Objective: To investigate the association between bedtime screen use and sleep health among fourth and fifthgrade primary school students, so as to provide evidence to support interventions for improving sleep quality. Methods: From April to June 2024, a survey was conducted among 4 232 fourth and fifthgrade students from nine primary schools in a district of Beijing. A selfdesigned questionnaire assessed bedtime screen use behavior and sleep health indicators. Generalized linear models and Logistic regression were used to analyze the associations. Results: Among the surveyed students, 28.3% reported bedtime screen use. Mean sleep duration every day was (9.31±0.90) hours on school days and (10.08±1.36) hours on weekends. Compared to nonusers, students with bedtime screen use exhibited every day: later bedtimes on school days (10.18 min delay, 95%CI=6.88-13.47) and weekends (22.09 min delay, 95%CI=17.33-26.85) (P<0.05); later weekend wake times (7.97 min delay, 95%CI=1.78-14.16, P<0.05); reduced sleep duration on school days (-9.82 min, 95%CI=-13.62 to -6.03) and weekends (-14.12 min, 95%CI=-20.24 to -8.00) (P<0.05); greater weekend-school day bedtime discrepancy (β=1.15, 95%CI=1.08-1.23, P<0.01). Additionally, they had lower odds of falling asleep within 20 minutes (OR=0.62, 95%CI=0.54-0.72), daytime alertness (OR=0.66, 95%CI=0.56-0.77), and subjective sleep satisfaction (OR=0.57, 95%CI=0.49-0.66)(P<0.01). Conclusions Bedtime screen use is associated with adverse effects on multiple dimensions of sleep health in primary school students. Reducing screen exposure before bed may help improve their sleep quality.

Objective: To develop a health literacy evaluation scale for Chinese high school students, providing a tool for dynamic monitoring of health literacy among high school students and evaluating the effectiveness of health school construction. Methods: Through theoretical research, an evaluation index system for health literacy of Chinese high school students was constructed. Two rounds of Delphi expert consultations were conducted to quantitatively screen the items, and the item pool was revised based on expert opinions to compile the health literacy evaluation scale for Chinese students. Two focus group interviews were held to collect suggestions from health educators, high school teachers, and high school students regarding optimized scale length, question types, difficulty and wording of the scale. The scale was revised accordingly. A pilot survey was conducted in Beijing and Tianjin in November 2024, and the reliability and validity of the scale were evaluated based on the pilot survey data. Results: The response rate in both rounds of Delphi expert consultations was over 80%, and the expert authority coefficient was over 0.70. The expert opinions were highly concentrated, and the dispersion was small. The revised item pool based on expert opinions contained 39 items. The revised scale based on the suggestions and opinions collected from the focus group interviews had a moderate number of questions and difficulty level. The pilot survey obtained 800 valid responses, with the response rate of 89.39%. The Cronbach α coefficient of the scale was 0.911, χ 2/df =3.321, the root mean square error of approximation was 0.054, the adjusted goodness-of-fit index was 0.991 , and the factor loadings of some items were less than 0.40. Conclusion The health literacy evaluation scale for Chinese high school students demonstrates scientific rigor and practical applicability, with good internal consistency and structural validity.

Objective: To investigate the independent prognostic factors affecting disease-free survival(DFS) after radical surgery in Ⅱ and Ⅲ adenocarcinoma of gastroesophageal junction(AEG) patients, and to construct a nomogram prediction model. Methods : A retrospective analysis was conducted on a cohort comprising 326 patients who were diagnosed with AEG. Chi-square test was used for categorical variable analysis. The survival analysis was drawn by Kaplan-Meier method and tested by log-rank method. Univariate and multivariate Cox regression analyses identified independent prognostic factors, and based on these factors, a nomogram was constructed to predict 3-year and 5-year DFS in AEG patients. The calibration curves evaluated the performance of nomogram. Results: Among 326 AEG patients, 281 were in the young group(<70 years old) and 45 were in the old group(≥70 years old). Kaplan-Meier curve showed that patients with advanced age, TNM stage Ⅰ-Ⅱ and no history of hepatitis B had longer DFS. Univariate and multivariate analysis showed that age, TNM stage and history of hepatitis B were independent prognostic factors for DFS. The 3-year and 5-year correction curves showed that the prediction efficiency of nomogram was good. The decision curve analysis showed that the model had a good clinical net benefit. Conclusion Age, TNM stage and history of hepatitis B are independent prognostic factors for DFS in AEG patients. The nomogram constructed and validated can be used to predict DFS in AEG patients.

