Objective: To examine the characteristics of physical activity among secondary vocational school students and its associations with depressive symptoms, anxiety symptoms, and their co-existence, so as to provide evidence for promoting their mental health. Methods: From September to December 2024, a questionnaire survey was conducted on 5 141 secondary vocational school students using convenience sampling method across 16 secondary vocational schools in 8 provinces/municipalities, including Fujian, Chongqing, Guangdong, Guangxi, Hubei, Jiangxi, Shanghai and Zhejiang. A self designed questionnaire, International Physical Activity Questionnaire Short Form, Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7 were used to assess basic information, physical activity characteristics, and depressive and anxiety symptoms. Chi-square test and Logistic regression model were used to analyze the associations of physical activity characteristics with depressive symptoms, anxiety symptoms, and their co-existence. Results: Among secondary vocational school students, 22.2% had depressive symptoms, 12.2% had anxiety symptoms, and 10.5% had both conditions. After adjustment for confounding factors such as sex, grade, and family structure, Logistic regression analyses showed that a high physical activity level, meeting the recommendation for daily moderate to vigorous physical activity (MVPA), and a concentrated physical activity pattern were associated with lower odds of depressive symptoms, anxiety symptoms, and their co-existence ( OR =0.70-0.81, all P <0.05). Regular weekly MVPA and a regular physical activity pattern were associated only with lower odds of depressive symptoms ( OR =0.79, 0.70, both P <0.05). Sex stratified analyses showed that meeting the recommendation for daily MVPA and a concentrated physical activity pattern were associated with lower odds of depressive symptoms, anxiety symptoms, and their co-existence among boys ( OR =0.60-0.71); a high physical activity level, regular weekly MVPA, and a regular physical activity pattern were associated with lower odds of depressive symptoms among boys ( OR =0.65-0.78)(all P <0.05). Meanwhile, a high physical activity level, meeting the recommendation for daily MVPA, regular weekly MVPA, and regular and concentrated physical activity patterns were associated with lower odds of depressive symptoms in female students ( OR =0.72-0.79) (all P <0.05). Conclusions Physical activity characteristics are associated with depressive symptoms, anxiety symptoms, and their co-existence among secondary vocational school students. Schools should optimize physical activity promotion strategies according to sex specific characteristics to reduce the occurrence of depressive and anxiety symptoms among secondary vocational school students.

Objective: To analyze the compliance status of physical fitness indicator and lifestyle characteristics among secondary vocational school students, as well as their associations, so as to provide a reference for physical fitness promotion among secondary vocational school students. Methods: Using a convenience sampling method, a questionnaire survey and physical fitness tests were conducted from September to December 2024 among 5 141 secondary vocational school students recruited from 16 secondary vocational schools across 8 provinces/municipalities in China, including Fujian, Chongqing, Guangdong, Guangxi, Hubei, Jiangxi, Shanghai and Zhejiang. Data on lifestyle factors were collected using a self designed questionnaire combined with standardized scales, including dietary habits, unhealthy behaviors, and 24 hour behaviors (physical activity, screen time, and sleep behavior). Multivariable Logistic regression model was used to analyze the associations of individual lifestyle behaviors and clustering of unhealthy lifestyle behaviors with non-compliance in physical fitness indicators among secondary vocational school students. Results: The compliance rates for waist circumference, vital capacity, grip strength, standing long jump, 30 second sit ups, 20 meter shuttle run, 50 meter dash, sit and reach, 20 second side steps among secondary vocational school students were 55.9%, 89.6%, 81.8%, 79.4%, 77.8%, 61.4%, 87.0%, 12.6%, and 63.5%, respectively, with a non-overweight/obesity rate of 78.9%. The reporting rates of daily breakfast consumption, milk consumption, and vegetable consumption were 58.9%, 18.3%, and 37.5%, respectively. The reporting rates of frequent takeout consumption, frequent sugar sweetened beverage consumption, smoking, alcohol drinking, insufficient moderate to vigorous physical activity (MVPA), excessive screen time, and insufficient sleep were 30.0%, 43.8%, 8.4%, 15.8%, 42.9%, 90.8%, and 42.6%, respectively. Multivariable Logistic regression analysis showed that secondary vocational school students with insufficient MVPA had higher risks of non-compliance in vital capacity, grip strength, standing long jump, 30 second sit ups, 20 meter shuttle run, 50 meter dash, and 20 second side steps ( OR =1.22- 1.60 ); secondary vocational school students who consumed breakfast daily had lower risks of non-compliance in vital capacity and overweight/obesity ( OR =0.81, 0.85); daily vegetable consumption was associated with a lower risk of vital capacity non-compliance ( OR =0.72); frequent takeout consumption was associated with an increased risk of non-compliance in the sit and reach test ( OR =1.28); smoking was associated with increased risks of non-compliance in the 20 meter shuttle run and 20 second side steps ( OR =1.38, 1.58) (all P <0.05). Regarding the clustering of unhealthy behaviors, secondary vocational school students with 4- 5 clustered unhealthy behaviors had higher risks of non-compliance in waist circumference and standing long jump; those with≥6 clustered behaviors had higher risks of non-compliance in standing long jump, 20 meter shuttle run, and 20 second side step ( OR = 1.17-1.36, all P <0.05). Conclusions The clustering of unhealthy behaviors is negatively associated with physical fitness status among secondary vocational school students. Secondary vocational schools should prioritize the promotion of comprehensive lifestyle management to improve the physical fitness levels of secondary vocational school students.

