Objective: The association between school bullying and attention deficit hyperactivity disorder (ADHD) symptoms among students in primary schools and the moderating role of gender was explored to provide scientific evidence for the prevention and control of school bullying. Methods: A total of 4 764 students from 2 primary schools in Wuhan were selected using the convenience sampling method in March 2023. The Olweus Bully/Victim Questionnaire and Strengths and Difficulties Questionnaire were used. A Pearson χ 2 test was used to compare differences in school bullying rates among children with and without ADHD symptoms. Pearson correlation analysis and Process 3.3 were used to analyse the association between ADHD symptoms, and school bullying behaviour and the moderating role of gender. Results: The reported rate of bullying victims in primary schools was 24.2% and the rate of bullying perpetration was 3.8%. The rate of ADHD symptom detection among primary school students was 5.9%. ADHD symptoms were positively associated with bullying and bullying victim behaviour ( r =0.16, 0.27, P <0.01). Specifically, the association between ADHD symptoms and bullying behavior tended to be stronger among boys than girls ( β boy =0.17, t =11.13; β girl =0.07, t =4.11, P <0.01). Conclusions ADHD symptoms are an important factor influencing school bullying behaviors in students, and gender moderates the association. In the process of preventing and controlling school bullying, ADHD symptoms and gender differences should be emphasized and comprehensive interventions should be implemented.

Objectives:To evaluate the cost-effectiveness of typical pharmaceutical smoking cessation intervention strategies in China in the context of primary cancer prevention.Methods:Markov cohort simulation models were established to simulate the burden of 12 smoking caused cancer, including lung cancer, oral cancer, nasopharyngeal cancer, laryngeal cancer, esophageal cancer, gastric cancer, pancreatic cancer, liver cancer, kidney cancer, bladder cancer, cervical cancer, and acute myeloid leukemia. Taking incremental cost effectiveness ratio (ICER) as the main indicator, the model sets one year as the cycling period for 50 periods and simulates the cohort of 10 000 thirty-five-year-old current smokers with various smoking cessation strategies. To ensure the robustness of conclusion, univariate sensitivity analysis, probability sensitivity analysis, and age-group sensitivity analysis were conducted.Results:The results showed that varenicline intervention was the most cost-effective intervention. Compared to the next most effective option, incremental cost of each additional quality-adjusted life year is 11 140.28 yuan, which is below the threshold of willingness to pay (1 year GDP per capita). The value of ICER increased as the increasing age group of adopting intervention, but neither exceeded the threshold of willingness to pay. One-way sensitivity analysis showed that the value of discount rate, the hazard ratio and cost of intervention strategy had a greater impact on the result of ICER.Conclusion:In China, the use of varenicline to quit smoking is highly cost effective in the context of cancer primary prevention, especially for younger smokers.

Objective:To compare the short-term and long-term efficacies and safety of short-term spinal cord stimulation (st-SCS) and pulsed radiofrequency (PRF) in treating zoster-associated pain (ZAP).Methods:A total of 208 ZAP patients who received treatment in Department of Pain Management, Provincial Hospital Affiliated to Shandong University from January 2019 to September 2021 were selected. They were divided into st-SCS group ( n=107) and PRF group ( n=101) according to different treatments. After differences of baseline data being balanced by 1∶1 propensity score matching between the two groups, scores of numerical rating scale (NRS), NRS remission rate, drug dosage, Pittsburgh Sleep Quality Index (PSQI) and complications of 86 patients from each 2 groups were compared and analyzed before surgery, 3 and 7 d after surgery, at discharge, and 1, 3, 6, 12 and 24 months after surgery. Results:NRS scores in st-SCS group and PRF group 3 and 7 d after surgery, at discharge, and 1, 3, 6, 12 and 24 months after surgery were significantly lower than those before surgery ( P<0.05). NRS scores in st-SCS group were significantly lower than those in PRF group at discharge and 1, 3, 6 and 12 months after surgery ( P<0.05). NRS remission rate in st-SCS group was significantly higher than that in PRF group at discharge and 1, 3, 6, 12 and 24 months after surgery, and total effective rate in st-SCS group was significantly higher than that in PRF group 1, 3, 6, and 12 months after surgery ( P<0.05). The pregabalin and gabapentin dosages in st-SCS group and PRF group 1, 3, 6, 12, and 24 months after surgery were significantly lower than those before surgery, and the gabapentin dosage in st-SCS group was significantly lower than that in PRF group 3 months after surgery ( P<0.05). PSQI in st-SCS group and PRF group at discharge and 6, 12 and 24 months after surgery was significantly decreased compared with that before surgery, and PSQI in st-SCS group at discharge and 6, 12 and 24 months after surgery was significantly decreased compared with that in PRF group ( P<0.05). No serious complications as spinal epidural hematoma or spinal nerve root and spinal cord injuries occurred in st-SCS group and PRF group. Conclusion:Both st-SCS and PRF can treat ZAP safely and effectively, but st-SCS has more advantages than PRF.

