Sleep is an active and complex neurophysiological process.Premature babies sleep most of the day，and adequate sleep is conducive to the growth and development of premature infants.Sleep problems may be more common in preterm infants，but the studies about sleep and neurodevelopment in preterm infants are rare.This review systematically expounds the characteristics of shortened sleep time and fragmented sleep patterns in preterm infants，and the related mechanisms affecting their sleep quality，and summarizes measures to improve the sleep quality of preterm infants，in order to improve the sleep quality of preterm infants and thus promote neurodevelopment.

BACKGROUND:Temporomandibular joint osteoarthritis can cause severe pain,which significantly affects the patient's quality of life and psychological health.Studies have found that medical ozone can effectively alleviate pain due to temporomandibular joint osteoarthritis,but its analgesic effect and mechanism are still unclear. OBJECTIVE:To explore the effects of medical ozone on pain relief in temporomandibular joint osteoarthritis and the potential mechanisms. METHODS:Twenty-four Sprague-Dawley rats were randomly divided into four groups(n=6 per group):control group,model group,air group,and medical ozone group.A sodium iodate-induced rat model of temporomandibular joint osteoarthritis was established in all groups except for the control group.After 1 week of modeling,rats in the air group and medical ozone group were injected with clean air and medical ozone,respectively,in the temporomandibular joint.The injection frequency for the air group and medical ozone group was once a week for three times in total.The von Frey mechanized pain measurement technique was used to assess the mechanical pain threshold of the temporomandibular joint in rats before and 28 days after modeling.ELISA was utilized to detect interleukin-1β in both serum and temporomandibular joint fluid at 28 days after modeling.Histopathologic changes of the temporomandibular joint were evaluated through hematoxylin-eosin staining.Additionally,the expression levels of hypoxia-inducible factor 1α and cyclooxygenase 2 in the temporomandibular joint were analyzed using immunohistochemistry. RESULTS AND CONCLUSION:Compared with the control group,the mechanical pain thresholds of the temporomandibular joint in the model group were decreased at 1,3,7,14,21,and 28 days after modeling(P<0.01);and compared with the model and air groups,the mechanical pain thresholds of the temporomandibular joint in the medical ozone group were increased at 28 days after modeling(P<0.01).Compared with the control group,the level of interleukin 1β in the serum and joint fluid of rats in the model group was elevated(P<0.01);compared with the model and air groups,the level of interleukin 1β in the serum and joint fluid of rats in the medical ozone group was decreased(P<0.01).Hematoxylin-eosin staining results showed derangement and degeneration of the cartilage structure in the model group and the air group,while the derangement of the cartilage structure in the medical ozone group was less than that in the model group and the air group.Immunohistochemical staining showed that the expression of hypoxia-inducible factor 1α and cyclooxygenase 2 in the temporomandibular joints of rats in the model group was elevated compared with that in the control group(P<0.01);the expression of hypoxia-inducible factor 1α and cyclooxygenase 2 in the temporomandibular joints of rats in the medical ozone group was decreased compared with that in the model group and the air group(P<0.01,P<0.05).These findings suggest that medical ozone can alleviate the pain caused by osteoarthritis of the temporomandibular joints in Sprague-Dawley rats by reducing the expression of hypoxia-inducible factor 1α,interleukin 1β,and cyclooxygenase 2.

Objective To investigate the effect of medical ozone injection therapy on temporomandibular joint(TMJ)osteoarthritis and its pain in SD rats.Methods Fifity-four rats were randomly assigned according to a random number table into three groups:con-trol group,model group,and medical ozone group,with 18 rats in each group.In the control group,only physiological saline was in-jected during modeling;in the model group,only sodium iodoacetate was injected for modeling;in the medical ozone group,after in-jecting sodium iodoacetate into the joint cavity for modeling for one week,medical ozone was then injected into the joint cavity for inter-vention at a frequency of once a week,totaling 5 times.One week(week 2 after modeling),3 weeks(week 4 after modeling),and 5 weeks(week 6 after modeling)after medical ozone injections,6 rats from each group were euthanized.Mechanical withdrawal thresh-old of rats in each group was assessed before euthanasia,and the expression levels of interleukin-1β(IL-1β)in joint fluid of rats in each group were measured after euthanasia.Gross observation and modified Mankin's scoring were performed on TMJ cartilage of rats in each group after stained with Pelletier score and Safranin O-Fast Green.Results During the same time period,compared to the control group,the model group showed a significant decrease in the mechanical pain threshold of the TMJ in rats at 1 week,3 weeks,and 5 weeks(P＜0.01).The expression levels of IL-1β in the TMJ fluid increased(P＜0.01),and the Pelletier score and modified Mankin's score of TMJ cartilage increased(P＜0.01).In comparison to the model group,the medical ozone group exhibited a significant increase in the mechanical pain threshold of the TMJ in rats after 3 weeks and 5 weeks of medical ozone injections(P＜0.01).The expression levels of IL-1β in the TMJ fluid decreased(P＜0.01),and the Pelletier score and modified Mankin's score of TMJ cartilage decreased(P＜0.01).However,there were no statistically significant difference in the measured parameters in the TMJ cavity after 1 week of medical ozone injection(P＞0.05).Within the medical ozone group,compared to the 1-week treatment,the mechanical pain threshold of the TMJ increased(P＜0.01)and the expression levels of IL-1β in the TMJ fluid decreased at 3 weeks and 5 weeks(P＜0.01).However,there was no statistically significant difference in the Pelletier score and modified Mankin's score of TMJ cartilage(P＞0.05)between different treatment duration.Additionally,there were no statistically signif-icant differences in the mechanical pain threshold of the TMJ,expression levels of IL-1β in the TMJ fluid,Pelletier score,and modi-fied Mankin's score of TMJ cartilage between the medical ozone group at 3 weeks and 5 weeks(P＞0.05).Conclusion Medical ozone treatment for more than 3 weeks can improve temporomandibular joint osteoarthritis and its associated pain in rats.