Abstract As a systematic psychological intervention method, bibliotherapy possesses advantages such as low cost, high accessibility, and significant efficacy. The paper systematically reviews the recent research progress of bibliotherapy in the field of adolescent mental health intervention including covering preventive, therapeutic, developmental, personalized, and comprehensive approaches. It discusses the effectiveness and key influencing factors of these interventions. Findings indicate that bibliotherapy can effectively reduce the risk of depressive and anxiety symptoms in adolescents, and improve their emotional regulation skills and social adaptability. Different types of interventions demonstrate varied effects across different populations. Personalized and comprehensive intervention models can further enhance the outcomes, to provide theoretical basis and practical guidance for the development of localized bibliotherapy intervention programs.

Objective To explore the value of one-stop spectral CT scanning of computer tomography pulmonary angiography(CTPA)combined with abdominal-pelvic enhancement in preoperative evaluation for patients with gynecological tumors.Methods Ninety-six patients with gynecological tumors who received both spectral CTPA and abdominal-pelvic enhanced CT examination at Zhongshan Hospital(Xiamen Branch),Fudan University,between January 2022 and December 2023 were collected.The conventional scanning group(n=48)received two independent spectral CT scans with twice contrast injections,while the one-stop scanning group(n=48)received one-stop spectral CTPA and abdominal-pelvic enhancement with once contrast injection.Virtual monochromatic images(VMIs)at 65 keV for CTPA,50 keV VMIs for abdominal-pelvic enhancement,contrast-enhanced iodine maps and effective atomic number images for the two parts were generated for all patients.The scanning parameters such as contrast agent dose,scanning duration,objective parameters of the images(CT values,iodine concentration,effective atomic number,etc.),as well as overall image quality score,the confidence score in diagnosing pulmonary embolization(PE),and the conspicuity of gynecological tumors were compared between the two groups.Results A total of 24 cases(25% )of PE were found in 96 patients.Compared with the conventional scanning group,the one-stop scanning group showed a significant reduction in contrast agent dosage([62.88±3.59]mL vs[98.52±2.63]mL,P＜0.001)and scan duration([95.94±0.38]s vs[108.91±0.35]s,P＜0.001).There was no statistically significant difference in dose length product(DLP),volume CT dose index,and effective dose(ED)between the two groups.There was no statistically significant difference in objective parameters and subjective image scores between the two groups of patients'CTPA images,abdominal and pelvic CT plain scans,and enhanced images.All image scores were≥3 points,meeting the diagnostic requirements.There was no statistically significant difference of confidence score in diagnosing PE and the ability to display tumor lesions between the two groups.Conclusions In comparison to conventional scanning,one-stop spectral scanning provides comparable image quality,confidence in diagnosing PE,and the conspicuity of gynecological tumors under a lower contrast agent dosage,a shorter scanning time,and a less patient waiting time in the preoperative evaluation for patients with gynecologic tumors,which is highly valuable.