Objective:To explore the mediating effect between anxiety, depression and quality of life in adult patients with epilepsy.Methods:A total of 118 adult patients with epilepsy from Affiliated Hospital of Jining Medical University were investigated with the ruminative responses scale (RRS), neurological disorders depression inventory for epilepsy (NDDI-E), generalized anxiety disorder (GAD-7), quality of life scale for adult epilepsy patients (QOLIE-31 Chinese Version) and the self-made general situation questionnaire. Statistical analysis was performed by SPSS 20.0 software.Pearson correlation analysis was employed to assess the relationships between rumination, quality of life, anxiety, and depression scores. Hierarchical regression analysis was employed to examine the mediating effect.Results:Among the 118 participants, 5 (4.24%), 58 (49.15%), and 55 (46.61%) patients exhibited high (RRS=66-88), middle (RRS=44-65), and low (RRS=22-43) level of rumination, respectively. Pearson correlation analysis revealed significantly negative correlations between the scores of rumination and its dimensions and quality of life in patients with epilepsy ( r=-0.411--0.318, all P<0.05). Additionally, there were significantly positive correlations between the scores of rumination and its dimensions and anxiety scores ( r=0.524-0.676, all P<0.05) and depression scores ( r=0.566-0.767, all P<0.05). Hierarchical regression analysis demonstrated that rumination played partially mediating role in the relationship between anxiety and quality of life, as well as the relationship between depression and quality of life, with mediation effect values of -0.201 and -0.215, respectively. Conclusion:Anxiety and depression can affect the quality of life of adult patients with epilepsy through rumination.

Objective: To provide a largescale assessment the prevalence of poor vision in 2020 among children and adolescents in Wuhan City, Hubei province and to provide basis for healthy vision promotion. Methods: This crosssectional epidemiological study was conducted among 156 783 students, who lived in Wuhan during the COVID-19 period participated the vision screening through the online applet designed by Wuhan Center for Adolescent Poor Vision Prevetion and Control under the guidance of their guardians between June 19 and July 6, 2020. The demographic information and daily hours spent on various activities in the past week were investigated. The corresponding visual acuity data of students in 2019 before the COVID-19 outbreak was extracted from school vision monitoring records for each semester, which was measured by the experienced eye care professionals. Results: The detection rate of poor vision (51.04%) in 2020 was significantly higher than that in 2019(43.04%)( χ 2=68 944.95, P <0.01). After adjustment for covariates, the odds ratio and 95% confidence interval for poor vision were 1.17(1.13-1.20), 1.07(1.04-1.10), 0.67 (0.65-0.69) and 0.62(0.60-0.64) in students with online class time, recreational screen time, indoor and outdoor activity time in the highest tertile, compared with the lowest tertile groups. Conclusion Increased rate of poor vision among primary and secondary schoool students deserves further concern. It is necessary to strengthen intervention of eyesight protection. Policies and programs aimed at improving opportunities for physical activities and decreasing multiple screen behaviors should be given priority.

Refeeding syndrome (RFS) is a potentially fatal complication of clinical nutritional therapy. Patients in intensive care unit (ICU) consuming nutrients under high stress and high metabolism are more likely to develop RFS, which is closely related to the poor prognosis and higher mortality. However, due to the lack of characteristic clinical manifestations of RFS and the incomplete evaluation of risk factors, there are few reports on the related research of RFS risk prediction model, and it is easily ignored by clinicians. The key to prevention and treatment is to clarify the risk factors of RFS in ICU patients, early identify high-risk patients and initiate intervention. In this paper, the diagnostic criteria, current domestic and abroad situation, risk prediction indexes and preventive therapy of RFS are reviewed. It provides a reference for constructing an RFS risk prediction model that is in line with our national conditions, in order to improve the ability of medical staff to early identify RFS and improve the survival rate of ICU patients.

Objective:To understand the true experience and feelings of thestoma therapists on sense of career success, so as to provide a basis for enhancing their sense of career success.Methods:Using the qualitative research method, a semi-structured in-depth interview with 18 stoma therapists from different levels of medical institutions in Henan Province who have been certified for more than one year from August 2 to October 30, 2020. Nvivo12.0 software was used for data analysis, and the Colaizzi 7-step analysis method was used to refine the theme.Results:After repeated reading and analysis of the data, two themes of positive experience and negative experience of stoma therapists' true experience of career success were extracted.Conclusions:The specific policies for the professional development of specialist nurses should be further improved to reduce the negative experience in the career success of stoma therapists and avoid the loss of specialist nursing talents.

