Abstract To promote adolescents active participation in physical activity and improve sleep quality, the article analyzes the relationship of adolescent physical activity with subjective sleep satisfaction, sleep latency, sleep continuity, sleep efficiency, and sleep duration. It explores potential mechanisms underlying the link between physical activity and sleep quality, including physiological mechanisms (circadian rhythms, body temperature, neuroendocrine systems, and immune function), and psychological mechanisms (stress relief, improvement of negative emotions, and promotion of mental relaxation). Based on existing research, it is recommended that adolescents engage in moderate to vigorous physical activity daily to promote improved sleep quality.

Objective: To explore the association between executive function and emotional and behavioral problems in first-grade elementary school students, so as to provide a reference for promoting children s mental health. Methods: From March to May 2024, 423 first-grade elementary school students from 6 primary schools aged 6-7 were selected by using stratified cluster random sampling in Shanxi, Shanghai, Shandong, Guangxi, Xinjiang, and Jiangxi. Data were collected by using the Executive Function Assessment Scale and the Strengths and Difficulties Questionnaire. An independent samples t-test was used to analyze differences in executive function of different genders and differences in emotional and behavioral problems among first-grade school students with varying executive function levels; a linear regression model was employed to analyze the association between children s executive function and emotional and behavioral problems. Results: A total of 42 first-grade elementary school students (9.9%) were identified as having executive function deficits. Students in the executive function deficit group scored higher on internalizing behavior (7.50±0.52), externalizing behavior (11.26±0.52), and total difficulties (18.52± 0.93 ) were significantly higher than those of children without deficits (4.37±0.14, 6.69±0.17, 10.64±0.27) ( t =5.79, 8.50, 9.23, all P <0.05). Results of linear regression analysis showed that, after controlling for relevant covariates such as gender, age, family economic status, being an only child, and body mass index, the factor scores, dimensional scores, and total scores of executive function were all positively correlated with scores for externalizing problems, internalizing problems, and total difficulties ( β =0.07-0.32, all P <0.05). Conclusions Children s executive function is closely associated with emotional and behavioral problems, and those with poorer executive function exhibit more pronounced emotional and behavioral problems. Improving children s executive function may help promote their mental health.

Objective: To investigate the relationship between night-time noise exposure and depressive symptoms among junior and senior high school students, so as to provide evidence to support strategies for promoting their physical and mental health. Methods: From September 2024 to December 2025, 2 900 junior and senior high school students were selected using stratified cluster random sampling in the three cities of Nanning, Lhasa, and Yanji. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive symptoms in junior and senior high school students, and a noise exposure survey was conducted. Chi-square test was used to compare the prevalence of depressive symptoms among junior and senior high school students with different types of night-time noise exposure, and Logistic regression models were employed to examine the association between night-time noise exposure and depressive symptoms among junior and senior high school students. Results: The prevalence of depressive symptoms among junior and senior high school students without night-time noise exposure was 33.0%, while that among junior and senior high school students with night-time noise exposure was 49.0%; the difference was statistically significant ( χ 2= 45.85 , P <0.01) . After adjusting for gender, age and region, Logistic regression analysis showed that exposure to night-time traffic noise, neighborhood noise, air conditioner noise, and other types of noise showed increased risk of detecting depressive symptoms in junior and senior high school students ( OR =2.22, 1.84, 2.41, 2.17, all P <0.05). Conclusion Night-time noise exposure is associated with an increased risk of depressive symptoms among junior and senior high school students.

