Objective: To analyze the bidirectional association between sleep status and depressive symptoms among primary school students, so as to provide scientific evidence for developing targeted intervention and health education on children s mental health. Methods: In December 2021, 1 787 students in grades 2 and 3 selected from three primary schools in a district of Tianjin by a convenient sampling method were investigated in a baseline questionnaire survey, which was followed by a one year follow up in December 2022. The survey content included sociodemographic characteristics, lifestyle, etc., and the Children s Sleep Habits Questionnaire and the Center for Epidemiologic Studies Depression Scale for Children were used to assess students sleep quality, sleep duration, social jetlag and depressive symptoms. Linear regression model was applied to examine the association between sleep status and depressive symptoms score in primary school students, and cross lagged panel model was adopted to analyze the bidirectional association between sleep status and depressive symptoms. Results: At baseline, the sleep quality score among primary school students was 43.00(39.00, 47.00), the daily sleep duration was 9.42(9.12, 9.76) h, the social jetlag was 0.58( 0.29 , 0.92) h, and the depressive symptoms score was 5.00(2.00, 9.00). At the oneyear followup, the score of sleep quality among primary school students was 42.00(38.00, 47.00), the daily sleep duration was 9.43(9.12, 9.78)h, the social jetlag was 0.50 (0.25, 0.78)h, and the score of depressive symptoms was 4.00(2.00, 9.00). After adjusting for confounding factors such as gender, parental education level, and monthly family income, linear regression analyses showed that the baseline sleep quality score was positively associated with follow up depressive symptoms scores ( β =0.25) among primary school students, while baseline sleep duration ( β =-0.06) and baseline social jetlag ( β =-0.08) were both negatively associated with follow up depressive symptoms score (all P <0.05). Cross lagged regression models indicated that baseline sleep quality score positively predicted depressive symptoms score at the 1 year follow up ( β =0.10), and baseline depressive symptoms score positively predicted follow up sleep quality score ( β = 0.08 )(both P <0.05). Conclusions There is a bidirectional association between sleep quality and depressive symptoms among primary school students. Improving sleep quality may help alleviate children s depressive symptoms.

Objective： ：To investigate the expression of miR-137 in cervical cancer tissues and cells, and to explore its effect on proliferation, migration and invasion of cervical cancer cells as well as the mechanisms. Methods： ：Thirty-two pairs of cervical cancer tissues and corresponding para-cancerous tissues that surgically resected at the Department of Gynecology and Obstetrics of Dongguan People's Hospital from January 2017 to March 2018 were collected for this study. In addition, cervical cancer cell lines C33A, HeLa, SiHa and cervical epithelial immortalized cell line H8 were also collected. The expression of miR-137 in cervical cancer tissues and cell lines was detected by RT-PCR. miR-137 mimics and miR-137 NC were respectively transfected into C33Aand HeLa cells, and the effects of miR-137 over-expression on proliferation, migration and invasion of cervical cancer cell lines were observed by CCK-8 and Transwell assay. Luciferase reporter gene assay and WB were used to determine the relationship between miR-137 and Wnt5a in cervical cancer. Wnt5a over-expression vector was constructed, and the effects of simultaneous over-expression of Wnt5a and miR-137 on proliferation, migration and invasion of C33Aand HeLa cells were observed. Results： ：The expression level of miR-137 was significantly down-regulated in cervical cancer tissues and cell lines, as compared to para-cancerous tissues and H8 cells (all P<0.05). The over-expression of miR-137 significantly inhibited cell proliferation, migration and invasion of C33A and HeLa cells (all P<0.05). Moreover, Wnt5a was identified as a target of miR-137 by luciferase reporter gene assay. Furthermore, Wnt5a over-expression, to a certain degree, attenuated the suppressive effects of miR-137 on the proliferation, migration and invasion of C33A and HeLa cells. Conclusion： ：miR-137 can inhibit the proliferation, migration and invasion of cervical cancer cells via targeting Wnt5a, which may be an effective target for the treatment of cervical cancer.

