohesion, school climate, stress, and life satisfaction. It is recommended that targeted measures be taken from the perspectives of individuals, families, schools, and society to promote the mental health of middle school students.

OBJECTIVES: Osteoarthritis (OA) is one of the most common chronic degenerative diseases, with chondrocyte apoptosis and extracellular matrix (ECM) degradation as the major pathological changes. The mechanical stimulation can attenuate chondrocyte apoptosis and promote ECM synthesis, but the underlying molecular mechanisms remain unclear. This study aims to investigate the role of primary cilia (PC) in mediating the effects of mechanical stimulation on OA progression. METHODS: In vivo, conditional knockout mice lacking intraflagellar transport 88 (IFT88^flox/flox IFT88 knockout; i.e., primary cilia-deficient mice) were generated, with wild-type mice as controls. OA models were established via anterior cruciate ligament transection combined with destabilization of the medial meniscus, followed by treadmill exercise intervention. OA progression was evaluated by hematoxylin-eosin staining, safranin O-fast green staining, and immunohistochemistry; apoptosis was assessed by TUNEL staining; and limb function by rotarod testing. In vitro, primary articular chondrocytes were isolated from mice and transfected with lentiviral vectors to suppress IFT88 expression, thereby constructing a primary cilia-deficient cell model. Interleukin-1β (IL-1β) was used to induce an inflammatory environment, while cyclic tensile strain (CTS) was applied via a cell stretcher to mimic mechanical loading on chondrocytes. Immunofluorescence and Western blotting were used to detect the protein expression levels of type II collagen α1 chain (COL2A1), primary cilia, IFT88, and caspase-12; reverse transcription polymerase chain reaction was performed to assess COL2A1 mRNA levels; and flow cytometry was used to evaluate apoptosis. RESULTS: In vivo, treadmill exercise significantly reduced Osteoarthritis Research Society International (OARSI) scores and apoptotic cell rates, and improved balance ability in wild-type OA mice, whereas IFT88-deficient OA mice showed no significant improvement. In vitro, CTS inhibited IL-1β-induced ECM degradation and apoptosis in primary chondrocytes; however, this protective effect was abolished in cells with suppressed primary cilia expression. CONCLUSIONS Mechanical stimulation delays OA progression by mediating signal transduction through primary cilia, thereby inhibiting cartilage degeneration and chondrocyte apoptosis.
Animals ; Chondrocytes/cytology* ; Apoptosis/physiology* ; Mice ; Cilia/metabolism* ; Osteoarthritis/pathology* ; Extracellular Matrix/metabolism* ; Mice, Knockout ; Disease Progression ; Interleukin-1beta ; Male ; Cells, Cultured

Objective:To explore the influence and mechanism of perceived school climate on life satisfaction of junior high school students.Methods:From June to September 2022, students in sixth, seventh and eighth grade of junior high school were surveyed by the perceived school climate scale, the family cumulative risk-related questionnaire, the cognitive emotion regulation strategy questionnaire and the life satisfaction scale.SPSS 25.0 software was used to process data and the macro program PROCESS 4.1 was used for model testing.Results:(1) The total scores of perceived school climate, negative cognitive emotion regulation strategy, life satisfaction and family cumulative risk were 83.00(19.00), 21.00(8.00), 23.00(9.00) and 1.00(2.00), respectively.(2) Perceived school climate was significantly and negatively correlated with negative cognitive emotion regulation strategy and family cumulative risk( r=-0.30, -0.40, both P<0.01), while significantly and positively correlated with life satisfaction ( r=0.51, P<0.01).Negative cognitive emotion regulation strategy was significantly and negatively correlated with life satisfaction ( r=-0.37, P<0.01), while significantly and positively correlated with family cumulative risk ( r=0.29, P<0.01). Family cumulative risk was significantly and negatively correlated with life satisfaction ( r=-0.45, P<0.01). (3) Negative cognitive emotion regulation strategy played a mediating role between perceived school climate and life satisfaction, and the mediating effect accounted for 13.46%(0.07/0.52) of the total effect. (4) Family cumulative risk played a moderating role in the relationship between perceived school climate and life satisfaction, and between perceived school climate and negative cognitive emotion regulation strategy. Specifically, as the level of family cumulative risk decreased, the positive predictive effect of perceived school climate on life satisfaction significantly increased ( βsimple=0.42, P<0.001). Perceived school climate significantly and negatively predicted negative cognitive emotion regulation strategy under the condition of low level family cumulative risk ( βsimple=-0.30, P<0.001). Conclusion:Under the condition of low family cumulative risk in junior high school students, the perceived positive school climate can help reduce negative cognitive emotion regulation strategy, thereby improving life satisfaction.

