Objective: To understand the microclimate in primary and secondary school classrooms for the study period during the winter heating season, so as to provide a reference for the revision and improvement of relevant health standards. Methods: In December 2024, stratified random sampling was used to select 30 primary and secondary schools and 180 classrooms from the northern regions with centralized heating (Liaoning Province, Tianjin City) and the southern regions without centralized heating (Shanghai City, Anhui Province, and Jiangxi Province). Indoor temperature, relative humidity, wind speed, CO 2 and other indicators were measured on site. Variance analysis, t-test, Mann-Whitney U test and Kruskal-Wallis H test were used to analyze the differences in the microclimate of classrooms among regions and urban and rural differences. Results: The average temperature in the middle of the classrooms tested on site was (16.47±4.72)℃, and the variance analysis showed that the difference between the regions was statistically significant ( F=27.80, P <0.01). Among them, Tianjin had the highest average temperature of (20.43± 2.12 )℃, followed by Liaoning (19.03±2.23)℃, Shanghai (15.33±5.32)℃, Anhui (12.79±1.74)℃, and Jiangxi (11.69± 1.68 )℃. Horizontal temperature difference was 0.90 (0.50, 1.60)℃, the vertical temperature difference was 0.20 (0.10,0.60)℃, the average relative humidity was (44.39±16.16)%, the wind speed was 0.03(0.01,0.11)m/s, and the differences among different provinces and cities were statistically significant ( H/F =40.62, 82.69, 95.06, 55.28, all P <0.01). The average CO 2 volume concentration in urban areas of Tianjin, Liaoning, and Shanghai was 0.21(0.16,0.30)%, and there was no statistically significant difference ( H=4.65, P =0.10). There were grade differences in relative humidity ( F =3.71, 6.21) and CO 2 ( H =14.72, 12.92) in the north and the south (all P <0.05). In addition, the temperature, relative humidity, wind speed and CO 2 in the middle of the classroom were 42.8%, 67.8%, 100.0% and 22.2% respectively. Conclusions The temperature in the middle of the classroom in the non centralized heating area is lower than the standard, the relative humidity of classroom in the centralized heating area is lower than the standard，and the CO 2 in the classroom in winter is lower than the standard. It is recommended to install heating facilities in schools with low temperatures to increase the temperature and increase the frequency of ventilation in classrooms or adopt mechanical ventilation strategies to reduce CO 2 volume concentration.

Objective: To compare the effects of height-desk-chair matching on the viewing distance of primary school students before and after intervention, so as to provide scientific basis for the hygiene management of desks and chairs. Methods: From April to June 2025, a random cluster sampling method was used to select 141 third grade students from three classes equipped with adjustable desks and chairs in a primary school in Hefei City for a height-desk-chair matching intervention study. The height of students desks and chairs was adjusted according to the standard height and height range specified in the Functional Sizes and Technical Requirements of Chairs and Tables for Educational Institutions (GB/T 3976-2014), with an intervention period of one week. Before and after the intervention, eye use data were measured by using the electronic smart device "Cloud Clip", while collecting data on vision data viewing distance, time spent using eyes at close range and outdoor time, desk and chair height, and physical examination. Linear regression analysis was used to investigate the factors related to viewing distance before the intervention of height-desk-chair matching, and a paired t-test was used to analyze the difference in viewing distance before and after the intervention. A mixed effects model was used to explore the effect of height desk and chair adaptation intervention on viewing distance. Results: The compliance rates for desk and chair adjustments before and after the intervention were 1.4% and 18.4%, respectively, with a statistically significant difference ( χ 2=22.84, P <0.01). The viewing distance increased from (30.48±5.01) cm before intervention to (32.06±5.75) cm post intervention, with a statistically significant difference ( t=4.57, P <0.01). The proportion of students meeting the viewing distance standard increased from 33.3% to 51.1%. The linear mixedeffects model results indicated that the association between height appropriate desk and chair interventions and viewing distance was statistically significant, regardless of whether covariates such as time spent using eyes at close range and outdoor time were adjusted ( β=-1.58, 95%CI = -2.25 to -0.91; β=-1.14, 95%CI =-1.85 to -0.43, both P <0.05). Conclusion Height adjusted desks and chairs, which can effectively increase the viewing distance for primary school students, has positive implications for improving healthy eye care behaviors among children and adolescents.