Objective To investigate the distribution and transmission characteristics of vancomycin -resistant Enterococcus faecium (VREF) carrying both vanA and vanM in the intensive care unit.Methods VREF strains were isolated from patients in the intensive care unit of Jinshan Hospital , Fudan University in Shanghai from 2013 to 2017.Antimicrobial susceptibilities of the VREF strains to nine antibiotics , including vancomycin, teicoplanin, linezolid and chloromycetin , were tested by broth microdilution method.Multiple polymerase chain reaction (PCR) was used for van genotyping and pulsed field gel electrophoresis (PFGE) was used for homology analysis.Results Thirty-five strains were mainly isolated from urine (16 strains), blood (11 strains), feces ( five strains ), bile ( two strains ) and pleural effusion ( one strain ).All the strains (100.00%) were resistant to vancomycin , ampicillin and levofloxacin , but only 40.00% were resistant to teicoplanin.All the strains were sensitive to linezolid.The results of van genotyping showed that 33 (94.3%) strains belonged to vanA and vanM dual genotype VREF, and the other two were vanA type VREF.PFGE results showed that 35 strains could be divided into 14 PFGE patterns, and seven out of 10 strains isolated in 2014 were identical and the other three belonged to three different PFGE patterns.Conclusions A dual genotype VREF carrying both vanA and vanM has been emerging and spreading in the intensive care unit of Jinshan Hospital , Fudan University in Shanghai.

Objective:To analyze the immunogenicity of the extracellular region of Δ42PD1.Methods: Six fragments ofΔ42PD1 extracellular region-encoding sequence were amplified by PCR, and were cloned into pCTCON2 vector, a yeast surface displaying vector.Yeast cells were transfected with Δ42PD1 fragment-carrying plasmids, then yeast cells were spread on SDCAA plates.Single cell clones were selected and cultured in SGCAA media to induce expression of the target genes.Mouse anti-humanΔ42PD1 anti-serum were generated by immunization of BALB/c mice via intramuscular injection ofΔ42PD1-carrying plasmid plus in-situ electroporation.The binding of anti-serum with yeast cells surface-displaying Δ42PD1 fragments were analyzed using flowcytometry.Results:Nucleotide sequences analysis indicated that the amplified six fragments ofΔ42PD1 sequence length were 110 bp,and the isolated sequence ofΔ42PD1 fragments were 100%homology with PD1 gene previously registered in GenBank.Results from flowcytometry showed that among the six fragments of Δ42PD1 displaying on the surface of yeast cells,F3 and F2 profoundly boundΔ42PD1-specific polyclonal antibodies.Conclusion:F3 and F2 ofΔ42PD1 is an immunogenic dominant region,which pave the way for generation of Δ42PD1-specific monoclonal antibody and epitope mapping.

Objective To analyze clinical and laboratory features, viral load and viral shedding period of patients with mild or severe H1N1 influenza A infection. Methods Seventy mild cases and 16 severe cases with concurrent pneumonia were included from Shcnzhen area for analysis.Nasopharyngeal-swab specimens of patients were collected and viral load was detected by real-time quantitative polymerase chain reaction (PCR) assay during their hospitalization. The viral load and viral shedding period were compared between patients over 14 years old and less than 14 years old, and between 70 mild cases without pneumonia and 16 severe cases with pneumonia. The statistic analysis was performed using t test and chi square test. Results The most common symptoms and signs of the patients were fever, cough and enlargement of tonsils. However, the severe cases suffered more frequently from cough, dyspnea and high fever compared with the mild cases (x2 = 10. 9 and 14.3, respectively, t=3.65; both P＜0.01 ). The levels of white blood cell (WBC) count and alanine arninotransferase (ALT) of severe patients were both significantly higher than those of mild patients(t= 3.2, 2.4,respectively; both P＜0.05). The chest radiology of the severe cases showed interstitial pneumonia,mostly with ground glass image. The viral load of patients under 14 years was significantly higher than those over 14 years [(4.86± 1.23) lg vs (4. 17±0.89) lg; t=2.3, P＜0.05], and the viral shedding period of patients under 14 years was significantly longer than those over 14 years [(5.33±0. 49) d vs(3. 63±0.28) d; t=3.4, P＜0.01]. The severe patients also displayed significantly higher viral load and prolonged viral shedding period than the mild patients [(6. 36±1. 44) lg vs (4. 35±0.99) lg, t=6.1,P＜0.01; (5.75±1.77) d vs (4. 24±1. 96) d, t=3.2, P＜0.01]. Conclusion Age anddisease severity of patients with H1N1 influenza A infection are significantly associated with viral load and viral shedding period.

