Objective: To examine the characteristics of physical activity among secondary vocational school students and its associations with depressive symptoms, anxiety symptoms, and their co-existence, so as to provide evidence for promoting their mental health. Methods: From September to December 2024, a questionnaire survey was conducted on 5 141 secondary vocational school students using convenience sampling method across 16 secondary vocational schools in 8 provinces/municipalities, including Fujian, Chongqing, Guangdong, Guangxi, Hubei, Jiangxi, Shanghai and Zhejiang. A self designed questionnaire, International Physical Activity Questionnaire Short Form, Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7 were used to assess basic information, physical activity characteristics, and depressive and anxiety symptoms. Chi-square test and Logistic regression model were used to analyze the associations of physical activity characteristics with depressive symptoms, anxiety symptoms, and their co-existence. Results: Among secondary vocational school students, 22.2% had depressive symptoms, 12.2% had anxiety symptoms, and 10.5% had both conditions. After adjustment for confounding factors such as sex, grade, and family structure, Logistic regression analyses showed that a high physical activity level, meeting the recommendation for daily moderate to vigorous physical activity (MVPA), and a concentrated physical activity pattern were associated with lower odds of depressive symptoms, anxiety symptoms, and their co-existence ( OR =0.70-0.81, all P <0.05). Regular weekly MVPA and a regular physical activity pattern were associated only with lower odds of depressive symptoms ( OR =0.79, 0.70, both P <0.05). Sex stratified analyses showed that meeting the recommendation for daily MVPA and a concentrated physical activity pattern were associated with lower odds of depressive symptoms, anxiety symptoms, and their co-existence among boys ( OR =0.60-0.71); a high physical activity level, regular weekly MVPA, and a regular physical activity pattern were associated with lower odds of depressive symptoms among boys ( OR =0.65-0.78)(all P <0.05). Meanwhile, a high physical activity level, meeting the recommendation for daily MVPA, regular weekly MVPA, and regular and concentrated physical activity patterns were associated with lower odds of depressive symptoms in female students ( OR =0.72-0.79) (all P <0.05). Conclusions Physical activity characteristics are associated with depressive symptoms, anxiety symptoms, and their co-existence among secondary vocational school students. Schools should optimize physical activity promotion strategies according to sex specific characteristics to reduce the occurrence of depressive and anxiety symptoms among secondary vocational school students.

Objective: To analyze the compliance status of physical fitness indicator and lifestyle characteristics among secondary vocational school students, as well as their associations, so as to provide a reference for physical fitness promotion among secondary vocational school students. Methods: Using a convenience sampling method, a questionnaire survey and physical fitness tests were conducted from September to December 2024 among 5 141 secondary vocational school students recruited from 16 secondary vocational schools across 8 provinces/municipalities in China, including Fujian, Chongqing, Guangdong, Guangxi, Hubei, Jiangxi, Shanghai and Zhejiang. Data on lifestyle factors were collected using a self designed questionnaire combined with standardized scales, including dietary habits, unhealthy behaviors, and 24 hour behaviors (physical activity, screen time, and sleep behavior). Multivariable Logistic regression model was used to analyze the associations of individual lifestyle behaviors and clustering of unhealthy lifestyle behaviors with non-compliance in physical fitness indicators among secondary vocational school students. Results: The compliance rates for waist circumference, vital capacity, grip strength, standing long jump, 30 second sit ups, 20 meter shuttle run, 50 meter dash, sit and reach, 20 second side steps among secondary vocational school students were 55.9%, 89.6%, 81.8%, 79.4%, 77.8%, 61.4%, 87.0%, 12.6%, and 63.5%, respectively, with a non-overweight/obesity rate of 78.9%. The reporting rates of daily breakfast consumption, milk consumption, and vegetable consumption were 58.9%, 18.3%, and 37.5%, respectively. The reporting rates of frequent takeout consumption, frequent sugar sweetened beverage consumption, smoking, alcohol drinking, insufficient moderate to vigorous physical activity (MVPA), excessive screen time, and insufficient sleep were 30.0%, 43.8%, 8.4%, 15.8%, 42.9%, 90.8%, and 42.6%, respectively. Multivariable Logistic regression analysis showed that secondary vocational school students with insufficient MVPA had higher risks of non-compliance in vital capacity, grip strength, standing long jump, 30 second sit ups, 20 meter shuttle run, 50 meter dash, and 20 second side steps ( OR =1.22- 1.60 ); secondary vocational school students who consumed breakfast daily had lower risks of non-compliance in vital capacity and overweight/obesity ( OR =0.81, 0.85); daily vegetable consumption was associated with a lower risk of vital capacity non-compliance ( OR =0.72); frequent takeout consumption was associated with an increased risk of non-compliance in the sit and reach test ( OR =1.28); smoking was associated with increased risks of non-compliance in the 20 meter shuttle run and 20 second side steps ( OR =1.38, 1.58) (all P <0.05). Regarding the clustering of unhealthy behaviors, secondary vocational school students with 4- 5 clustered unhealthy behaviors had higher risks of non-compliance in waist circumference and standing long jump; those with≥6 clustered behaviors had higher risks of non-compliance in standing long jump, 20 meter shuttle run, and 20 second side step ( OR = 1.17-1.36, all P <0.05). Conclusions The clustering of unhealthy behaviors is negatively associated with physical fitness status among secondary vocational school students. Secondary vocational schools should prioritize the promotion of comprehensive lifestyle management to improve the physical fitness levels of secondary vocational school students.

