ObjectiveTo investigate the epidemiological characteristics and influencing factors of depressive symptoms among middle school (junior, senior, and vocational high school) students in Yunnan Province, China, and to inform evidence-based intervention strategies for adolescent mental health. MethodsA cross-sectional survey was conducted between October and November 2023 using stratified random cluster sampling. Students from eight counties (districts) across four prefectures (cities) in Yunnan Province were included. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Multivariate logistic regression analysis was performed to examine factors associated with depressive symptoms, with stratified analyses conducted by gender, educational stage, and ethnicity. ResultsA total of 4 672 questionnaires were distributed, with 4 670 valid questionnaires retrieved, yielding a valid response rate of 99.96%. The surveyed participants were predominantly female students (50.81%), junior high school students (49.13%), ethnic minorities (52.78%), and urban residents (79.29%). The mean CES-D score for middle school students in Yunnan Province was (15.31±10.83). Female students had a significantly higher mean score (16.63±11.41) than male students (13.95±10.02) (P<0.001). Senior high school students had a significantly higher mean score (16.61±10.61) compared to both junior high school students (14.74±11.45) and vocational high school students (13.10±7.71) (all pairwise comparisons P<0.001). The prevalence of depressive symptoms among middle school students in Yunnan Province was 28.18%. The prevalence was significantly higher in females (34.09%) than in males (22.07%). By school type, the detection rate was highest among senior high school students (33.39%), followed by junior high school students (26.29%) and vocational high school students (17.27%) (P<0.05). Multivariate logistic regression analysis showed that female gender (OR=2.16, 95%CI: 1.86‒2.50), being in junior high school (OR=2.43, 95%CI: 1.84‒3.20) or senior high school (OR=2.27, 95%CI: 1.73‒2.98), not living with parents (OR=1.24, 95%CI: 1.07‒1.44), irregular breakfast consumption (OR=1.52, 95%CI: 1.33‒1.75), lack of moderate-to-vigorous physical activity (MVPA) (OR=1.69, 95%CI: 1.37‒2.09), sleep duration ≤5 h per night (OR=2.52, 95%CI: 2.02‒3.14) or 6‒7 h per night (OR=1.47, 95%CI: 1.25‒1.73), smoking (OR=1.86, 95%CI: 1.56‒2.23), and alcohol consumption (OR=1.81, 95%CI: 1.54‒2.13) were positively associated with depressive symptoms. In contrast, screen time ≤1 h (OR=0.71, 95%CI: 0.59‒0.86) was negatively associated with depressive symptoms. Stratified analyses showed that female students not living with parents (OR=1.29, 95%CI: 1.06‒1.58), senior high school students (OR=1.51, 95%CI: 1.21‒1.88), and Han Chinese students (OR=1.37, 95%CI: 1.11‒1.69) were more likely to experience depressive symptoms. Han Chinese students who smoked were also more likely to have depressive symptoms (OR=1.72, 95%CI: 1.34‒2.21). In contrast, male students with screen time ≤1 h (OR=0.71, 95%CI: 0.53‒0.95) and ethnic minority students (OR=0.74, 95%CI: 0.58‒0.95) were less likely to experience depressive symptoms. Regardless of gender, irregular breakfast consumption, lack of MVPA, sleep duration less than 8 h per night, smoking, and alcohol consumption were all positively associated with depressive symptoms (P<0.05). Among both junior and senior high school students, irregular breakfast consumption, lack of MVPA, smoking, and alcohol consumption were positively associated with depressive symptoms (all P<0.05), while screen time ≤1 h was negatively associated with depressive symptoms (all P<0.05). For junior high school students, engaging in 1‒2 days of MVPA per week, screen time more than 2 h per day, and sleep duration 6‒7 h per night were all positively associated with depressive symptoms (all P<0.05). Among junior high, senior high, and vocational high school students, sleep duration ≤5 h per night was positively associated with depressive symptoms (P<0.05). For both Han Chinese and ethnic minority students, irregular breakfast consumption, lack of MVPA, sleep duration less than 8 h per night, and alcohol consumption were all positively associated with depressive symptoms (all P<0.05). ConclusionThe prevalence of depressive symptoms among middle school students in Yunnan Province is comparable to that in central China and higher than that in northern regions. Prevention and control efforts should prioritize female students and those in junior and senior high school stages. Universal improvements in lifestyle behaviors among middle school students, such as regular breakfast consumption, MVPA, sufficient sleep (≥8 h), and abstinence from smoking and alcohol. Particular attention should be given to limiting excessive screen time among junior high school students and addressing the mental health needs of females not living with their parents, senior high school students, and Han Chinese students.

