Abstract Recently, the Ministry of Education issued Guiding Opinions on Comprehensively Promoting the Construction of Healthy Schools hereinafter referred to as the Guiding Opinions, which systematically established the goal system, key tasks, critical measures, and safeguard mechanisms for the construction of healthy schools in the new era. Against the backdrop, comprehensively promoting the construction of healthy schools has become a core project for implementing the concept of "Health First", carrying out joint prevention and control of multiple diseases, and responding to national action plans. Based on a systematic analysis of the internal logic between healthy school construction and the "education powerhouse strategy", the study deeply expounds on its core mission as a "foundational project for talent cultivation" and a "hub for the integration of five educations". Combining the eight key tasks and three critical measures clarified in the Guiding Opinions, it constructs a multi dimensional, systematic, and operable implementation path from the aspects of concept leadership and practice internalization, data monitoring and closed loop management, team support and environmental optimization, literacy promotion and evaluation innovation, innovation drive and characteristic development,digital empowerment and smart governance. The study provides a forward looking and strategic comprehensive solution for improving the collective health literacy of students and building a comprehensive prevention and control system for common campus diseases in the new era.

Elderly patients with lung cancer have a significantly increased risk of perioperative cardiopulmonary complications due to physiological decline, high incidence of complications and reduced surgical tolerance, which directly affects postoperative recovery and long-term survival. Although the concepts of minimally invasive surgery and enhanced recovery after surgery have improved clinical outcomes, early recognition and intervention of postoperative complications in elderly patients remains a significant challenge in the field of thoracic surgery. By integrating recent literature and clinical practice, this paper systematically analyzes the pathophysiological mechanism and risk factors of perioperative cardiopulmonary complications in elderly patients with lung cancer, and discusses individualized intervention strategies based on risk stratification and multidisciplinary team, in order to provide theoretical basis and practical guidance for optimizing perioperative management and improving postoperative prognosis in elderly patients.

Objective: To analyze the association of eating dining locations and their association with nutritional status among Chinese children aged 6-17 years,so as to provide reference for guiding children s reasonable diet. Methods: Stratified random cluster sampling was used to select children aged 6 to 17 years from 28 cities and rural areas of 14 provinces in East, North, Central, South, Southwest, Northwest, Northeast of China, and a total of 52 535 children were included in the study from 2019 to 2021. Information including dining locations, demographic characteristics, dietary intakes and physical activity were collected through a questionnaire survey. Fasting body height and weight were measured in the morning. Unordered multiclass Logistic regression analysis was conducted to assess the relationship between dining locations and nutritional status in children. Results: Regarding children s dining locations, 66.3% ate breakfast at home,25.8% ate breakfast at school,7.9% ate breakfast outside (small dining tables, restaurants, stalls, etc.); 67.7% ate dinner at home,29.0% ate dinner at school,3.3% ate dinner outside; and 63.6% ate lunch at school,30.8% ate lunch at home,5.7% ate lunch outside. The prevalence rates of overweight/obesity and undernutrition were 28.6% and 9.3%, respectively. The adjusted multiclass Logistic regression analysis (controlling for age, region, parental education, household income, total energy intake, and moderate-to-vigorous physical activity) demonstrated that, compared to eating at home, school based breakfast and dinner consumption was associated with significantly lower overweight/obesity risks for both genders (boys: breakfast OR =0.70, 95% CI =0.65-0.75; dinner OR =0.80, 95% CI = 0.74- 0.86; girls: breakfast OR = 0.89 , 95% CI = 0.82-0.96; dinner OR =0.88, 95% CI =0.81-0.95), whereas eating lunch away from home significantly increased overweight/obesity risks (boys: OR =1.32, 95% CI =1.17-1.48; girls: OR =1.43, 95% CI =1.26- 1.62 ), with all associations being statistically significant ( P <0.05). After adjusting for confounding factors, boys who ate breakfast away from home showed a significantly reduced risk of undernutrition ( OR =0.80,95% CI =0.66-0.97), while those consuming lunch away from home had an increased risk ( OR =1.26, 95% CI =1.01-1.57) ( P <0.05). Conclusions The choice of dining locations for children is becoming more diverse, and a relatively high proportion of children eat meals outside the home and at school. Eating out have a higher risk of malnutrition for children. School feeding may be beneficial to children s physical health.