Objective:To explore the influence and mechanism of perceived school climate on life satisfaction of junior high school students.Methods:From June to September 2022, students in sixth, seventh and eighth grade of junior high school were surveyed by the perceived school climate scale, the family cumulative risk-related questionnaire, the cognitive emotion regulation strategy questionnaire and the life satisfaction scale.SPSS 25.0 software was used to process data and the macro program PROCESS 4.1 was used for model testing.Results:(1) The total scores of perceived school climate, negative cognitive emotion regulation strategy, life satisfaction and family cumulative risk were 83.00(19.00), 21.00(8.00), 23.00(9.00) and 1.00(2.00), respectively.(2) Perceived school climate was significantly and negatively correlated with negative cognitive emotion regulation strategy and family cumulative risk( r=-0.30, -0.40, both P<0.01), while significantly and positively correlated with life satisfaction ( r=0.51, P<0.01).Negative cognitive emotion regulation strategy was significantly and negatively correlated with life satisfaction ( r=-0.37, P<0.01), while significantly and positively correlated with family cumulative risk ( r=0.29, P<0.01). Family cumulative risk was significantly and negatively correlated with life satisfaction ( r=-0.45, P<0.01). (3) Negative cognitive emotion regulation strategy played a mediating role between perceived school climate and life satisfaction, and the mediating effect accounted for 13.46%(0.07/0.52) of the total effect. (4) Family cumulative risk played a moderating role in the relationship between perceived school climate and life satisfaction, and between perceived school climate and negative cognitive emotion regulation strategy. Specifically, as the level of family cumulative risk decreased, the positive predictive effect of perceived school climate on life satisfaction significantly increased ( βsimple=0.42, P<0.001). Perceived school climate significantly and negatively predicted negative cognitive emotion regulation strategy under the condition of low level family cumulative risk ( βsimple=-0.30, P<0.001). Conclusion:Under the condition of low family cumulative risk in junior high school students, the perceived positive school climate can help reduce negative cognitive emotion regulation strategy, thereby improving life satisfaction.

ObjectiveTo understand the acceptance of sex-related behaviors， sexual safety awareness， and refusal skills among junior high school students and conduct association analysis， and to provide a reference for the implementation of sex and reproductive health education for adolescents. MethodsA questionnaire survey related to knowledge of sexual and reproductive health was conducted among 478 students from two junior high schools in Jiading District， Shanghai. ResultsThe pass rate for sex and reproductive health knowledge among junior high school students was only 36.6%， with acceptance rates for dating， watching pornography， engaging in sexual behavior， pregnancy， and artificial abortion at 24.5%， 11.1%， 5.6%， 4.8%， and 5.9%， respectively. Binary logistic regression analysis showed that students who passed the sexual and reproductive health assessment had a significantly lower acceptance rate of sex-related behaviors than those who did not （aOR=1.666， 95%CI： 1.124‒2.470， P=0.011）. Adolescents with a passing knowledge of sexual and reproductive health （aOR=1.607， 95%CI： 1.060‒2.438， P=0.026） or a lower acceptance of sex-related behaviors （aOR=4.199， 95%CI： 2.804‒6.289， P<0.001） had higher awareness of sexual safety. Adolescents with a passing knowledge of sexual and reproductive health （aOR=1.691， 95%CI： 1.066‒2.684， P=0.026）， a lower acceptance of sex-related behaviors （aOR=1.756， 95%CI： 1.130‒2.729， P=0.012）， or higher awareness of sexual safety （aOR=2.872， 95%CI： 1.826‒4.516， P<0.001） had stronger skills to refuse sex-related behaviors. ConclusionSexual and reproductive attitudes， sexual safety awareness， and refusal skills for sex-related behaviors among junior high school students in Jiading District need to be improved. Schools should focus on cultivating adolescents’ sexual and reproductive knowledge and related skills， and advocate for relevant institutions to provide appropriate sexual healthcare services to meet their needs for reproductive healthcare.

