Objective: To investigate the prevalence and associated factors of depressive symptoms among junior and senior high school students in Beijing from 2019 to 2023, in order to provide a scientific basis for interventions targeting high risk groups. Methods: From 2019 to 2023, a stratified cluster random sampling method was used to select 88 927 junior and senior high school students from 16 districts in Beijing. The Center for Epidemiologic Studies Depression Scale(CES-D) was conducted to assess depressive symptoms. The Chi square test was used to compare the detection rates of depressive symptoms among different student groups, and the trend Chi square test was employed for trend analysis of detection rates across the years. Multivariate Logistic regression analysis was applied to examine the association between the detection of depressive symptoms and related factors among junior and senior high school students. Results: From 2019 to 2023, the prevalence rates of depressive symptoms among junior and senior high school students in Beijing were 20.45%, 18.19%, 16.64%, 17.89% and 18.17%, respectively, with an overall downward trend ( χ 2 trend =27.51, P <0.01). Multivariate Logistic regression analysis revealed that after adjusting for gender, monitoring year, educational stage,family structure,boarding status and has taken a medical leave of absence in the past year unhealthy dietary behaviors ( OR=1.80, 95%CI =1.73-1.87), physical inactivity ( OR=1.24, 95%CI =1.19-1.29), try smoking ( OR=1.46, 95%CI =1.35-1.58), try alcohol( OR=1.96, 95%CI =1.88-2.05), Internet addiction ( OR=3.88, 95%CI =3.57-4.22), and adverse ear related behavior ( OR=1.82, 95%CI =1.71-1.93) were all associated with an increased risk of depressive symptoms among junior and senior high school students (all P <0.05). Conclusions The prevalence depression symptoms among middle school students in Beijing showed a fluctuating downward trend from 2019 to 2023. Targeted interventions should be adopted to reduce the occurrence of depression symptoms among junior and senior high school students.

Objective: To understand the trends of classroom lighting and illumination of primary and secondary schools in Beijing from 2016 to 2023, so as to provide a scientific basis for targeted improvement measures. Methods: A sampling survey was conducted on the lighting and illumination indicators of 8 390 classrooms in primary and secondary schools in Beijing from 2016 to 2023. The survey included classroom daylight factor, window to floor area ratio, average illuminance and illuminance uniformity on the desks, average illuminance and illuminance uniformity on blackboards, as well as classroom lighting and blackboard illumination sources. Intergroup comparisons were performed using the Kruskal-Wallis H test and the Chi square test, and Spearman correlation analysis was used to examine the trend of classroom lighting and illumination changes. Results: Except the window to floor area ratio, the measured values and compliance rates of all lighting and illumination indicators showed an overall upward trend from 2016 to 2023 (daylight factor r = 0.27, χ 2 trend =206.80, average illuminance on the desk surface r =0.30, χ 2 trend =87.97, illuminance uniformity on the desk surface r =0.14, χ 2 trend =73.59, average illuminance on the blackboard r =0.33, χ 2 trend =477.43, illuminance uniformity on the blackboard r = 0.09, χ 2 trend =50.76) (all P ＜0.01). The lighting and illumination indicators of classrooms (included classroom daylight factor, average illuminance and illuminance uniformity on the desks, average illuminance and illuminance uniformity on blackboards) in urban schools, primary schools, and secondary schools from 2016 to 2023 showed an upward trend (urban r =0.23-0.40, χ 2 trend =88.66-392.18; primary school r =0.12-0.36, χ 2 trend =39.50-281.44; secondary schools r =0.06-0.31, χ 2 trend =11.79-213.73) (all P ＜ 0.01 ). The illuminance uniformity on the blackboard in suburban schools showed a downward trend ( r = -0.09, χ 2 trend =31.53, both P ＜0.01). The illuminance uniformity on the desk surface in suburban schools showed no significant change ( r =0.03, χ 2 trend =1.23, both P ＞0.05). The other indicators showed an upward trend (daylight factor r =0.28, χ 2 trend =40.69, average illuminance on the desk surface r =0.24, χ 2 trend =16.35, average illuminance on the blackboard r =0.25, χ 2 trend =118.05, all P ＜0.01). The trends of classroom and blackboard illumination sources were that fluorescent lamps decreased year by year and LED lamps increased by year (classroom illumination sources χ 2 trend =1 059.82, blackboard illumination sources χ 2 trend =1 070.25, both P ＜0.01). Conclusions The classroom lighting and illumination in primary and secondary schools in Beijing has shown an overall improving trend from 2016 to 2023. However, problems remain, such as limited improvement of illuminance uniformity indicators, late start and poor effect of reconstruction in suburban schools. Further improvements are still needed.

