1.Different Tendon Reconstruction Techniques for Repairing Medial Meniscus Posterior Root Tears:A Biomechanical Study
Yian SUN ; Zhou ZHANG ; Qiang ZHAO ; Xindong ZHAO ; Ming ZHOU ; Liao SONG ; Fei TENG ; Daijun XIE ; Xu LI ; Meng WU ; Jin JIANG
Journal of Medical Biomechanics 2025;40(3):719-725
Objective Through in vitro experiments,biomechanical data of the transtibial pullout suture(TPS),tendon reconstruction(TR),and tendon reconstruction with suture augmentation(TRS)were collected,so as to evaluate the biomechanical effectiveness of tendon reconstruction for repairing medial meniscus posterior root tear(MMPRT).Methods Eighteen porcine knee joint models were divided into TPS,TR,and TRS groups.Sutures were used to fix the meniscal root in TPS group.Tendons were passed through an incision at the meniscal root in TR group.Tendons were passed through an incision at the meniscal root and secured at tendon-meniscus contact area with additional sutures in TRS group.The sutures and tendons were pulled out through tibial tunnels and fixed at the anteromedial tibia.All groups underwent failure load tests,and ultimate failure load,displacement at failure load,load at clinical failure,stiffness,and failure modes of the samples were recorded.Results The maximum failure load in TPS group was significantly higher than that in TR group(P<0.05),but there was no significant difference between TPS group and TRS group(P>0.05).The maximum failure load in TRS group was significantly higher than that in TR group(P<0.05).The displacement under failure load in TR group and TRS group was significantly lower than that in TPS group(P<0.05),but there was no significant difference between TR group and TRS group(P>0.05).There were no significant differences in the load under clinical failure among the 3 groups(P>0.05).The stiffness of TRS group was significantly greater than that of TPS group(P<0.05),but no significant difference was observed between TR group and TPS group,as well as between TR group and TRS group(P>0.05).All failures were caused by suture or tendon cutting through the meniscus.Conclusions The tendon reconstruction techniques is superior to the TPS in terms of failure displacement and stiffness,while the TRS further enhances the stability of the repair.
2.Clinical Study on the Effect of Hongqi Shenmai Drink on Regulating Secretory Phosphoprotein 1 to Improve Heart Failure after Myocardial Infarction of Qi-Yin Deficiency and Blood Stasis Type
Haohao BO ; Chengbo ZHANG ; Chenhan MAO ; Rui YIN ; Meng ZHANG ; Xuemei SUN ; Yansong LI ; Xindong WANG
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(12):1734-1741
OBJECTIVE To study the therapeutic effect of Hongqi Shenmai Drink on heart failure(HF)after acute myocardial in-farction(AMI)with qi-yin deficiency and blood stasis,and its regulatory effect on serum secretory phosphoprotein 1(SPP1)in AMI-HF patients.METHODS Seventy-six patients with AMI-HF of qi-yin deficiency and blood stasis type were enrolled in this study from three centers:Affiliated Hospital of Integrated Traditional and Western Medicine,Nanjing University of Chinese Medicine;Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine;and Changzhou Hospital of Traditional Chinese Medicine.They were randomly di-vided into a traditional Chinese medicine(TCM)group and a control group,with 38 patients in each group.During the treatment period,4 patients in the TCM group and 3 patients in the control group dropped out.The control group received conventional Guideline-directed medical therapy(GDMT),while the TCM group received GDMT plus Hongqi Shenmai Drink.The treatment course for both groups was 12 weeks.The TCM syndrome scores of the two groups of patients were compared before and after treatment,and the clini-cal efficacy and readmission rate were assessed.Echocardiography was used to assess cardiac structure and function.ELISA was used to detect changes in serum SPP1,N-terminal pro-brain natriuretic peptide(NT-proBNP),interleukin-1β(IL-1β),type Ⅰ collagen α1(COL1α1),and matrix metalloproteinase 9(MMP9)levels.The 6-minute walk test(6MWT)was used to assess exercise tolerance,and the Minnesota living with heart failure questionnaire(MLHFQ)was used to assess patients'quality of life.Adverse reactions were monitored in both groups during treatment.RESULTS After treatment,the TCM syndrome scores of both groups decreased signifi-cantly(P<0.01),with the TCM group showing a significantly lower score than the control group(P<0.01).The total effective rate of TCM clinical efficacy in the TCM group was superior to that in the control group(P<0.05),and the readmission rate in the TCM group was significantly lower than that in the control group(P<0.01).Left ventricular end diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),6MWT,and MLHFQ scores