Objective To obtain different fragments of human carboxypeptidase H,and evaluate the diagnostic application of the recombination carboxypeptidase H in detecting autoantibody.Methods The coding gene of carboxypeptidase H was ob-tained by RT-PCR.The corresponding prokaryotic expression vectors were constructed and transformed into E.coli to in-duce the expression of the recombination different fragments of carboxypeptidase H.Using these antigen fragments as the coating antigens,the enzyme-linked immunosorbent assay (ELISA)was established for the detection of carboxypeptidase H autoantibody in 95 newly diagnosed type 2 diabetes patients.Results Three fragments of human carboxypeptidase H were obtained,in which the 42~476aa fragment antigen was ideal one.Using the full-length carboxypeptidase H as coating anti-gen,the positive rate of carboxypeptidase H autoantibody was 8.42%.Conclusion Because of the favorable antigenicity,the 42~476aa fragment antigen of carboxypeptidase H could be the candidate antigen for discrimination and diagnosis of latent autoimmune diabetes in adults.

Objective:To explore the effect of goal-oriented rehabilitation nursing in patients with thoracolumbar fracture.Methods:From April 2019 to April 2021, 109 patients with thoracolumbar fracture admitted to the Shandong Provincial Third Hospital were selected as the study subject by convenience sampling. The patients admitted from April 2019 to April 2020 were set as the control group ( n=57) , and the patients admitted from May 2020 to April 2021 were set as the observation group ( n=52) . The patients in the control group received routine rehabilitation management, while the patients in the observation group received goal-oriented rehabilitation nursing on the basis of the control group. The hospitalization time, the inidence of complications and lower limb motor function before and after intervention were compared between the two groups. Results:The hospitalization time of patients in the observation group was shorter than that in the control group, and the incidence of complications was lower than that in the control group, and the differences were statistically significant ( P<0.05) . After the intervention, the lower limb motor function score of the patients in the observation group was higher than that of the control group, with a statistically significant difference ( P<0.05) . Conclusions:The goal-oriented rehabilitation nursing in patients with thoracolumbar fracture can shorten the rehabilitation time, improve limb function, and reduce the risk of complications.

Objective To investigate the mediating role of physical activity and negative psychological state be-tween sleep quality and cognitive function in stroke patients.Methods A total of 119 patients who were admitted and di-agnosed with acute ischemic stroke(AIS)in Zibo Central Hospital from January 2021 to December 2022 were selected,and a self-made scale was used to conduct a questionnaire survey.A Pearson correlation analysis was used to investigate the correlation of physical activity and negative emotions with sleep quality and cognitive function,and the hierarchical re-gression method was used to investigate the mediating role of physical activity and negative emotions.Results The 117 patients had a Pittsburgh Sleep Quality Index of(8.39±1.20).There were significant differences between the two groups in sex,age,physical activity score,Hospital Anxiety and Depression Scale score,and Montreal Cognitive Assessment Scale score(P<0.05).The Pearson correlation analysis showed that sleep quality score was negatively correlated with physical activity score and cognitive function score(r=-0.677 and-0.750,P<0.001)and was positively correlated with negative emotion score(r=0.585,P<0.001).The hierarchical regression analysis showed that physical activity and nega-tive emotions had a mediating role between sleep quality and cognitive function(P<0.05).Conclusion AIS patients have poor sleep quality after 30 days.There is a good correlation between sleep quality and physical activity/negative emo-tions/cognitive function,and physical activity and negative emotions plays a mediating role between sleep quality and cogni-tive function.

Objective To explore the application effect of multi-component home-based exercise in elderly patients with osteoporosis and frailty.Methods A total of 52 elderly patients with osteoporosis and frailty were recruited from the osteoporosis clinic of a tertiary hospital in Nanjing,Jiangsu Province from March to August 2022 using the convenience sampling method.Subjects were randomly divided into an experimental group and a control group with 26 cases in each group by the random number table.The experimental group was given the home-based exercise program,while the control group maintained the daily lifestyle.Short Physical Performance Battery(SPPB),grip strength,Frail Scale and Chinese Osteoporosis-targeted Quality of Life Questionnaire(COQOL)of the 2 groups were compared at 12 weeks and 24 weeks,and bone mineral density(BMD)was analyzed after 24-week intervention.Results The scores in the experimental group had significant statistical differences in SPPB,grip strength,Frail Scale and COQOL compared with those in the control group after 12-week and 24-week intervention(P＜0.05).The BMD of total hip of the experimental group was significantly higher than it in the control group(P＜0.05).Conclusion The home-based exercise program can help the elderly with osteoporosis and frailty to improve the physical function and upper body strength,improve the frailty state,and enhance the quality of life,and it may be one of the effective intervention methods to prevent and reverse the frailty state of osteoporosis patients.

