Abstract To promote adolescents active participation in physical activity and improve sleep quality, the article analyzes the relationship of adolescent physical activity with subjective sleep satisfaction, sleep latency, sleep continuity, sleep efficiency, and sleep duration. It explores potential mechanisms underlying the link between physical activity and sleep quality, including physiological mechanisms (circadian rhythms, body temperature, neuroendocrine systems, and immune function), and psychological mechanisms (stress relief, improvement of negative emotions, and promotion of mental relaxation). Based on existing research, it is recommended that adolescents engage in moderate to vigorous physical activity daily to promote improved sleep quality.

Objective: To explore the association between sleep quality and cardiorespiratory fitness among secondary school students, so as to provide a reference for promoting the overall development of physical and mental health of Chinese adolescents. Methods: From September to December 2023, 5 713 secondary school students aged 13 to 18 years were selected by the stratified cluster random sampling method from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi, respectively. Sleep quality and cardiorespiratory fitness level of secondary school students were evaluated by Pittsburgh Sleep Quality Index(PSQI) combined with cardiorespiratory fitness test, and the association between sleep quality and cardiorespiratory fitness was analyzed by Pearson s correlation and multivariate linear regression. Results: The report rate of poor sleep quality among secondary school students was 33.7 %(1 926/5 713). The PSQI scores of girls aged 13-18 years were higher than those of boys ( χ 2=1.60, 12.78, 15.62, 3.04, 10.09, 13.65 ) ( P <0.05). The 20 m SRT of secondary school students was 40 (27，51) times, and the VO 2max was 46.27 (40. 84 ，51.30) mL/(kg min). The 20 m SRT and VO 2max of girls of all ages were lower than those of boys( Z =-15.27 to -6.41 , -18.06 to -14.07, P <0.05). Cardiorespiratory fitness (VO 2max) was negatively correlated with sleep duration and hypnotic medication scores in boys ( r =-0.032, -0.005); VO 2max was negatively correlated with sleep duration and daytime dysfunction scores in girls ( r =-0.028, -0.008) ( P <0.05). After controlling the related variables, linear regression analysis showed that the total PSQI score was negatively correlated with VO 2max among secondary school students( β =-0.347, P <0.01). Conclusions Secondary school students with better sleep quality have higher levels of cardiorespiratory fitness. Sleep quality should be promoted to improve cardiorespiratory fitness levels in secondary school students.

Objective: To explore the relationship between sleep quality and mental health among middle school students, so as to provide scientific basis for improving mental health among adolescents. Methods: From September to December 2023, a stratified cluster random sampling method was employed to select 5 713 middle school students aged 13-18 from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi. Sleep quality and mental health were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Brief Adolescent Mental Health Assessment Questionnaire. Spearman correlation analysis and linear regression analysis were used to explore the relationship between sleep quality and various dimensions of mental health among middle school students. Results: There was a statistically significant difference in the total PSQI score among middle school students of different age groups ( H=226.49, P <0.01), and there was no statistically significant difference in the psychological health scores of middle school students in different age groups ( H=5.37, P >0.05). In terms of gender, the total PSQI score for girls [5.00 (3.00, 6.00)] was higher than that for boys [4.00 (2.00, 6.00)]; additionally, boys had higher mental health scores [85.00 (75.00, 90.00)] than females [83.00 (70.00, 89.00)], with statistically significant differences ( Z=-10.90, -8.16, P <0.01). Spearman correlation analysis revealed a negative correlation between total PSQI scores and mental health scores ( r=-0.51, P <0.05) among middle school students. After controlling for variables such as maximum oxygen uptake, physical activity and nutritional status, linear regression analysis further confirmed that higher PSQI scores were associated with lower mental health scores ( B=-3.76, 95%CI = -4.15 to -3.38, P <0.01). Conclusion There is a negative correlation between PSQI scores and mental health scores among middle school students, indicating that improving sleep quality may contribute to better mental health among middle school students.

Objective: To explore the relationship between sleep quality and executive function among middle school students, so as to provide theoretical support for the promotion of adolescents physical and mental health development. Methods: From September to December 2023, 5 713 junior and senior high school students aged 13 to 18 were selected by stratified cluster random sampling method from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi. Pittsburgh Sleep Quality Index was used to conduct sleep quality survey. And conduct executive function was tested on middle school students, including inhibitory function, refresh function and conversion function tests. Spearman correlation and linear regression were used to analyze the relationship between sleep quality and executive function of middle school students. Results: The total Pittsburgh Sleep Quality Index (PSQI) score of boys was [4.0(2.0,6.0)] and that of girls was [5.0(3.0,6.0)], and the difference was statistically significant ( Z=-10.90, P < 0.01 ). The total PSQI score of boys was positively correlated with both 2-back reaction time and conversion function of executive function ( r =0.04, 0.04); the total PSQI score of girls was negatively correlated with 2-back reaction time ( r =-0.04) ( P <0.05). After controlling for variables such as mental health, physical activity and nutritional status,linear regression analyses showed that PSQI total score of middle school students was positively correlated with the inhibitory function and the conversion function response time [ B (95% CI )=1.28(0.21-2.34), 7.62(2.34-12.90), P <0.05]; the associations of total PSQI scores among middle school students with both 2-back and 1-back response time were not statistically significant [ B (95% CI )=-5.88(-16.14-4.37), 8.05( -3.39 -19.50), P >0.05]. Conclusion Positive correlations are observed on sleep quality with inhibitory and conversion functions of executive function among middle school students.