Objective: To develop and validate a health literacy assessment scale for junior high school students, providing an effective tool for evaluating and monitoring health literacy among Chinese adolescents. Methods: Based on school health education policy documents, a health literacy assessment framework was constructed, comprising five horizontal and four vertical dimensions. From May to June and August to September in 2024, the framework was refined through Delphi expert consultations and focus group discussions, leading to the development of the Health Literacy Assessment Scale for Junior High School Students. In September 2024, a convenience sample of 625 students from three junior high schools in Beijing and Tianjin completed the questionnaire. Item analysis, reliability, and validity tests were conducted to evaluate the scale. Results: The recovery rate for two rounds of expert consultation questionnaires was 100%. The expert authority coefficients ( Cr ) were 0.86 and 0.87 respectively (both >0.70), with Kendall W values of 0.34 and 0.27 ( P <0.05). The focus group discussions followed a rigorous structure, and after multiple rounds of item screening and revision, the version 3.0 of the junior high school students health literacy assessment scale was developed, comprising 57 items. Three items that failed to meet the comprehensive screening criteria were preliminarily removed, and the final scale contained 54 items. The scale demonstrated excellent reliability, with an overall Cronbach s α coefficient of 0.92 and split half reliability of 0.93. Confirmatory factor analysis [ χ 2/df =2.094, root mean square error of approximation ( RMSEA )=0.042, comparative fit index ( CFI )=0.911, Tucker Lewis index ( TLI )=0.907] indicated good model fit indices. Conclusions The preliminary development of the health literacy assessment scale for junior high school students follows a rigorous item screening process with well designed dimensions, demonstrating good reliability and validity, thus serving as an appropriate evaluation tool for adolescent health literacy.

Objective: To analyze and evaluate the comprehensiveness and reliability of the content related to comprehensive sexuality education in 16 subject curriculum standards in the current compulsory education system, and the feasibility and effectiveness of comprehensive sexuality education teaching practice. Methods: Based on the textbook analysis model, a curriculum standard analysis model was established, and the interpretive structure model was used to analyze and evaluate the content related to comprehensive sexual education in the curriculum standards of 16 subjects in the current compulsory education system, including Ethics and Rule of Law, Chinese, History, Mathematics, English, Japanese, Russian, Geography, Science, Physics, Chemistry, Biology, Information Technology, Physical Education and Health, Arts, Labor. Results: There were 7 subject curriculum standards including Ethics and Rule of Law, Chinese, English, Science, Biology, Information Technology, Physical Education and Health reflecting 5 core concepts and 12 themes of comprehensive sexuality education, and the most frequent core concept was Violence and Staying Safe and the Human Body and Development,as well as the most frequent theme was "Puberty". History, Mathematics, Japanese, Russian, Geography, Physics, Chemistry, Art and Labor didn t include content related to comprehensive sexuality education. The content related to comprehensive sexuality education in the curriculum standard of compulsory education presented three characteristics:it was closely related to the subject content, partial content was consistent with the teaching goal of the subject, and the content depth increased with the growth of grade. The comprehensiveness and reliability of comprehensive sexual education in the current compulsory education curriculum standards of China needed to be improved. Conclusion The comprehensiveness, reliability, feasibility and effectiveness of teaching practice of comprehensive sexuality education in 16 subject curriculum standards in the current compulsory education stage need to be improved.

Objective: To understand the association of healthrelated quality of life of middle school students with parental companionship, so as to provide a reference for school and family health education. Methods: From September to November 2023, 4 594 middle school students were selected through convenient sampling from four economic zones in China (Liaoning Province, Beijing City, Sichuan Province, Shanxi Province). Structured questionnaires were used to evaluate healthrelated quality of life among middle school students. The ttest, variance analysis and linear regression were used to analyze the relationship between healthrelated quality of life with parental companionship among middle school students. Results: The average score of healthrelated quality of life among middle school students was (140.99±21.38). There were statistically significant differences in the scores of healthrelated quality life among middle school students in different regions, genders, educational stages, grades, whether they live on campus and parental companionship(F/t=20.73, 8.62,16.71,105.70, -9.51, 52.29, P<0.01). Linear regression analysis showed that students who were living in eastern region, boys, with higher selfevaluation of academic performance, with higher subjective family socioeconomic status, with parental companionship (β=3.19, 4.96, 2.19, 6.11, 3.19), and older students had lower healthrelated quality of life levels (β=-2.34)(P<0.01). Conclusions There are significant regional differences in the healthrelated quality of life levels among middle school students. It is necessary to strengthen the popularization of school health education and focus on students who do not live with their parents on a daily basis to provide more psychological support for them.

