Objective: To analyze the bidirectional association between sleep status and depressive symptoms among primary school students, so as to provide scientific evidence for developing targeted intervention and health education on children s mental health. Methods: In December 2021, 1 787 students in grades 2 and 3 selected from three primary schools in a district of Tianjin by a convenient sampling method were investigated in a baseline questionnaire survey, which was followed by a one year follow up in December 2022. The survey content included sociodemographic characteristics, lifestyle, etc., and the Children s Sleep Habits Questionnaire and the Center for Epidemiologic Studies Depression Scale for Children were used to assess students sleep quality, sleep duration, social jetlag and depressive symptoms. Linear regression model was applied to examine the association between sleep status and depressive symptoms score in primary school students, and cross lagged panel model was adopted to analyze the bidirectional association between sleep status and depressive symptoms. Results: At baseline, the sleep quality score among primary school students was 43.00(39.00, 47.00), the daily sleep duration was 9.42(9.12, 9.76) h, the social jetlag was 0.58( 0.29 , 0.92) h, and the depressive symptoms score was 5.00(2.00, 9.00). At the oneyear followup, the score of sleep quality among primary school students was 42.00(38.00, 47.00), the daily sleep duration was 9.43(9.12, 9.78)h, the social jetlag was 0.50 (0.25, 0.78)h, and the score of depressive symptoms was 4.00(2.00, 9.00). After adjusting for confounding factors such as gender, parental education level, and monthly family income, linear regression analyses showed that the baseline sleep quality score was positively associated with follow up depressive symptoms scores ( β =0.25) among primary school students, while baseline sleep duration ( β =-0.06) and baseline social jetlag ( β =-0.08) were both negatively associated with follow up depressive symptoms score (all P <0.05). Cross lagged regression models indicated that baseline sleep quality score positively predicted depressive symptoms score at the 1 year follow up ( β =0.10), and baseline depressive symptoms score positively predicted follow up sleep quality score ( β = 0.08 )(both P <0.05). Conclusions There is a bidirectional association between sleep quality and depressive symptoms among primary school students. Improving sleep quality may help alleviate children s depressive symptoms.

The main health problems faced by children and adolescents in China are constantly changing. Myopia, overweight and obesity, abnormal spinal curvature, and mental health issues have become the main health problems for children and adolescents. However, multidimensional health problems such as infectious diseases, chronic non-communicable diseases and injuries still coexist and present regional imbalances. Since these coexisting health problems usually have common behavioral and environmental factors, implementing joint prevention works for children and adolescents could improve the efficiency of monitoring and intervention of multimorbidity among students. School health standards are an important component of China′s school health regulations and a crucial technical basis for implementing various school health laws and regulations. Carrying out high-quality revision, preliminary research, implementation evaluation, and promotion of school health standards could provide important technical support for monitoring, comprehensive intervention, and evaluation of common diseases among students, implementing the policy of joint prevention of multimorbidity of common diseases among students, and promoting the high-quality development of disease prevention and control in the field of school health in the new era.

Objective:To explore the association between lifestyle behavior and the risk of overweight and depression comorbidity in children aged 7 to 9 years in Tianjin City.Methods:The random cluster sampling was used to conduct a baseline survey among 1 632 7-year-old children in Tianjin in 2021, and the follow-up survey was then conducted in 2023. Age, gender and lifestyle behavior of children were collected at baseline and follow-up, and physical examination and depression symptom evaluation were also performed. Four behavioral factors, including sugary beverage intake, physical activity, screen time duration, and sleep duration, were included in the comprehensive lifestyle score, with a total score of 0 to 4 points. A higher score means a better lifestyle. The multi-nominal logistic regression model was used to analyze the association between lifestyle behavior changes at different time points and the risk of overweight and depression comorbidity.Results:The mean age of the children was (7.72±0.62) years at baseline and (9.61±0.62) years at follow-up, with 350 boys (52.08%). After adjusting for confounding factors, the results showed that compared to children with moderate lifestyle behavior, those with poor lifestyle behavior had a higher risk of overweight and depression comorbidity both at baseline and follow-up (Baseline: OR=2.62, 95% CI: 1.28-5.37; Follow-up: OR=2.28, 95% CI: 1.26-4.11), while those with a better lifestyle behavior had a lower risk of depression during follow-up ( OR=0.35, 95% CI: 0.19-0.64). Based on the comprehensive baseline and follow-up lifestyle behaviors, it was found that children with improved lifestyle were more likely to experience the disappearance of overweight and depression comorbidity ( OR=1.29, 95% CI: 1.04-1.61), and were less likely to develop overweight and depression comorbidity ( OR=0.82, 95% CI: 0.69-0.97). Conclusion:There is an association between lifestyle behavior and overweight and depression comorbidity among children aged 7 to 9 years in Tianjin. Improvement in children′s lifestyle behavior may reduce the risk of overweight and depression comorbidity.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