Objective To build an inpatient hospital discharge preparation service management platform,to explore its application outcomes,and to enhance the quality of discharge preparation service management.Methods A research team was set up,and the literature was referenced.The platform was built on the basis of connecting and optimizing various existing information systems in the hospital,including 6 modules:evaluation,implementation of nursing,referral,monitoring feedback,follow-up,and continued nursing.Patients admitted to a tertiary comprehensive hospital were conveniently selected as research subjects in Shandong Province from August 2023 to January 2024.The 97 patients included after the platform application(November 2023 to January 2024)were selected as an experimental group,and the 97 patients included before the platform application(August to October 2023)were selected as a control group.The rate of unplanned readmission within 30 days,the utilization rate of"Internet+Nursing Services",and the time for assessing the demand for discharge planning service were compared between the 2 groups.In addition,in February 2024,300 healthcare professionals from the same hospital were selected to evaluate their satisfaction with the use of the platform.Results There were 7 cases dropping out in each of the 2 groups.The rate of unplanned readmission within 30 days in the experimental group was lower than that in the control group;the utilization rate of"Internet+Nursing Services"was higher than that in the control group;the time for assessing the demand for discharge planning service was less than that in the control group,with statistically significant differences(P＜0.05).In the satisfaction survey of medical staff on the use of the platform,the effective questionnaire response rate was 94.67％,and the score of the clinical nursing information system effectiveness evaluation scale was(100.84±16.48)points.Conclusion The use of this platform can reduce the unplanned readmission rate of patients within 30 days,promote the development of"Internet+Nursing Services",reduce the time for assessing the needs of discharge planning services,and medical staff are highly satisfied with the use of the platform.

In order to fully consider the physiological characteristics and movement mechanism of the human body under the premise of ensuring the function and practicality of the product,the human-fabric contact finite element model based on biomechanical feedback plays an important role in the design of'people-oriented'health protection products.This review focuses on the design of protective products made of flexible materials,and discusses the application status and development trend of human finite element model in the design of protective products.The construction process of finite element models of different parts of the human body in recent years is summarized from the perspective of human biomechanics.Secondly,from the contact models established between the human head,torso,upper limbs and lower limbs and protective devices,the application status and challenges of finite element method in the design of health protective products are sorted out.Finally,the problems existing in the use of finite element method in such researches are discussed.It is pointed out that in the context of pursuing accuracy,real-time and realism,finite element contact models with the advantages of high efficiency,precision and reusability still have a broad application prospect.

Objective:To systematically evaluate the risk prediction model for readmission in patients after percutaneous coronary intervention, and to provide reference for medical staff to apply or optimize relevant risk assessment tools.Methods:China National Knowledge Infrastructure, VIP, Wanfang Data, China Biomedical Literature Database, and Cochrane Library, PubMed, Embase, CINAHL, Scopus and Web of Science were searched for the related studies on readmission risk prediction models in patients with percutaneous coronary intervention from the establishment of the databases to April 25, 2024. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies.Results:A total of eleven articles were included, involving sixteen readmission risk prediction models, with readmission rates ranging from 0.70% to 31.44% and the areas under subjects′working characteristic curves ranging from 0.604 to 0.899. Calibration methods were reported in ten models, five studies reported processing methods of missing data, and external validation was used in three studies. The overall risk of bias was higher. The top six predictors of repeated reports in the readmitted model were age, renal insufficiency, sex, congestive heart failure, diabetes and health insurance.Conclusions:The readmission risk prediction models had good predictive performance. However, the quality of the model methodology was limited. It is necessary to improve the research quality in data sources, measurement and definition of predictive factors, processing of missing data and model evaluation. In the future, data mining can be used to apply the readmission prediction model in the early stage of admission, so as to identify high-risk patients as early as possible and effectively prevent the occurrence of readmission.

Objective:To explore the latent profiles of humanistic care competence among undergraduate nursing interns during clinical placements and analyze the influencing factors.Methods:This was a cross-sectional study. Totally 217 undergraduate nursing interns undergoing clinical practice at the China-Japan Friendship Hospital from March to May 2023 were recruited by convenience sampling. Data were collected using a general information questionnaire, the Caring Ability Inventory (CAI), the Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS), the Healthcare Education Micro Learning Environment Measure (HEMLEM), and the Professional Self-Efficacy Questionnaire. Latent profile analysis was used to classify the nursing interns based on their humanistic care competence, and disordered multinomial Logistic regression was employed to identify factors influencing different latent categories.Results:A total of 217 questionnaires were distributed and all were returned with a 100.00% valid response rate (217/217). The total score for CAI was (200.16±22.49). The scores for the dimensions were as follows: understanding (80.60±8.42), courage (61.24±11.28), and patience (58.31±5.72). The nursing interns' humanistic care competence was categorized into three latent profiles: "at-risk group" "potential group" and "advantage group". Logistic regression analysis revealed that professional self-efficacy, learning environment, and ethical sensitivity were significant factors influencing these latent profiles ( P<0.05) . Conclusions:There are differences in the humanistic care competence of nursing interns, which are influenced by factors such as professional self-efficacy, learning environment and ethical sensitivity. Educators and managers should tailor training based on these influencing factors to enable nursing interns to internalize humanistic care values and enhance their humanistic care competence.