Objective: To investigate the prevalence and influencing factors of the co-occurrence of elevated blood pressure and depressive symptoms among junior and senior high school students in Anhui Province, so as to provide evidence for comprehensive interventions on physical and mental health among adolescents. Methods: From September to December 2024, a multi stage random cluster sampling method was used to select 103 225 junior and senior high school students from 16 prefecture level cities in Anhui Province. Data were collected through questionnaire surveys and physical measurements. Elevated blood pressure was determined according to the Reference of Screening for Elevated Blood Pressure among Children and Adolescents Aged 7-18 Years. Depressive symptoms among middle school students were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Chi-square test, Chi-square test for trend, and multivariate Logistic regression model were used to analyze the risk factors for the co-occurrence of elevated blood pressure and depressive symptoms. Results: The detection rate of elevated blood pressure was 15.22%, the detection rate of depressive symptoms was 18.56%, and the co-occurrence rate of the two conditions was 2.67% among junior and senior high school students. Multivariate Logistic regression analysis showed that after controlling for gender, school stage, household registration, and overweight and obesity status,compared with those who don t drink sugary drink and eat fried food, and get enough sleep, sugar sweetened beverage intake <1 and ≥1 time/d( OR =1.28,1.61), fried food consumption ≥1 time/d( OR =1.37), and insufficient sleep ( OR =1.54) were all associated with an increased risk of the co-occurrence of elevated blood pressure and depressive symptoms(all P <0.05). Daily fresh vegetable intake ≥1 time/d( OR =0.78) and fresh fruit intake ≥1 time/d( OR =0.85) were both associated with a decreased risk of the co-occurrence(both P <0.05). Compared with students who did not eat breakfast, students who ate breakfast sometimes and every day ( OR =0.62,0.36) had a lower co-occurrence risk(both P < 0.05). Junior and senior high school students with daily outdoor activity duration≥1 h ( OR =0.81) had a lower risk of the co-occurrence of elevated blood pressure and depressive symptoms ( P <0.05). Conclusions Sugar sweetened beverage drink and fried food consumption, inadequate consumption of fresh vegetables, fruits and breakfast, lack of outdoor activity, and insufficient sleep are risk factors for the co-occurrence of elevated blood pressure and depressive symptoms among junior and senior high school students in Anhui Province. It is necessary to establish school health promotion strategies integrating nutrition, exercise and sleep management as intervention targets to reduce the co-occurrence risk of elevated blood pressure and depressive symptoms among junior and senior high school students.

Objective: To analyze the association of participation in non-sports extracurricular tutoring classes with the prevalence of screening myopia, axial length (AL) and axial length to corneal radius ratio (AL/CR) among primary school students, so as to provide evidences for formulating myopia prevention and control policies. Methods: In December 2024, combination of convenience and cluster sampling method was used to select 2 273 students from two primary schools in Hefei City, Anhui Province. Ophthalmic examinations and questionnaire surveys were conducted to obtain information on myopia, AL, AL/CR and participation in various types of extracurricular tutoring. A binary Logistic regression model was used to analyze the association between non-sports tutoring and screening myopia, and multiple linear regression models were used to examine the associations between non-sports tutoring and AL and AL/CR. Results: Among the surveyed students, the participation rate in non-sports extracurricular tutoring classes was 64.9% , and the overall prevalence of screening myopia was 39.1%. The average AL and AL/CR were (23.60± 1.01 ) mm and (3.00±0.12), respectively. Univariate analysis showed that students who attended non-sports, music, or academic tutoring classes for ≥2 h per week had higher risks of screening myopia and greater AL/CR values than non-participants (screening myopia: OR =1.38, 1.82, 1.55; AL/CR: β =0.01, 0.03, 0.03; all P <0.05). After adjusting for sex, grade, and participation in sports tutoring, multivariate analysis indicated that participation in non-sports and musical instrument tutoring classes for ≥2 h per week remained significantly associated with higher risks of screening myopia ( OR =1.26, 1.49, both P <0.05). Multiple linear regression showed that participation in musical instrument tutoring for ≥2 h per week was positively correlated with AL ( β=0.14, P < 0.05). Conclusions Participation in non-sports extracurricular tutoring is common among primary school students. Attending non-sports tutoring classes for ≥2 h per week increases the risk of screening myopia.