Scutellaria baicalensis (S. baicalensis) and Scutellaria barbata (S. barbata) are common medicinal plants of the Lamiaceae family. Both produce specific flavonoid compounds, including baicalein, scutellarein, norwogonin, and wogonin, as well as their glycosides, which exhibit antioxidant and antitumor activities. Here, we report chromosome-level genome assemblies of S. baicalensis and S. barbata with quantitative chromosomal variation (2n = 18 and 2n = 26, respectively). The divergence of S. baicalensis and S. barbata occurred far earlier than previously reported, and a whole-genome duplication (WGD) event was identified. The insertion of long terminal repeat elements after speciation might be responsible for the observed chromosomal expansion and rearrangement. Comparative genome analysis of the congeneric species revealed the species-specific evolution of chrysin and apigenin biosynthetic genes, such as the S. baicalensis-specific tandem duplication of genes encoding phenylalanine ammonia lyase and chalcone synthase, and the S. barbata-specific duplication of genes encoding 4-CoA ligase. In addition, the paralogous duplication, colinearity, and expression diversity of CYP82D subfamily members revealed the functional divergence of genes encoding flavone hydroxylase between S. baicalensis and S. barbata. Analyzing these Scutellaria genomes reveals the common and species-specific evolution of flavone biosynthetic genes. Thus, these findings would facilitate the development of molecular breeding and studies of biosynthesis and regulation of bioactive compounds.
Evolution, Molecular ; Flavonoids/biosynthesis* ; Genome, Plant ; Plant Extracts/genetics* ; Scutellaria/metabolism* ; Whole Genome Sequencing

Objective:To evaluate the effectiveness and safety of early exercise safety management in patients undergoing mechanical ventilation in intensive care unit (ICU).Methods:A prospective historical control observation was conducted. Forty-five patients with severe respiratory failure undergoing mechanical ventilation admitted to the ICU of Affiliated Hospital of Jining Medical University from April to June in 2019 were enrolled in the observation group and implemented early exercise safety management, including establishing multidisciplinary safety management team with ICU doctors, ICU nurses, respiratory therapists, rehabilitation therapists, dietitians and psychological consultants to jointly develop early exercise plan; equipping with sports and safety protection equipment; assessing the early exercise risks, formulating early exercise prescriptions; formulating the nutritional and psychological prescriptions; carrying out the propaganda and education in the early exercise process of patients and communicating with patients timely; strengthening team training. Other 45 patients with severe respiratory failure admitted for mechanical ventilation from January to March in 2019 were enrolled in the control group, whose gender, age and artificial airway conditions were matched with those in the observation group. Routine mechanical ventilation nursing was performed, including condition monitoring, medication nursing, environmental management and routine examination assistance. The improvement of depression, anxiety, comfort, lung function, and quality of life before and after nursing intervention were observed, and the occurrence of complications was recorded.Results:There was no significant difference in gender, age or artificial airway conditions between the two groups. Before nursing intervention, there was no significant difference in depression, anxiety, comfort, lung function and quality of life between the two groups. After the intervention of different nursing programs, the above conditions of the two groups were significantly improved, and the improvement was more significant in the observation group, which showed that the hospital anxiety and depression scale (HAD) score and forced vital capacity (FVC) of the observation group were significantly lower than those of the control group [HAD score: 10.80±2.54 vs. 17.51±3.66, FVC (L): 1.81±0.42 vs. 2.23±0.39, both P < 0.01], while the general comfort questionnaire (GCQ) score, forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, FEV1 percentage of predicted (FEV1%) and each dimension score of 36-item short form health survey (SF-36) scale were significantly higher than those of the control group [GCQ score: 110.87±5.33 vs. 96.93±3.02, FEV1 (L): 1.99±0.37 vs. 1.71±0.15, FEV1/FVC ratio: 0.88±0.04 vs. 0.84±0.03, FEV1%: (88.98±8.57)% vs. (80.41±4.45)%, mental function score: 49.74±9.88 vs. 40.17±8.95, physical function score: 27.65±9.46 vs. 20.32±9.53, social relationship score: 62.14±6.33 vs. 50.28±8.76, general health score: 38.61±8.48 vs. 30.63±8.93, all P < 0.01]. The overall incidence of complications in the observation group was significantly lower than that in the control group (24.44% vs. 57.78%, P < 0.01). Conclusions:Early exercise safety management scheme for patients undergoing mechanical ventilation in ICU can improve clinical efficacy and reduce complications. At the same time, it can further standardize the behaviors of medical staff and ensure the early exercise.

Objective? To explore the experience of patients with mechanical ventilation in Intensive Care Uni(t ICU) during early ambulation, and explore the process of early ambulation from the perspectives of patients. Methods? Applying the interview method in qualitative research, in-depth interviews were conducted for 15 conscious patients with artificial airway for mechanical ventilation in ICU of Affiliated Hospital of Ji'ning Medical University from January of 2017 to December of 2018. Colaizzi's 7-step phenomenological data analysis method was used to analyze and sort out the data obtained and get the theme. Results? Six themes were summarized:patients worried about the high risk of early ambulation, discomfort caused by early ambulation, lack of correct understanding on the importance of early ambulation and its benefits, early termination of ambulation caused by unacceptable ambulation way, patients hope to be encouraged by medical staff, patients look forward to social support and economic assistance. Conclusions? Early ambulation is not a separate experience, but interwoven with the experience of mechanical ventilation in ICU. In the process of early ambulation, patients are eager to get more professional, safe and comprehensive care.