Objective: To develop a 24 hour physical activity index for school aged children, and to analyze the association of 24 hour physical activity index with screening myopia and obesity, so as to provide a more effective assessment tool for student health risk screening. Methods: From April to June 2024, a total of 451 students in Grades 3-4 from two monitored primary schools in Shanghai were selected using stratified cluster random sampling method. Data on eight core indicators, including daily moderate to vigorous physical activity time, total physical activity time, outdoor activity time, screen time, sleep duration, sleep efficiency, social jetlag and daytime sleepiness, were collected through questionnaires and accelerometer monitoring. Each indicator was standardized and synthesized into a 0-80 point school aged children s 24 hour physical activity index. Spearman correlation analysis and t-test were used to assess consistency between questionnaire and accelerometer derived indices. Multivariate Logistic regression was applied to analyze the association of strength of the composite index with single behavior indicators in screening myopia and overweight/obesity. Results: The compliance rates were higher for moderate to vigorous physical activity time and screen time (50.8%, 98.7%), while the compliance rate for outdoor activity time was only 42.6%, and that for sufficient sleep duration was merely 10.2%. There was no significant difference between the total scores derived from the questionnaire and accelerometer methods (45.13±5.83, 45.05±6.87, t=0.29, P >0.05), but they showed a strong positive correlation ( r=0.58, P <0.01). Multivariate Logistic regression revealed that adjusting for individual behaviors such as grade, gender and both parents being myopic, among single behavior indicators of 24 hour physical activity index, only insufficient outdoor activity time was significantly associated with screening myopia among school aged children ( OR=1.50, 95%CI =1.01-2.21); the detection risk of screening myopia and obesity in the low index group were higher than those in the high index group ( OR=2.47, 95%CI =1.02-5.96; OR=16.63,95%CI = 5.99- 46.20) (all P <0.05). Conclusion The developed 24 hour physical activity index for school aged children demonstrates good measurement accuracy and shows stronger associations with screening myopia and obesity than single behavior indicator.

Objective: To analyze near work illuminance patterns on school days and weekends among third and fourth grade primary school students by using objectively monitored data, and to examine the associations of the duration of near work under different illuminance levels and time weighted average near work illuminance with screening myopia. Methods: From April to June 2024, students from grades 3 and 4 in two primary schools in Jiading District, Shanghai were selected as study subjects by using stratified random cluster sampling method. Continuous objective monitoring of near work behavior was conducted for 7 days while information from uncorrected visual acuity and refractive assessment was collected, and an online questionnaire survey was administered to their parents. Valid samples comprised 372 students on school days and 292 on weekends. Welch s t test was used to compare differences in the duration of near work under different illuminance levels between the screening myopia and non-myopia groups. Multivariable binary Logistic regression analysis was employed to assess the association between the duration of near work under different illuminance levels and screening myopia. Restricted cubic spline (RCS) model was used to explore the nonlinear association between time weighted average near work illuminance with 60 cm and screening myopia, and the critical thresholds identified by the RCS model were used to categorize illuminance levels for subsequent Logistic regression analyses. Results: Objective monitoring of near work behavior showed that the duration of near work in the low illuminance range of [0,125)lx was significantly longer on weekends[(4.12±2.21)h] than on school days [(2.42±1.22)h]. Multivariate Logistic regression analysis revealed that only on school days, each additional hour of near work duration in the [0,125)lx ( OR =1.56, 95% CI =1.23-1.98) and ≥1 000 lx range ( OR =5.92, 95% CI =1.48-23.73) were significantly associated with higher odds of screening myopia(both P < 0.05). RCS plot showed that on school days, time weighted average near work illuminance with 60 cm had a non-linear association with screening myopia ( P non-linear <0.05). On weekends, no significant association was found between near work illuminance indicators and screening myopia (all P >0.05). Conclusions Primary school students engage in near work for considerable durations in insufficient lighting environments on both school days and weekends. Increased duration of near work in overly dim or bright environments on school days may increase the risk of screening myopia.