OBJECTIVE To investigate the improvement effects of 3，5，6，7，8，3′，4′-heptamethoxyflavone （HMF） of Fructus Aurantii on rats with damp blockage of the middle energizer. METHODS The rats were randomly divided into normal group， model group， positive control group （Raceanisodamine tablet， 1 mg/kg）， HMF low-dose， medium-dose and high-dose groups （0.3， 0.6， 0.9 mg/kg）， with 7 rats in each group. Except for the normal group， the other groups were modeled by internal and external composite factors. After successful modeling， the rats in each group were given the corresponding drug or normal saline， once a day， for 14 days. The general behavioral states such as dietary intake， water intake and mental state of the rats were observed， and the fecal water content rate and saliva flow rate were measured. Hematoxylin-eosin （HE） staining was used to observe the pathological and morphology in gastric and small intestinal tissues of rats. The plasma content of aldosterone was detected， and the expression of aquaporins （AQP3） in the gastric tissue of rats was determined. RESULTS Compared with the normal group， the dietary intake and water intake of the model group rats were significantly decreased （P＜0.01）， the fecal water content rate， salivary flow rate， plasma content of aldosterone and the expression of AQP3 in gastric tissue were increased significantly （P＜0.01）. Gastric tissue injury invaded the mucosal muscle layer， resulting in mucosal muscle layer rupture； pathological and morphological changes such as small intestinal villous erosion and glandular structure destruction were observed in the small intestine. Compared with the model group， the dietary intake and water intake of rats were increased in HMF groups； fecal water content rate， salivary flow rate， plasma content of aldosterone， the expression of AQP3 in gastric tissue were decreased， most of the above differences were statistically significant （P＜0.05 or P＜0.01）. The pathological and morphological changes in the gastric and small intestine tissues of rats had been improved to varying degrees. CONCLUSIONS HMF of Fructus Aurantii with dry property HMF could improve the symptoms of rats with damp blockage of middle energizer， the mechanism of which may be associated with reducing the content of plasma aldosterone and down-regulating the expression of gastric AQP3.

Objective:To investigate the effect of modified Retzius-sparing robot-assisted radical prostatectomy(RS-RARP) and " Sandwich" technique of total urethral reconstruction on the early postoperative urinary continence.Methods:The clinical data of 70 consecutive patients who underwent RS-RARP by the same operator at the Cancer Hospital of the Chinese Academy of Medical Sciences from October 2021 to November 2023 were retrospectively analyzed. The age was (65.1±8.0) years old, the body mass index (BMI) was (25.6±3.1) kg/m 2, the prostate volume was (31.9±18.1)ml and the preoperative prostate specific antigen(PSA) was (16.3±16.1)ng/ml. Four patients treated with neoadjuvant hormonal therapy before radical prostatectomy. Eleven patients underwent radical prostatectomy without prostate biopsy, while the remaining 59 patients underwent prostate biopsy. There were 10, 23, 14, 10 and 2 patients with Gleason scores of 6, 7, 8, 9 and 10 respectively.There were 48 patients with clinical stage cT 2 and 22 with cT 3. The surgical method was RS-RARP and "Sandwich" technique of total urethral reconstruction. The operation time, intraoperative blood loss, postoperative drain tube preservation time, postoperative hospitalization time, pathological staging and positive margin rate, and recovery of urinary continence immediately after postoperative catheter removal were recorded. Results:In this study, all 70 surgeries were successfully completed, with no cases converted to anterior approach radical surgery or open surgery, and no serious intraoperative complications such as post-shamus hemorrhage or ureteric/rectal injury. The median postoperative follow-up was 14(3, 28) months, and there were no cases of readmission for surgical complications. The duration of surgery was (89.8±19.5) min, and the blood loss volume was (53.7±25.2)ml. The duration of drainage tube after surgery was (6.7±1.8)d, the duration of hospitalization after surgery was (7.1±1.9)d, and the duration of urinary catheter was (8.9±3.0)d. Immediate urinary continence was achieved in 50 cases when the catheter was removed, and the rate of immediate urinary continence was 71.4%(50/70). Postoperative urinary continence rate was 81.4% (57/70) at 1 month after surgery, and 90.0% (63/70) at 3 months after surgery.At 1 month postoperatively, 94.3% (66/70) of patients had a PSA <0.2 ng/ml. At 3 months postoperatively, 98.5% (69/70) of patients had a PSA <0.2 ng/ml.Conclusions:The RS-RARP and "Sandwich" technique of total urethral reconstruction is technically feasible for patients with localized prostate cancer.The short-term follow-up effect of tumor control and urinary continence are satisfactory.