improved in both groups(P<0.01),with the TCM group showing superior improvement compared to the control group(P<0.05,P<0.01).Serum levels of NT-proBNP,IL-1β,COL1α1,and MMP9 decreased in both groups(P<0.05,P<0.01).Serum SPP1 levels were significantly decreased in the TCM group(P<0.01),and serum levels of NT-proBNP,IL-1β,COL1α1,and MMP9 in the TCM group were significantly lower than those in the con-trol group(P<0.01).The change in SPP1(ΔSPP1)showed a negative correlation with the change in the cardiac function ΔLVEF(r=-0.42,P<0.01),and a positive correlation with the myocardial fibrosis marker ΔCOL1α1(r=0.58,P<0.01)and the matrix degradation marker ΔMMP9(r=0.51,P<0.01).There was no significant difference in adverse reaction rates between the two groups during treat-ment(P>0.05).CONCLUSION Hongqi Shenmai Drink combined with GDMT can effectively improve clinical symptoms and cardiac function in patients with AMI-HF of qi-yin deficiency and blood stasis type,with good safety.Its mechanism may be related to the in-hibition of SPP1-mediated inflammation-fibrosis pathway and the downregulation of IL-1β,COL1α1,and MMP9 expression.
3.Clinical Study on the Effect of Hongqi Shenmai Drink on Regulating Secretory Phosphoprotein 1 to Improve Heart Failure after Myocardial Infarction of Qi-Yin Deficiency and Blood Stasis Type
Haohao BO ; Chengbo ZHANG ; Chenhan MAO ; Rui YIN ; Meng ZHANG ; Xuemei SUN ; Yansong LI ; Xindong WANG
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(12):1734-1741
OBJECTIVE To study the therapeutic effect of Hongqi Shenmai Drink on heart failure(HF)after acute myocardial in-farction(AMI)with qi-yin deficiency and blood stasis,and its regulatory effect on serum secretory phosphoprotein 1(SPP1)in AMI-HF patients.METHODS Seventy-six patients with AMI-HF of qi-yin deficiency and blood stasis type were enrolled in this study from three centers:Affiliated Hospital of Integrated Traditional and Western Medicine,Nanjing University of Chinese Medicine;Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine;and Changzhou Hospital of Traditional Chinese Medicine.They were randomly di-vided into a traditional Chinese medicine(TCM)group and a control group,with 38 patients in each group.During the treatment period,4 patients in the TCM group and 3 patients in the control group dropped out.The control group received conventional Guideline-directed medical therapy(GDMT),while the TCM group received GDMT plus Hongqi Shenmai Drink.The treatment course for both groups was 12 weeks.The TCM syndrome scores of the two groups of patients were compared before and after treatment,and the clini-cal efficacy and readmission rate were assessed.Echocardiography was used to assess cardiac structure and function.ELISA was used to detect changes in serum SPP1,N-terminal pro-brain natriuretic peptide(NT-proBNP),interleukin-1β(IL-1β),type Ⅰ collagen α1(COL1α1),and matrix metalloproteinase 9(MMP9)levels.The 6-minute walk test(6MWT)was used to assess exercise tolerance,and the Minnesota living with heart failure questionnaire(MLHFQ)was used to assess patients'quality of life.Adverse reactions were monitored in both groups during treatment.RESULTS After treatment,the TCM syndrome scores of both groups decreased signifi-cantly(P<0.01),with the TCM group showing a significantly lower score than the control group(P<0.01).The total effective rate of TCM clinical efficacy in the TCM group was superior to that in the control group(P<0.05),and the readmission rate in the TCM group was significantly lower than that in the control group(P<0.01).Left ventricular end diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),6MWT,and MLHFQ scores improved in both groups(P<0.01),with the TCM group showing superior improvement compared to the control group(P<0.05,P<0.01).Serum levels of NT-proBNP,IL-1β,COL1α1,and MMP9 decreased in both groups(P<0.05,P<0.01).Serum SPP1 levels were significantly decreased in the TCM group(P<0.01),and serum levels of NT-proBNP,IL-1β,COL1α1,and MMP9 in the TCM group were significantly lower than those in the con-trol group(P<0.01).The change in SPP1(ΔSPP1)showed a negative correlation with the change in the cardiac function ΔLVEF(r=-0.42,P<0.01),and a positive correlation with the myocardial fibrosis marker ΔCOL1α1(r=0.58,P<0.01)and the matrix degradation marker ΔMMP9(r=0.51,P<0.01).There was no significant difference in adverse reaction rates between the two groups during treat-ment(P>0.05).CONCLUSION Hongqi Shenmai Drink combined with GDMT can effectively improve clinical symptoms and cardiac function in patients with AMI-HF of qi-yin deficiency and blood stasis type,with good safety.Its mechanism may be related to the in-hibition of SPP1-mediated inflammation-fibrosis pathway and the downregulation of IL-1β,COL1α1,and MMP9 expression.