Objective To investigate the incidence of anaemia in patients with psoriatic arthritis(PsA)and explore the relationship between serum hemoglobin(Hb)levels and disease activity and treatment outcomes.Methods Clinical data of PsA patients who visited the Department of Rheuma-tology and Immunology of the First Affiliated Hospital of Nanjing Medical University from March 2019 to May 2024 were collected.Anemia was determined based on Hb values(female＜110 g/L,male＜120 g/L),and clinical characteristics were compared between anemic and non-anaemic patients.Multivariate Logistic regression analysis was used to identify factors associated with treatment response.Results Among anemic patients,the proportion of males was higher than that of females,and the difference was statistically significant(P=0.03).The incidence of skin lesions(P=0.002),pe-ripheral arthritis(P＜0.001),spondylitis(P＜0.001),and enthesitis(P＜0.001)was higher in the anemic group than in the non-anemic group,with statistically significant differences.Patients with anemia had higher composite psoriatic disease activity index(CPDAI)(P＜0.008)and acute-phase reactant levels(P＜0.001),and the differences were statistically significant.Multivariate logistic re-gression analysis showed that patients with concomitant anemia were less likely to achieve the Ameri-can College of Rheumatology 20％improvement criteria(ACR20)than those without concomitant anemia(OR=0.36,P=0.02).Conclusion Anaemia is a common complication of PsA,associated with high disease activity and is a predictor of poor treatment response.

Objective: To understand the current situation of health rooms in primary and secondary schools in Jilin Province, so as to provide the data support for scientific decision making. Methods: From April to July 2023, 512 primary and secondary schools and 1 432 school doctors and health care teachers were selected through convenience sampling method in Jilin Province to conduct an electronic questionnaire survey, including the basic information of the school, the situation of health rooms, personnel setting, and the development of school health work. Results: Among the 512 schools, only 6.4% of the 299 schools that should have clinics had medical institution practice licenses. The compliance rate of clinic area was 16.6%, and the compliance rate of health room area was 75.0%. About 92.1% of the middle schools and 90.6% of the primary schools identified the reporters of infectious diseases, and 90.9% of the primary schools and 85.5% of the secondary schools filed files for students. Totally 73.5% of the staff in the health room were teachers, and only 17.9% were health professionals. Nearly 70.1% of school doctors or health care teachers were engaged in part time jobs, and 60.9% engaged in school health for ≤5 years. In terms of the content in urgent need of training and improvement, the top five were knowledge about first aid (79.7%)，infectious disease prevention and treatment( 73.3 %), health education (64.0%), common disease diagnosis (60.1%) and psychological counseling (53.6%). Conclusions Health care institutions, equipment and facilities in primary and secondary schools in Jilin Province are inadequate, and the construction of school doctors and health care teachers is in need of improvement. It should pay more attention to school health and work together to optimize the team of school doctors and health care teachers.

Authenticity verification is a very important aspect of medical device registration quality management system verification of medical device. How to verify the authenticity of samples is a problem worth discussing. This study analyzes the methods of authenticity verification from the aspects of product retention sample, registration inspection report, traceability of records, hardware facilities and equipment. In order to provide reference for relevant supervisors and inspectors in the verification of registration quality management system.

The tumors of central nervous system refer to a group of benign and malignant diseases originating from tissues or structures within the central nervous system. Common tumors of central nervous system are sporadic, but a few have familial onset. Compared with sporadic brain tumors, the clinical symptoms, diagnostic ideas and follow-up review plans of familial brain tumors are more complicated. The multidisciplinary diagnosis and treatment (MDT) mode usually refers to a treatment mode in which a case involving multiple organs and systems is discussed, and the best treatment plan is formulated for the patient based on the comprehensive opinions of various disciplines. Because familial brain tumors often involve multiple organs, multiple disciplines and multiple systems, and their low incidence leads to less clinical experience for neurosurgeons, the MDT model is more conducive to efficient diagnosis, treatment and management of familial brain tumors. This review elaborates on the neurosurgeon-led MDT model, and introduces the latest research on the epidemiology, genetic characteristics, clinical manifestations, diagnostic ideas and multidisciplinary management of familial brain tumors.