Objective:To evaluate the safety and efficacy of secondary transport on extracorporeal membrane oxygenation (ECMO) for critically ill children.Methods:This was a retrospective cohort study. Data from 222 pediatric patients who underwent ECMO transport from May 2019 to May 2024 at 5 ECMO centers and Chinese Database of Pediatric Extracorporeal Life Support Organization were collected. The cases were divided into primary and secondary transport groups by nature of transport. The clinical data, including demographics, ECMO indications, transport distance, pre-transport lab results, prognosis and complications were analyzed. Two independent samples t-test, Wilcoxon test, and χ2 test or Fisher′s exact probability method were used to compare the differences between 2 groups and evaluate the safety and efficacy of secondary transport. Results:Among the 222 children transported with ECMO, there were 135 males and 87 females, with an age of 3.0 (0.2, 7.0) years. There were 202 cases in the primary transport group and 20 cases in the secondary transport group. All secondary transport patients had failed attempts at weaning ECMO before transfer. The patients in the secondary transport group were older, had higher rates of surgical cannulation, circulatory support, and pre-ECMO lactate levels compared to the primary transport group (7.0 (2.8, 10.0) vs. 3.0 (0.2, 6.0) years old, 55.0% (11/20) vs. 3.6% (7/202), 80.0% (16/20) vs. 41.6% (84/202), (10±4) vs. (7±6) mmol/L, Z=3.41, χ 2=66.31, 10.99, t=2.24, all P<0.05). In the secondary transport group, the vasoactive-inotropic scores of patients on circulatory support and the oxygenation index for patients requiring respiratory support were higher than those in the primary transport group (83±33 vs. 82±68, 51.0±1.8 vs. 37.4±10.2, t=2.36, 2.63, respectively; both P<0.05). There were no statistically significant differences between the 2 groups in sex, transport distance, pre-ECMO creatinine, arterial blood gas BE values, and ECMO duration (all P>0.05). No life-threatening complications occurred during the transport in either group. Two patients in the secondary transport group underwent heart transplantation, and 1 patient underwent radiofrequency ablation. The overall survival rate between the 2 groups showed no statistically significant difference (45.0% (9/20) vs. 55.4% (112/202), χ2=1.15, P>0.05). Conclusions:Secondary ECMO transport for critically ill children don't increase mortality or life-threatening complications during transport. ECMO patients who cannot receive effective treatment locally can benefit from secondary transport to an advanced ECMO center provides further treatment opportunities.

Radiotherapy remains one of the primary therapeutic modalities for various cancers. However, individual heterogeneity exists in treatment outcomes and adverse reactions. In recent years, the interaction between the gut microbiota and radiotherapy has garnered increasing attention. The gut microbiota plays a crucial role in modulating host immune responses, maintaining intestinal barrier integrity, and participating in metabolic processes, thereby influencing both the efficacy and tolerance of radiotherapy. Modulating gut microbiota composition through probiotics, antibiotics, or dietary interventions may reduce the toxic side effects induced by radiotherapy, thereby enhancing therapeutic outcomes. Despite numerous challenges in mechanistic studies and clinical application, current research has shed light on cancer therapies. This review emphasizes the significant role of gut microbiota in radiotherapy, impacting treatment outcomes and patients’ tolerance and quality of life. Future research should further explore the links between microbiota regulation and optimization of radiotherapy outcomes, with the prospect of translating these strategies into clinical practice to provide more personalized treatment options for patients.

Acute lower respiratory infections in infants and young children, caused by respiratory syncytial virus (RSV), represent a significant global public health challenge, characterized by a substantial disease burden. During the winter and spring seasons, various respiratory viruses tend to co-circulate, leading to increased pressure on pediatric healthcare services due to heightened rates of visits and hospitalizations. Currently, there is no approved RSV vaccine available for children worldwide; however, the development and application of long-acting monoclonal antibodies present a promising avenue for the prevention of RSV in this vulnerable population. In June 2024, Tianjin released"Guidelines for the monoclonal antibody of respiratory syncytial virus in Tianjin (2024 version)", which outlines the promotion of monoclonal antibody administration in vaccination clinics throughout the region. The objective of this paper is to provide reference information that may assist in the formulation and implementation of a national RSV immunization strategy.