4.Different Tendon Reconstruction Techniques for Repairing Medial Meniscus Posterior Root Tears:A Biomechanical Study
Yian SUN ; Zhou ZHANG ; Qiang ZHAO ; Xindong ZHAO ; Ming ZHOU ; Liao SONG ; Fei TENG ; Daijun XIE ; Xu LI ; Meng WU ; Jin JIANG
Journal of Medical Biomechanics 2025;40(3):719-725
Objective Through in vitro experiments,biomechanical data of the transtibial pullout suture(TPS),tendon reconstruction(TR),and tendon reconstruction with suture augmentation(TRS)were collected,so as to evaluate the biomechanical effectiveness of tendon reconstruction for repairing medial meniscus posterior root tear(MMPRT).Methods Eighteen porcine knee joint models were divided into TPS,TR,and TRS groups.Sutures were used to fix the meniscal root in TPS group.Tendons were passed through an incision at the meniscal root in TR group.Tendons were passed through an incision at the meniscal root and secured at tendon-meniscus contact area with additional sutures in TRS group.The sutures and tendons were pulled out through tibial tunnels and fixed at the anteromedial tibia.All groups underwent failure load tests,and ultimate failure load,displacement at failure load,load at clinical failure,stiffness,and failure modes of the samples were recorded.Results The maximum failure load in TPS group was significantly higher than that in TR group(P<0.05),but there was no significant difference between TPS group and TRS group(P>0.05).The maximum failure load in TRS group was significantly higher than that in TR group(P<0.05).The displacement under failure load in TR group and TRS group was significantly lower than that in TPS group(P<0.05),but there was no significant difference between TR group and TRS group(P>0.05).There were no significant differences in the load under clinical failure among the 3 groups(P>0.05).The stiffness of TRS group was significantly greater than that of TPS group(P<0.05),but no significant difference was observed between TR group and TPS group,as well as between TR group and TRS group(P>0.05).All failures were caused by suture or tendon cutting through the meniscus.Conclusions The tendon reconstruction techniques is superior to the TPS in terms of failure displacement and stiffness,while the TRS further enhances the stability of the repair.
5.Effects of Bushen Jiedu Formula combined with auricular pressure by coxherb seeds on cancer-induced pain and quality of life in patients with advanced colorectal cancer
Jianna SHI ; Xindong ZHOU ; Ke SUN ; Haibo SHI ; Xia CHEN
Journal of Clinical Medicine in Practice 2024;28(7):41-44
Objective To explore the effects of Bushen Jiedu Formula combined with auricular pressure by coxherb seeds on cancer pain and quality of life in patients with advanced colorectal cancer. Methods A total of 120 patients with advanced colorectal cancer admitted to our hospital from June 2019 to May 2023 were included in the study, and were randomly divided into two groups. The control group (60 cases) received routine nursing care and the "three-step" analgesic method to intervene pain, while the observation group (60 cases) received treatment with Bushen Jiedu Formula combined with auricular pressure by coxherb seeds on the basis of the control group. Both groups were treated for one month. The Numerical Rating Scale (NRS) score, the therapeutic effect, the quality of life (QOL) score and the occurrence of adverse reactions were compared between the two groups before and after treatment, and the levels of substance P (SP), β-endorphin (β-EP) and prostaglandin E2(PGE2) of the two groups before and after treatment in serum were detected. Results After treatment, the NRS score and the levels of SP, β-EP and PGE2 in the observation group were (2.23±0.64), (11.51±2.64) ng/mL, (78.64±9.46) ng/L and (41.90±6.32) ng/L, respectively, which were lower than (2.87±1.25), (15.64±2.42) ng/mL, (101.29±11.26) ng/L and (78.63±10.17) ng/L, respectively of the control group (
6.Relationship between anthropometric parameters and 20 meter shuttle run test among children and adolescents
Chinese Journal of School Health 2023;44(11):1708-1712
Objective:
To determine the association between anthropometric parameters and 20 meter shuttle run test (20 m SRT) score among children and adolescents.