Objective:To analyze the group heterogeneity of different types of self-management ability of patients with nonalcoholic fatty liver disease (NAFLD) through potential category analysis, and to explore the differences of nursing interventions among different types of people, so as to provide reference for intervention research.Methods:From March to August 2021, NAFLD patients undergoing physical examination and hospitalization in the First Affiliated Hospital of Xinjiang Medical University were selected as the research object by convenience sampling. The General Information Questionnaire, Health Promoting Lifestyle Profile-Ⅱ (HPLP-Ⅱ) and Self-management Behavior Scale for Patients with NAFLD were used to investigate the patients, and the height and weight of the patients were also measured. A total of 1 189 questionnaires were distributed and 1 124 valid questionnaires were recovered.Results:Self-management ability of NAFLD patients were divided into five types, including good self-management group (32.03%) , lack of self-management-medium level psychological cognition group (23.84%) , lack of health promoting behavior group (11.30%) , lack of disease-cognition-life management group (27.31%) , serious lack of self-management-medium level stress group (5.52%) . Taking the good self-management group as a reference, the results showed that age, marital status, occupation, education level, average monthly income, treatment methods, smoking, body mass index (BMI) , sleep quality, and concomitant diseases were the influencing factors that caused the potential category differences of self-management behavior in NAFLD patients, and the differences were statistically significant ( P<0.05) . Conclusions:Each potential category of NAFLD patients' self-management ability has specificity, which suggests that the formulation of nursing interventions for NAFLD patients in the future should be based on the heterogeneity of various types of groups, so as to improve the effectiveness of self-management intervention.

Objective: To understand comprehensive sexuality education knowledge among junior high school students in China, and to analyze relevant influencing factors to provide scientific basis for the implementation of school based sexuality education or comprehensive sexuality education in the future. Methods: By using convenient sampling method, a cross sectional survey was conducted among 4 545 students at grade 1 to grade 3 from junior middle schools in Beijing, Liaoning, Sichuan, Chongqing, Yunnan, Henan, using an online electronic questionnaire during September to October 2021. The questionnaire included general demographic information, subjective social status, sex education received at home and school, bullying, as well as knowledge, attitude, practice and needs towards comprehensive sexuality education. Results: The average score of the comprehensive sexuality education knowledge was (12.21±3.10) points, which was converted to (71.82±18.21) points based on the percentage based system. The scores varied by grade, sex and sexuality education setting, significantly higher in grade 3 students (12.69±2.99), girls (12.28±3.01) ( P < 0.01), and students who have received sex education at home (12.67±2.88) and students who received sex education at school (12.63±2.91), as well as those who had actively searched for sex information online had a higher score (12.71±2.94) ( t =35.10, 28.78, 10.55, P <0.01).Further analysis using multiple linear regression and Logistic regression, "whether you have received sex education at home" "whether you have received sex education at school" "whether you have searched the Internet actively" and "whether it is necessary to carry out comprehensive sex education" are still correlated with the score of comprehensive sex education knowledge; "self reported bullying" was still associated with "subjective social status" score, correct rate of question 2, and "shyness and inferiority toward the development of secondary sexual characteristics" ( P <0.01). Conclusion The current comprehensive sexuality education knowledge among junior high school students needs to be improved. The level of implementation of sexuality education in different settings varies, but the implementation of sexuality education in schools can help improve students comprehensive sexuality education knowledge level.