Objective: To investigate the prevalence of depressive and anxiety symptoms and their co-occurrence among secondary vocational school students and to examine their associations with physical activity (PA) and screen time (ST), so as to provide evidence for promoting mental health of the students. Methods: From September to December 2024, a convenience sampling method was used to conduct a questionnaire survey among 5 141 students across 16 secondary vocational schools in eight provincial level regions of China, including Fujian, Chongqing, Guangdong, Guangxi, Hubei, Jiangxi, Shanghai, and Zhejiang. Information on general demographic characteristics, lifestyle behaviors, and depressive and anxiety symptoms was collected using questionnaires. Multivariable Logistic regression model was used to analyze the associations of PA, ST with depressive symptoms, anxiety symptoms, and their co-occurrence. Results: The detection rates of depressive symptoms, anxiety symptoms, and their co-occurrence among secondary vocational school students were 22.2%, 12.2%, and 10.5%, respectively. Univariate analyses showed that sex, left behind experience, maternal education level, family economic status, body mass index category, family structure, smoking, alcohol consumption, sugar sweetened beverage intake, eating takeout, sleep duration, PA, and ST were associated with the detection rates of depressive symptoms, anxiety symptoms, and their cooccurrence ( χ 2=3.94-110.51, all P <0.05). Multivariable Logistic regression analyses showed that failure to meet the PA recommendation was associated with higher risks of depressive symptoms, anxiety symptoms, and their co-occurrence ( OR =1.44, 1.33, 1.25); failure to meet the daily ST recommendation was associated with higher risks of anxiety symptoms and co-occurring depressive and anxiety symptoms ( OR = 1.51,1.76) (all P < 0.05 ). Combined analysis showed that, compared with the group meeting both PA and ST guidelines, students who met neither guideline, and those who failed the PA guideline but met the ST guideline had higher risks of depressive and anxiety symptoms, and their co-occurrence ( OR =1.88-2.96); students who met PA recommendation but failed ST guidelines had higher risks of anxiety symptoms and co-occurring depressive and anxiety symptoms ( OR =2.03, 2.46) (all P <0.05). Conclusions Insufficient PA is associated with depressive symptoms, anxiety symptoms, and their co-occurrence among secondary vocational school students, whereas excessive screen time is associated with anxiety symptoms and co-occurring depressive and anxiety symptoms. These associations are more pronounced when insufficient PA and excessive screen time occurred simultaneously.

Platelet transfusion refractoriness (PTR) is a common issue among patients with hematological diseases and tumors. This article reviews the diagnostic criteria, influencing factors, and recent prevention and management strategies for immune PTR. The diagnostic criteria typically involve post-transfusion platelet increment (PI), platelet recovery rate (PPR), and corrected count increment (CCI). Both immune and non-immune factors can lead to PTR, with immune factors mainly including HLA and HPA antibodies. Prevention and management strategies include the use of leukocyte-reduced platelets, HLA and HPA antigen-matched platelets, intravenous immunoglobulin therapy, and immunosuppressive strategies. Although various strategies have been proposed and applied in clinical practice, the prevention and management of immune PTR remain challenging. Future research needs to explore more effective individualized treatment strategies, while also considering the potential application of emerging technologies such as nanotechnology in the field of transfusion.