Objective:To investigate the effect of modified Retzius-sparing robot-assisted radical prostatectomy(RS-RARP) and " Sandwich" technique of total urethral reconstruction on the early postoperative urinary continence.Methods:The clinical data of 70 consecutive patients who underwent RS-RARP by the same operator at the Cancer Hospital of the Chinese Academy of Medical Sciences from October 2021 to November 2023 were retrospectively analyzed. The age was (65.1±8.0) years old, the body mass index (BMI) was (25.6±3.1) kg/m 2, the prostate volume was (31.9±18.1)ml and the preoperative prostate specific antigen(PSA) was (16.3±16.1)ng/ml. Four patients treated with neoadjuvant hormonal therapy before radical prostatectomy. Eleven patients underwent radical prostatectomy without prostate biopsy, while the remaining 59 patients underwent prostate biopsy. There were 10, 23, 14, 10 and 2 patients with Gleason scores of 6, 7, 8, 9 and 10 respectively.There were 48 patients with clinical stage cT 2 and 22 with cT 3. The surgical method was RS-RARP and "Sandwich" technique of total urethral reconstruction. The operation time, intraoperative blood loss, postoperative drain tube preservation time, postoperative hospitalization time, pathological staging and positive margin rate, and recovery of urinary continence immediately after postoperative catheter removal were recorded. Results:In this study, all 70 surgeries were successfully completed, with no cases converted to anterior approach radical surgery or open surgery, and no serious intraoperative complications such as post-shamus hemorrhage or ureteric/rectal injury. The median postoperative follow-up was 14(3, 28) months, and there were no cases of readmission for surgical complications. The duration of surgery was (89.8±19.5) min, and the blood loss volume was (53.7±25.2)ml. The duration of drainage tube after surgery was (6.7±1.8)d, the duration of hospitalization after surgery was (7.1±1.9)d, and the duration of urinary catheter was (8.9±3.0)d. Immediate urinary continence was achieved in 50 cases when the catheter was removed, and the rate of immediate urinary continence was 71.4%(50/70). Postoperative urinary continence rate was 81.4% (57/70) at 1 month after surgery, and 90.0% (63/70) at 3 months after surgery.At 1 month postoperatively, 94.3% (66/70) of patients had a PSA <0.2 ng/ml. At 3 months postoperatively, 98.5% (69/70) of patients had a PSA <0.2 ng/ml.Conclusions:The RS-RARP and "Sandwich" technique of total urethral reconstruction is technically feasible for patients with localized prostate cancer.The short-term follow-up effect of tumor control and urinary continence are satisfactory.

Objective: To preliminarily develop Health Literacy Scale for pupils, providing a tool for dynamic monitoring and related health literacy research among pupils. Methods: Through policy and literature review, the health literacy evaluation index system of pupils was established. Through two rounds of expert consultation, the evaluation index system and scale item pool of three levels in primary school were formed, and "Evaluation Scale 1.0" was developed. Through two panel discussions, health education experts, teachers and students were invited to provide advices on the content, expression and structure of scale 1.0, turning it into "Evaluation Scale 2.0", and completing the preliminary development of the scale. Results: The health literacy assessment index system of primary school students includes three levels，including level-1 was Grade 1-2, level-2 was Grade 3-4,level-3 was Grade 5-6, covering two level indexes. The scale for primary school students contained five horizontal dimensions and four vertical dimensions. In the Delphi consultation, the response rate was 100%, and the authority coefficient was 0.85. After item selection and modification, the final version of level-1, level-2 and level-3 scales contained 36, 44 and 50 items respectively. Conclusion The development of Health Literacy Evaluation Scale for pupils has high applicability and practical value.