Objective:To explore the distribution of circadian rhythm types in middle school students and analyze the influencing factors of evening-type circadian rhythms.Methods:A cluster sampling method was used to select 10 classes from the junior or senior middle school departments of a certain school, with a total of 381 valid samples obtained from September 16 to October 24, 2023.Psychological health assessments were conducted by the morning and evening questionnaire 5 (MEQ-5), 24-item Hamilton depression scale(HAMD-24), Hamilton anxiety scale (HAMA), social disability screening schedule (SDSS), international physical activity questionnaire short form(IPAQ-SF), and Pittsburgh sleep quality index (PSQI).Based on the score of MEQ-5, students were categorized into evening-type (≤11, n=140), intermediate-type (12-17, n=166), and morning-type (≥18, n=75).The SPSS 25.0 software was used for data analysis, including χ2 test, Kruskal-Wallis test, Spearman correlation analysis, and multiple Logistic stepwise regression analysis. Results:(1)The evening-type, intermediate-type, and morning-type circadian rhythm accounted for 36.7%, 43.6% and 19.7%, respectively.(2) Comparisons among the three groups revealed that the incidence of depression was higher in the evening-type group (32.1%, 45/140) compared to the morning-type(10.7%, 8/75) ( χ2=13.35, P=0.001), the incidence of anxiety was higher in the evening-type (38.6%, 54/140) than in the other two groups(23.5%, 39/166; 20.0%, 15/75) ( χ2=11.70, P=0.003), the incidence of poor sleep quality was higher in the evening-type (61.4%, 86/140) than in the other two groups(44.6%, 74/166; 29.3%, 22/75) ( χ2=21.36, P<0.001), the incidence of social dysfunction was higher in the evening-type (57.9%, 81/140) than in the morning-type(34.7%, 26/75) ( χ2=10.69, P=0.005), and the evening-type had a lower rate of physical activity compared to the other two types ( χ2=19.73, P=0.001).(3) Spearman correlation analysis found a negative correlation between the total MEQ-5 score and the total PSQI score in the evening-type ( r=-0.19, P<0.05).(4) Multiple Logistic regression analysis showed that, compared to the intermediate-type, the risk factors for the evening-type included introverted mother personality ( B=-2.68, OR=0.07, 95% CI=0.01-0.63, P<0.05), and neutral mother personality ( B=-0.66, OR=0.52, 95% CI=0.28-0.96, P<0.05) compared to extroverted mother personality.Compared to high physical activity, low physical activity ( B=-1.12, OR=0.33, 95% CI=0.19-0.57, P<0.01) and moderate physical activity ( B=-0.71, OR=0.49, 95% CI=0.27-0.91, P<0.05) were risk factors for evening-type.Compared to the morning-type, the introverted personality ( B=1.23, OR=3.41, 95% CI=1.18-9.87, P<0.05) and neutral personality ( B=1.36, OR=3.91, 95% CI=1.52-10.05, P<0.01) were the protective factors of the evening-type relative to the extroverted personality.Low physical activity ( B=-1.33, OR=0.26, 95% CI=0.13-0.55, P<0.01) was a risk factor for the evening-type relative to high physical activity. Conclusion:The evening-type circadian rhythm may be associated with anxiety and depressive emotions, reduced sleep quality, and impaired social function in middle school students.Additionally, low physical activity levels may be a risk factor for the occurrence of evening-type circadian rhythm.

Objective:To explore the distribution of circadian rhythm types in middle school students and analyze the influencing factors of evening-type circadian rhythms.Methods:A cluster sampling method was used to select 10 classes from the junior or senior middle school departments of a certain school, with a total of 381 valid samples obtained from September 16 to October 24, 2023.Psychological health assessments were conducted by the morning and evening questionnaire 5 (MEQ-5), 24-item Hamilton depression scale(HAMD-24), Hamilton anxiety scale (HAMA), social disability screening schedule (SDSS), international physical activity questionnaire short form(IPAQ-SF), and Pittsburgh sleep quality index (PSQI).Based on the score of MEQ-5, students were categorized into evening-type (≤11, n=140), intermediate-type (12-17, n=166), and morning-type (≥18, n=75).The SPSS 25.0 software was used for data analysis, including χ2 test, Kruskal-Wallis test, Spearman correlation analysis, and multiple Logistic stepwise regression analysis. Results:(1)The evening-type, intermediate-type, and morning-type circadian rhythm accounted for 36.7%, 43.6% and 19.7%, respectively.(2) Comparisons among the three groups revealed that the incidence of depression was higher in the evening-type group (32.1%, 45/140) compared to the morning-type(10.7%, 8/75) ( χ2=13.35, P=0.001), the incidence of anxiety was higher in the evening-type (38.6%, 54/140) than in the other two groups(23.5%, 39/166; 20.0%, 15/75) ( χ2=11.70, P=0.003), the incidence of poor sleep quality was higher in the evening-type (61.4%, 86/140) than in the other two groups(44.6%, 74/166; 29.3%, 22/75) ( χ2=21.36, P<0.001), the incidence of social dysfunction was higher in the evening-type (57.9%, 81/140) than in the morning-type(34.7%, 26/75) ( χ2=10.69, P=0.005), and the evening-type had a lower rate of physical activity compared to the other two types ( χ2=19.73, P=0.001).(3) Spearman correlation analysis found a negative correlation between the total MEQ-5 score and the total PSQI score in the evening-type ( r=-0.19, P<0.05).(4) Multiple Logistic regression analysis showed that, compared to the intermediate-type, the risk factors for the evening-type included introverted mother personality ( B=-2.68, OR=0.07, 95% CI=0.01-0.63, P<0.05), and neutral mother personality ( B=-0.66, OR=0.52, 95% CI=0.28-0.96, P<0.05) compared to extroverted mother personality.Compared to high physical activity, low physical activity ( B=-1.12, OR=0.33, 95% CI=0.19-0.57, P<0.01) and moderate physical activity ( B=-0.71, OR=0.49, 95% CI=0.27-0.91, P<0.05) were risk factors for evening-type.Compared to the morning-type, the introverted personality ( B=1.23, OR=3.41, 95% CI=1.18-9.87, P<0.05) and neutral personality ( B=1.36, OR=3.91, 95% CI=1.52-10.05, P<0.01) were the protective factors of the evening-type relative to the extroverted personality.Low physical activity ( B=-1.33, OR=0.26, 95% CI=0.13-0.55, P<0.01) was a risk factor for the evening-type relative to high physical activity. Conclusion:The evening-type circadian rhythm may be associated with anxiety and depressive emotions, reduced sleep quality, and impaired social function in middle school students.Additionally, low physical activity levels may be a risk factor for the occurrence of evening-type circadian rhythm.

