Objective: To explore the barriers to physical activity behavior among overweight and obese children and adolescents, so as to provide evidence for developing physical activity intervention programs. Methods: From March to April 2025, 13 overweight or obese children and adolescents from one primary school and one secondary school in Nanjing were selected by purposive sampling for semi structured interviews. Guided by the capability, opportunity and motivation-behavior model, data were coded, categorized and analyzed using content analysis. Results: A total of 13 interviews were completed, with a cumulative duration of 358 minutes. Three themes and eight subthemes were identified:capability factors, including physical discomfort and limited physical fitness, weak exercise skills and insufficient behavioral regulation ability, and insufficient psychological capability; opportunity factors, including insufficient family support and negative influence, pressure from school and peer environments, and limited time resources and exercise conditions; and motivation factors, including low self efficacy and situations prone to giving up, and insufficient positive feedback and lack of attractiveness of exercise forms. Conclusions Barriers to physical activity among overweight and obese children and adolescents result from the combined effects of capability, opportunity and motivation. It is necessary to lower the threshold for initiating exercise, strengthen positive experiences and feedback, and build integrate family-school support environments to promote the initiation and maintenance of physical activity behaviors in children and adolescents.

Objective To investigate the changes in the density of Aedes albopictus across different regions and different breeding habitats in Baoshan District, Shanghai Municipality from 2018 to 2024, so as to inform evidence-based control strategies for mosquito-borne infectious diseases in Shanghai Municipality. Methods Ae. albopictus surveillance sites were deployed in 12 subdistricts (towns) of Baoshan District, Shanghai Municipality from 2018 to 2024, and the surveillance on the density of Ae. albopictus was performed in each surveillance site once weekly during the peak activity period of Aedes mosquitoes from May to October each year from 2018 to 2024. Mosquito ovitraps were deployed in various breeding habitats in each surveillance site according to geographical locations, including residential areas, schools, government institutions, hospitals, recycling stations, and construction sites, and regularly collected, and the mosquito ovitrap index (MOI) was calculated. The changes in the Ae. albopictus density were analyzed based on MOI across years, regions, and breeding habitats. Additionally, from May to October each year between 2018 and 2024, monthly risk assessments of Aedes albopictus density were conducted in every subdistrict (town) of Baoshan District, Shanghai. Results The annual mean MOI values of Ae. albopictus were 5.88 ± 2.29, 8.19 ± 4.46, 7.43 ± 3.40, 5.44 ± 2.52, 3.97 ± 2.72, 3.82 ± 1.57, and 2.56 ± 1.11 in Baoshan District from 2018 to 2024, respectively (F = 75.886, P < 0.05), and the MOI appeared a rise followed by a reduction each year and peaked during the period between June and August. There was a significant difference in the 7-year mean MOI of Ae. albopictus across the 12 subdistricts/towns (F = 26.558, P < 0.05), and there were 6 subdistricts/towns with a 7-year mean MOI of over 5, including Songnan Town (8.44 ± 4.68), Dachang Town (7.71 ± 5.28), Gucun Town (7.13 ± 3.57), Yuepu Town (5.74 ± 1.69), Gaojing Town (5.51 ± 3.44), and Wusong Subdistrict (5.41 ± 2.04). There was a significant difference in the MOI of Ae. albopictus across breeding habitats (F = 3.843, P < 0.05), with the highest MOI seen in recycling stations (9.86 ± 4.61), which was significantly higher than in other habitats (P < 0.05), and the lowest seen in construction sites (4.90 ± 2.95), which was significantly lower than in other habitats (P < 0.05). The proportion of frequency with Ae. albopictus density transmission risk decreased from 54.17% in 2018 to 11.11% in 2024 in all subdistricts (towns) of Baoshan District, and the frequency of outbreak risks peaked in 2019 (18 instances) and declined substantially in 2021 (6 instances), with no records of outbreak or transmission risk documented across the district in 2024. Conclusions There were substantial seasonal variations in the Ae. albopictus density in Baoshan District, Shanghai Municipality from 2018 to 2024. The Ae. albopictus density peaked during the period between June and August in Baoshan District each year from 2018 to 2024, with a relatively higher density in Songnan Town and Dachang Town, and in recycling stations. Precision control measures and intensified seasonal interventions are recommended in high-risk settings in Baoshan District to reduce the transmission risk of Aedes-borne infectious diseases.