Objective To investigate the relationship between internet addiction and SIOSS score,and to examine the mediating role of impulsivity and the moderating role of mental health level.Methods A total of 393 college students were tested with internet addiction scale,Barratt impulsiveness scale-version 11,SIOSS and symptom checklist 90 to establish a moderated mediation model.Results After adjusted for age,internet addiction tendency had a positive predictive effect on SIOSS score(β=0.523,P＜0.01).Impulsivity played a partial mediating role in the relationship between internet addiction and SIOSS score,with a mediating effect value of 0.087(45.72％).The first half of the mediating effect of internet addiction→impulsivity→SIOSS score was moderated by mental health level(β=-0.118,P＜0.001).The predictive effect of internet addiction on impulsivity was stronger in individuals with good mental health level(with the indirect effect value of 0.619 9+0.048 7)compared with the individuals with poor mental health level(with the indirect effect value of 0.439 5+0.048 5).Conclusion Internet addiction can increase SIOSS score by enhancing individual impulsivity,but this effect is more pronounced in individuals with good mental health and then affect SIOSS score.

Objective To describe and analyze the influencing factors of psychological crisis among college students with borderline personality disorder(BPD)traits.Methods Self-compiled general information questionnaire,personality assessment inventory-borderline features scale(PAI-BOR),brief version of the difficulties in emotion regulation scale(DERS-16),short version of the UPPS-P impulsive behavior scale(S-UPPS-P),patient health questionnaire-9(PHQ-9),and psychological crisis screening questionnaire were used to survey 340 college students in Shanghai selected by convenience sampling.Participants were assigned to BPD trait or non-BPD trait groups based on PAI-BOR scores.The risk of psychological crisis and influencing factors of the 2 groups were analyzed.Results A total of 323 valid questionnaires were collected.The average age of the participants was(21.39±2.98)years old,and 164 participants were male and 159 were female.The detection rate of borderline personality disorder traits was 19.20%(62/323).There were significant differences in family relationship,experiences of major changes,difficulties in emotion regulation,impulsivity and depression between the 2 groups(all P＜0.05).The detection rates of mild psychological crisis and severe psychological crisis were significantly higher in the BPD trait group than in the non-BPD trait group(both P＜0.001).Stepwise multinomial logistic regression analysis showed that sensation seeking and difficulties in emotion regulation were risk factors for mild psychological crisis in the BPD trait group(both P＜0.05),and sensation seeking and history of mental disorders in close relatives were risk factors for severe psychological crisis in the BPD trait group(both P＜0.05).Conclusion BPD traits in college students are associated with the risk of psychological crisis.Sensation seeking,difficulties in emotion regulation,and history of mental disorders in close relatives are risk factors of psychological crisis among students with BPD traits.Colleges and universities should put more emphasis on the mental health of students with BPD traits,and formulate targeted preventive measures.

OBJECTIVE:To systematically evaluate the correlation between phase angle and sarcopenia and its diagnostic indexes.METHODS:The PubMed,EMbase,Cochrane Library,Web of Science,CNKI,WanFang Data,VIP and SinoMed databases were electronically searched to collect studies on the correlation between phase angle and sarcopenia and its diagnostic indexes from database inception to May 8,2024. Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 and Stata 14.0 software. RESULTS:A total of 50 eligible articles were included. Meta-analysis results showed that compared with the non-sarcopenic population,the phase angle was significantly reduced in sarcopenic patients[standardized mean difference (SMD)=-0.99,95％ confidence interval (CI) (-1.09,-0.90),P<0.00001]. The results of subgroup analysis indicated that the difference of phase angle was more significant in patients with severe sarcopenia and Asian sarcopenia. Moreover,reduction in the phase angle was more obvious in patients with malignant tumors and respiratory diseases with sarcopenia. And skeletal muscle mass index (Pearson's r=0.565,P<0.00001),grip strength (Pearson's r=0.446,P<0.00001),and gait speed (Pearson's r=0.405,P<0.00001) all showed a moderate positive correlation with phase angle. However,appendicular skeletal muscle mass index showed a very weak positive correlation with phase angle (Pearson's r=0.139,P=0.02). CONCLUSION:Phase angle has a significant difference between sarcopenia and non-sarcopenia population,and it is correlated with the diagnostic indexes of sarcopenia to different extents. It suggests that phase angle has some clinical values in the objective diagnosis of sarcopenia. However,the results may be influenced by some factors such as sarcopenia severity and detection instruments of phase angle. Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.