Objective: To analyze the factors related to dual use of traditional cigarettes and e-cigarettes among middle school students in Beijing, in order to provide a scientific basis for adapting to the new situation and carrying out tobacco control among adolescents. Methods: A multi stage cluster random sampling method was used to select 15 688 and 13 607 junior and senior middle school students from 16 districts in Beijing from April to June in 2019 and 2023, respectively. Online self administered questionnaires among middle school students in Beijing were completed, including use of traditional cigarettes and e-cigarettes, exposure to second hand smoke, attitudes and perceptions towards tobacco, etc. The Chi-square test was used to compare rates, and a multiple factors Logistic regression model was used to analyze related factors of traditional cigarettes and e-cigarettes dual use among middle school students. Results: The dual use rate of traditional cigarettes and e-cigarettes in 2023 had decreased to 2.46% from 4.88% in 2019 among middle school students in Beijing. The results of the multiple Logistic regression model analysis showed that among middle school students, tobacco control anywhere at home (boys: OR =0.47, girls: OR =0.34), without anyone smoking on campus in the past month (boys: OR =0.43, girls: OR =0.26) had lower risks of dual use ( P <0.05); and middle school students strongly or slightly agreeing that smoking could bring happiness (boys: OR =4.11, 2.22, girls: OR =5.32, 3.87), believing that smoking could increase attractiveness of young people (boys: OR =3.13, girls: OR =5.81), smoking cigarettes handed over by good friends (boys: OR =4.24, girls: OR =7.21), thinking smoking in the next year (boys: OR =5.77, girls: OR =7.74) had higher risks of dual use ( P <0.05).Among boys, junior middle school students ( OR =0.50), excellent academic performance ( OR =0.36), no acceptance of free tobacco products from tobacco companies ( OR =0.38), believing that smoking couldn t refresh oneself ( OR =0.37) and smoking still could pose a health hazard though not yet addictive ( OR =0.32) had lower risks of dual use ( P <0.05);and boys with a history of secondhand smoke exposure indoor outside home ( OR =2.19), believing that quitting smoking without difficulty ( OR =2.57),smoking e-cigarettes handed over by good friends ( OR =11.27) had higher risks of dual use ( P <0.05). Among girls, no acceptance of using tobacco product labeled items ( OR =0.28) had lower risks of dual use ( P <0.05); and girls whose parents both smoke ( OR =5.53), believing that quitting smoking might not be difficult ( OR =4.44) had higher risks of dual use ( P < 0.05 ). Conclusions The dual use rate of traditional cigarettes and e-cigarettes among middle school students in Beijing has decreased. It is recommended to take the construction of smoke free families as the starting point, so as to reduce indoor second hand smoke exposure and control tobacco promotions, and promote the formation of correct tobacco control culture and moral constraints among secondary school students.

Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

Objective: To explore the current status of hyperopic reserve and its related factors among non-myopia preschool and primary school students aged 5 to 12 years in Guangdong Province, so as to provide a basis for formulating intervention strategies for the pre myopia stage of children. Methods: From October to December 2023, by using stratified cluster random sampling method, a survey on hyperopic reserve among preschool children and primary school students in Guangdong were conducted. And a total of 10 567 children from the senior class of kindergarten to the sixth grade of primary school who completed autorefraction measurements with and without cycloplegia and the questionnaire survey were included in the study. The prevalence characteristics of low hyperopic reserve among non-myopia children were analyzed, and multivariable Logistic regression was used to analyze the related factors. Results: The prevalence rate of low hyperopic reserve among 8 790 non-myopia children was 62.4%. The average spherical equivalent (SE) for children aged 5 to 12 years was 0.88 (0.25, 1.25)D, decreasing from 1.13 ( 0.75 , 1.50)D in senior kindergarten to -1.00 (-2.50, 0.38)D in sixth grade, with the difference was statistically significant ( H=2 475.3, P <0.01). Multivariable Logistic regression analysis, after adjusting for confounders including gender, urban and rural, and grade, revealed that parental myopia was a risk factor for low hyperopic reserve in the preschool stage (one parent with myopia: OR=1.62, 95%CI =1.35-1.93; both parents with myopia: OR=2.05, 95%CI = 1.66 -2.55); in the lower primary school stage, parental myopia (one parent with myopia: OR=1.46, 95%CI =1.27-1.68; both parents with myopia: OR=1.58, 95%CI =1.33-1.89), frequently or always reading or using electronic screens while lying down or on one s stomach ( OR=1.43, 95%CI =1.13-1.81), and never or occasionally maintaining a viewing distance of over 3 meters when watching TV/playing video games ( OR=1.34, 95%CI =1.04-1.72) were risk factors; in the higher primary school stage, failing to take a break every hour during near work ( OR=1.79, 95%CI =1.16-2.75) was a risk factor (all P <0.05). Conclusions The emmetropization of children aged 5-12 years in Guangdong Province is accelerated, and non-myopia children generally exhibit insufficient hyperopic reserve. The contributing factors for insufficient hyperopia reserve in non-myopia children vary across different educational stages, necessitating targeted precision interventions.

Objective: To understand the prevalence and related factors of tobacco use among junior high school students in Beijing, so as to provide evidence to effectively conduct tobacco control intervention strategy. Methods: From April to June in 2019 and 2023, 6 489 and 6 898 junior high school students were selected by the probability proportion to size(PPS) method, and a total of 13 387 questionnaires were completed. Questionnaire on tobacco monitoring among junior high school students in Beijing was completed by selffilling. The monitoring content included demographic information, secondhand smoke exposure, tobacco product use, tobacco awareness, etc. Chisquare test was used to compare the difference of various indicators in different groups, and multivariate Logistic regression analysis was adopted to analysis the influencing factors related to the current smoking among junior high school students. Results: In 2019,the current traditional cigarettes and ecigarette smoking rates among junior high school students in Beijing were 1.34%, 1.88%, respectively, and decreased to 0.81%, 1.06% in 2023 (χ2=8.36, 15.17, P＜0.01). The attempted traditional cigarettes and ecigarette smoking rates among junior high school students in Beijing decreased from 6.67%, 6.47% in 2019 to 3.93%, 4.16% in 2023 (χ2=49.99, 35.26, P＜0.01). In 2019, the secondhand smoke exposure rates of junior high school students at homes, indoor public places, and outdoor public places were 31.04%, 44.94%, and 49.88% respectively which decreased to 22.59%, 30.23%, and 36.14% in 2023 (χ2=121.63, 308.60, 257.41, P<0.01). In 2023, male students (OR=2.88), senior students (grade 2 and 3) (OR=4.37, 4.92), disposable pocket money>20 yuan/week (OR=2.01), secondhand smoke exposure at home (OR=2.74), indoor public places (OR=2.64), perception that smoking makes young people more attractive (OR=6.29), and perception that ecigarettes help quit smoking (OR=4.31) were associated with higher tobacco use (P<0.05). Conclusions Tobacco use and secondhand smoke among junior high school students in Beijing decrease significantly. Tobacco control interventions should be provided for junior high school students continuously with a focus on ecigarettes use to promote physical and mental health development among students.