Since the attenuated live vaccine against measles was developed,the epidemic of measles has been controlled effectively,however,there is a trend of gradual increase of measles cases in recent years.The epidemiological and clinical features of 4430 measles patients in Shenzhen Municipality in last 10 years were reviewed.The data showed that the epidemic season was postponed with the peak of June to September;the prevalent age groups were infants and adults,the number of severe cases increased;and the positive rate of serological antibody in infants with measles was the lowest.

Objective To develop an ELISA(Enzyme-Linked Immunosorbent Assay)diagnostic kit for early rapid detection of sarum anti-EV71 antibody and evaluate its clinical application value.Methods Recombinant protein VP1 of EV71 were prepared and purified as an immobilized antigen for establishment of an indirect ELISA for detection of serum anti-EV71 IgM and anti-EV71 IgG.Compared with RT-PCR.isolation of EV71 and micro-neutralizing assay.the clinical application value of anti-EV71 IgM and anti-EV71 ISG in the diagnosis of EV71 disease was evaluated.Results In comparison with RT-PCR.the sensitivity,specificity,positive predictive value and negative predictive value of anti-EV71 IgM antibody were 83%,85%,81%and 87%,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of anti-EV71 IgG antibody were 72%,74%,68%and 77%.respectively.Compared with viral isolation assay.the sensitivity and specificity of anti-EV71 IgM antibody were 85%and 97%,respectively.The sensitivity and specificity of anti-EV71 IsG antibody were 75%and 77%,respectively.In addition.the titers of anti-EV71 IgG antibody were significantly correlated with the titers of neutralizing antibody to EV71 by linear regression analysis(r=0.72,P＜0.05).Finally,the serum titers of anti-IgG from patients with EV71 associated hand food and mouth disease at convalescent stage exhibited significantly higher than that of the same patients at acute stage(P＜0.01),but the titers of anti-IgM had no significant difference(P＞0.05).Conclusions With VP1 recombinant protein used as an immobilized antigen,an indirect ELISA diagnostic kit was successfully develooed for detection of serum anti-human EV71 IgM and anti-human EV71 IgG antibodies.

Objective:To investigate the impact of self-concealment,self-disclosure,coping style and per- ceived social support on university students'loneliness.Methods:Loneliness and related factors were assessed among 482 university students using scales including UCLA Loneliness Scale,Self-concealment Scale(SCS),Self-disclosure Index(SDI),Simplified Coping Style Questionnaire(SCSQ)and Perceived Social Support Scale(PSSS).Results: The level of university students'loneliness was not high(36.5?7.4);males experienced more loneliness than fe- males(37.4?7.5/35.4?7.3,F=8.25,P0.05). Regression analysis showed that SCS,SCSQ and PSSS predicted UCLA effectively(?=0.207,-0.218,0.157, -0.380).The testing of mediating effect indicated that SCS had direct and indirect impact on UCLA through nega- tive coping style and PSSS;SDI had only indirect impact on UCLA through positive coping style and PSSS.Conclusion:SCS,SDI,SCSQ and PSSS are important factors influencing UCLA,and the intervention of univer- sity students'loneliness should focus on these variables.

Objective To identify subtypes of human immunodeficiency virus 1(HIV-1)strains from the AIDS patients in Shenzhen and determine whether the HIV-1 subtypes differ in disease progression.Methods HIV-1 env gene was amplified by the nest-RT-PCR from plasma obtained from 26 patients with AIDS in Shenzhen. The C2-V3 regions were sequenced to identify subtypes The plasma viral loads and CD4T lymphocyte were measured as the same time.Results Phylogenetic trees showed that the 12 AIDS patients had subtype B in which, one was close with the U.S reference strain and 11 with the Chinese Yunnan reference strain;13 AIDS patients had subtype CRF01-AE from Thailand;There were no differences in the CD4 cell count and plasma HIV-RNA levels between individuals infected with subtypes B and CRF01-AE.Conclusion Our study indicated that HIV-1 subtype B and CRF01-AE strains were present in AIDS patients in Shenzhen. There was no evidence that the subtypes of virus could determine disease progression.