Objective:To evaluate the impact of the surgical strategy of selective thoracic duct(TD) ligation established through fluorescence thoracoscopy TD imaging technology on the occurrence of chylothorax after lung cancer surgery in the elderly.Methods:A prospective cohort study was conducted.Elderly patients who underwent right lung cancer surgery in the Department of Thoracic Surgery of Beijing Hospital from October 2023 to June 2024 were enrolled as the research subjects.The surgical approaches involved pulmonary resection, systematic lymphadenectomy, and selective TD ligation using fluorescence thoracoscopy.Prior to the surgery, 0.4 mg/kg indocyanine green(ICG)was injected subcutaneously into the right inguinal region of all patients.Clinical data, surgical details, pathological information, and intraoperative TD imaging, including the course, collateral vessels, and any injuries, were collected.Postoperative chylothorax and other complications were also recorded.Results:A total of 83 patients were enrolled, of which 38 were males, and 45 were females, with a median age of 68 years raging from 60 to 83 years old, TD imaging was observed in 69 cases(83.1%)within one hour after IGC injection.Intraoperative injuries of collateral branches were visualized in 4 cases(4.8%). Among them, 2 cases had injuries in both the 2R+ 4R and the subcarinal station, while 2 others had injuries of collateral branches only in the 2R+ 4R station.These 4 patients underwent concurrent TD ligation.No TD or collateral injury was found in the remaining patients during the surgery, and the TD was not ligated, none of the patients developed chylothorax postoperatively, and no adverse reactions related to indocyanine green were observed.Conclusions:Fluorescence thoracoscopy-guided TD imaging technique can well visualize TD and its collateral injuries in elderly lung cancer surgeries, assist in the management of leaks or TD ligation, thereby effectively preventing the occurrence of postoperative chylothorax.

Traditional Chinese Medicine(TCM)emphasizes syndrome differentiation and treatment,characterized by"maintaining the prescription if effective"and"changing the prescription if ineffective".Traditional randomized controlled trials(RCTs)are inadequate for evaluating the efficacy of dynamic treatment adjustments.The Sequential Multiple Assignment Randomized Trial(SMART)is an emerging adaptive research design that incorporates randomization at multiple stages,allowing for adjustments in subsequent interventions based on treatment responses.This approach is suitable for evaluating dynamic treatment regimens while retaining the low bias risk of traditional RCTs,making it highly promising for clinical research in TCM.This paper summarizes recent methodological advancements in SMART design,including different sample size estimation and statistical analysis methods for primary effect objectives,embedded adaptive intervention objectives,and optimization objectives,along with providing corresponding operational software.Additionally,it offers considerations for applying SMART design in TCM research,such as the selection of disease types,interventions,decision points,tailoring variables,sample size calculation,statistical methods,the importance of pilot trials,ethical considerations,and limitations.The aim is to promote the exploration and practice of this method in the field of TCM,thereby contributing to the generation of high-quality evidence-based evidence for TCM.

Objective To investigate the distribution of plantar pressures and bone stresses of the foot with high,normal and low arch morphologies,and reveal the influence of arch morphology on foot biomechanical properties.Methods A total of 127 young females were recruited.The foot type was classified by collecting the morphological data of the foot with the three-dimensional(3D)foot scanner,and three types of the foot arch morphology were selected for analysis.The geometric model of foot bone was obtained by CT scanning,so as to establish the biomechanical finite element model of the foot.A load of 50％human body weight was applied to the model to simulate the state of bipedal standing.Results The calculated plantar contact area was compared with the measured results,and the relative error values were smaller than 10％,which proved the validity of the finite element model.The peak plantar pressure under three types of arch morphologies was located in the hind foot region,and the heel pressure of high-and low-arched foot was higher than that of normal-arched foot.Compared with normal-arched foot,high-arched foot showed a significant increase in stress in the hind foot area,the peak stress of soft tissues was 299.45％higher,and the peak bone stress was 93.19％higher.For low-arched foot,the plantar contact area increased by 13.28％and calcaneal stress increased by 98.09％.The peak bone stresses of high-,normal-and low-arched foot were located at the talus,which were 9.903,19.921 and 36.308 MPa,respectively.Conclusions This study supports the association between abnormal arch morphology,foot pain and foot diseases,and provides a basis and direction for the design of orthopedic insoles and arch support structures for abnormal feet.