Objective: To explore the association between parental myopia and extracurricular activities before school age with myopia among lower grade students, so as to provide evidence for myopia prevention on low grade students. Methods: From November 2020 to June 2022, a total of 8 368 students of grade 1-3 were selected from Beijing, Liaoning, Zhejiang, Henan, Chongqing, Shaanxi Province by the stratified cluster random sampling and probability sampling methods, and were administered with a questionnaire survey and eye examinations. Multivariate Logistic regression was used to analyze the association between parental myopia and extracurricular activities before school age with myopia among lower grade students. Results: The prevalence of myopia in grade 1-3 was 23.7% in 6 provinces in China. Students who in central area, grade 3, boarding at school, doing homework/reading/writing time ≥1 h/d after school, extracurricular activities ≥1 h in the past week, extracurricular activities before school age, parental myopia, poor reading and writing posture, sleeping time <10 h/d, less exercise time because of homework or extracurricular activities, having annual vision examination had a higher myopia detection rate, with statistically significant differences ( χ 2=36.41, 487.72, 15.97, 21.35, 43.95, 15.33, 54.04, 6.67, 3.88, 20.02, 20.06, P <0.05). After adjusted for the confounding factors, there was a significant interaction between parental myopia and extracurricular activities before school age with myopia ( P interaction <0.01). After adjusting for confounding factors, Logistic regression analysis showed that those having extracurricular activities before school age had a higher risk of myopia ( OR=1.33, 95%CI =1.19-1.56), compared with those who did not. Compared with children without nearsighted parents, children with nearsighted parents had higher prevalence of myopia ( OR=1.64, 95%CI = 1.45- 1.84) ( P <0.05); and the values of indicators ( RERI, API, Index S ) for interaction between parental myopia and extracurricular activities before school age were 0.35, 0.27, 1.37, respectively. Conclusion Both parental myopia and extracurricular activities before school age are associated with myopia among lower grade students, with interactive effects.

Objective: To analyze prevalence and associated factors of attempting e cigarettes use among senior high school students in Beijing City between 2019 and 2023, in order to providing references for the construction of smoke free senior high schools environments. Methods: In 2019, 9 137 students from 44 senior high schools in Beijing City were monitored, including 27 general senior high schools and 17 vocational senior high schools. In 2023, the study included 6 709 students from 30 senior high schools comprising 21 general senior high schools and 9 vocational senior high schools. On site investigations using anonymous questionnaires were conducted. The monitoring content included demographic information, second hand smoke exposure, tobacco product use and tobacco awareness. Chi square test was used to compare the differences of various indicators in different groups, and multivariate Logistic regression analysis was adopted to analysis the influencing factors among senior high school students attempting to use e cigarettes between 2019 and 2023. Results: In 2019, the rates of vocational senior high school and general senior high school students attempting to use e-cigarettes were 22.57% and 9.78%, respectively. In 2023, it decreased to 14.39% and 6.43%, respectively. In 2019 ( OR =1.59,95% CI =1.35-1.88) and 2023 ( OR =1.71,95% CI =1.38-2.11), vocational senior high school students both hold higher risk of attempting to use e-cigarettes,compared with general senior high school students. In 2019, non-indigenous senior high school students attempting to use e cigarettes were more than indigenous senior high school students ( OR = 1.28 , 95% CI =1.05-1.56). In 2019 ( OR =1.62, 95% CI =1.34-1.95) and 2023 ( OR =1.77, 95% CI =1.35-2.31), smoking anywhere in households increased the risk of attempting to use e-cigarettes among senior high school students. In both 2019 and 2023, not attempting to smoke cigarettes ( OR =0.24,95% CI =0.21-0.29; OR =0.15,95% CI =0.11-0.19), not currently smoking cigarettes ( OR =0.29,95% CI =0.22-0.40; OR =0.30,95% CI =0.17-0.53), not being exposed to secondhand smoke in school ( OR =0.62, 95% CI = 0.53 -0.72; OR =0.51, 95% CI =0.41-0.64) or in outdoor public places ( OR =0.74, 95% CI =0.63-0.86; OR = 0.62 , 95% CI =0.50-0.78) all reduced the risk of attempting to use e-cigarettes among senior hgih school students( P <0.05). Conclusion The influencing factors of attempts by senior high school students in Beijing City to use e-cigarettes are generally consistent between 2023 and 2019, with a focus on vocational senior high schools to ensure the continuity of intervention measures and promote the construction of smoke free senior high schools.