Opacification of intraocular lens(IOL)is a rare postoperative complication of cataract surgery. Its occurrence may be associated with various factors, including manufacturing processes, IOL material, patient factors, and surgical intervention. IOL opacification has been reported in all kinds of materials, and the morphological changes and pathological features of IOL opacification from different materials have their own characteristics, with varying clinical manifestations. With the development of related researches, the understanding of IOL opacification is becoming more and more comprehensive. This article reviews the latest research progress in the morphology, etiology, diagnosis and treatment of IOL opacification, with a view to providing guidance for current clinical work and potential directions for future scientific research.

Objective: To investigate the relationship between health literacy and sports injuries among high school students with athletic specialization, so as to provide theoretical basis for the intervention of sports injury occurrence of sports special students. Methods: A total of 443 high school students with athletic specialization aged 16-18 years old from 21 urban and rural areas in Shangrao City, Ganzhou City and Nanchang City of Jiangxi Province were selected by convenient sampling method from March to April 2023, and the health literacy and sports injury incidence were investigated. The assessment of sports injury was based on the Monitoring Method of Child and Adolescent Injury, and the assessment of health literacy level was conducted using the Interactive Health Literacy Questionnaire of Chinese Adolescents. χ 2 test was used to compare the reported rate of sports injuries among the demographic and sports training groups and the correlation between health literacy and sports injuries. Binary Logistic regression analysis was used to infer the correlation between the health literacy level of high school students with athletic specialization and the occurrence of sports injuries. Results: The prevalence of sports injury was 49.4% in high school students with athletic specialization. Binary Logistic regression analysis showed that the risk of sports injury of high school students with athletic specialization with medium and low level of health literacy was significantly increased compared with high level (medium level: OR = 1.98,95% CI =1.12-3.51; low level: OR =2.08, 95% CI =1.18-3.68), high school students with athletic specialization in low level of health awareness of sports injury risk was higher than other dimensions of health literacy level (middle level: OR =2.77, 95% CI =1.48-5.19; low level: OR =2.01, 95% CI =1.04-3.88)( P <0.05). The results of stratified analysis showed that among male students with athletic specialization and students with track and field, students with moderate/low overall health literacy had a higher risk of sports injuries compared to high level students (male students: low level, OR =2.46, 95% CI =1.15-5.28; track and field: intermediate level, OR =2.17, 95% CI =1.06-4.43, low level, OR =2.09, 95% CI =1.02-4.30; P <0.05). Conclusions There is a correlation between the health literacy level of high school students with athletic specialization and the occurrence of sports injuries. Students health awareness should be improved to reduce the risk of sports injuries.

Objective: To explore the relationship between adolescents physical fitness and depressive symptoms, and to provide reference for the early prevention and intervention of depressive symptoms and improvement of physical fitness in Chinese adolescents. Methods: From September to December 2021, a total of 8 102 adolescents were selected by random cluster sampling method in Shanghai, Urumqi, Changsha and Kunming. The Center for Epidemiologic Studies Depression Scale(CES-D) was used to investigate the depressive symptoms, and completed grip strength, standing long jump, 50 m running, modified sitting forward flexion, 20 s repeated traverse, 30 s sit ups, 20 m round trip running (20 m SRT) test. χ 2 test, Goodman Kruskal Gamma and Logistic regression analysis were used to analyze the relationship between physical fitness index(PFI) and depressive symptoms. Results: The overall detection rate of depressive symptoms in adolescents with high level PFI was 23.4%, and the detection rate of low level adolescents was 26.3%, with a statistically significant difference ( χ 2=6.73, P =0.01). There was a significant positive correlation between PFI and depressive symptoms in the high school group ( G=0.09, P <0.05) and the boy group ( G=0.12, P < 0.05 ), and there was no significant association between PFI and depressive symptoms in the junior high school group and the girl group ( P >0.05). After adjusting for gender and age in the Logistic regression model, compared with those with high PFI, the risk of depressive symptoms in those with low PFI was 1.18 times (95% CI =1.05-1.33). Conclusion There is a correlation between physical fitness and depressive symptoms in adolescents. Adolescents with low PFI are at higher risk of developing depressive symptoms than those with high PFI.