ObjectiveTo understand the utilization of preconception healthcare services and the influencing factors among the women expecting additional childbirth in Jiading District， Shanghai， and to provide references for promoting the utilization of preconception healthcare services under the new population policy. MethodsA questionnaire survey on the utilization of preconception healthcare services and related influencing factors was carried out among 682 women expecting additional childbirth across six subdistricts in Jiading District， Shanghai. The results were statistically analyzed. ResultsThe average age of the women was （31.7±4.5） years， 30.2% of whom were ≥35 years old. The proportion of women having their third or subsequent children was low， at 16.4%. A significant majority， 92.4%， were found to have various risk factors during initial pregnancy screening. The utilization rate of preconception healthcare services among women seeking additional childbirth was relatively low at 26.7%. Awareness of the free preconception check-up program in Jiading District was also low at 28.6%， and the utilization rate for these services was even lower at 7.69%. Unplanned pregnancies were the primary reason for not utilizing preconception healthcare services， accounting for 63.6%. The results of multifactorial binary logistic regression analysis showed that the utilization rate of preconception healthcare services before the current pregnancy was higher for women aged between 35 and 39 compared to women aged ≤29 years old （OR=1.789， 95%CI： 1.033‒3.099）. Women with planned pregnancies had a higher utilization of preconception healthcare services prior to this pregnancy （OR=4.164， 95%CI： 2.627‒6.602）. Women who had received preconception care prior to their first birth had a higher utilization rate of preconception care prior to the current pregnancy （OR=7.534， 95%CI： 4.954‒11.456）. Women without a family history of chronic diseases had a higher utilization rate of preconception healthcare services （OR=1.903， 95%CI： 1.083‒3.345）. ConclusionUnder the context of three-child policy， the proportion of women seeking three or more children in Jiading District is low. Most of these women have risk factors identified during initial pregnancy screenings. The utilization rate of preconception healthcare services and the awareness of the free preconception screening program in Jiading District are both low. Unplanned pregnancies remain the primary reason for failing to receive timely preconception healthcare services. Age， whether the pregnancy was planned， whether the women had received preconception healthcare services before their first baby and family history of chronic diseases are the main factors affecting the utilization of preconception healthcare services. Relevant departments should enhance the promotion of preconception healthcare service programs， especially for women of childbearing age who have not yet given birth， so as to improve the utilization rate of preconception health care services.

Objective:To analyze the health system appeal orders from Beijing 12345 citizen service hotline, for references for further promoting the efficient implementation of swift response to publis complaints in Beijing.Methods:12345 citizen service hotline orders received by Beijing health system from 2021 to 2023 were collected. The spatial and temporal distribution of orders and its appeal text were analyzed. Unit root test and cointegration test were used to determine the correlation between the number of effective appeal orders and the number of notifable disease cases in Beijing. Pearson correlation analysis was used to analyze the correlation between the number of effective appeal orders received by tertiary hospitals and their medical service volume.Results:From 2021 to 2023, there were 252.6 thousand valid orders with an increasing trend year by year; There was a time series correlation( P<0.001) between the number of orders and the number of notifable disease cases. There were 231.8 thousand effective appeal orders for tertiary hospitals, which were densely distributed in Xicheng District, and their quantity was positively correlated with the medical service volume of tertiary hospitals( P<0.001). The most common type of work order was medical service management(215.5 thousand items), and the number of orders related to patient experience and performance evaluation of tertiary hospitals had been increasing year by year. Conclusions:The number of work orders in the health system from the 12345 citizen service hotline in Beijing had been increasing year by year, and the number of orders were effected by the volume of public health emergencies and medical services provided by tertiary hospitals; The classification of demands in existing work orders was not detailed enough. It was recommended to strengthen departmental linkage, establish early warning and response mechanisms, formulate refined classification standards for orders, and accurately assess potential demands. Moreover, it was necessary to focus on the patient, move the gate of " Handling Complaints Immediately" forward, truly realize the handling complaints before they are filed and proactive governance, and promote high-quality development of health field.