Objective:To assess cognitive impairment in children with obstructive sleep-disordered breathing (OSDB) using event-related potentials (ERPs).Methods:This case-control study analyzed data from 143 OSDB children[94 males, 49 females, aged 9.0(7.0-11.0) years] scheduled for adenotonsillectomy at the Department of Otolaryngology-Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, between June 2023 and September 2024, along with 17 healthy controls [control group: 10 males, 7 females, aged 10.0 (7.5-12.0) years]. Based on polysomnography results, OSDB children were divided into a mild group [obstructive apnea-hypopnea index (OAHI)≤5 events/hour, 49 males, 29 females, aged 9.0 (7.0-10.0) years] and a moderate-to-severe group [OAHI>5 events/hour, 45 males, 20 females, aged 9.0 (8.0-10.0) years]. All children completed a face perception integration task. The occipital P100 and parietal, central and frontal P300 components of incomplete face stimuli (S1) and complete face stimuli (S2) were recorded. Amplitude and latency differences across groups were analyzed. Intergroup comparisons were performed using ANOVA, while independent samples t-tests were used for pairwise comparisons. Non-normally distributed data were analyzed using the Mann-Whitney U test. Results:(1) P100: Both the mild group [occipital P100 amplitude: O1-S1(12.44±5.96) μV, O2-S1(14.19±6.39) μV, O2-S2(30.34±11.30) μV] and moderate-to-severe group [O1-S1 (12.12±5.58) μV, O2-S1 (14.08±5.48) μV, O2-S2(29.12±10.89) μV] showed significantly higher amplitudes than the control group [O1-S1(8.46±4.74) μV,O2-S1(9.68±3.70) μV,O2-S2(23.09±9.16) μV] ( F=3.501, 4.486, 3.072; all P<0.05). No significant differences were found between the two OSDB subgroups ( P>0.05), suggesting compensatory neuronal hyperactivity maintaining normal perceptual function. The moderate-to-severe group exhibited significantly prolonged P100 latency [O2-S1 (134.52±13.42) ms] compared to controls [O2-S1 (125.18±15.31) ms] ( F=3.156 , P<0.05), while no significant difference was observed between the mild group and either the control or moderate-to-severe groups ( P>0.05), indicating delayed visual processing in severely affected children. (2) P300: The mild group exhibited significantly higher P300 amplitudes in parietal regions [P4-S1(8.22±4.32) μV, P4-S2(17.67±9.42) μV] compared to controls [P4-S1 (4.84±2.89) μV, P4-S2 (13.19±7.23) μV] ( F=7.19, 4.771; both P<0.05), whereas no significant differences were observed between the moderate-to-severe group and either the control or mild groups ( P>0.05), indicating mild group reduced alertness. The latency of P300 in the central region showed an increase in the mild group, although not significantly ( P>0.05), indicating a potential decrease in attentional response speed. However, the moderate-to-severe group demonstrated significantly shorter P300 latencies [CZ-S1(394.18±89.12) ms] compared to the mild group [CZ-S1 (433.33±100.33) ms] ( F=3.145, P<0.05), possibly reflecting compensatory enhancement of attentional engagement in more severe cases. Conclusion:Children with OSDB exhibit impairments in primary visual processing and attentional regulation, as evidenced by altered ERP components such as P100 and P300. These findings suggest that OSDB may affect neural mechanisms underlying sensory integration and executive functioning.