Abstract Children s emotional and behavioral problems are characterized by a relatively high incidence, concealed manifestations, and a potential correlation with an increased risk of subsequent mental disorders. These problems have a sustained impact on children s social-emotional development, learning adaptation, and peer relationships. The study reviews the main influencing factors and their mechanisms of action regarding children s emotional and behavioral problems from three levels:individual, family, and social. Under a multi-level integrated perspective, it deepens the understanding of these mechanisms and proposes that future efforts should focus on factors such as improving physical fitness, enhancing sleep, and reducing sedentary behavior. Furthermore, it suggests strengthening collaborative interventions among schools, families, and communities to promote the early prevention of childrens emotional and behavioral problems and support their healthy development.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

A child aged 5 years with pulmonary arterial hypertension was admitted to the First Affiliated Hospital of Xiamen University in December 2017. A truncated mutation in the bone morphogenetic protein receptor 2 (BMPR2) gene [Chr2(GRCh37):g.203395656delA] was detected, which might be responsible for the disease and the diagnosis of hereditary pulmonary arterial hypertension (HPAH) was confirmed. Genetic testing revealed that the child′s father also carried the same mutation in BMPR2 gene, but no gene mutation was detected in child′s mother and young brother; however, no HPAH was developed in child′s father and other family members. The child was treated with targeted drugs for pulmonary arteries with poor response, and died in April 2019. Later, the child′s mother accidentally became pregnant. Gene sequencing test of the amniotic fluid showed that the fetus also carried the BMPR2 gene mutation; the pregnancy was terminated after genetic counseling. HPAH has the clinical characteristics of early onset, rapid progression, and poor prognosis, and the BMPR2 gene mutation is an important pathogenic factor. For HPAH patients with unknown etiology, particularly for pediatric patients, genetic testing is recommended to identify the cause and to make an appropriate clinical management plan.

Objective:To explore the impact of the stimulator of interferon genes(STING)-interferon regulatory factor 3(IRF3)pathway on the senescence of rapid pacing HL-1 myocytes.Methods:HL-1 cells were divided into five groups: the control group(HL-1 cells without any treatment), pacing group(HL-1 cells paced for 48 hours), STING siRNA group(HL-1 cells paced for 48 hours and transfected with STING siRNA), NC siRNA group(HL-1 cells paced for 48 hours and transfected with NC siRNA), and H151 inhibitor group(HL-1 cells paced for 48 hours with the addition of 1 μmol/L STING inhibitor H151). Mitochondrial membrane potential was assessed in control and pacing group cells, and mitochondrial MitoTracker and TFAM co-localization staining was performed on these cells.Cellular senescence was evaluated using β-galactosidase staining in each group, and the positive rate of cellular senescence was observed and calculated.Western blotting was employed to detect the expression levels of STING, IRF3, P-IRF3, P16, P21, and P53 proteins in all groups.Immunofluorescence was utilized to examine the expression distribution of STING and P21 across the various groups.ELISA was performed to measure the concentrations of interleukin(IL)-1β, IL-6, and IL-8 in the cell supernatants from each group as part of the senescence-associated secretory phenotype(SASP).Results:Compared with the control group, the ratio of mitochondrial JC-1 multimer to monomer was significantly decreased in the pacing group( t=16.42, P<0.05), the co-localization of mitochondrial MitoTracker and TFAM in the cells was significantly weakened, the proportion of cells with positive cellular senescence-associated β-galactosidase staining significantly increased in the pacing group, the expression levels of STING, P-IRF3/IRF3, P16, P21, and P53 proteins were significantly elevated in the pacing group, and the concentrations of IL-1β, IL-6, and IL-8 in the cell supernatants were markedly increased.Compared with the pacing group, the proportion of cells with positive cellular senescence-associated β-galactosidase staining decreased in the STING siRNA group and H151 inhibitor group ( F= 18.13, P<0.05), the expression levels of STING, P-IRF3/IRF3, P16, P21, and P53 were reduced in the STING siRNA group and H151 inhibitor group ( F=16.84, 26.56, 74.70, 31.80, 31.23, all P<0.05), and the concentrations of IL-1β, IL-6, and IL-8 in the cell supernatants decreased( F=197.80、1 339.00、1 308.00, all P<0.001). Conclusions:Rapid pacing of HL-1 cells can promote mtDNA release into the cytoplasm, activate the STING-IRF3 pathway, accelerate cellular senescence, and enhance the secretion of SASP.Inhibiting the expression of STING can delay the senescence induced by the rapid pacing of HL-1 cells and reduce SASP secretion.