Purpose: This research observed the efficacy and safety of soft tissue expansion combined with recombinant human epidermal growth factor (rhEGF) in repairing second-degree scald scars. Methods: This study conducted a prospective, single-blind, randomized controlled trial. Eighty-four patients with deep second-degree scald scars were evenly divided into the control and observation groups. The control group was treated with soft tissue expansion, and the observation group was additionally treated with rhEGF. The skin expansion and wound healing times were compared. The changes in wound exudate and inflammation around the wound were observed after first-stage surgery. The hydroxyproline (OHP) and collagen I/III ratios were compared during the second stage of surgery.The complications and repair effects during treatment were evaluated. Results: The observation group exhibited lower expansion time, immediate retraction rate, and wound healing time, higher skin expansion rate, higher wound exudate score and inflammation score, higher OHP, lower collagen I/III, lower complication rate, and higher total effective rate than the control group (all P < 0.05). Conclusion Skin soft tissue expansion combined with rhEGF is more effective in repairing second-degree scald scars, which can effectively increase skin expansion area and reduce wound infection and complications.

Objective To measure and analyze through cone-beam computed tomography(CBCT)of the incidence of alveolar bone fenestration and dehiscence,as well as the thickness and height of the alveolar bone in the maxillary canine region of adult patients with different sagittal skeletal patterns.Methods A total of 174 adult patients meeting the criteria were selected.In the first step,the inci-dence rates of fenestration and dehiscence were measured and statistically analyzed after grouping according to ANB.In the second step,the patients with bone fenestration and bone dehiscence were excluded,and the thickness of the alveolar bone at the apical,mid-dle and cervical regions on the labial and palatal sides of the maxillary canine area and the height of the alveolar crest were measured in the remaining samples.Then,the three groups of patients were further divided into three groups according to the FMA for comparison and analysis.Results The incidence of bone fenestration and bone dehiscence in the maxillary canine area was higher in adult patients with skeletal Class Ⅱ.The thickness of the labial alveolar bone at the apical region in skeletal Class Ⅲ was greater than that in skeletal Class Ⅱ and skeletal Class Ⅰ.The thickness of the palatal alveolar bone at the middle root in skeletal Class Ⅱ:average angle＞low angle＞high angle.In skeletal Class Ⅲ,the thickness of the palatal alveolar bone at the cervical root:low angle＞average angle＞high angle.Conclusion The incidence of bone fenestration and bone dehiscence was the highest in adult patients with skeletal ClassⅡ.The thickness of the labial alveolar bone at the apical region was greater in skeletal Class Ⅲ than in skeletal Class Ⅱ and skeletal Class Ⅰ.The thickness of the palatal alveolar bone at the middle root in skeletal Class Ⅱ high angle patients was thinner than that in the average angle and low angle groups,and the thickness of the palatal alveolar bone at the cervical region in skeletal Class Ⅲ was thinner in the high angle group than in the average angle and low angle groups.

Objective·To elucidate the causal relationship between obstructive sleep apnea(OSA)and imaging-derived phenotypes(IDPs)through two-sample Mendelian randomization(MR)studies.Methods·The genetic data related to OSA were obtained from the genome-wide association study(GWAS)(ncase group=50 200,ncontrol group=401 484)in the FinnGen Biobank R11.Twenty-seven single nucleotide polymorphisms(SNPs)were screened out as instrumental variables of OSA.The GWAS of 3 935 IDPs was based on multimodal neuroimaging data from 39 691 individuals of European ancestry in the UK Biobank.Multiple MR methods,primarily utilizing inverse variance weighted(IVW)analysis,were applied,along with assessments for heterogeneity,pleiotropy,and sensitivity.Results·MR analysis indicated that 8 IDPs were associated with OSA.For example,the genetically determined volume of caudal middle frontal gyrus in the right hemisphere was associated with an increased risk of OSA.A one?standard-deviation increase in volume corresponded to an 11%higher risk of OSA(IVW OR=1.11,95%CI 1.06?1.17,P<0.001).Genetically determined reduced risk of OSA was associated with a resting-state functional connectivity characteristic(IVW β=-0.10,95%CI-0.19?-0.01,P=0.025),representing the functional connectivity strength between the bilateral frontal poles and the right frontal-parietal cortex.The heterogeneity test did not find significant heterogeneity among the instrumental variables.The pleiotropy test did not detect any pleiotropy.The sensitivity analysis indicated stable results.Conclusion·Eight IDPs may have a causal relationship with the occurrence of OSA,among which one IDP shows a bidirectional causal relationship,providing potential targets for non-invasive neuromodulation interventions in OSA.

