Objective: To investigate the association between bedtime screen use and sleep health among fourth and fifthgrade primary school students, so as to provide evidence to support interventions for improving sleep quality. Methods: From April to June 2024, a survey was conducted among 4 232 fourth and fifthgrade students from nine primary schools in a district of Beijing. A selfdesigned questionnaire assessed bedtime screen use behavior and sleep health indicators. Generalized linear models and Logistic regression were used to analyze the associations. Results: Among the surveyed students, 28.3% reported bedtime screen use. Mean sleep duration every day was (9.31±0.90) hours on school days and (10.08±1.36) hours on weekends. Compared to nonusers, students with bedtime screen use exhibited every day: later bedtimes on school days (10.18 min delay, 95%CI=6.88-13.47) and weekends (22.09 min delay, 95%CI=17.33-26.85) (P<0.05); later weekend wake times (7.97 min delay, 95%CI=1.78-14.16, P<0.05); reduced sleep duration on school days (-9.82 min, 95%CI=-13.62 to -6.03) and weekends (-14.12 min, 95%CI=-20.24 to -8.00) (P<0.05); greater weekend-school day bedtime discrepancy (β=1.15, 95%CI=1.08-1.23, P<0.01). Additionally, they had lower odds of falling asleep within 20 minutes (OR=0.62, 95%CI=0.54-0.72), daytime alertness (OR=0.66, 95%CI=0.56-0.77), and subjective sleep satisfaction (OR=0.57, 95%CI=0.49-0.66)(P<0.01). Conclusions Bedtime screen use is associated with adverse effects on multiple dimensions of sleep health in primary school students. Reducing screen exposure before bed may help improve their sleep quality.

Objective: To develop a health literacy evaluation scale for Chinese high school students, providing a tool for dynamic monitoring of health literacy among high school students and evaluating the effectiveness of health school construction. Methods: Through theoretical research, an evaluation index system for health literacy of Chinese high school students was constructed. Two rounds of Delphi expert consultations were conducted to quantitatively screen the items, and the item pool was revised based on expert opinions to compile the health literacy evaluation scale for Chinese students. Two focus group interviews were held to collect suggestions from health educators, high school teachers, and high school students regarding optimized scale length, question types, difficulty and wording of the scale. The scale was revised accordingly. A pilot survey was conducted in Beijing and Tianjin in November 2024, and the reliability and validity of the scale were evaluated based on the pilot survey data. Results: The response rate in both rounds of Delphi expert consultations was over 80%, and the expert authority coefficient was over 0.70. The expert opinions were highly concentrated, and the dispersion was small. The revised item pool based on expert opinions contained 39 items. The revised scale based on the suggestions and opinions collected from the focus group interviews had a moderate number of questions and difficulty level. The pilot survey obtained 800 valid responses, with the response rate of 89.39%. The Cronbach α coefficient of the scale was 0.911, χ 2/df =3.321, the root mean square error of approximation was 0.054, the adjusted goodness-of-fit index was 0.991 , and the factor loadings of some items were less than 0.40. Conclusion The health literacy evaluation scale for Chinese high school students demonstrates scientific rigor and practical applicability, with good internal consistency and structural validity.

Objective: To develop and validate a health literacy assessment scale for junior high school students, providing an effective tool for evaluating and monitoring health literacy among Chinese adolescents. Methods: Based on school health education policy documents, a health literacy assessment framework was constructed, comprising five horizontal and four vertical dimensions. From May to June and August to September in 2024, the framework was refined through Delphi expert consultations and focus group discussions, leading to the development of the Health Literacy Assessment Scale for Junior High School Students. In September 2024, a convenience sample of 625 students from three junior high schools in Beijing and Tianjin completed the questionnaire. Item analysis, reliability, and validity tests were conducted to evaluate the scale. Results: The recovery rate for two rounds of expert consultation questionnaires was 100%. The expert authority coefficients ( Cr ) were 0.86 and 0.87 respectively (both >0.70), with Kendall W values of 0.34 and 0.27 ( P <0.05). The focus group discussions followed a rigorous structure, and after multiple rounds of item screening and revision, the version 3.0 of the junior high school students health literacy assessment scale was developed, comprising 57 items. Three items that failed to meet the comprehensive screening criteria were preliminarily removed, and the final scale contained 54 items. The scale demonstrated excellent reliability, with an overall Cronbach s α coefficient of 0.92 and split half reliability of 0.93. Confirmatory factor analysis [ χ 2/df =2.094, root mean square error of approximation ( RMSEA )=0.042, comparative fit index ( CFI )=0.911, Tucker Lewis index ( TLI )=0.907] indicated good model fit indices. Conclusions The preliminary development of the health literacy assessment scale for junior high school students follows a rigorous item screening process with well designed dimensions, demonstrating good reliability and validity, thus serving as an appropriate evaluation tool for adolescent health literacy.