The main health problems faced by children and adolescents in China are constantly changing. Myopia, overweight and obesity, abnormal spinal curvature, and mental health issues have become the main health problems for children and adolescents. However, multidimensional health problems such as infectious diseases, chronic non-communicable diseases and injuries still coexist and present regional imbalances. Since these coexisting health problems usually have common behavioral and environmental factors, implementing joint prevention works for children and adolescents could improve the efficiency of monitoring and intervention of multimorbidity among students. School health standards are an important component of China′s school health regulations and a crucial technical basis for implementing various school health laws and regulations. Carrying out high-quality revision, preliminary research, implementation evaluation, and promotion of school health standards could provide important technical support for monitoring, comprehensive intervention, and evaluation of common diseases among students, implementing the policy of joint prevention of multimorbidity of common diseases among students, and promoting the high-quality development of disease prevention and control in the field of school health in the new era.

Objective:To explore the association between lifestyle behavior and the risk of overweight and depression comorbidity in children aged 7 to 9 years in Tianjin City.Methods:The random cluster sampling was used to conduct a baseline survey among 1 632 7-year-old children in Tianjin in 2021, and the follow-up survey was then conducted in 2023. Age, gender and lifestyle behavior of children were collected at baseline and follow-up, and physical examination and depression symptom evaluation were also performed. Four behavioral factors, including sugary beverage intake, physical activity, screen time duration, and sleep duration, were included in the comprehensive lifestyle score, with a total score of 0 to 4 points. A higher score means a better lifestyle. The multi-nominal logistic regression model was used to analyze the association between lifestyle behavior changes at different time points and the risk of overweight and depression comorbidity.Results:The mean age of the children was (7.72±0.62) years at baseline and (9.61±0.62) years at follow-up, with 350 boys (52.08%). After adjusting for confounding factors, the results showed that compared to children with moderate lifestyle behavior, those with poor lifestyle behavior had a higher risk of overweight and depression comorbidity both at baseline and follow-up (Baseline: OR=2.62, 95% CI: 1.28-5.37; Follow-up: OR=2.28, 95% CI: 1.26-4.11), while those with a better lifestyle behavior had a lower risk of depression during follow-up ( OR=0.35, 95% CI: 0.19-0.64). Based on the comprehensive baseline and follow-up lifestyle behaviors, it was found that children with improved lifestyle were more likely to experience the disappearance of overweight and depression comorbidity ( OR=1.29, 95% CI: 1.04-1.61), and were less likely to develop overweight and depression comorbidity ( OR=0.82, 95% CI: 0.69-0.97). Conclusion:There is an association between lifestyle behavior and overweight and depression comorbidity among children aged 7 to 9 years in Tianjin. Improvement in children′s lifestyle behavior may reduce the risk of overweight and depression comorbidity.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

OBJECTIVE To study the correlation between color and inner quality during the processing of Prunus mume carbon， and provide reference for the determination of processing end point of P. mume carbon. METHODS The chromaticity value of P. mume carbon powder was measured by colorimeter， and the inner quality of P. mume carbon was measured by selecting the contents of water， water-soluble extract， citric acid and tannin. The dynamic change trend of the chromaticity value， water， water- soluble extract， the contents of citric acid and tannin in P. mume carbon under different processing time was analyzed. The correlation between color and the above indexe contents was analyzed， and the regression equation of inner quality-chromaticity value was established. Combined with principal component analysis （PCA）， hierarchical cluster analysis （CA） and partial least squares discriminant analysis （PLS-DA）， the difference of P. mume carbon at different processing times was analyzed to determine the processing end point. RESULTS With the extension of processing time， the sample color gradually deepened； the chromaticity values L* and E* of the samples increased at first and then decreased， the chromaticity values a* and b* decreased， and finally all tended to be stable. The content of water-soluble extract， citric acid and tannin in the sample increased at first and then decreased， the water content of the sample decreased with time and finally stabilized. Correlation analysis showed that water， water-soluble extract， citric acid and tannin were positively correlated with L*， a*， b* and E*（P＜0.001）. PCA and HCA showed that P. mume carbon under different processing time could be clustered into two categories： the processed samples of 0-30 min and those of 40-60 min. PLS-DA showed that water and water-soluble extract were important quality indexes and b* was an important chrominance index in the processing of P. mume carbon. The chromaticity value of the samples processed for 50 min and 60 min were not significantly different. The contents of water， water- soluble extract， citric acid and tannin in the samples processed for 60 min were less than those processed for 50 min. CONCLUSIONS There is a certain correlation between the color and the inner quality of P. mume carbon. The processing time of P. mume carbon should be 40-50 min.