Objective:To explore the gait and eye movement parameters in early Parkinson's disease(PD)with sleep disorders, and analyze their association with underlying pathophysiological mechanisms.Methods:This study was a cross-sectional single-center design that included 82 early PD patients with Hoehn-Yahr(H-Y)staging ≤2.5 who visited Beijing Hospital from October 2023 to May 2025.Patients were divided into two groups according to the PDSS-2 score(total score ≤15 for the no sleep disorder group and total score >15 for the sleep disorder group). Gait and eye movement parameters were collected respectively through the ReadyGo system and the EyeKnow eye movement system, and analyzed in combination with clinical scales.Multivariate logistic regression was employed to identify independent characteristic parameters associated with sleep disorders.Results:In terms of gait, the sleep disorder group had significantly lower step speed, left-right stride speed, and left-right swing speed(all P<0.05), and significantly higher variability of left-right stride time( P=0.017, 0.026). Regarding eye movements, the sleep disorder group had significantly more vertical smooth pursuit offsets[(56.24±2.87)times vs.(45.98±18.18)times, P=0.040], significantly higher maximum real-time variability of the right eye in response to light stimuli(90.75 vs.67.95%, P=0.006), and a longer latency to error responses in the counter-scanning task(337.06 vs.286.63 ms, P=0.005). To precisely control for confounding factors, key covariates such as mood and disease severity were included in the multivariate logistic regression model.After comprehensive adjustment, higher anxiety levels(Hamilton Anxiety Rating Scale, HAMA)( OR=1.32, P<0.001)and an increased number of vertical smooth pursuit offsets( OR=1.06, P=0.010)were independent factors associated with sleep disorders in early PD patients. Conclusions:In early PD patients, sleep disorders are closely associated with specific abnormalities in gait and eye movement parameters.In particular, vertical smooth pursuit offsets may serve as an objective biomarker independent of emotional status, reflecting the dysfunction of shared neural circuits.However, further mechanism studies are needed to verify whether they reflect the dysfunction of shared neural circuits.

It is proposed that the brain Xuanfu and the glymphatic system(GS)have commonality in physiological structure and similarity in functions such as transporting brain substances,transmitting brain information and clearing metabolites.It is believed that GS may be the substantial manifestation of the brain Xuanfu,and GS dysfunction is the key pathological link of depression.Xuanfu stagnation and Shenji dysfunction are the core pathogenesis of depression.Taking"Brain Xuanfu-GS"as the starting point,the patho-logical mechanism of depression is deeply explored,providing a theoretical basis for the clinical diagnosis and treatment of depression in traditional Chinese medicine.

Objective:To explore the dilemmas of caregivers in managing pulmonary rehabilitation exercises in children with post-infectious bronchiolitis obliterans, so as to provide guidance for the development of a pulmonary rehabilitation exercise program.Methods:This study utilized the descriptive qualitative research method. From August to December 2023, 22 primary caregivers of children with post-infectious bronchiolitis obliterans in the First Affiliated Hospital of Guangzhou Medical University were selected by purposive sampling method as study subjects for semi-structured interviews. The information was analyzed using the Colaizzi 7-step analysis.Results:A total of three themes and nine sub-themes were distilled, including information (concern for information on pulmonary rehabilitation exercise showing dynamic changes with the course of the disease, access to information on disease diagnosis and treatment and pulmonary rehabilitation exercise management through non-professional channels, biased perceptions of pulmonary rehabilitation exercise, and lack of a unified guide to information on pulmonary rehabilitation exercise) ; motivation (physiological and psychological barriers in the management and implementation of pulmonary rehabilitation exercises, lack of comprehensiveness and continuity of professional instruction in pulmonary rehabilitation exercises, and insufficient communication and collaborative support among family members) ; and behavioral skills (insufficient mastery of respiratory training methods with complex procedures, and lack of the ability to effectively plan a pulmonary rehabilitation exercise program) .Conclusions:Caregivers of children with post-infectious bronchiolitis obliterans face certain dilemmas in managing pulmonary rehabilitation exercises. It is necessary to improve caregivers' awareness of the benefits of pulmonary rehabilitation exercise, strengthen their perception of exercise benefits, and enhance their training in pulmonary rehabilitation exercise skills, pay attention to children's exercise preferences, and perfect the social support system for diseases to promote the implementation of pulmonary rehabilitation exercise in children.