Objective: To explore relationship of sleep quality with overweight and obesity among middle school students, so as to provide a reference basis for improving adolescent sleep health. Methods: From September to December 2023, 5 713 middle school students aged 13 to 18 were selected by stratified cluster random sampling method in six regions, including Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi and Urumqi. Sleep quality survey was conducted on middle school students by Pittsburgh Sleep Quality Index. Height and weight were measured, and World Health Organization s standards for growth and development of children and adolescents was used to evaluate their nutritional status. Both χ 2 test and Logistic regression analysis were used to analyze the association between sleep quality and nutritional status of middle school students. Results: The non compliance detection rate of sleep quality was 38.4% among girls, but 29.2% among boys, and the difference was of statistical significance( χ 2=54.08, P < 0.01 ). The detection rate of substandard sleep quality was 34.2% in the group with normal nutritional status, 38.3% in the group with overweight, 43.7% in the group with obesity and 26.0% in the group with emaciation, and the difference in the rates of substandard sleep quality among middle school students of different nutritional status was statistically significant ( χ 2=68.15, P <0.01). Logistic regression analysis showed that, after controlling for mental health and physical activity, the detection rate of substandard sleep quality in the obese groups was 1.30 times higher than that in the normal group, respectively( OR =1.30, 95% CI =1.06- 1.59 , P <0.01). Conclusions Sleep quality is correlated with overweight and obesity among middle school students, and there are gender differences. Intervention policies should be formulated according to the characteristics of different genders.

Objective: To explore the association between physical activity and sleep quality among middle school students, so as to provide reference for adolescent sleep improvement. Methods: From September to December 2023, 5 713 middle school students aged 13-18 years were selected from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi and Urumqi by stratified cluster random sampling method. Pittsburgh Sleep Quality Index (PSQI) and Evaluation of Physical Activity Levels of Children and Adolescents Aged 7-18 Years were used to investigate and evaluate sleep quality and physical activity. Comparisons between groups were made using the t-test, Mann-Whitney U-test, and associations between physical activity and sleep quality of middle school students were analyzed using Spearman correlation and linear regression methods. Results: The total PSQI scores were 4.0(2.0,6.0) and 5.0 (3.0,6.0) for boys and girls, respectively, with significant sex difference ( Z =-10.90, P <0.01); light physical activity(LPA) and moderate to vigorous physical activity(MVPA) of boys were 18.57 (2.86, 42.86) and 68.57 (35.71, 119.18)min, and girls were 14.29 (0.00, 30.00) and 55.71 (31.43, 92.86)min respectively, and the differences were statistically significant ( Z =3.65, -8.65 , P <0.01). The results of Spearman correlation regression showed that adolescents MVPA was negatively correlated with the total PSQI score ( r =-0.04, P <0.01). After controlling for variables such as mental health, nutritional status and maximum oxygen uptake, the results of linear regression analysis showed that PSQI total score negatively predicted MVPA among middle school students ( B =-4.76, 95% CI =-7.16 to -2.36, P <0.05). Conclusion The longer the duration of physical activity among middle school students, the better the quality of sleep.

Mycophenolic acid (MPA), the active moiety of both mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), serves as a primary immunosuppressant for maintaining solid organ transplants. Therapeutic drug monitoring (TDM) enhances treatment outcomes through tailored approaches. This study aimed to develop an evidence-based guideline for MPA TDM, facilitating its rational application in clinical settings. The guideline plan was drawn from the Institute of Medicine and World Health Organization (WHO) guidelines. Using the Delphi method, clinical questions and outcome indicators were generated. Systematic reviews, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence quality evaluations, expert opinions, and patient values guided evidence-based suggestions for the guideline. External reviews further refined the recommendations. The guideline for the TDM of MPA (IPGRP-2020CN099) consists of four sections and 16 recommendations encompassing target populations, monitoring strategies, dosage regimens, and influencing factors. High-risk populations, timing of TDM, area under the curve (AUC) versus trough concentration (C₀), target concentration ranges, monitoring frequency, and analytical methods are addressed. Formulation-specific recommendations, initial dosage regimens, populations with unique considerations, pharmacokinetic-informed dosing, body weight factors, pharmacogenetics, and drug‍-‍drug interactions are covered. The evidence-based guideline offers a comprehensive recommendation for solid organ transplant recipients undergoing MPA therapy, promoting standardization of MPA TDM, and enhancing treatment efficacy and safety.
Mycophenolic Acid/administration & dosage* ; Drug Monitoring/methods* ; Humans ; Organ Transplantation ; Immunosuppressive Agents/administration & dosage* ; Delphi Technique