OBJECTIVES: Ovarian cancer is a common gynecologic malignancy, with poor prognosis in advanced stages. This study aimed to identify differentially expressed long noncoding RNA (lncRNA) associated with ovarian cancer prognosis and to explore the effects of lncRNA RP11-499E18.1 on the malignant biological behavior of ovarian cancer cells. METHODS: Ovarian cancer-related lncRNA datasets were obtained from the Gene Expression Omnibus (GEO) database. Differentially expressed and prognostically relevant tumor-suppressive lncRNAs were screened using lncRNA sequencing combined with clinical data. Reverse transcription PCR (RT-PCR) was used to detect the expression of lncRNA RP11-499E18.1 in ovarian cancer tissues, adjacent normal tissues, the IOSE80 normal ovarian epithelial cell line, and various ovarian cancer cell lines. Fluorescence in situ hybridization (FISH) was performed to determine its subcellular localization. Ovarian cancer cell lines CaOV3 and SKOV3 were divided into 3 groups: a negative control (NC) group, a knockdown (si-RP11-499E18.1) group, and a overexpression (pcDNA-RP11-499E18.1) group. Methyl thiazolyl tetrazolium (MTT) and Transwell assays were used to assess the effects of lncRNA RP11-499E18.1 on cell proliferation and migration. Western blotting was used to evaluate its effect on epithelial-mesenchymal transition (EMT)-related molecules. BALB/c nude mice were injected with CaOV3 cells transfected with pcDNA-RP11-499E18.1 (experimental group) or empty vector (control group), and tumor growth was monitored. Immunohistochemistry was used to assess the expression of Caspase 3 and Ki67 in tumor tissues. RESULTS: LncRNA sequencing identified RP11-499E18.1 as a differentially expressed and associated with prognosis. GEO data analysis showed that low RP11-499E18.1 expression was correlated with shorter overall and progression-free survival (both P<0.05). Its expression was significantly lower in ovarian cancer tissues and cell lines compared to normal controls (P<0.05 or P<0.001), and it was localized in both the nucleus and cytoplasm. In CaOV3 and SKOV3 cells, proliferation rates increased significantly in the si-RP11-499E18.1 group and decreased in the pcDNA-RP11-499E18.1 group (P<0.05 or P<0.001). Cell migration was enhanced in the si-RP11-499E18.1 group and suppressed in the pcDNA-RP11-499E18.1 group. Overexpression increased E-cadherin and decreased vimentin expression, while knockdown had the opposite effect. Tumor volume in the mouse model was significantly smaller in the experimental group (P<0.001), with increased Caspase 3 and decreased Ki67 expression in tumor tissues (both P<0.05). CONCLUSIONS LncRNA RP11-499E18.1 inhibits proliferation, migration, and EMT of ovarian cancer cells, and its low expression is associated with poor prognosis.
Female ; Humans ; RNA, Long Noncoding/physiology* ; Ovarian Neoplasms/pathology* ; Cell Line, Tumor ; Animals ; Mice ; Mice, Nude ; Cell Proliferation ; Prognosis ; Mice, Inbred BALB C ; Gene Expression Regulation, Neoplastic ; Cell Movement ; Epithelial-Mesenchymal Transition

OBJECTIVES: To construct a bone tumor classification model based on feature decoupling and fusion for processing modality loss and fusing multimodal information to improve classification accuracy. METHODS: A decoupling completion module was designed to extract local and global bone tumor image features from available modalities. These features were then decomposed into shared and modality-specific features, which were used to complete the missing modality features, thereby reducing completion bias caused by modality differences. To address the challenge of modality differences that hinder multimodal information fusion, a cross-attention-based fusion module was introduced to enhance the model's ability to learn cross-modal information and fully integrate specific features, thereby improving the accuracy of bone tumor classification. RESULTS: The experiment was conducted using a bone tumor dataset collected from the Third Affiliated Hospital of Southern Medical University for training and testing. Among the 7 available modality combinations, the proposed method achieved an average AUC, accuracy, and specificity of 0.766, 0.621, and 0.793, respectively, which represent improvements of 2.6%, 3.5%, and 1.7% over existing methods for handling missing modalities. The best performance was observed when all the modalities were available, resulting in an AUC of 0.837, which still reached 0.826 even with MRI alone. CONCLUSIONS The proposed method can effectively handle missing modalities and successfully integrate multimodal information, and show robust performance in bone tumor classification under various complex missing modality scenarios.
Humans ; Bone Neoplasms/diagnosis* ; Multimodal Imaging/methods* ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Image Processing, Computer-Assisted/methods* ; Algorithms