Objective:To analyze the application value of tibial transverse transport (TTT) microvascular reconstruction combined with antibiotic bone cement in the limb salvage of diabetic foot.Methods:Seventy-seven patients with diabetic foot admitted to the Traditional Chinese Medicine Hospital of Zhongshan from January 2018 to January 2021 were enrolled retrospectively, and they were divided into the control group (performed TTT microvascular reconstruction, 47 cases) and the combined group (performed TTT microvascular reconstruction combined with antibiotic bone cement, 30 cases) according to the surgical method. Wound healing rate, limb salvage rate, the ulcer healing time, bone window healing time, wound infection control status, affected side lower limb vascular blood supply situation, and peripheral nerve function recovery were compared between the two groups.Results:The amputation rate between the two groups had no significant difference ( P>0.05), but the healing rate in the combined group was higher than that in the control group: 90.00%(27/30) vs. 68.08%(32/47); and the ulcer healing time, bone window healing time in the combined group were shorter than those in the control group: (12.55 ± 2.14) weeks vs. (15.01 ± 3.17) weeks, (17.47 ± 2.09) weeks vs. (19.00 ± 2.58) weeks, there were statistical differences ( P<0.05). The positive percentage of bacteria culture in wound secretions in the combined group after the surgery for 6 d was lower than that in the control group: 20.00%(6/30) vs. 44.68%(21/47), there was statistical difference ( P<0.05). After the surgery for 3 months, the dorsal skin temperature and ankle brachial index in the combined group were higher than those in the control group: (31.05 ± 1.74) ℃ vs. (29.27 ± 1.66) ℃, 0.93 ± 0.29 vs. 0.80 ± 0.19, there were statistical differences ( P<0.05), but the scores of visual analog scale (VAS) and 10 g nylon line test values between the two groups had no significant differences ( P>0.05). Conclusions:TTT combined with antibiotic bone cement can achieve better wound healing and infection control effect in the limb salvage of diabetic foot, and the blood supply improvement of the affected limb is more significant.

Objective To investigate the anatomical features of different types of unstable fractures of pelvic ring,and to observe the therapeutic effect of open reduction and internal fixation combined with three-stage syndrome differentiation and treatment.Methods Nineteen patients with pelvic fracture were classified according to Tile's classification for pelvic fracture.Of 19 patients,12 were classified into type B(6 being type B1,3 type B2,and 3 type B3),and 7 into type C(3 being type C1,2 type C2,and 2 type C3).All of the patients received pelvic reconstruction through open reduction and internal fixation with titanium plate.After treatment,three-stage syndrome differentiation and treatment were carried out: Taohe Chengqi Decoction was used in the early stage of fractures,Xugu Huoxue Decoction in the middle stage and Yangjin Jiangu Decoction in the late stage.Meanwhile,traumatic ointment was applied on the affected region after the union of operation wound.Results After operation,the follow-up was carried out in all of the patients for 12 ～ 36 months,averaged 18 months.The results of follow-up showed that the fractures and dislocation of all the patients were healed within 3 ～ 6 months,and the patients obtained the normal life and walking function.The results of Majeed's classification showed that 17 were effective,2 ineffective and the effective rate was 89.47%.Conclusion According to the classification of pelvic fractures,it is a better method for pelvic fractures by pelvic reconstruction through different methods of open reduction and internal fixation with titanium plate,and then by three-stage syndrome differentiation and treatment.