Objective: To describe the epidemiological characteristics and clinical manifestations of the 2019 coronavirus disease (COVID-19) in pediatric patients, and to provide data support and decision-making basis for the prevention and control of COVID-19. Methods: Cases of children aged 0-17 years reported by provincial health commissions in Anhui, Shandong, Zhejiang and Henan provinces were collected to analyze their spatial, temporal, and demographic distribution. Results: By 24:00 on February 6, 2020, a total of 107 pediatric patients had been reported in the four provinces, accounting for 3.8% (107/2 808) of the total cases reported in the four provinces during the same period. Anhui, Shandong, Zhejiang and Henan provinces had 25, 25, 28 and 29 cases, respectively. Cases ranged in age from 5 days after birth to 17 years, with a median age of 8 years. Boys accounted for 58.9%. Totally 38 cases had a history of sojourn in Wuhan or Hubei, 63 cases had a history of exposure to confirmed cases, and 6 cases with unknown exposure history. A group of 52 family clustering were found in 107 cases. All cases presented mild symptoms, no serious and no death. Conclusion Children were also susceptible to the COVID-19. Before February 2, the index pediatric cases were mainly the first generation cases, and after February 3, these pediatric cases were mainly the secondary-generation cases and those who had close contact with confirmed cases. The monitoring of children with secondgeneration cases and close contact with COVID-19 cases were valued.

Objective To investigate the prevalence of skin diseases in pre-school children aged 0-7 years in cities of China.Methods From November 2014 to April 2015,12 cities were chosen as survey spots,and pre-school children aged 0-7 years served as respondents.A population-based study was conducted,and 40 vaccination clinics and 80 kindergartens were selected by stratified random sampling.A questionnaire survey and dermatological examination were performed by trained dermatologists.Results A total of 20 033 pre-school children received questionnaires,whose age was 2.41 ± 1.82 years (range,0.08-6.83 years).Among these respondents,7 823 children were found to have skin diseases,with the total prevalence of skin diseases being 39.05％ (7 823/20 033).Additionally,the prevalence of skin diseases reported in the 12 cities from high to low was as follows:66.96％ (612/914,Dalian),56.73％ (2 310/4 072,Shanghai),55.49％ (556/1 002,Wuhan),49.18％ (390/793,Taiyuan),47.16％ (316/670,Chengdu),41.93 ％ (566/1 350,Nanjing),41.03％ (318/775,Chongqing),35.98％ (240/667,Hefei),33.87％ (677/1999,Shenzhen),31.37％ (554/1 766,Changsha),23.52％ (1 107/4 706,Beijing),13.42％ (177/1 319,Shenyang).Totally,40 kinds of skin diseases were investigated,and the 10 most common skin diseases were eczema/infantile eczema/atopic dermatitis (18.71％,3 749/20 033),ichthyosis vulgaris(6.25％,1 253/20 033),lichen pilaris (5.73％,1 148/20 033),diaper dermatitis (5.29％,1 059/20 033),papular urticaria(5.25％,1 052/20 033),hemangioma/vascular malformation (3.86％,774/20 033),pityriasis alba (3.45％,691/20 033),infectious skin diseases (2.59％,519/20 033),urticaria(1.71％,344/20 033)and contact dermatitis (0.5％,100/20 033).Conclusion The total prevalence of skin diseases among pre-school children in cities of China is 39.05％,and eczema/atopic dermatitis is the most common skin disease.

Objective To investigate the resistance development of Aedes albopictus to commonly used insecticides in Yangpu District of Shanghai， China， and to provide scientific bases for the control of A. albopictus and the emergency treatment of dengue fever. Methods The larva immersion method recommended by WHO was used to assay the median lethal concentration （LC₅₀） of A. albopictus larva. SPSS 25.0 was used to calculate the toxicity baselines of insecticides. Results A. albopictus kept a medium resistance to beta-cypermethrin， and the resistance ratios were 14.44， 10.00， 17.78， respectively， in 2015， 2017， 2019. The mosquitos kept a high resistance to permethrin， and the resistance ratios were 54.00， 140.00， 52.00 respectively， in 2015， 2017， 2019. Besides， A. albopictus also kept a medium resistance to propoxur， and the resistance ratios were 15.34， 13.06， 10.83 respectively， in 2015， 2017， 2019. To deltamethrin， A. albopictus showed high resistance in 2015 and medium resistance in 2017， the resistance ratios were 40.00 and 35.00. To temephos， A. albopictus showed low resistance in 2015， with the resistance ratio of 9.38. Conclusion A. albopictus has developed high resistance to permethrin in Yangpu District of Shanghai， and cautious and reduced use of permethrin is suggested. It is necessary to implement and adopt the strategy of comprehensive management， in order to establish the long-term mechanism for mosquito control and prevention.