Objective: To analyze and evaluate the comprehensiveness and reliability of the content related to comprehensive sexuality education in 16 subject curriculum standards in the current compulsory education system, and the feasibility and effectiveness of comprehensive sexuality education teaching practice. Methods: Based on the textbook analysis model, a curriculum standard analysis model was established, and the interpretive structure model was used to analyze and evaluate the content related to comprehensive sexual education in the curriculum standards of 16 subjects in the current compulsory education system, including Ethics and Rule of Law, Chinese, History, Mathematics, English, Japanese, Russian, Geography, Science, Physics, Chemistry, Biology, Information Technology, Physical Education and Health, Arts, Labor. Results: There were 7 subject curriculum standards including Ethics and Rule of Law, Chinese, English, Science, Biology, Information Technology, Physical Education and Health reflecting 5 core concepts and 12 themes of comprehensive sexuality education, and the most frequent core concept was Violence and Staying Safe and the Human Body and Development,as well as the most frequent theme was "Puberty". History, Mathematics, Japanese, Russian, Geography, Physics, Chemistry, Art and Labor didn t include content related to comprehensive sexuality education. The content related to comprehensive sexuality education in the curriculum standard of compulsory education presented three characteristics:it was closely related to the subject content, partial content was consistent with the teaching goal of the subject, and the content depth increased with the growth of grade. The comprehensiveness and reliability of comprehensive sexual education in the current compulsory education curriculum standards of China needed to be improved. Conclusion The comprehensiveness, reliability, feasibility and effectiveness of teaching practice of comprehensive sexuality education in 16 subject curriculum standards in the current compulsory education stage need to be improved.

ObjectiveTo reveal the effects of Huanglian Jiedutang （HLJDT） on the learning and memory abilities of APP/PS1 transgenic mice via hypoxia-inducible factor-1α （HIF-1α）/vascular endothelial growth factor （VEGF） signaling pathway. MethodForty 5-month-old β-amyloid precursor protein （APP）/presenilin 1（PS1） mice were randomized into the model， donepezil （0.001 g·kg^-1·d^-1）， and low-， medium-， and high-dose （1.5， 3， 6 g·kg^-1·d^-1， respectively） HLJDT groups， and 8 C57BL/6 mice were taken as the normal group. After 45 days of continuous administration， Morris water maze test was conducted， and the organ indexes were calculated. The morphological structure of cerebral vascular endothelial cells in mice was observed under a transmission electron microscope. Western blot was employed to measure the protein levels of APP， HIF-1α， VEGF，VEGFA， and brain-derived neurotrophic factor （BDNF） in the hippocampus. The mRNA levels of APP， HIF-1α， and VEGF were determined by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultCompared with the normal group， the model group showed prolonged escape latency （P<0.05）， reduced distance and time around the target platform （P<0.05）， decrease brain and spleen indexes （P<0.05）， vascular endothelial cells with karyopyknosis and not abundant cytoplasm， up-regulated protein levels of APP， HIF-1α， VEGF， and VEGFA （P<0.05）， down-regulated protein level of BDNF （P<0.05）， and up-regulated mRNA levels of APP， HIF-1α， and VEGF （P<0.05） in the hippocampus. Compared with the model group， high-dose HLJDT shortened the escape latency （P<0.05）， increased the distance and time around the target platform （P<0.05）， raised the brain and spleen indexes （P<0.05）， repaired the organelles of vascular endothelial cells， down-regulated the protein levels of APP， HIF-1α， VEGF， and VEGFA （P<0.05）， up-regulated the protein level of BDNF （P<0.05）， and down-regulated the mRNA levels of APP， HIF-1α， and VEGF （P<0.05） in the hippocampus. ConclusionHLJDT can improve the learning and memory abilities of mice by reducing the expression of HIF-1α and VEGF， thus protecting the nerves.