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

ObjectiveTo improve the quality and service performance of community visual health services in Shanghai, and to establish a set of reasonable and effective evaluation index system for community visual health services. MethodsCentered on the national and Shanghai-based visual health policies and based on the current status and development trends of community visual health service program in Shanghai, the candidate indicators were formed through literature review and expert interviews, firstly. The framework of an evaluation index system was formulated through qualitative research successively, which was further revised and perfected using the Delphi method. Coefficient weights were calculated using the analytic hierarchy process (AHP), culminating in the establishment of the community visual health evaluation index system, lastly. ResultsA total of 22 visual health experts from district-level center for disease control, hospital ophthalmology and leaders in charging of visual health service in community health centers participated in the Delphi questionnaire survey, with a questionnaire recovery rate of 100% and an expert authority coefficient of 0.86, indicating high credibility. After a round of correspondence to experts’ importance ratings and discussions, a comprehensive evaluation index system comprising 3 primary indicators, 12 secondary indicators, and 47 tertiary indicators, along with 5 additional indicators, was finalized. ConclusionAn index system tailored to effective evaluation for community visual health initiatives was drawn up in this study, which can promote the capacity building in community eye health services, facilitating the high-quality development of visual health courses, and enhancing residents’ eye health.

ObjectiveThis study aims to explore the effects of Huangqin Qingre Chubi capsules-containing serum on the expression of CircRNA_0001543/nuclear factor-kappa B （NF-κB） in co-cultured peripheral blood mononuclear cells （PBMCs） and human fibroblast-like synoviocytes （FLSs） from patients with ankylosing spondylitis （AS）. MethodsVenous blood was collected from patients with AS to isolate PBMCs. FLSs were co-cultured with AS patients' PBMCs， and FLSs were harvested after co-culture for subsequent experiments. The normal control group consisted of normal FLSs， while the model group comprised co-cultured AS PBMCs and FLSs to simulate AS pathology. The Huangqin Qingre Chubi capsules group involved adding Huangqin Qingre Chubi capsules-containing serum to the co-cultured cells（6.48 g·kg^-1）. To investigate the effect of HQC-containing serum on the viability of co-cultured cells， and the experiment was divided into the following groups based on the dilution concentration： blank group， 10% HQC group， 20% HQC group， and 30% HQC group.To study the influence of the optimal concentration of HQC-containing serum on cytokine and pathway indicators in each group， the experiment was divided into three groups： normal group， model group， and optimal concentration HQC-containing serum group.For the validation of the transfection efficiency of the CircRNA_0001543 interference plasmid， the experiment was divided into the following groups： blank group， si-NC group （with transfection reagent）， si-circ_0001543-1 group （with transfection reagent and interference plasmid No. 1 targeting circ_0001543）， si-circ_0001543-2 group （with transfection reagent and interference plasmid No. 2 targeting circ_0001543）， and si-circ_0001543-3 group （with transfection reagent and interference plasmid No. 3 targeting circ_0001543）.For the validation of the transfection efficiency of the CircRNA_0001543 overexpression plasmid， the experiment was divided into the following groups： blank group， OE-NC group （with transfection reagent）， and OE-circ_0001543 group （with transfection reagent and overexpression plasmid targeting circ_0001543）.To study the effects of CircRNA_0001543 interference/overexpression on cytokine and pathway indicators in each group， the experiment was divided into the following groups： si-NC group， si-CircRNA_0001543 group， OE-NC group， and OE-CircRNA_0001543 group. Enzyme-linked immunosorbent assay （ELISA） was used to detect levels of interleukin-1β （IL-1β）， IL-10， IL-37， and tumor necrosis factor-α （TNF-α）. Real-time quantitative polymerase chain reaction （Real-time PCR） was utilized to measure the expression of CircRNA_0001543， IκBα， and NF-κB p65. ResultsAfter 48 hours， 30% Huangqin Qingre Chubi Capsules-containing serum significantly inhibited the proliferation of co-cultured PBMCs and FLSs， which was determined to be the optimal experimental drug-containing serum concentration. Compared with those in the normal group， the expressions of NF-κB p65 mRNA， IκBα mRNA， IL-1β， and TNF-α in the model group were significantly increased （P<0.01）， while the expressions of CircRNA_0001543 mRNA， IL-10， and IL-37 were significantly decreased （P<0.01）. Compared with those in the model group， the expressions of NF-κB p65 mRNA， IκBα mRNA， IL-1β， and TNF-α in the Huangqin Qingre Chubi Capsules-containing serum group were significantly decreased （P<0.05）， and the expressions of CircRNA_0001543 mRNA， IL-10， and IL-37 were significantly increased （P<0.05）， with the most prominent changes in the 30% drug-containing serum group （P<0.01）. Compared with that in the si-NC group， the expression of CircRNA_0001543 was significantly reduced in the si-CircRNA_0001543 group （P<0.01）. Compared with that in the OE-NC group， the expression of CircRNA_0001543 was significantly increased in the OE-CircRNA_0001543 group （P<0.01）， indicating that the si-CircRNA_0001543 and OE-CircRNA_0001543 plasmids were successfully transfected. Based on the optimal drug-containing serum of Huangqin Qingre Chubi Capsules， si-CircRNA_0001543 transfection led to significantly increased expressions of NF-κB p65 mRNA， IκBα mRNA， IL-1β， and TNF-α and decreased the expressions of IL-10 and IL-37 （P<0.01）. In contrast， OE-CircRNA_0001543 transfection significantly decreased the expressions of NF-κB p65 mRNA， IκBα mRNA， IL-1β， and TNF-α （P<0.01） and increased the expressions of IL-10 and IL-37 （P<0.01）. ConclusionHuangqin Qingre Chubi capsules-containing serum can improve immune inflammation in AS by increasing the expression of CircRNA_0001543， regulating the NF-κB pathway， suppressing pro-inflammatory cytokines， and enhancing anti-inflammatory cytokine expression.