Objective To discuss the application value of coronary CT angiography(CCTA)evaluation of morphological parameters of coronary chronic total occlusion(CTO)in guiding interventional therapy.Methods A total of 300 patients with coronary angiography-confirmed CTO in Jinhua Municipal People's Hospital from January 2021 to December 2023 were selected.All patients received CCTA examination before surgery.The morphological parameters of CCTA,including proximal morphology of occlusion segment,length of occlusion vessel,length of linear enhancement in occlusion segment,length of linear enhancement in occlusion segment/length of occlusion vessel,vascular linear enhancement in occlusion segment,vascular calcification in occlusion segment,vascular calcification area in occlusion segment ≥50％on cross section image,tortuous path of lesion(＞45°),collateral vessels and lesion of vascular opening,were recorded.The correlation between the above parameters and therapeutic results of percutaneous coronary intervention(PCI)was analyzed.Results There were 325 lesions in 300 patients with CTO,and 227 lesions(69.85％)were successfully treated by PCI and PCI treatment failed in 98 lesions(30.15％).The proximal blunt shape of occlusion segment,length of occlusion vessel,vascular calcification area of occlusion segment ≥50％on cross section image,and tortuous path of lesion(＞45°)in the failure group were significantly higher than those in the successful group(all P＜0.05),while the length of linear enhancement in occlusion segment,length of linear enhancement in occlusion segment/length of occlusion vessel and vascular linear enhancement in occlusion segment in the failure group were strikingly lower than those in the successful group(all P＜0.05).No obvious significant differences in other parameters existed between the two groups(all P＞0.05).Multivariate logistic regression analysis showed that the length of linear enhancement in occlusion segment(OR=1.975,95％CI:1.306-2.988),the length of linear enhancement in occlusion segment/length of occlusion vessel(OR=3.831,95％CI:1.332-11.017),and the linear enhancement in occlusion segment(OR=1.702,95％CI:1.007-2.879)were the valuable factors for predicting the success of PCI treatment(all P＜0.05).Conclusion CCTA evaluation of coronary CTO morphological parameters has a certain value in guiding interventional therapy.The length of linear enhancement in occlusion segment,the length of linear enhancement in occlusion segment/length of occlusion vessel,and the linear enhancement in occlusion segment are the useful factors for predicting the success of PCI treatment.

Objective: To explore the characteristics and related factors of adolescent executive function, so as to provide theoretical basis for promoting the development of adolescent executive function. Methods: A total of 5 018 adolescents aged 13-18 from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi and Urumqi were selected by convenient cluster random sampling method from September to December 2022, and their basic information, family status, lifestyle behavior, physical fitness and executive function were investigated by questionnaire survey. Considering the heterogeneity between schools, a multilevel Logistic model was established to analyze the related factors of adolescent executive function. Results: The inhibitory function of high school students was better than that of middle school students (Z=-2.69). In terms of refreshment function, high school students were superior than middle school students (1-back:Z=-11.32; 2-back:Z=-11.36), and male students were superior than female students (2-back:Z=-2.18); in terms of shifting function, high school students were superior than middle school students (Z=-2.63), and boys were superior than girls (Z=-7.10)(P<0.05). The results of multilevel model analysis showed that the executive function of adolescents was clustered at the school level. At the individual level, junior high school refreshment function (1-back:β=56.94; 2-back:β=127.00), and shifting function (β=35.64) were worse than that of high school students; the refreshment function 2-back (β=-21.24) and shifting function (β=-28.42) of male students were better than those of female students; the refreshment function 2-back of nononly child was better than that of only child (β=-19.36); refreshment function of low fitness was worse than that of high fitness (β=37.35); the shifting function of the video screen time not up to standard was better than that of the standard (β=-14.30)(P<0.05). Conclusions The executive function of high school students is better than that of middle school students, the refreshment function and shifting function of boys are better than that of girls. Family environment, lifestyle and physical health are significant factors related to executive function of Chinese adolescents. By raising awareness of the major supporting and impeding factors for executive functioning in adolescents, it can help to develop effective intervention programs for adolescents.

Abstract Executive function is an advanced cognitive process aimed at the flexible coordination, optimization, and control of the cognitive processes of task solving in order to accomplish a specific task, ensuring that the individual produces effective behaviors, including inhibitory control, working memory, and cognitive flexibility. Given the sensitivities and specificities that characterize an individual s physical and mental development during adolescence, this period is critical for the development of executive function in adolescents. In the paper, the influencing factors of adolescents executive function development are systematically described from three dimensions, namely, biology, environment and lifestyle; by analyzing the mechanisms and differences in the effects of different influencing factors, this editorial provides a scientific basis for adolescents executive function improvement and intervention.