Objective: To explore the association between parents health literacy and health risk behaviors of middle school students, so as to provide theoretical basis for parental health literacy improvement and adolescent health risk behaviors prevention. Methods: A questionnaire survey was conducted among 1 993 middle school students and their parents in northeast Jiangxi Province by multistage stratified random sampling during Jun. to Sept. of 2020. Spearman correlation and generalized linear model were used to explore association between parents health literacy with 5 types of unhealthy behaviors. Results: Generalized linear model analysis showed that after adjusting household economic status and other covariates, parents health literacy was associated with adolescent health risk behaviors, and the scientific health view ( β =-0.05, 95% CI =-0.09--0.01), health information literacy ( β = -0.06 , 95% CI =-0.08--0.05) were associated with substance abuse and violence among middle school students; health information literacy ( β =-0.03, 95% CI =-0.04--0.01) was associated with adolescent healthy eating behavior; health information literacy ( β =-0.03, 95% CI =-0.05--0.02) was associated with breakfast and exercise in middle school students; chronic disease literacy ( β =0.05, 95% CI =0.00-0.09), health information literacy ( β =-0.02, 95% CI =-0.03--0.00) was associated with screen related behavior of middle school students; scientific health view ( β =-0.05, 95% CI =-0.09--0.01), basic medical literacy ( β =-0.08, 95% CI =-0.13--0.04), health information literacy ( β =0.02, 95% CI =0.00-0.03) were associated with middle school students traffic safety behavior( P <0.05). Conclusion There is a certain cross sectional correlation between parents health literacy and adolescent health risk behaviors. It is necessary to clarify the direction and intensity of the correlation in the cohort study.

Objective:To compare the efficacy and safety of Changsulin ? with Lantus ? in treating patients with type 2 diabetes mellitus (T2DM). Methods:This was a phase Ⅲ, multicenter, randomized, open-label, parallel-group, active-controlled clinical trial. A total of 578 participants with T2DM inadequately controlled on oral hypoglycemic agents were randomized 3∶1 to Changsulin ? or Lantus ? treatment for 24 weeks. The efficacy measures included changes in glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2h postprandial plasma glucose (2hPG), 8-point self-monitoring of blood glucose (SMBG) profiles from baseline, and proportions of subjects achieving targets of HbA1c and FPG. The safety outcomes included rates of hypoglycemia, adverse events (AEs) and anti-insulin glargine antibody. Results:After 24 weeks of treatment, mean HbAlc decreased 1.16% and 1.25%, FPG decreased 3.05 mmol/L and 2.90 mmol/L, 2hPG decreased 2.49 mmol/L and 2.38 mmol/L in Changsulin ? and in Lantus ?, respectively. No significant differences could be viewed in above parameters between the two groups (all P>0.05). There were also no significant differences between Changsulin ? and Lantus ? in 8-point SMBG profiles from baseline and proportions of subjects achieving the targets of HbA1c and FPG (all P>0.05). The rates of total hypoglycemia (38.00% and 39.01% for Changsulin ? and Lantus ?, respectively) and nocturnal hypoglycemia (17.25% and 16.31% for Changsulin ? and Lantus ?, respectively) were similar between the two groups (all P>0.05). Most of the hypoglycemia events were asymptomatic, and no severe hypoglycemia were found in both groups. No differences were observed in rates of AEs (61.77% vs.52.48%) and anti-insulin glargine antibody (after 24 weeks of treatment, 6.91% vs.3.65%) between the two groups (all P>0.05). Conclusions:Changsulin ? shows similar efficacy and safety profiles compared with Lantus ? and Changsulin ? treatment was well tolerated in patients with T2DM.