Objective:To improve the diagnosis and treatment of autoimmune hepatitis (AIH) in children by analyzing their clinical characteristics and outcomes.Methods:Case summary.The general data, clinical manifestations, laboratory parameters, liver pathology, treatment and outcomes of 6 AIH children diagnosed at Xi′an Children′s Hospital from January 2019 to March 2024 were retrospectively analyzed.Results:All the 6 patients were diagnosed with AIH-1, and 5 of them were female, accounting for 83.3%.The median age of onset was 6.2 years old.Three cases (50.0%) had insidious onset.Elevated hepatic aminotransferase levels were detected incidentally in 2 cases (33.3%).One case (16.7%) presented symptoms resembling those of viral hepatitis.Two cases (33.3%) were accompanied by extrahepatic autoimmune diseases.All the children tested positive for anti-nuclear antibodies with a titer ≥1∶80 or 1∶100.Four cases (66.7%), 3 cases (50.0%), and 1 case (16.7%) tested positive for anti-smooth muscle antibodies, anti-perinuclear neutrophil cytoplasm antibodies and anti-soluble liver antigen, respectively.Liver pathology showed infiltration of lymphocytes-plasma cells and moderate or severe interfacial inflammation in all the 6 cases.Two cases (33.3%) had rosettes.All the patients were given oral corticosteroids combined with Azathioprine or Mycophenolate mofetil.The patients were followed up for 24.8 (12.0-52.0) months, during which 3 cases (50.0%) had partial remission and 3 cases (50.0%) achieved complete remission.Four cases (66.7%) showed transaminase fluctuations during corticosteroid reduction or cessation.Conclusions:Autoantibodies and liver pathology are important evidence for diagnosing AIH in children.Immunosuppressants have a high remission rate in the treatment of this disease, but transaminase fluctuations are prone to occur during corticosteroid reduction or cessation.

Objective: To analyze the trajectory of dietary behaviors among middle school students in Jiading District, Shanghai, from 2021 to 2023, and longitudinally verify their association with anxiety and depression symptoms, aiming to provide scientific evidence for promoting the mental health of adolescents. Methods: The data were sourced from the National Monitoring and Intervention Project on Common Diseases and Health Impact Factors of students in Jiading District, Shanghai. A total of 1 217 middle school students who participated in at least two surveys from 2021 to 2023 were selected as the research objects, and group-based trajectory model was constructed to identify their dietary behavior scores trajectories. Modified Poisson regression was used to investigate the impact of dietary behavior scores trajectories on anxiety and depression, while Logistic regression was employed to explore the association between trajectories and changes in depression score levels. Results: The dietary behavior scores trajectories of middle school students were divided into three groups: Persistent Healthy Dietary Behavior (9.5%), Persistent Relatively Unhealthy Dietary Behavior (85.0%), and Persistent Very Unhealthy Dietary Behavior (5.5%). Students who perceived their academic performance as poor and whose parents had a cultural level of high school or below had a significantly lower proportion in the Persistent Healthy Dietary Behavior group compared to students with other characteristics ( χ 2=12.87, 8.69, 6.50, P <0.05). Compared with the Persistent Healthy Dietary Behavior group, the risk of anxiety symptoms in middle school students in the Persistent Very Unhealthy Dietary Behavior group was significantly increased ( aRR=3.04, 95%CI =1.15-8.02); Persistent Relatively Unhealthy Dietary Behavior and Persistent Very Unhealthy Dietary Behavior increased the risk of depressive symptoms ( aRR = 1.80 , 2.45, respectively), and were positively correlated with the increase in depression scores ( aOR =1.70, 2.24) ( P <0.05). Conclusions The dietary behavior of middle school students have not changed significantly in the past three years, with persistent unhealthy dietary behavior being the most common. Unhealthy dietary behaviors are positively correlated with the risk of anxiety and depressive symptoms and an increase in depression scores.