Objective:To analyze the health system appeal orders from Beijing 12345 citizen service hotline, for references for further promoting the efficient implementation of swift response to publis complaints in Beijing.Methods:12345 citizen service hotline orders received by Beijing health system from 2021 to 2023 were collected. The spatial and temporal distribution of orders and its appeal text were analyzed. Unit root test and cointegration test were used to determine the correlation between the number of effective appeal orders and the number of notifable disease cases in Beijing. Pearson correlation analysis was used to analyze the correlation between the number of effective appeal orders received by tertiary hospitals and their medical service volume.Results:From 2021 to 2023, there were 252.6 thousand valid orders with an increasing trend year by year; There was a time series correlation( P<0.001) between the number of orders and the number of notifable disease cases. There were 231.8 thousand effective appeal orders for tertiary hospitals, which were densely distributed in Xicheng District, and their quantity was positively correlated with the medical service volume of tertiary hospitals( P<0.001). The most common type of work order was medical service management(215.5 thousand items), and the number of orders related to patient experience and performance evaluation of tertiary hospitals had been increasing year by year. Conclusions:The number of work orders in the health system from the 12345 citizen service hotline in Beijing had been increasing year by year, and the number of orders were effected by the volume of public health emergencies and medical services provided by tertiary hospitals; The classification of demands in existing work orders was not detailed enough. It was recommended to strengthen departmental linkage, establish early warning and response mechanisms, formulate refined classification standards for orders, and accurately assess potential demands. Moreover, it was necessary to focus on the patient, move the gate of " Handling Complaints Immediately" forward, truly realize the handling complaints before they are filed and proactive governance, and promote high-quality development of health field.

Objective     To investigate the safety and feasibility of day surgery for patients with palmar hyperhidrosis based on the principles of enhanced recovery after surgery (ERAS). Methods     We retrospectively reviewed the medical records of consecutive patients who underwent endoscopic thoracic sympathicotomy (ETS) in the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to December 2021. Patients were divided into a day surgery group and a conventional group according to their perioperative management methods. The patients in the day surgery group underwent an optimized perioperative procedure under the guidance of ERAS, and were ventilated with a laryngeal or face mask during the operation. The patients in the conventional group completed the preoperative examination, operation and postoperative observation according to the conventional procedures, and were intubated with a single-lumen endotracheal tube. The demographic characteristics, operation time, hospital stay, postoperative complications, and hospitalization cost were compared between the two groups. Results     Finally 172 patients were collected, including 90 males and 82 females, with an average age of 25.97±7.43 years. There were 86 patients in each group. All patients ceased suffering from palmar sweating after surgery. No patient experienced massive bleeding or conversion to thoracotomy. There was no statistical difference in operation time between the two groups (P=0.534). Patients in the day surgery group were discharged within 24 hours. The average hospital stay in the conventional group was 2.09±0.41 days. Incidence of postoperative respiratory complications, and the hospitalization cost of the day surgery group were significantly lower than those of the conventional group (P<0.001). The satisfaction rate in both groups was greater than 95%. Conclusion     Day surgery for patients with palmar hyperhidrosis based on the principles of ERAS is safe and feasible, which can reduce postoperative complications, shorten the length of hospital stay and save the cost of hospitalization.