Objective: To identify the lifestyle pattern of adolescents in Guangzhou and to provide a scientific basis for targeted and individualized interventions for adolescents with different lifestyle pattern. Methods: A survey was conducted by questionnaire among 12 540 students from 27 middle schools in the urban area of Guangzhou using a convenient sampling method. The latent class model (LCM) was used to identify lifestyle patterns of adolescents, and further analyses were conducted to compare differences in dietary habits and willingness to exercise among the different classes. Results: Three lifestyle patterns were identified based on the latent class model: "high sweet snacks/excessive screen time, sleep and exercise deficiency group", 3 797 people, accounting for 30.3%; "low nutrition diet/severe sleep and exercise deficiency group", 2 745 people, accounting for 21.9%; "general diet/sleep and exercise deficiency group", 5 998 people, accounting for 47.8%. Adolescents of different classes had different perceptions of their eating habits and different degrees of willingness to participate in physical exercise, these differences were statistically significant(χ 2=671.54, Z=153.16, P<0.05). Conclusion The results of the latent class model showed that the three classes of adolescents had their own unique characteristics. It is necessary to inform them of their needs, provide guidance and implement targeted interventions according to the unique characteristics of the different lifestyle patterns in empirical work.

Objective:To retrieve, appraise and integrate the best evidence of exercise rehabilitation in adult aplastic anemia patients after hematopoietic stem cell transplantation, so as to provide a reference for developing exercise rehabilitation program.Methods:All the evidences of exercise rehabilitation for aplastic anemia patients after hematopoietic stem cell transplantation were searched from the computer decision support systems, guideline websites, association official websites and databases, including guidelines, systematic reviews, evidence summaries, best practice, recommended practice, expert consensuses and randomized controlled trials. The retrieval period was from January 2010 to July 2021. Australian JBI Evidence Based Health Care Centre Evidence Grading and Evidence Recommendation Grading System was used to evaluate literature quality and evidence rating.Results:A total of 14 articles were included, and 35 evidences were summarized from 8 aspects, including exercise effectiveness, exercise principles, exercise evaluation, exercise methods, exercise intensity, exercise time, exercise site and notes.Conclusions:The summary of the best evidence for exercise rehabilitation in adult aplastic anemia patients after hematopoietic stem cell can provide a reference for clinical nursing practice. Medical and nursing staff should provide exercise guidance for patients according to the clinical practice and their own condition.

Objective:To investigate the clinical characteristic, gene mutations and genotype-phenotype correlation of 21-hydroxylase deficiency (21-OHD) in Hunan.Methods:A total of 48 patients with 21-OHD who were admitted to the Department of Pediatrics, the Second Xiangya Hospital, Central South University from March 2016 to March 2017 were collected.According to the clinical manifestations and biochemical characteristics of the patients, they were divided into salt wasting (SW) and simple virilizing (SV). Sanger sequencing combined with multiplex ligation-dependent probe amplification(MLPA) were used to detect the mutations of CYP21A2 gene.The patients were divided into 3 groups according to their mutations severity: severe mutation group, moderate mutation group and unknown mutation group.Then, the correlation between genotype and phenotype was analyzed. Results:(1) Forty-eight 21-OHD patients included 28 SW cases and 20 SV cases, and the first visiting age of SW was younger than that of SV, and the difference was statistically significant ( U=44.5, P<0.05). The SW cases had high incidence rate of adrenal crisis and the SV patients were liable to advanced bone age and precocious puberty.(2) Forty-four patients were detected abnormal gene mutation and the positive rate of genetic diagnosis was 91.7%.Fourteen mutation types including I2G, Del, I173N, R357W, R484fs(c.1451_1452delGGinsC, c.1450dupC), R483fs, G111Vfs*21, Q319X, c.292+ 1G>A, c.377C>G, E6Cluster, p.H393Q and m. 1647C>T, were found in 88 alleles.The most frequent mutations were I2G(36.4%), I173N(20.4%), and Del(22.7%). p.H393Q and m. 1647C>T were 2 novel mutations.I2G (47.3%) and Del (27.3%) were the most frequent mutations in SW cases, and I173N (48.5%) was the most frequent mutation in SV cases.(3) Severe mutation was in 29 patients, including 26 SW, and moderate mutation was in 13 patients, including 12 SW.The percentage of SW in severe mutation group was 89.7% and SV in moderate mutation was 92.3%. Conclusions:I2G, I173N and Del were the frequent mutations of 21-OHD in Hunan, and the total percen-tage was 79.5%.Genotype of 21-OHD has strong correlation with clinical phenotype, which can effectively predict SW by severe mutation and predict SV by moderate mutation.