Objective To evaluate the outcomes of acute lower extremity deep venous thrombosis (DVT) in bedridden patients by vascular ultrasound monitoring and analyze the influencing factors. Methods Bedridden patients with acute lower extremity DVT diagnosed by vascular ultrasound were recruited from March 2013 to August 2017. All patients accepted the lower extremity deep venous ultrasound after 2 weeks, and the outcomes of DVT were observed. The patients were divided into DVT improvement group and non-improvement group. The relationships between the factors including clinical characteristics, past history, laboratory examinations, medications and outcomes of DVT were analyzed. The statistically significant influencing factors were taken into the multi factor Logistic regression analysis. Results There were 134 bedridden patients with lower extremity DVT, including 85 males and 49 females, with an average age of (63.9 ± 18.1) years. DVT was improved in 32.8% (44/134) patients, and was not improved in 67.2% (90/134) patients. Anticoagulation therapy, increased international normalized ratio, and delayed thrombin time were associated with improved DVT. Non traumatic causes of bed rest and dehydration were associated with not improved DVT. Anticoagulation therapy ( P＝0.021, OR＝2.729, 95% CI 1.162-6.410) and dehydration treatment ( P＝0.032, OR＝0.240, 95% CI 0.065-0.882) were independent risk factors for improvement of lower extremity DVT. Conclusions Anticoagulation therapy may improve DVT of the lower extremities, and dehydration may aggravate the DVT of the lower extremities. Vascular ultrasound can conveniently and dynamically monitor the changes of the lower limbs DVT in bedridden patients.

Objective To explore the clinical characteristics,prevention,and treatment of acute liver injury (AHI) induced by intravenous amiodarone.Methods The medical records data of 5 patients with AHI caused by intravenous amiodarone in our hospital were collected and retrospectively analyzed,and in the meantime,case reports on intravenous amiodarone-induced AHI in PubMed,CNKI and Wanfang Data were searched.The clinical data of 5 patients in our hospital and case reports from the literature were summarized and the clinical characteristics of AHI induced by intravenous amiodarone were analyzed.Results The 5 patients with AHI induced by intravenous amiodarone in our hospital included 3 males and 2 females with ages of 22-70 years.The total doses of amiodarone were 450-750 mg,incubation periods (the period from drug use to AHI occurrence) were 24-48 h,and the types of liver injury were all hepatocyte type,of which 2 patients' were liver failure.A total of 59 patients with amiodarone-induced AHI were collected (5 in our hospital and 54 from the literature),including 40 males (67.8％) and 19 females (32.2％) with ages from 1 year and 10 months to 93 years and a median age of 69 (58,75) years.In these 59 patients,the incubation periods ranged from 6 hours to 8 days and the median period was 2 (1,3) days,and that of 55 patients (93.2％) were less than or equal to 3 days.The incubation periods of 17 patients with liver failure and 42 patients with non-liver failure were 1 (1,2) days and 2 (1,3) days respectively,and the difference was statistically significant (P =0.033).The peak values of ALT,which were recorded in 55 patients,ranged from 178 to 8 400 U/L,and the median value was 2 418 (922,4 250) U/L.The peak values of AST,which were recorded in 56 patients,ranged from 165 to 17 471 U/L,and the median value was 2 658 (1 205,7 250)U/L.The AST peak values of 16 patients with liver failure and 42 patients with non-liver failure were 6 195 (3 370,6 850) U/L and 2 383 (1 115,5 040) U/L,respectively,and the difference was statistically significant (P =0.032).Among the 59 AHI patients,44 patients' liver function returned to normal,4 patients' liver function improved,and 11 patients died,of whom 9 (81.8％) developed liver failure.Conclusion AHI induced by intravenous amiodarone is an acute onset and severe disease with a short incubation period,and should be monitored timely.