Objective: To understand the changing trends and related factors of knowledge, attitude and practice (KAP) regarding the three major infectious diseases (acquired immunodeficiency syndrome, tuberculosis, hepatitis B) among freshmen in Jiangsu from 2019 to 2022, so as to provide a reference basis for the health education of infectious diseases in schools. Methods: From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were randomly selected for four consecutive years to investigate their KAP levels online through self designed questionnaires on three major infectious diseases. The multiple linear regression model was used to analyze the changing trends of students KAP levels of the three major infectious diseases, and to explore the influencing factors of KAP. Results: From 2019 to 2022, the knowledge scores(18.0±3.1,18.4±3.2,18.7±3.2,18.8±3.2), related to the three major infectious diseases showed an upward trend ( F=436.50, P <0.01), and the positive attitude reporting rates were 81.77%, 81.46%, 82.68% and 81.74%, respectively. The reporting rates of positive practice were 80.11%, 79.25%, 79.08 % and 79.04%, respectively. Multiple linear regression showed that school type, parental education level, mother s occupation, average income per person in family and living arrangements during high school all had an impact on the knowledge ( β = -1.510 -0.559), attitudes ( β =-0.043-0.065) and practice ( β =-0.028-0.027) of the three major infectious diseases ( P < 0.05 ). The family residence areas only affected the reporting rate of positive attitude scores ( β =0.002-0.065), and whether only children or not affected the reporting rate of positive practice scores ( β =0.009)( P <0.05). The knowledge score showed an upward trend ( β= 0.297, P <0.01), the positive attitude reporting rate showed no statistically significant change ( β=0.001, P =0.22), and the positive practice reporting rate showed a downward trend ( β=-0.005, P <0.01). Conclusions Freshman in Jiangsu Province from 2019 to 2022 have shown a separation in KAP scores regarding the three major infectious diseases. Targeted measures should be taken to improve their health practice level.

Objective To compare the technical indicators and clinical effect of catheter-directed thrombolysis(CDT)via two types of non-popliteal venous access in the treatment of acute mixed-type lower extremity deep vein thrombosis(DVT).Methods The clinical data of 119 patients with acute mixed-type lower extremity DVT,who were admitted to the Affiliated Jiangning Hospital of Nanjing Medical University and the Affiliated Nanjing Hospital of Nanjing Medical University of China to receive CDT treatment from January 2016 to June 2022,were retrospectively analyzed.Of the 119 patients,CDT via deep calf vein access was carries out in 45(calf vein group)and CDT via healthy-side femoral venous access was performed in 74(femoral vein group).The success rate of vascular puncture,success rate of catheterization technique,number of successful CDT venous puncturing,time spent for sheath placement,time spent for catheterization,thrombolysis time,used amount of thrombolytic agent and associated complications(including vein puncturing and anticoagulant thrombolysis-related complications),the thrombolytic effect of different anatomical segments,and the clinical efficacy during the follow-up period for at least 12 months were compared between the two groups.Results Successful catheterization via deep calf vein access and via healthy-side femoral vein access was obtained in 31 and 58 CDT patients respectively,with a technical success rate of 68.89％(31/45)and 78.38％(58/74)respectively,the difference between the two groups was not statistically significant(P=0.248).In 26 patients(67.74％)of the calf vein group,more than two times of puncturing were needed before the sheath placement could be successfully achieved.The time spent for sheath placement in the femoral vein group was(1.84±0.87)min,which was remarkably shorter than(10.52+6.13)min in the calf vein group(P＜0.001),but the time spent for catheterization in the femoral vein group was(41.60±13.31)min,which was obviously longer than(20.06+4.46)min in the calf vein group(P＜0.001).The thrombolysis time in the femoral vein group and the calf vein group was(5.34+1.43)days and(5.06±1.18)days respectively(P=0.354),and the used amount of thrombolytic agent in the femoral vein group was(352.16±71.98)×104 U,which was prominently larger than(284.68±77.64)× 104 U in the calf vein group(P＜0.001).The last follow-up check showed that the patency rate of the popliteal vein in the calf vein group was significantly higher than that in the femoral vein group(P=0.037).No statistically significant differences in the incidence of post-thrombotic syndrome(PTS)and the mean VEINES-QOL/Sym scores existed between the two groups(all P＞0.05).Conclusion Compared with CDT via healthy-side femoral vein access,CDT via deep calf vein access can better remove the thrombus in the popliteal vein and superficial femoral vein,and improve the femoropopliteal vein patency rate,although it has no obvious advantages in reducing the occurrence of PTS and in improving the VEINES-QOL/Sym score,moreover,the deep calf vein puncture and sheath placement require a high-level technique.