Objective: To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) and influencing factors among vegetable greenhouse workers, so as to provide insights into relevant intervention measurements. Methods: Workers from 4 vegetable greenhouse villages were sampled in the suburbs of Xining City using a cluster sampling method from March to April 2023. Participants' demographic information, characteristics of greenhouse operation and prevalence of WMSDs were collected using questionnaire surveys. Factors affecting the prevalence of WMSDs among vegetable greenhouse workers were identified using a multivariable logistic regression model. Results: A total of 550 questionnaires were distributed, and 518 valid questionnaires were recovered, with an effective response rate of 94.18%. There were 264 males (50.97%) and 254 females (49.03%), and 269 participants (51.93%) aged 50 years and older. The prevalence of WMSDs among vegetable greenhouse workers was 40.93% (212 cases). Waist, neck and back were mainly affected, with 185 (35.71%), 157 (30.31%), and 153 (29.54%) cases, respectively. Multivariable logistic regression analysis showed that workers who smoke (OR=2.406, 95%CI: 1.133-5.110), worked 8 hours and longer per day (OR=6.618, 95%CI: 3.492-12.542) and lift heavy loads of about 20 kg (OR=1.770, 95%CI: 1.013-3.092) had a higher risk of WMSDs. Conclusions WMSDs occurred in 40.93% of vegetable greenhouse workers in Xining City, and waist, neck and back were mainly affected. Smoking, working duration and lifting heavy loads may influence the prevalence of WMSDs among vegetable greenhouse workers in Xining City.

Objective:To evaluate the effectiveness of oral-nasal oxygen supply mouth guard in painless gastroscopy for snoring patients.Methods:The snoring patients who underwent painless gastroscopy at two Endoscopy Centers of Shanghai East Hospital, Tongji University in July 2022 were randomly divided into the observation group (using oral-nasal oxygen supply mouth guard) and the control group (using ordinary nasal oxygen tube and mouth guard). Parameters such as the wearing time and the removal time of the mouth guard, lowest pulse oxygen saturation (SpO 2), incidence of hypoxemia, and the satisfaction of medical staff were compared between the two groups. Results:The wearing time of mouth guard was 11.63±0.84 seconds and the removal time was 5.33±0.76 seconds in the observation group ( n=40), which were lower than those in the control group ( n=47) (14.91±1.21 seconds, t=-14.463, P<0.001; 10.38±0.80 seconds, t=-30.095, P<0.001). The wearing satisfaction score was 9.80±0.61, the lowest SpO 2 was (96.70±3.42)%, the removal satisfaction score was 9.75±0.67, and the anesthesiologists' satisfaction score was 9.20±1.42 in the observation group, which were higher than those in the control group [7.70±0.93, t=12.209, P<0.001; (94.06±3.72)%, t=3.417, P=0.001; 7.96±0.98, t=9.803, P<0.001; 8.13±1.35, t=3.615, P=0.001] with significant difference. There was no significant difference in the incidence of hypoxemia [10.00% (4/40) VS 14.89% (7/47), χ2=0.130, P=0.718] and endoscopic physician satisfaction score (9.30±0.97 VS 9.02±1.31, t=1.112, P=0.269) between the two groups. Conclusion:The oral-nasal oxygen supply mouth guard is easy to wear and remove, effectively reducing SpO 2 fluctuations during painless gastroscopy for snoring patients. It can enhance medical staff satisfaction with high clinical value.

Objective:To develop and test the reliability and validity of the scale of nurses′ medication competence. To provide scientific basis for the safe medication management of clinical nurses.Methods:Based on the qualitative interview results, combined with role theory and core competence theory, the initial item pool of the scale was formed through literature analysis and discussion in the research group. The first draft of the scale was formed through expert correspondence and pre-investigation. Using the cross-sectional survey methed, from October to November 2022, a questionnaire survey was conducted among 825 clinical nurses from 6 tertiary hospitals in Dalian by convenience sampling method to test the reliability and validity of the scale.Results:Totally 20 experts were consulted, aged 35-49 years old. The nurses′ medication competence evaluation scale contained 11 dimensions, including pharmacological knowledge, medication management ability, medication evaluation ability, medication order checking and execution ability, clinical practice ability, modern technology application ability, educational consulting ability, communication and coordination ability, scientific research and learning ability, ethical and legal practice ability, quality management and risk management ability, with a total of 50 items. Exploratory factor analysis identified 11 common factors, which accounted for 86.525% of the variance. The Cronbach α coefficient of the scale was 0.975, the Cronbach α coefficient of all dimensions were 0.880-0.977, and the retest reliabilities were 0.721-0.875. The content validity index of the scale was 0.99, and the content validity index of all items were 0.83-1.00. The correlation coefficients between the scale and the Competency Inventory for Registered Nurse were 0.636-0.938. Conclusions:The nurses′ medication competence evaluation scale had good reliability and validity, and could be used as an effective tool to evaluate the medication ability of nurses.