Objective:To explore the pain sensations and experiences of patients with post-stroke hemiplegic shoulder pain, and to provide reference for the formulation of intervention plans.Methods:Objective sampling method was used to conduct semi-structured interviews on 15 patients with post-stroke hemiplegic shoulder pain in the department of neurology and rehabilitation department of Wuhan No.1 Hospital from January to March 2024. The interview outline was established based on the information-knowledge-attitude-practice (IKAP) theory, and the data were analyzed, summarized and extracted by Colaizzi 7-step analysis method.Results:According to the four core components of the IKAP theory, ten themes were extracted. The information and knowledge included the neglect of the importance of early management for hemiplegic shoulder pain, the lack of understanding of the relevant knowledge about hemiplegic shoulder pain, and the use of restricted or incorrect attribution methods in relation to hemiplegic shoulder pain. The attitude included a perception of pain as uncontrollable, the suppression of pain expression, the concern regarding the persistent presence of pain, and the experience of negative emotions. The practice included the adverse effects stemming from hemiplegic shoulder pain, the strategies employed to cope with hemiplegic shoulder pain, and the expectation of multifaceted social support.Conclusions:Patients with post-stroke hemiplegic shoulder pain bear many burdens and have needs in terms of pain experiences. Healthcare professionals need to strengthen pain health education and guidance, help patients develop correct pain cognition and beliefs, refine the pain management system, assist patients in establishing a diverse social support system, enhance their pain coping abilities, and comprehensively promote the rehabilitation of the disease.

Objective:To evaluate the progress and trends in perioperative management of postoperative delirium(POD)in the elderly over the past decade,providing insights for future research in China.Methods:Literature related to perioperative management of POD in elderly patients was retrieved from the Web of Science database published from Jan 1,2014,to Dec 31,2023.Articles and reviews were selected,and CiteSpace 6.3.1 software was used for duplicate removal and comprehensive analysis.Results:A total of 655 relevant publications were included,showing an overall increasing trend in annual output.China contributed 147 publications(22.44%,147/655),while the United States produced 134 publications(20.46%,134/655).Research hotspots focused on"hip fracture","neurocognitive disorders","Alzheimer's disease",and"oxidative stress".Conclusions:Research on the prevention and treatment of POD in elderly patients is growing globally.Although China has produced a substantial number of publications,its academic influence remains relatively limited.While clinical studies have elucidated strategies for POD prevention and treatment,further research is needed to validate intervention efficacy and explore underlying mechanisms.

Objective To evaluate the value of ultrasound and magnetic resonance imaging(MRI)in the diagnosis of knee osteoarthritis(KOA)by Meta-analysis.Methods Multiple databases for literature on KOA ultrasound and MRI diagnosis were screened.After data extraction and study quality assessment,14 articles involving 1613 patients were finally included.Meta-analysis were used on the extracted data to comprehensively evaluate the effectiveness of ultrasound and MRI in the diagnosis of KOA.Results All included studies used arthroscopy or surgical pathology as the gold standard for diagnosis.The pooled sensitivity,specificity,and diagnostic odds ratio(DOR)for ultrasound in diagnosing KOA were 0.79,0.82,and 20.30,respectively,with area under the curve(AUC)was 0.89.In comparison,the pooled sensitivity,specificity,and DOR for MRI in diagnosing KOA were 0.88,0.85,and 42.35,respectively,with AUC of 0.92.Conclusion Ultrasound and MRI have good accuracy in the diagnosis of KOA,and MRI is superior to ultrasound.

OBJECTIVE To investigate the serotypes and antimicrobial resistance rate of clinically isolated Salmonel-la in a children's hospital in Suzhou,and to provide reference for the treatment of salmonellosis.METHOD Totally 177 strains of Salmonella isolated from Children's Hospital of Wujiang District from Jan.2021 to Dec.2023 were collected,and the results of serotypes and drug sensitivity of Salmonella were analyzed.RESULTS The male to fe-male isolation rate of Salmonella was 1.39∶1,with a median age of children infection at 1.3(0.8,2.3)years.The highest number of Salmonella strains were isolated in the month of Jun.,followed by Jul.,Aug.,Sep.,Oct.and May,collectively accounting for 82.49％of all isolates.Acute gastroenteritis was manifested in 142 cases(80.22％),with respiratory tract infections in 38 cases(21.47％)and septicemia in 7 cases(3.95％).The differ-ence in detection rates across the three years was not statistically significant(P=0.806).Salmonella Typhimuri-um was the predominant serotype,representing 54.24％of all isolates.The antimicrobial drug with the highest rate of resistance in Salmonella was ampicillin(71.35％,122/171),followed by sulfamethoxazole/metronidazole(43.60％,75/172),and ampicillin/sulbactam(30.23％,52/172),and no imipenem resistant strains were found.29.07％(50/172)of strains showed multidrug resistance.CONCLUSIONS Boys under three years of age are sus-ceptible to Salmonella infections in summer and fall in this region,with Salmonella Typhimurium being the pre-dominant serotype.Clinical attention should be paid to the characteristics of Salmonella infection and drug resist-ance,as well as the early diagnosis and rational use of antimicrobial drugs.