Objective: To understand the trend of changes of hygiene status in the teaching environment among primary and secondary schools in Beijing City during 2016-2020, so as to provide basis for further improving the teaching environment and campus hygiene conditions in primary and secondary schools. Methods: A proportional systematic sampling method covered over 50% of schools selected annually in Beijing from 2016 to 2019, and 34% were selected in 2020. Two representative classrooms were selected from each selected school for testing based on their structure and other factors, with 6 196 classrooms supervised, from 2016 to 2020,1 330,1 312,1 384,1 322,848 classrooms were monitored for each year. Results: From 2016 to 2020, the overall lighting qualification rate of classrooms (lighting coefficient 72.8%, window to floor area ratio 41.8%, rear wall reflectance ratio 42.2%, blackboard reflection ratio 37.4%), the overall qualification rate of average blackboard illumination and uniformity (50.6%, 34.9 %), and the overall qualification rate of desk and chair allocation (58.6%) were all below 80%. The overall qualification rate of per capita classroom area (87.5%), blackboard size (83.2%), average desk illumination ( 80.1% ), average desk illumination and uniformity (82.9%), the distance between lamp and desk (99.1%), carbon dioxide ( 86.6% ), temperature (84.9%), and noise (96.6%) were all above 80%. The following indicators, blackboard size, the distance between lamp and desk, average blackboard illumination, lighting coefficient, blackboard reflectance, rear wall reflectance, carbon dioxide, temperature, and noise ( χ 2=78.38, 9.71, 11.76, 320.59, 37.63, 58.45, 236.45, 1 347.56, 101.97), had statistically significance between years. Among those indicators, the qualified rates of blackboard size, blackboard reflectance, lighting coefficient, and noise had been increasing year by year ( χ 2 trend =69.98, 15.82, 240.02, 5.77) ( P <0.05). The qualified rates of per capita classroom area, window to floor area ratio, and blackboard reflection ratio in primary schools (81.6%, 39.8%, 36.3%) were all lower than those in secondary schools (94.9%, 44.5%, 40.3%) ( χ 2=246.32, 12.03, 10.51, P <0.05). The qualified rates of blackboard size, average blackboard illumination, average blackboard illumination and uniformity, and desk and chair allocation (89.3%, 55.6% , 36.0%, and 60.2%) were all higher than those in secondary schools (75.4%, 44.1%, 33.3%, and 56.5%) ( χ 2=209.33, 78.41, 4.44, 8.22) ( P <0.05). The qualified rates of average desk illumination and uniformity, average blackboard illumination, rear wall reflectance ratio, desk and chair allocation, carbon dioxide, temperature, and noise indicators in urban area (82.9%, 84.1% , 51.9%, 45.0%, 60.9%, 91.2%, 89.5%, 97.8%) were all higher than those in suburban area (77.3%, 81.7%, 49.2%, 39.5%, 56.3%, 82.3%, 80.4%, 95.5%) ( χ 2=31.16, 6.28, 4.36, 16.40, 13.39, 105.29, 98.23, 24.66， P <0.05). The qualified rates of the distance between lamp and desk, lighting coefficient, window to floor area ratio, blackboard size, blackboard reflection ratio, average blackboard illumination and uniformity, and per capita classroom area in urban areas (98.8%, 65.2%, 34.3%, 76.7%, 35.9%, 30.1%, 84.6%) were all lower than those in suburban areas (99.4%, 81.4%, 49.8%, 89.7%, 40.2%, 39.6%, 90.3%) ( χ 2=6.80, 171.67, 132.43, 188.46 , 12.45, 60.28, 44.82) ( P <0.05). Conclusions The main problems in the teaching environment of schools in Beijing are classroom lighting, as well as desk and chair allocation. The findings suggest technical rationality and operability of relevant standard should be considered when under revision, and standard training and supervision management should be strengthened, with the aim of teaching environment improvement.

Abstract Mycoplasma pneumoniae pneumonia (MPP) refers to pulmonary inflammation caused by mycoplasma pneumoniae (MP) infection, commonly seen in children aged 5 and above, with fever and cough as the main clinical symptoms. As the primary transmission is through direct contact and respiratory droplets, MPP is prone to cause cross infections in schools and homes. To improve school based prevention and control of MPP, the article proposes comprehensive and multi link technical requirements for the organization and management system of MPP syndromic surveillance and early warning, monitoring contents and methods, information report and disposal. A set of MPP syndromic surveillance, early warning and management plans in school is formulated to strictly prevent and control clustered epidemics on campus.