Objective To explore the influencing factors of coronary artery lesion severity in patients with acute coronary syndrome (ACS). Methods Clinical data of ACS patients admitted to Zhongshan Hospital, Fudan University from December 2017 to December 2019 were consecutively collected. The modified Gensini score was used to assess the severity of coronary artery lesions. Univariate and multivariate linear regression analyses were performed to identify independent factors associated with coronary artery lesion severity. Results A total of 1 689 ACS patients were included, with an average age of (64.04±11.45) years; 1 353 (80.11%) were male, and the mean modified Gensini score was (8.12±4.03). Multivariate linear regression analysis revealed that sex (β＝0.97, P＝0.001), age (β＝0.03, P＝0.021), estimated glomerular filtration rate (eGFR; β＝－0.03, P＜0.001), low-density lipoprotein cholesterol (LDL-C; β＝0.58, P＜0.001), apolipoprotein A1 (Apo A1; β＝－1.28, P＝0.012), lipoprotein(a) [Lp(a); β＝0.001, P＝0.033], and glycated hemoglobin A_1C (HbA_1C; β＝0.45, P＜0.001) were independent influencing factors of the modified Gensini score. Conclusions Metabolic indicators, including Apo A1, LDL-C, HbA_1C, and Lp(a), may serve as risk factors for coronary artery lesion severity in ACS patients, with Apo A1 demonstrating the strongest impact.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Objective:To report the blood group antigen and antibody specificity identification methods for a patient with high-frequency antibodies, and the process of finding and providing compatible blood for the patient.Methods:A patient sent from the Blood Transfusion Department of Shanxi Provincial People′s Hospital to Taiyuan Blood Center in November 2022 was selected for the study. Classical serological methods were used to determine the patient′s blood type, screen for unexpected antibodies, identify antibodies, and perform crossmatching. High-frequency antibody identification was carried out using red blood cells treated with various enzymes. Blood group genotyping was conducted using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF) and Sanger sequencing. Multiple strategies were employed to address the patient′s blood source problem. The study was approved by the Medical Ethics Committee of Taiyuan Blood Center [Ethics No. 2024 Ethics Review No.(2)].Results:①The patient′s blood type was B, RhD positive. Initial screening of the patient′s serum with multiple screening cells and antibody identification cells in saline medium was negative, but positive in antiglobulin medium. The patient′s serum showed varying reaction intensities with red blood cells treated with different enzymes. ②MALDI-TOF mass spectrometry and Sanger sequencing revealed a homozygous nonsense variant c. 376C>T (p.Gln126Ter) in the ABCG2 gene, resulting in the Jr(a-) phenotype. During family donor selection, the patient′s son was found to have a heterozygous variant c. 376C>T (p.Gln126Ter), and another heterozygous variant c. 421C>A (p.Gln141Lys), which predicted a Jr(a+ w) phenotype. ③Crossmatch tests confirmed the compatibility of blood from the patient′s son, which was used to address the urgent blood requirement. Later, rare blood from a Jr(a-) donor from the Guangzhou Blood Center was used for the patient′s ongoing treatment, saving the patient′s life. Conclusion:Combining classic serological testing with blood group gene typing techniques successfully identified the rare Jr(a-) blood type and high-frequency anti-Jra antibodies. Enzyme-treated red blood cell identification methods confirmed the presence of anti-Jra antibodies. By searching within the family and seeking help from other blood centers, compatible blood was found. This approach may provide insights for resolving similar complex blood matching problems in the future.