Methods:
The convenient sampling method was conducted to select 3 192 primary and secondary school students in Baoan District, Shenzhen, based on the street school types school from April to May 2019. Height, weight, 20 m SRT score and general demographic indicators were assessed and collected. Individuals were divided into two groups based on the dose response correlation between different anthropometric parameters (the Z score of height, weight and BMI) and 20 m SRT score analyzed with the restricted cubic spline. The association between the Z score of height and 20 m SRT score was further analyzed using the Spearman correlation analysis. Logistic regression analysis was used to analyze separately the relationship different anthropometric parameters and 20 m SRT score.
Results:
The Z value of weight and 20 m SRT score showed a non linear dose response association ( P <0.01), the significant but weak linear correlation between the Z value of height and 20 m SRT score ( r=0.06, P <0.05). The prevalence rate on the low level of the Z value of 20 m SRT score in 3 192 children and adolescents was 44.7%, and the gender ( χ 2=14.02, P <0.01) and grade difference ( χ 2=93.28, P <0.01) were both statistically significant. There was no significant relationship between the Z value of height and 20 m SRT score grade among total population, different genders and different grades ( P > 0.05). Compared with the reference group on the Z value of weight ≤-0.23, individuals with the Z value of weight >-0.23 had the low level of 20 m SRT score ( OR =0.61, P <0.05). Compared with the reference group on the Z value of BMI ≤ 0.25, individuals with the Z value of weight >0.25 had the low level of 20 m SRT score ( OR =0.45, P <0.05). Stratified for gender and grade, the above significant relationship on the Z value of weight, Z value of BMI and 20 m SRT score were still observed ( P <0.01).
Conclusions
The higher height Z value shows on correlations with 20 m SRT score, but the positive association is found between weight and BMI Z value and the 20 m SRT score. The cardiopulmonary fitness improvement may be more effective among children and adolescents when tuking weight and BMI Z scores into consideration.
7.Clinical characteristics of coronavirus disease 2019 infected with Delta variant in Guangzhou:A real-world study
Danwen ZHENG ; Heng WENG ; Yuntao LIU ; Xin YIN ; Jun ZHANG ; Jian ZHANG ; Luming CHEN ; Yuanshen ZHOU ; Jing ZENG ; Yan CAI ; Wanxin WEN ; Qinghua ZHANG ; Lanting TAO ; Liangsheng SUN ; Tianjin CAI ; Weiliang WANG ; Shubin CAI ; Xindong QIN ; Xiaofeng LIN ; Xiaohua XU ; Haimei ZOU ; Qiaoli HUA ; Peipei LU ; Jingnan LIN ; Kaiyuan ZHANG ; Aihua OU ; Jiqiang LI ; Fang YAN ; Xu ZOU ; Lin LIN ; Banghan DING ; Jianwen GUO ; Tiehe QIN ; Yimin LI ; Xiangdong GUAN ; Xiaoneng MO ; Zhongde ZHANG
Chinese Journal of Emergency Medicine 2021;30(10):1220-1228
Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.