Objective To explore the clinical characteristics,prevention,and treatment of acute liver injury (AHI) induced by intravenous amiodarone.Methods The medical records data of 5 patients with AHI caused by intravenous amiodarone in our hospital were collected and retrospectively analyzed,and in the meantime,case reports on intravenous amiodarone-induced AHI in PubMed,CNKI and Wanfang Data were searched.The clinical data of 5 patients in our hospital and case reports from the literature were summarized and the clinical characteristics of AHI induced by intravenous amiodarone were analyzed.Results The 5 patients with AHI induced by intravenous amiodarone in our hospital included 3 males and 2 females with ages of 22-70 years.The total doses of amiodarone were 450-750 mg,incubation periods (the period from drug use to AHI occurrence) were 24-48 h,and the types of liver injury were all hepatocyte type,of which 2 patients' were liver failure.A total of 59 patients with amiodarone-induced AHI were collected (5 in our hospital and 54 from the literature),including 40 males (67.8％) and 19 females (32.2％) with ages from 1 year and 10 months to 93 years and a median age of 69 (58,75) years.In these 59 patients,the incubation periods ranged from 6 hours to 8 days and the median period was 2 (1,3) days,and that of 55 patients (93.2％) were less than or equal to 3 days.The incubation periods of 17 patients with liver failure and 42 patients with non-liver failure were 1 (1,2) days and 2 (1,3) days respectively,and the difference was statistically significant (P =0.033).The peak values of ALT,which were recorded in 55 patients,ranged from 178 to 8 400 U/L,and the median value was 2 418 (922,4 250) U/L.The peak values of AST,which were recorded in 56 patients,ranged from 165 to 17 471 U/L,and the median value was 2 658 (1 205,7 250)U/L.The AST peak values of 16 patients with liver failure and 42 patients with non-liver failure were 6 195 (3 370,6 850) U/L and 2 383 (1 115,5 040) U/L,respectively,and the difference was statistically significant (P =0.032).Among the 59 AHI patients,44 patients' liver function returned to normal,4 patients' liver function improved,and 11 patients died,of whom 9 (81.8％) developed liver failure.Conclusion AHI induced by intravenous amiodarone is an acute onset and severe disease with a short incubation period,and should be monitored timely.

Objective The incidence rate of pressure ulcer is high in critical patients and off-loading mattresses and reposi-tioning are known as effective interventions for the prevention of pressure ulcers .However, evidence is lacking for selection of the right type of mattresses and suitable interval of repositioning .This study was to compare the effects of two types of off-loading mattresses with two different repositioning intervals in preventing pressure ulcers in critical patients . Methods According to the design of this ran-domized controlled trial , we made a training plan concerning the participants , methods of intervention and comparison , criteria and methods of observation , and methods of recording , and trained 26 nurses from 7 hospitals .Using non-inferiority design and the method of stratified blocked randomization , we divided 1194 patients with the risk of pressure ulcer into a trial group ( n=596) and a control group ( n=598) , a viscoelastic sponge mattress with every-four-hours repositioning used for the former and an automatic aeration mat-tress with every-two-hours repositioning for the latter , both for 7 successive days .We examined the patients every day , recorded the in-cidence and stages of pressure ulcer , and compared the data obtained between the two groups of patients . Results The total inci-dence rate of pressure ulcer was 1.09%(13/1194), significantly lower in the trial than in the control group (0.34%[2/596] vs 1.84%[11/598], P=0.012). Conclusion A viscoelastic sponge mattress with every-four-hours repositioning is superior to an automatic aeration mattress with every-two-hours repositioning and therefore is preferred to the latter in preventing the incidence of pressure ulcer in critical patients in the ICU .

Objective To explore the establishment and implementation of nursing quality evaluation system in department of orthopedics. Methods Randomly 527 patients hospitalized in the department of orthopedics from December 2011 to December 2012 were selected and assigned into the control group, where a traditional evaluation system was used. Another 528 patients hospitalized from April 2013 to June 2014 as the observation group, where orthopedics specialist evaluation system was used. The two groups were compared in terms of hospital evaluation accuracy, observation accuracy, accuracy rate of specialist intervention complications, the qualified rate of nursing records and patient satisfaction. Result The hospital evaluation accuracy, observation accuracy, the accuracy rate of specialist intervention complications, the qualified rate of nursing records and patients satisfaction of the observation group were significantly higher than those of the control group (P<0.01) and there was no incidence in two groups. Conclusion The establishment of orthopaedic nurse quality evaluation system can make up the shortage of traditional evaluation system and improve the quality of the orthopaedic nursing management.