Objective:To investigate the behavioral problems of children with congenital adrenal hyperplasia (CAH), and to explore the influencing factors, thus providing evidence for their prevention and interventions.Methods:A case-control study was carried out.A total of 25 children with CAH who were aged 4-16 and regularly followed up in the Outpatient Department of the Second Xiangya Hospital, Central South University from June 1, 2017 to March 31, 2019 were enrolled in the study group, and 50 age-and gender-matched healthy children in Hunan Province were selected as the healthy control group.The parents of the selected subjects were investigated with the Achenbach Child Behavior Checklist (CBCL) to evaluate children′s behavior problems.SPSS 22.0 software was applied to statistical analysis.Results:(1) The scores of externalizing behaviors, aggressive factors and behavior problems in 4-to 5-year-old male children in the CAH group were significantly higher than those in the healthy control group [(12.440±8.353) scores vs.(5.060±5.230) scores, (9.670±6.481) scores vs.(4.110±4.157) scores, (22.110±13.062) scores vs.(12.890±9.405) scores] ( t=2.829, 2.711, 2.109, respectively, all P<0.05). There was no significant difference in the scores of other behavior problems and influencing factors between the CAH group and the healthy control group (all P>0.05). (2) The influencing factor of behavioral problems was progesterone ( β=0.567). Testoste-rone not only was the influencing factor of externalizing and internalizing behaviors ( β=0.582, 0.497, respectively), but also affected the behavior of physical complaints, violation of discipline and social withdrawal ( β=0.735, 0.531 and 0.492, respectively). The factor influencing the schizoid behavior was the initial treatment age ( β=0.402). Conclusions:Four- to 5-year-old male children with CAH have behavioral problems, among which aggression and externalizing behaviors are more common.The increase of testosterone may cause the problems of internalizing and externalizing behaviors in children with CAH, and has a great impact on physical complaints, social withdrawal, and discipline violation.The increase of progesterone may lead to the behavior problems of the children.The older the initial treatment age, the more serious the schizoid behavior problem may be.

OBJECTIVE: To investigate the epidemiological situation and temporal-spatial clustering changes of hand-foot-mouth disease (HFMD) in Hunan.
 METHODS: Spatial autocorrelation and temporal-spatial clustering analysis were used to analyze the HFMD in Hunan.
 RESULTS: The incidence rates of HFMD ranged from 54.31/10 million to 318.06/10 million between 2009 and 2015 in Hunan. Cases mainly displayed in 5-year-old or even younger children and there were two epidemic periods each year. HFMD cases did not show a random distribution but with significant spatial aggregation. When local autocorrelation analysis was applied at the county/district level, 4 hot spots in Changsha, Yiyang, Loudi and Zhuzhou were discovered. The tendency for temporal and spatial clustering existed among HFMD cases in Hunan. The temporal dimension of HFMD was from April to July annually. Clustering areas gathered in the northern regions in 2009 and in the middle regions from 2010 to 2012. They moved to middle-southern regions in 2013 or 2014 and middle-western regions in 2015. 
 CONCLUSION The HFMD incidence from 2009 to 2015 in Hunan showed temporal and spatial clustering tendency, with the shifting trend of clustered areas toward south and west.
Cluster Analysis ; Hand, Foot and Mouth Disease ; Humans ; Incidence

OBJECTIVE: To analyze the sexual behavior characteristics of the sexually transmitted HIV-positive people and to estimate the secondary transmission rate.
 METHODS: Field investigation and literature review were conducted among sexually transmitted HIV-positive people to collect general information during the last 6 months before notification of HIV infection. A mathematical model was used to estimate the secondary transmission rate.
 RESULTS: A total of 769 HIV-positive people were recruited for the study, 186 of them were women, 286 were men who have sex with women (MSW), 242 were men who have sex with men (MSM) and 55 were men who have sex with men and women (MSMW). During 6 months, the average sex partner among these 4 groups were 2.29, 1.61, 3.32 and 4.10, respectively; the sexual behavior frequency were 26.03, 20.97, 14.77 and 25.51, respectively; the rates of non-use of condom were 74.14%, 73.53%, 59.60% and 72.06%, respectively; the secondary transmission rate were 0.0095, 0.0151, 0.1759 and 0.1985, respectively. Under constant conditions of other factors, the secondary transmission rates decreased by 30.13%-82.00%, 23.00%-49.51%, and 16.10%-19.09%, respectively, if there was a reduction in 1 sex partner, 1 time/month for the sexual frequency and 20% of rate for non-use of condom.
 CONCLUSION The HIV secondary transmission from MSMW HIV-positive people to general population was the highest. Change in sexual behavior of the HIV-positive people can decrease the HIV secondary transmission rate significantly.
Female ; HIV Infections ; Humans ; Male ; Models, Theoretical ; Sexual Behavior ; Sexual Partners