Objective: To understand the current situation regarding sex education in home and school settings in China, and to provide a scientific basis for more effective family and school sex education. Methods: Using a convenient sampling method, a crosssectional survey of students from grade 7 to grade 9 in Beijing, Liaoning, Sichuan, Chongqing, Yunnan and Henan was carried out from September to December 2021. The questionnaire covered general demographic information, sex education at home and school, and the status of comprehensive sexuality education. Finally, 4 109 valid questionnaires were collected. Results: A total of 760(18.50%) middle school students had not received any form of sex education, 923(22.46%) had only received sex education at school, 299(7.28%) had only received sex education at home, and 2 127 (51.76%) had received sex education at home and at school. The scores related to junior middle school students knowledge of comprehensive sexuality education was (12.43±2.89) points, the attitude score was (47.86±5.31) points, the behavior score was (40.44±5.18) points, and the comprehensive level score was (82.02±9.01) points. Junior middle school students who received sex education at home and in school had the highest comprehensive level of sex education( P <0.01). Junior middle school students who only received sex education at school had a higher comprehensive sexuality education knowledge level than those who only received sex education at home( P < 0.01 ). The level of comprehensive sexuality education behavior among junior middle school students who only received family sex education was significantly higher than among those who only received sex education at school( P <0.01). Conclusion Receiving sex education in both home and school settings can effectively improve the comprehensive sexuality education competency among junior middle school students. School based sex education should be further implemented in the future and family sex education should be encouraged.

Adjuvant radiotherapy has become an important part of the standard treatment for breast cancer. Compared with the traditional postoperative radiotherapy, neoadjuvant radiotherapy has the theoretical advantages of more accurate target delineation, optimization of radiation strategy for breast reconstruction, increase of breast conservation surgery with tumor down-staging and avoiding breast surgery by improving pathological complete response rate, which have been confirmed by recent clinical research. Prospective studies are still needed for the optimal target delineation, dose fractionation, radiation-surgery interval, and combination with systemic therapies, aiming to provide the optimal treatment option for patients with early breast cancer.

Objective: To preliminarily develop the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, as an important measuring tool for assessment of comprehensive abilities in infectious disease prevention of Chinese middle school students. Methods: The basic dimensional framework and item pool were established by literature review in the view of public health. Then Delphi method was used to modify the framework and item pool to scale 1.0. Panel discussion in middle school students was used to adjust the expression and structure of scale 1.0, turning it into scale 2.0. With the confirmation of theory experts subjects, the scale was preliminarily developed. Results: Literature review suggested that the basic dimension framework included five longitudinal dimensions and seven horizontal dimensions. According to Delphi method ( n =18), the Kendall s coefficient of concordance ( W ) of the scale was equal to 0.14 ( P <0.01), the average importance, proportion of full marks, coefficient of variation and weight coefficient of all dimensions and items met the inclusion criteria. According to panel discussion, the scale was finally adjusted into scale 2.0 with 53 items. Conclusion This study preliminarily established the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, which might be applied in both scientific research and practical use.

Objective: To understand the characteristics of KAP (knowledge, attitude and practice) related to the prevention of AIDS among young male MSM (man sex with man) in China, and to evaluate the comprehensive ability of AIDS prevention and associated factors to provide a scientific basis for the development of MSM AIDS prevention and control. Methods: From November to December 2019, sampling was recruited by using snowball sampling methods centered on Beijing and Tianjin. A cross-sectional survey of 222 young students MSM was conducted through an online questionnaire with information of general demographic characteristics, sexual behavior and HIV testing, psychological status and comprehensive ability to prevent AIDS. Results: Average score on comprehensive AIDS prevention knowledge was (87.64±6.41),with knowledge,attitude,and behavior score of (11.32±1.67)(54.87±3.36) and (52.18±4.30) respectively.The pass rate of knowledge, attitude, practice related to AIDS prevention were respectively 95.5%, 56.3%, and 27.0%. The separation rate of knowledge from belief was 42.8%, the separation rate of knowledge from behavior was 71.2%, and the separation rate of faith from information was 48.2%. Whether have received AIDS prevention education was related to knowledge qualification rate (P<0.01). Conclusion Current AIDS education is associated with the knowledge level of AIDS prevention among young MSM groups, but it is not enough to improve their attitudes and behaviors. The comprehensive ability of MSM in preventing AIDS among young students is still not optimistic. Intervention measures need to be further strengthened to improve the comprehensive ability of young students MSM group to prevent AIDS.

Objective: To identify the characteristics of social network and the association between ego-centric network and HIV status among young MSM Chinese students. Methods: The cross-sectional study was conducted in Chongqing, Tianjin, Harbin and Xi an city from April to December 2017 and from March to May 2018. A mixed recruitment method of snowball sampling and RDS approach was used to recruit participants who reported information on social network and received HIV test. The Multiple Regression Analysis method was used to for the analysis of association between ego-centric social network and HIV status of men who have sex with men (MSM) among young students. Results: The sample included 547 participants who nominated 1 088 social partners in total with average age of 13 to 60 years old. The MSM with different sexual orientation from their social members (aOR=0.38), embedded in a large network (aOR=0.63), with a high individual betweenness centrality (aOR=0.27) were at lower risk of HIV-positive status; while MSM who differed greatly in education level with their social members(aOR=1.60), existed in sexual networks(aOR=1.41), existed in the “risky networks” (aOR=1.88) , with high network density (aOR=1.91) and a high individual degree (aOR=4.10) had higher risk of HIV-positive status(P<0.05). Conclusion MSM with great difference in education level from social members, existed in sexual networks, with a large network density and a high degree were exposed to higher risk of HIV-positive status.