8.The relationship between migration time and the prevalence of myopia of children and adolescents aged 6-18 years old in Shenzhen
Renjie WANG ; Qiang ZHANG ; Xiaoyan WU ; Xindong ZHANG ; Shaojun XU ; Jian SUN ; Shichen ZHANG ; Xi WANG ; Qiao ZONG ; Shuman TAO ; Danlin LI ; Wenwen LIU ; Juan TONG ; Tingting LI ; Qianling WANG ; Yi ZHANG ; Fangbiao TAO
Chinese Journal of Preventive Medicine 2021;55(4):460-464
Objective:To analyze the relationship between migration time and the prevalence of myopia of children and adolescents aged between 6 and 18 years old in Shenzhen.Methods:From April to May 2019, 26 618 children and adolescents from 14 schools in six streets of Baoan District, including Fuyong, Shajing, Xin′an, Xixiang, Songgang and Shiyan, were included in the study by using random cluster sampling method. The demographic characteristics, migration status, self-reported myopia, screen time in the last seven days, outdoor activities in the last one month and other information were collected through the questionnaire. The differences of myopia among children and adolescents with different characteristics were compared by χ 2 test, and the relationship between migration time and the prevalence of myopia was analyzed by multivariate unconditional logistic regression model. Results:The age of 26 618 study participants was (12.37±3.49) years old, and the overall prevalence of myopia was 49.4%. Multivariate logistic regression analysis showed that after controlling for relevant confounding factors, compared with migrant children and adolescents of migrant workers who migrated for 1-2 years, those of migrant workers who had migrated for more than 6 years had a higher risk of myopia [ OR (95% CI): 1.48 (1.14-1.92)]. After being grouped by phase of school, in the lower grade group of primary school, the children and adolescents of migrant workers who had migrated for more than 6 years had a higher risk of myopia compared with those of migrant workers who migrated for 1-2 years [ OR (95% CI): 1.96 (1.20-2.74)]. In the high school group, compared with the children and adolescents of migrant workers who migrated for 1-2 years, those of migrant workers who had migrated for 3-5 years and ≥6 years had a higher risk of myopia [ OR (95% CI): 6.03 (1.29-28.15) and 6.52 (1.51-28.11), respectively]. Conclusion:The migration time is related to the prevalence of myopia of the children and adolescents of migrant workers.
9.The relationship between migration time and the prevalence of myopia of children and adolescents aged 6-18 years old in Shenzhen
Renjie WANG ; Qiang ZHANG ; Xiaoyan WU ; Xindong ZHANG ; Shaojun XU ; Jian SUN ; Shichen ZHANG ; Xi WANG ; Qiao ZONG ; Shuman TAO ; Danlin LI ; Wenwen LIU ; Juan TONG ; Tingting LI ; Qianling WANG ; Yi ZHANG ; Fangbiao TAO
Chinese Journal of Preventive Medicine 2021;55(4):460-464
Objective:To analyze the relationship between migration time and the prevalence of myopia of children and adolescents aged between 6 and 18 years old in Shenzhen.Methods:From April to May 2019, 26 618 children and adolescents from 14 schools in six streets of Baoan District, including Fuyong, Shajing, Xin′an, Xixiang, Songgang and Shiyan, were included in the study by using random cluster sampling method. The demographic characteristics, migration status, self-reported myopia, screen time in the last seven days, outdoor activities in the last one month and other information were collected through the questionnaire. The differences of myopia among children and adolescents with different characteristics were compared by χ 2 test, and the relationship between migration time and the prevalence of myopia was analyzed by multivariate unconditional logistic regression model. Results:The age of 26 618 study participants was (12.37±3.49) years old, and the overall prevalence of myopia was 49.4%. Multivariate logistic regression analysis showed that after controlling for relevant confounding factors, compared with migrant children and adolescents of migrant workers who migrated for 1-2 years, those of migrant workers who had migrated for more than 6 years had a higher risk of myopia [ OR (95% CI): 1.48 (1.14-1.92)]. After being grouped by phase of school, in the lower grade group of primary school, the children and adolescents of migrant workers who had migrated for more than 6 years had a higher risk of myopia compared with those of migrant workers who migrated for 1-2 years [ OR (95% CI): 1.96 (1.20-2.74)]. In the high school group, compared with the children and adolescents of migrant workers who migrated for 1-2 years, those of migrant workers who had migrated for 3-5 years and ≥6 years had a higher risk of myopia [ OR (95% CI): 6.03 (1.29-28.15) and 6.52 (1.51-28.11), respectively]. Conclusion:The migration time is related to the prevalence of myopia of the children and adolescents of migrant workers.
10.Sleep status associated with psychological and behavioral problems in adolescents and children
Qianling WANG ; Xindong ZHANG ; Xiaoyan WU ; Qiang ZHANG ; Yi ZHANG ; Jian SUN ; Shichen ZHANG ; Xi WANG ; Qiao ZONG ; Shuman TAO ; Renjie WANG ; Fangbiao TAO
Chinese Journal of Epidemiology 2021;42(5):859-865
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.


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