Objective:To explore the risk factors of intensive care unit-acquired weakness (ICU-AW) and the characteristics of Medical Research Council (MRC) score and electromyogram.Methods:A case control study was conducted. Patients with mechanical ventilation ≥ 7 days and MRC score admitted to department of respiratory and critical care medicine of China-Japan Friendship Hospital from September 2018 to January 2020 were enrolled, and they were divided into ICU-AW group (MRC score < 48) and non-ICU-AW group (MRC score ≥ 48) according to MRC score. The general situation, past medical history, related risk factors, MRC score, respiratory support mode, laboratory examination results, electromyogram examination results, ICU-AW related treatment, outcome and length of ICU stay were collected, and the differences between the two groups were compared. The risk factors of ICU-AW were analyzed by binary multivariate Logistic regression, and the characteristics of MRC score and electromyogram were analyzed.Results:A total of 60 patients were enrolled in the analysis, including 17 patients in ICU-AW group and 43 patients in non-ICU-AW group. Univariate analysis showed that there were significant differences in acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, brain natriuretic peptide (BNP), blood urea nitrogen (BUN) on the first day of ICU admission and the ratio of invasive mechanical ventilation between ICU-AW group and non-ICU-AW group [APACHEⅡ score: 21 (18, 25) vs. 18 (15, 22), SOFA score: 7 (5, 12) vs. 5 (3, 8), BNP (ng/L): 364.3 (210.1, 551.2) vs. 160.1 (66.8, 357.8), BUN (mmol/L): 9.9 (6.2, 17.0) vs. 6.0 (4.8, 9.8), invasive mechanical ventilation ratio: 88.2% vs. 46.5%, all P < 0.05]. Binary multivariate Logistic regression analysis showed no independent risk factor for ICU-AW. The average MRC score of 17 ICU-AW patients was 33±11. The limb weakness was symmetrical, and the proximal limb weakness was the main manifestation. Electromyography examination showed that the results of nerve conduction examination in ICU-AW patients mainly revealed that the amplitude of compound muscle action potential (CMAP) and sensory nerve action potentials (SNAP) were decreased, and the conduction velocity was slowed down; needle electromyography showed increased area of motor unit potential (MUP), prolonged time limit and a large number of spontaneous potentials. Prognosis evaluation showed that compared with non-ICU-AW group, patients in ICU-AW group underwent more tracheotomy (70.6% vs. 11.6%), longer length of ICU stay (days: 57±52 vs. 16±8), and more rehabilitation treatment (58.8% vs. 14.0%), and the differences were statistically significant (all P < 0.01). Conclusions:The occurrence of ICU-AW may be related to high APACHEⅡ score and SOFA score, high levels of BNP and BUN on the first day of ICU admission and the proportion of invasive mechanical ventilation, but the above factors are not independent risk factors for ICU-AW. The MRC score of ICU-AW patients was characterized by symmetrical limb weakness, mainly proximal limb weakness; in electromyography examination, the nerve conduction examination results mainly showed that CMAP and SNAP amplitude were decreased, and conduction velocity was slowed down; needle electromyography examination showed increased MUP area, prolonged duration and a large number of spontaneous potentials.

Objective: To summarize the experience of applying cervical double parallel incision combined with mediastinoscope or thoracoscope in the treatment of cervical necrotizing fasciitis (CNF) accompanied with descending necrotizing mediastinitis (DNM), so as to provide a reference for clinical practice. Methods: The clinical data of six patients with CNF accompanied with DNM who were admitted to the Department of Stomatology and the Department of Otolaryngology Head and Neck Surgery, The First People′s Hospital of Changzhou from September 2014 to September 2018 were retrospectively analyzed. All of the six patients were confirmed by CT of neck and chest, among whom there were two males and four females aged from 48 to 73. Three patients were treated with cervical double parallel incision combined with mediastinoscope to be combined with cervical and thoracic drainage under general anesthesia while the other three with cervical double parallel incision combined with thoracoscope to be combined cervical and thoracic drainage under general anesthesia. The CT of neck and chest as well as infectious indicators including hematology, C-reactive protein (CRP) and procalcitonin (PCT) were reexamined during the postoperative period. Results: The cervical and thoracic combined drainage was unobstructed in all of the six patients, no secondary surgery was performed, and the infectious indicators gradually decreased. All patients had off-bed activities on the first day after the operation, were all cured and discharged after an average of 21 days (16 to 36 days) in hospital and followed up for an average of 18 months (4 to 30 months) after the operation. None of them experienced infection relapse, and they were all satisfied with the appearance of the cervical incision. Conclusions Cervical double parallel incision combined with mediastinoscope or thoracoscope for the treatment of CNF accompanied with DNM has the advantages of complete drainage, small trauma, excellent efficacy and aesthetic operative area, thus being deserved to be clinically popularized.