Objective:To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo.Methods:Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily (2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg) in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index (F-VASI) and total body VASI (T-VASI) at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course.Results:Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions (F-VASI 50), 1 patient achieved F-VASI 75 (75% ~ < 90% improvement), and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 (≥ 90% improvement), and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment.Conclusion:The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

The concept of harmony between heaven and man is an important concept in TCM. The theory of "harmful hyperactivity and responding inhibition" has been developed and perfected by medical professionals throughout history to explain physiological and pathological changes in humans based on a natural understanding. Guided by the TCM philosophy of "harmful hyperactivity and responding inhibition", it provides guidance for attention deficit hyperactivity disorder (ADHD). Sorting out the complex pathogenesis, it has been found that core pathogenesis of the disease is the excessive damage to the five organs, which leads to the overall state of yin deficiency and yang hyperactivity in the human body. The treatment mainly focuses on regulating the hyperactivity and damage of the organs, restoring the balance of yin and yang, while also taking into account the harm of pathological products. Based on clinical manifestations, the secondary selection of medication for liver and liver hyperactivity and spleen and kidney dysfunction has been determined, while improving the hyperactivity of the external environment, in order to achieve the goal of "tolerance is control", which fully embodies the TCM syndrome differentiation thinking of "unity of heaven and man, holistic concept".

Objective To discuss the application value of coronary CT angiography(CCTA)evaluation of morphological parameters of coronary chronic total occlusion(CTO)in guiding interventional therapy.Methods A total of 300 patients with coronary angiography-confirmed CTO in Jinhua Municipal People's Hospital from January 2021 to December 2023 were selected.All patients received CCTA examination before surgery.The morphological parameters of CCTA,including proximal morphology of occlusion segment,length of occlusion vessel,length of linear enhancement in occlusion segment,length of linear enhancement in occlusion segment/length of occlusion vessel,vascular linear enhancement in occlusion segment,vascular calcification in occlusion segment,vascular calcification area in occlusion segment ≥50％on cross section image,tortuous path of lesion(＞45°),collateral vessels and lesion of vascular opening,were recorded.The correlation between the above parameters and therapeutic results of percutaneous coronary intervention(PCI)was analyzed.Results There were 325 lesions in 300 patients with CTO,and 227 lesions(69.85％)were successfully treated by PCI and PCI treatment failed in 98 lesions(30.15％).The proximal blunt shape of occlusion segment,length of occlusion vessel,vascular calcification area of occlusion segment ≥50％on cross section image,and tortuous path of lesion(＞45°)in the failure group were significantly higher than those in the successful group(all P＜0.05),while the length of linear enhancement in occlusion segment,length of linear enhancement in occlusion segment/length of occlusion vessel and vascular linear enhancement in occlusion segment in the failure group were strikingly lower than those in the successful group(all P＜0.05).No obvious significant differences in other parameters existed between the two groups(all P＞0.05).Multivariate logistic regression analysis showed that the length of linear enhancement in occlusion segment(OR=1.975,95％CI:1.306-2.988),the length of linear enhancement in occlusion segment/length of occlusion vessel(OR=3.831,95％CI:1.332-11.017),and the linear enhancement in occlusion segment(OR=1.702,95％CI:1.007-2.879)were the valuable factors for predicting the success of PCI treatment(all P＜0.05).Conclusion CCTA evaluation of coronary CTO morphological parameters has a certain value in guiding interventional therapy.The length of linear enhancement in occlusion segment,the length of linear enhancement in occlusion segment/length of occlusion vessel,and the linear enhancement in occlusion segment are the useful factors for predicting the success of PCI treatment.