Objective To determine the current disinfection quality and understand existing problems in clinical institutions in Yangpu District， and provide scientific evidence for improving hospital infection control. Methods From 2018 to 2020， the specimens were collected from medical instruments， disinfectant in use， dialysis water in hemodialysis rooms， air， surface of objects， sterilization equipment， hands of medical staff， dental therapy water and sewage in clinical institutions in Yangpu District， and then examined for disinfection quality. Results A total of 1 420 samples were collected consecutively in 3 years， in which the total qualified rate was determined to be 88.52%. The qualified rates in secondary and tertiary hospitals， primary health centers， and private clinics were 94.86%， 90.22% and 75.74%， respectively， with a significant difference （χ²=95.01， P<0.01）. The qualified rates in sterilization equipment， air， and dialysis water were all 100.00%； in contrast， the rates in medical instruments， surface of objects， hands of medical staff， disinfectants in use， dental therapy water， and sewage were 98.28%， 97.63%， 95.05%， 93.39%， 54.71% and 50.00%， respectively. Conclusion Overall disinfection quality remains good in clinical institutions in Yangpu District of Shanghai， whereas the quality in private clinics is low. In addition， dental therapy water and hospital sewage might be susceptible to contamination， which warrants further improvement in the disinfection and monitoring.

Objective: To analyze the relationship between outdoor activity, screen time and 20 meter shuttle run test (20 m SRT) score among children and adolescents in Baoan District, Shenzhen, so as to provide scientific basis for the management and promotion of physical health of children and adolescents. Methods: Stratified cluster sampling was used to select students from 14 schools in 6 communities in Baoan District of Shenzhen, from April to May 2019. A self designed questionnaire was used to investigate demographic characteristics, outdoor activity duration and screen time of primary and middle school students. A total of 3 192 primary and secondary school students in grade 1-12 were selected from each school. Weight, height and 20 m SRT were measured. Results: About 985(30.9%) out of 3 192 primary and middle school students were estimated excellent on 20 m SRT test, with boys being higher than that of girls (34.7% vs 26.3%) ( χ 2=26.43, P <0.01). Logistic regression analysis showed that compared with the group with outdoor activity <2 h/d, the excellent and good performers on 20 m SRT with outdoor activity time ≥2 h/d was higher( OR=1.38, 95%CI =1.12-1.70). Compared with students with screen time ≥2 h/d, the excellent and good performers on 20 m SRT with screen time <2 h/d was higher( OR=1.42, 95%CI=1.17-1.71). Compared with students with outdoor activity time < 2 h/d and screen time ≥ 2 h/d, students with outdoor activity time ≥2 h/d and video time < 2 h/d had a higher proportion of excellent score on 20 m SRT( OR=1.97, 95%CI =1.46-2.67). Conclusion Increasing outdoor activity and reducing screen time are helpful to improve the performance score of 20 m SRT among primary and secondary school students.

Objective:To examine whether sleep status and social jet lag are related to the mental health behaviors in children and adolescents, providing a reference for preventing and improving children and adolescents' mental health behaviors.Methods:A large cross-section was conducted in Baoan District, Shenzhen, from April to May 2019. A total of 30 188 adolescents and children in grades 1-12 in 14 schools were included. The growth trajectory and health index questionnaire of primary and secondary school students were designed to evaluate the sleep status. Mental health behavior problems among students were accessed using the parents' and students' versions of the Strengths and Difficulties Questionnaire. After controlling for confounding factors of demographic variables, including gender, age, parental education level, academic performance, learning burden, and noise impact, a multivariate logistic regression model was used for statistical analyses.Results:The sleep duration of four grades students were 90.4％,90.1％, 98.2％, and 98.4％, respectively. 19.9％ did not have a post-lunch nap. 19.6％ had a wake-up delay of more than or equal to 2 h weekend morning. 35.1％ had an inconsistent bedtime and 15.5％ had an inconsistent awakening time. The multivariate logistic regression model showed that compared with 8-9 h, the sleep duration of elementary school juniors at night less than or equal to 7 h, 7-8 h increased the risk of psychological behavior problems. The sleep time more than 9 h was negatively correlated with psychological behavior problems. The sleep duration of elementary school seniors less than or equal to 7 h increased the risk of psychological behavior problems. The sleep duration of middle school and high school students less than or equal to 6 h increased psychological behavior problems. The ORs (95％ CI) appeared as 2.53(1.85-3.47), 2.41(1.11-5.25), respectively. The ones with a sleep time more than 9 h also increased the risk, and ORs (95％ CI) appeared as 2.37(1.40-4.01), 5.38 (1.79-16.1), respectively. Both the absence of post-lunch nap and the nap time less than 0.5 h were risk factors for psychological behavior problems in primary and middle school students. The nap time over 1-2 h was also a risk factor for high school students' psychological behavior problems. Waking up at irregular times in the morning, going to bed at varying times in the evening, and delaying getting up for more than or equal to 2 h on weekends were all risk factors for psychological and behavioral problems among primary and middle school students. The ORs (95％ CI) of psychological behavior problems of elementary school juniors and seniors, middle school and high school students were 2.07 (1.45-2.97), 1.57 (1.09-2.26), 2.66 (2.06-3.44), 2.48 (1.96-3.15), respectively. Conclusions:Sleep duration, no post-lunch sleep, and daily intraindividual variability of sleep is positively associated with poor mental health. Additionally, social jet lag is associated with mental health problems in students. It is noted that delaying sleep within half an hour on the weekends of elementary school juniors is significantly associated with an increase in bad mental behavior.